Stroke, and aphasia – know the risk factors and the signs

25 OCTOBER 2023

Stroke, and aphasia – know the risk factors and the signs

A Charles Sturt University speech pathologist advocates that World Stroke Day on Sunday 29 October aims to raise awareness that 90 per cent of strokes could be prevented by addressing a small number of risk factors.

By Ms Alexandra Spiller (pictured, inset), a Scholarly Teaching Fellow in speech pathology in the Charles Sturt School of Allied Health, Exercise and Sports Sciences.

Aphasia has been in the headlines this year following American actor Bruce Willis’ diagnosis of aphasia related to Frontotemporal Dementia. But what is aphasia?

Aphasia is a condition caused by damage to the brain in the areas you use for communication following a stroke, traumatic brain injury (TBI), brain tumour or, as in the case of Bruce Willis, some kinds of dementia.

Aphasia effects a person’s communication, not their intelligence

Different people experience aphasia in different ways; it can create difficulties with understanding speech, reading, writing, speaking, or a combination of these.

If you sat down at a BBQ next to a relative with aphasia would you feel comfortable to chat? What about if someone with aphasia came to your work looking for help with a product or service, but couldn’t tell you exactly what they were after? Would you know what to do?

The scenario at the BBQ is more likely than you think. Up to 38 per cent of stroke survivors can have aphasia (Stroke and aphasia | Aphasia Pathway), and the World Stroke Organisation (WSO) states that one in four of us will have a stroke in our lifetime.

This World Stroke Day, Sunday 29 October, the WSO is raising awareness that ‘90 per cent of strokes could be prevented by addressing a small number of risk factors including high blood pressure (hypertension), irregular heartbeat (atrial fibrillation), smoking, diet and exercise’.

What can you do to help?

So, back at the BBQ your relative may be finding it hard to keep up with the pace of all the different conversations going on around them, or might find it hard to get out what they want to say quickly enough to join in. People with aphasia can feel isolated and lonely. So, how can you help?

The most important thing you can do is give a person with aphasia your time and attention. Do not ignore a person with aphasia or leave them out and talk to their companions instead. Be patient and give them time to communicate. Remember aphasia impacts communication, not intelligence.

Turn down background noise (e.g. TV or music) if you can. Make sure you have their attention before you speak. Make eye contact. Speak clearly but without being patronising, they don’t want or need baby talk. Some people may want you to speak more slowly, others may find this irritating. Ask about their communication needs.

If you have not understood what was said, be honest. You can repeat what you heard and then try to clarify what was not clear. Asking yes/no questions and giving the person more time to think can be helpful. Most people dislike when you speak for them, so if you think you know what they want to say, ask “can I guess?” rather than just saying the word you think they mean.

Try to stick to one topic at a time and use gestures, writing, or pictures alongside the conversation. If they’re talking about a place, person, or thing and you don’t understand, then you could use whatever tools you have nearby to help.

For example, if you are talking about music, you might open a streaming app to look at the album covers. For travel, you could bring up some images of the places you want to go or a map. Sharing photos of important events can help your conversation stay focussed on a single topic.

Communicating with children can be tiring for people with aphasia. If possible, have children take turns talking without interrupting each other so the person with aphasia can concentrate on one speaker at a time.

Pictures can also help children communicate with people who have aphasia by being a shared reference point.

What about when you need to help someone with aphasia in the workplace?

Kym Brockoff, a stroke survivor, shares his experience of ordering food and coffee. Kym describes how he uses gestures to make choices when he cannot say the word he wants.

Improving communication access at the workplace (e.g. having a version of your menu that includes pictures and larger fonts) would help someone with aphasia access your full menu and not just the items they can say.

Visual support can also be as simple as tapping a takeaway cup when asking if someone wants their coffee to go or pointing to the cake fridge when asking if the customer would like something to eat.

Where to find support

If you, or someone close to you, has aphasia following a stroke, a speech pathologist can provide direct support to stroke survivors and more personalised communication training specific to their needs for friends and family.

Find a Speech Pathologist through Speech Pathology Australia.

Find out more about studying a Master of Speech Pathology and the Albury Speech Pathology clinic at the Charles Sturt Community Engagement and Wellness Centre (CEW) in Albury-Wodonga.

Learn more about World Stroke Day. You can explore local services through your state-based stroke or aphasia organisation.

Media Note:

To arrange interviews with Ms Alexandra Spiller who is based in Albury-Wodonga, contact Bruce Andrews at Charles Sturt Media on mobile 0418 669 362 or

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