Aphasia is a change in language caused by injury to the brain. It can affect speaking, understanding, reading and writing. It does not take away a person’s intelligence, personality or need to be included in conversation.
Aphasia often happens after a stroke, although other types of brain injury can also cause it. It can look very different from one person to another: someone may know exactly what they want to say but struggle to find the word, while someone else may speak easily yet find that their words do not come out as intended.
Aphasia affects language – not intelligence
When communication becomes difficult, it can be easy for other people to make assumptions about what someone understands or can contribute. A person with aphasia may need more time, a quieter setting or another way to express themselves. Their ideas, preferences and right to be part of decisions remain important.
What can aphasia look like?
A person with aphasia may experience one or more of the following:
- difficulty finding the word they want
- using a different word from the one they intended
- speaking in short or effortful sentences
- speaking fluently, but with words that are difficult for others to follow
- difficulty understanding longer or fast-moving conversations
- difficulty reading, writing, using messages or completing forms
- feeling more frustrated or tired in busy communication situations
The pattern and severity depend on the part of the brain affected, the extent of the injury and the person’s individual strengths and needs. Communication may also change depending on fatigue, noise, stress and the familiarity of the conversation.
What causes aphasia?
Stroke is the most common cause of aphasia. It can also follow a traumatic brain injury, brain tumour, infection or another neurological condition that affects the language areas of the brain.
If someone develops sudden new difficulty speaking, understanding, reading or writing, treat it as a medical emergency and seek urgent medical help. Sudden language change can be a sign of stroke.
How can speech-language therapy help?
A speech-language therapist first works to understand the person’s communication profile, everyday needs and priorities. Therapy is then shaped around what matters most to that person.
Support may include structured work on speaking, understanding, reading or writing; practising communication for real situations; finding useful ways to support a message with gesture, writing or pictures; and helping family members or carers make conversation easier and more successful.
Progress is different for every person. Therapy should not make promises about a particular outcome. Its role is to build on strengths, support participation and help the person and those around them communicate as effectively and confidently as possible.
What can family and friends do?
Small changes can make an important difference:
- reduce background noise and give the conversation your full attention
- speak naturally, using clear sentences and one idea at a time
- allow time for a response without rushing to fill every pause
- use yes-or-no questions or written choices when helpful
- encourage gesture, drawing, writing or pointing as valid ways to communicate
- check that you have understood instead of pretending
- keep the person involved in conversations and decisions that concern them
The aim is not to speak for the person. It is to create the time, support and opportunity they need to take part.
Communication support should fit real life
Aphasia affects more than performance in a therapy session. It can influence relationships, confidence, independence and a person’s ability to take part in daily life. Useful support therefore needs to consider the conversations, people and places that matter to them.
Natalie Gademan Speech-Language Therapy is a mobile adult communication practice serving Hillcrest, Kloof and Waterfall, with surrounding areas considered by enquiry. The practice is launching in 2027.
This article provides general information and is not a diagnosis or a substitute for individual medical advice.
Sources and further reading
American Speech-Language-Hearing Association — Aphasia: https://www.asha.org/practice-portal/clinical-topics/aphasia/
NHS — Aphasia: https://www.nhs.uk/conditions/aphasia/
Last reviewed: September 2026