Is now a good time to talk?

A yes-or-no opener does two things at once: it is answerable with a nod, and it hands over control of whether the conversation happens at all. People with aphasia are often talked at on someone else's schedule, when fatigue is the single biggest factor in how well language works that hour.

Would you rather I do the talking for a bit, or do you want to?

Offering exactly two options is the workhorse format for aphasia, because choosing is easier than producing. It also settles the thing that otherwise goes unspoken, which is whether they want to be an audience today or a participant.

Comprehension often holds up at a slower pace and falls apart at a normal one, and people rarely interrupt to say so. Asking outright gives them a one-word way to fix it. If the answer is yes, slow down and pause between sentences rather than raising your voice, which does not help.

Do you want me to write the key words down as we go?

Writing single words on paper, or drawing, gives the conversation something to point at when speech stalls. Some people find it steadying and some find it patronising, which is why it is a question rather than something you just start doing.

When you get stuck, do you want me to guess, or wait?

This is the most useful question on the list and almost nobody asks it. Some people want you to supply the word because the search is exhausting. Others find guessing derailing, since a wrong guess can replace the word they nearly had. Ask once and then remember the answer.

Special Contexts

Questions to Ask Someone With Aphasia

Aphasia affects language, not intelligence. These are questions to ask a person with aphasia in ordinary conversation, phrased so that answering is possible: yes-or-no forms, choices between two things, and openings that leave room for gesture, writing, pointing and time. What suits one person will not suit another, so ask them, and ask their speech and language therapist about this person in particular.

20 questions, each with the reason to ask it · includes a conversation guide

Open any question to see why it works.

1
Is now a good time to talk?
A yes-or-no opener does two things at once: it is answerable with a nod, and it hands over control of whether the conversation happens at all. People with aphasia are often talked at on someone else's schedule, when fatigue is the single biggest factor in how well language works that hour.
2
Would you rather I do the talking for a bit, or do you want to?
Offering exactly two options is the workhorse format for aphasia, because choosing is easier than producing. It also settles the thing that otherwise goes unspoken, which is whether they want to be an audience today or a participant.
3
Am I going too fast?
Comprehension often holds up at a slower pace and falls apart at a normal one, and people rarely interrupt to say so. Asking outright gives them a one-word way to fix it. If the answer is yes, slow down and pause between sentences rather than raising your voice, which does not help.
4
Do you want me to write the key words down as we go?
Writing single words on paper, or drawing, gives the conversation something to point at when speech stalls. Some people find it steadying and some find it patronising, which is why it is a question rather than something you just start doing.
5
When you get stuck, do you want me to guess, or wait?
This is the most useful question on the list and almost nobody asks it. Some people want you to supply the word because the search is exhausting. Others find guessing derailing, since a wrong guess can replace the word they nearly had. Ask once and then remember the answer.
6
Is it a person, a place, or a thing?
When a word is stuck, narrowing the category is often faster than guessing the word. It also keeps the person doing the work rather than handing the conversation to you. Follow with questions that can be answered by nodding: is it here, is it someone we both know.
7
Can you show me, or point?
Gesture, pointing, drawing and phone photos frequently succeed when speech does not, and they are underused because listeners keep waiting for words. Offering the alternative out loud makes it clear you are not treating it as second best.
8
Did I get that right?
Say back what you understood and check it. This matters more with aphasia than with almost any other conversation, because a person may produce a word that is not the word they meant, and both of you can carry on for ten minutes on a misunderstanding neither has noticed.
9
How is today: good, alright, or rough?
Three named options instead of an open how-are-you. It sounds blunt and it works, because open questions demand a word from a whole vocabulary while this one demands a choice from three. Fatigue, mood and language ability move together, so the answer also tells you what the next twenty minutes can hold.
10
Are people talking to you, or about you?
Being spoken about in the third person while present is one of the most common complaints in aphasia, and it usually happens in front of family and clinicians. Asking gives the person a chance to name it without having to start the subject themselves.
11
Who is easiest to talk to?
The answer is rarely the person who tries hardest. It is usually someone who is comfortable with silence, or who knows the shared history well enough to fill gaps without taking over. Ask what that person does differently, then copy it.
12
What do you want people to stop doing?
Expect specifics: finishing sentences, speaking to the person next to them, shouting, saying take your time in a way that means hurry up. This is a question people with aphasia usually have a very clear answer to and almost no invitation to give.
13
Do you want me to explain your aphasia to other people, or would you rather do it?
Waiters, receptionists and new acquaintances all raise this, and pre-agreeing avoids an awkward negotiation in the moment. Some people carry a card that explains it. If they want you to do it, ask them what words to use.
14
Are you tired? Do you want to stop?
Two short yes-or-no questions rather than one long one. Language fatigue arrives faster than physical tiredness and often looks like a sudden drop in ability partway through a visit. Stopping early and returning tomorrow usually produces more conversation than pushing on.
15
What did you used to do that you want back?
Anchors the conversation on the person rather than the impairment: work, driving, phone calls, reading, singing, ordering their own coffee. It also gives you something concrete to help with, which is more use than sympathy.
16
Is talking harder in some places than others?
Background noise, groups, phones and time pressure all degrade language, and the difference can be dramatic. Knowing which situations are hard lets you choose the cafe, the seat, and the number of people, which changes the conversation more than anything you say.
17
Do people think you cannot understand them?
Comprehension and speech are affected separately, so someone who says very little may follow everything. The assumption that silence means incapacity leads to real consequences in decisions about money, care and consent, and it is worth naming out loud with them.
18
What do you miss most about talking?
This is a harder question and belongs late. Answers often are not about words at all: joking, arguing, being the one who tells the story at dinner, saying something quickly before the moment passes. It may take several attempts to get out, and it is usually worth the wait.
19
Is there something you have been trying to tell someone and have not managed to?
Sometimes there is a specific stuck message, held for weeks, about pain, money, a wish, or someone they want to see. If the answer is yes, treat it as the only thing left on the agenda and use every route available: writing, pointing, choices, drawing.
20
What should I do differently next time?
Closes the conversation by making them the authority on it, which reverses the usual arrangement. Take the answer literally rather than politely, and change one thing next time so they can see you listened.

