I’ve heard from many a frustrated family member something like the following: “The therapist just comes in and sets up her bag of items. Every single time. She puts out a plate, a fork, and a cup and just says ‘show me the cup’. He can’t ever get it. This is all she does. How is this helping”?
I would venture to say that you will have a hard time assessing someone’s capabilities and competence using only auditory comprehension tasks.
- Just the words “show me” or “point to” are often lost to the person with aphasia. Want to improve it? Say “point to” while giving an example. Extend your index finger, hold it up, say “point to the…cup” and then point to the cup. People with lower levels of comprehension don’t know what you want them to do.
- Understanding is best in context. This means that while you are in the kitchen and you are talking about dinner, you may ask him to set the table and he understands. However, out of context—you are sitting and watching TV and you ask him what he ate for lunch—he will have a harder time knowing what you’re asking him. He may not understand what he is being asked to do, and he may not understand what or how he is to respond.
- Comprehension is a continuum. This means that you have different levels of support to reach more independent skills. For example, to help someone’s comprehension, you would point to items as you discussed them. “Can you hand me the scissors?” while pointing to the scissors. You may write the word “scissors” or you may use your fingers in a cutting gesture. Using only one way to communicate may not produce good results and it creates the idea that this person cannot understand anything. You are setting this person up for failure. Over time, using gesture, writing key words, or pointing while you speak will increase that person’s auditory comprehension. The idea of these levels of support is that you fade them, so that eventually you don’t need to use them anymore.
- Saying only a single word is actually harder to understand than if you say a whole sentence. The series of sounds of a single word, say “soap”, is almost meaningless for lowered comprehension. However, if I have a series of pictures and I say “I wash my hands with soap”, I’ve given a lot more information for them to use. I can take it a step further (more support) by making that ‘washing hands’ gesture while I say it.
The moral of the story is that everyone can have better comprehension and continue to improve with a little help. These communication tips and more are available for free on our site at https://www.theaphasiacenter.com/aphasia-communication-tips/