How to Talk to Children About Aphasia and Other Health Issues

July 24, 2019

Change can be confusing for a lot of people, especially children. This is often the case when the change involves the health of a loved one. Aphasia, a communication disorder that affects about 2 million Americans, is one such health issue that can leave children curious and concerned.

Through intentional conversations and time, children can better understand this conditions related to aging, and learn new ways to interact with a family member experiencing aphasia or other acquired communication disorders.

Understanding Aphasia

Aphasia is largely misunderstood by those who have not experienced it. Unlike other common conditions that come with aging, such as Alzheimer’s or Parkinson’s, aphasia does not affect a person’s cognitive ability. With the exception of individuals who experience other conditions caused by a stroke or brain injury, for most people with aphasia, loss of language does not necessarily equal loss of understanding.

“The person is who they were before they acquired aphasia,” said National Aphasia Association President Darlene Williamson. “Most people with aphasia have the same personality, the same strengths and weaknesses. It’s just that they’re having difficulty accessing their language.”

It’s important to understand a person’s diagnosis, as every case of aphasia presents differently. According to the American Stroke Association, individuals with aphasia can experience partial loss of any of the four of the modalities of language (i.e., listening, speaking, reading, and writing). There are several different types of aphasia that are differentiated by the amount of function available in each of the channels for the comprehension of language.

“Most people with aphasia have the same personality, the same strengths and weaknesses. It’s just that they’re having difficulty accessing their language.”

— National Aphasia Association President Darlene Williamson

Broca’s Aphasia

Also known as non-fluent or expressive aphasia, this type of aphasia makes is difficult to complete sentences, individuals with this diagnosis often omit words like “is” or “the.” Because they have a limited access to their former vocabulary, those experiencing Broca’s aphasia may offer imprecise words that are only generally associated to what they intend to convey (e.g., saying “paper” instead of “book”).

Wernicke’s Aphasia

Also called fluent or receptive aphasia, this type of aphasia affects communication in that words are not easily assigned meaning, as if being spoken to in a foreign language. In response, it is common for someone with receptive aphasia to utter a long stream of word salad, with nonsensical phrases that lack coherency, as a response.

Global Aphasia

This type of aphasia is the most severe kind of aphasia and affects both speech and the ability to understand other people’s language. Individuals with global aphasia are still cognitively intact with items unrelated to language and may be able to effectively communicate through gestures and facial expressions.

Communicating With Individuals Experiencing Aphasia

Loss of language does not mean that people with aphasia cannot have meaningful conversations and interactions with their loved ones. Darlene Williamson, president of the National Aphasia Association provided the following tips, which can be applied based on the modalities affected.

If someone is struggling to use their language:

Be patient. Try not to speak over someone or finish their sentence if they are working to get words out.
Affirm when you understand what they have said by paraphrasing the statement. Try saying, “So, you want to go to the store. Did I understand that correctly?”
Ask yes-or-no questions to allow for an easier response.

If someone is struggling to understand others’ language:

Use simplified, short sentences when speaking to the person so they can more easily digest the information.
Ask for affirmation that they understand what you are saying.
Use your body language to talk expressively. Many gestures are universally understood and make it easier for a person to follow your speech.
When appropriate, use visual aids. For example, bring pictures of your children’s music recital so you can have a conversation about the event.

Explaining Serious Health Issues to Children

Because stroke and head injuries are the most common causes of aphasia, the condition tends to come on suddenly. Having a family member experience a serious health issue, paired with the rapid change in their ability to communicate, can be unsettling for children. To help your child maintain their relationship with a loved one who is experiencing aphasia, first help them to understand what happened.

Conversation Guide for Talking About a Family Member’s Condition

Gauge a child’s age and interest in their family member’s brain injury.
Younger children don’t need every detail, but they may be concerned that they did something wrong or won’t receive the same level of care from their family member. Older children, however, may have more questions about what caused the health incident and what it means for their family member.

Try saying, “Aunt Linda still loves you and wants to spend time with you. She may act differently than before, but that’s okay.”

Let their questions guide the conversation.
An easy way to make sure that you are addressing a child’s concerns is to let them lead the discussion with their curiosity.

Try saying, “Do you understand what happened? What questions do you have?”

Use language and examples they can understand.
Williamson suggested explaining language loss to a younger child by comparing it to something they have experienced.

Try saying, “You know how sometimes you are looking for a specific color crayon and you can’t find it right away? Your grandpa is having trouble finding his words, so it may take him a little longer to share them with you.”

Be honest about the changes they can expect to see in their loved one.
A stroke can have a number of effects, from impaired mobility to conditions like aphasia. It’s important to set a child’s expectations for how they will be able to engage with their family member.

Try saying, “Grandma can’t sit on the floor with you to color, but I’m sure she’d like to sit at the table while you draw.”

Building Relationships Between Children and Their Family Member With Aphasia

A major challenge that people with aphasia face is the feeling of loneliness because of difficulty socializing with others. One study showed that more than 90% of people with aphasia reported feeling isolated. Families play an important role in helping people with aphasia stay connected and engaged.

Maintaining a relationship can be just as important for a child as it is for the family member experiencing language loss, too. However, there are a number of ways children can still interact with their loved one.

Activities for Children and Their Family Member With Aphasia

Play a board game.

This is an activity that children may already enjoy doing with their family member. Older children can even play games like Scrabble or Boggle to help their family member improve their language.

Simplify activities they enjoyed before acquiring aphasia.

Make it easier for your family member to do something they love with the help of a child. For example, try baking cookies with store-bought cookie dough instead of starting from scratch.

Share school projects and pictures.

This gives children the chance to express themselves, and the visual aids make it easier for a person with aphasia to follow along.

Show off a skill.

Whether a child is learning how to play catch or taking saxophone lessons, including a family member is an opportunity to share their growing interests.

Put on a play.

The use of body language and gestures is helpful for people with aphasia in understanding a story. Letting a child act out a story is a great way to encourage their creativity in a way their family member can engage with more easily.

Resources for Further Reading

Citation for this content: The online speech pathology program from Baylor University’s Robbins College of Health and Human Sciences.