Having the conversation

Practical guidance for the conversation itself.

Setting it up

Cut the background noise. A television, a busy cafe or a second conversation nearby costs more comprehension than most people expect.
Sit facing them, at eye level, close enough that gesture and expression are part of the conversation.
Have paper and a pen on the table from the start, and use them yourself first so writing is not framed as their failure.
One topic at a time, and say when you change topic. Unsignalled switches are one of the commonest sources of confusion.
Allow far longer pauses than feel natural. Counting silently to ten before you speak is a reasonable rule while you are learning the person.

When a word will not come

Narrow before you guess

Category questions get you further than guesses: is it a person, is it food, is it something in this room, is it something we did together. Each yes-or-no answer costs the person one nod instead of a whole word.

Offer two options, not five

Choosing between two is a different task from retrieving from memory, and it is usually intact when retrieval is not. Say the options slowly and separately, and give time between them.

Let them come back to it

Words often arrive minutes later, or the next day. Saying it will come, and then genuinely returning to it, is more respectful than moving on permanently as though the thought did not matter.

Watch for words that come out wrong

A person may say yes for no, or a related word instead of the one they mean, and hear it as correct. If an answer seems out of character, check it a second way rather than acting on it.

What not to do

Do not raise your voice. Aphasia is not a hearing problem, and volume makes the sentence harder to follow, not easier.
Do not talk to the person next to them about them. Address them directly even when someone else answers on their behalf.
Do not finish their sentences unless they have told you to. Ask once, then follow the answer.
Do not use baby talk, sing-song intonation, or the plural we for things only they are doing.
Do not quiz them. Testing what they can name, for practice, is a therapist's task and it makes ordinary conversation feel like an exam.
Do not pretend to understand. Nodding along produces mistakes that surface much later and undermines trust in everything else you say.

The questions

Is now a good time to talk?

Would you rather I do the talking for a bit, or do you want to?

Am I going too fast?

Do you want me to write the key words down as we go?

When you get stuck, do you want me to guess, or wait?

Is it a person, a place, or a thing?

Can you show me, or point?

Did I get that right?

How is today: good, alright, or rough?

Are people talking to you, or about you?

Who is easiest to talk to?

What do you want people to stop doing?

Do you want me to explain your aphasia to other people, or would you rather do it?

Are you tired? Do you want to stop?

What did you used to do that you want back?

Is talking harder in some places than others?

Do people think you cannot understand them?

What do you miss most about talking?

Is there something you have been trying to tell someone and have not managed to?

What should I do differently next time?