A video call becomes much easier for a person with aphasia when the call has one clear speaker at a time, good audio, a quiet background, visible faces and simple visual supports such as names, photos or written keywords.
Set up the call before it starts
Technology can remove travel barriers, but it can also add new communication problems: echoes, weak audio, people speaking over one another and small faces on a crowded screen. Ten minutes of setup can prevent much of that load.
Place the device on a stable surface, use the largest practical screen and position the camera so the person can see the speaker’s face clearly. Reduce background television and radio. If hearing is also a concern, test headphones or a speaker that makes speech clearer without becoming painfully loud.
The wider goal is supported communication, a theme you can continue exploring at Aphasia Guide: make the environment do more of the work so the person does not have to fight the environment and the language task at the same time.
Keep the group manageable
A six-person family call may feel friendly to everyone else and overwhelming to the person with aphasia. Start with one-to-one or a small group. If a larger family wants to join, agree that one person will guide the conversation.
Introduce each person by name at the start, especially if several faces appear in small tiles. A simple printed card with names or a screenshot labelled before the call can help. If someone joins late, pause and identify them rather than expecting the person with aphasia to infer who appeared.
Use clear turn-taking
Overlapping speech is difficult because there is no clean gap in which to process one message and prepare the next. Ask family members to speak one at a time and to leave a visible pause after questions.
Questions should be short enough to remember. Instead of, “What did you do this morning and are you going out later and did you hear from Anna?”, split it into three turns. If an open question is too demanding, offer two meaningful choices without turning the conversation into an interrogation.
- Say the person’s name before changing the topic.
- Keep one topic on screen for a few minutes rather than jumping rapidly.
- Use normal adult vocabulary and tone.
- Allow silence; do not immediately answer for the person.
- Confirm the intended meaning before moving on.
Add visual support without turning the call into a lesson
Visual supports are useful when they are part of the real conversation. If the family is discussing a birthday, show the invitation. If the topic is a holiday, share one or two photos. If a name is difficult, type it in the chat.
The chat box can hold keywords, dates and places that disappear too quickly in speech. Screen sharing can show a calendar, map or photo album. Keep the screen simple: one useful item is better than a busy slide full of text.
ASHA describes communication support that can include writing, drawing, pointing, gestures and visual materials. Video calls make many of those tools available at the same time.
What to do when the message gets stuck
First, give time. If the message still is not clear, ask a specific clarification question: “Are you talking about yesterday?” or “Do you mean John or Peter?” The person may point, gesture, type the first letter, show an object or use a photo.
Avoid repeating the same question at a faster speed. Changing the format is often more helpful than increasing pressure. If the conversation becomes frustrating, acknowledge that the technology is making it difficult and offer a short break.
Create a repeatable family routine
Regular calls become easier when the structure is familiar. For example: greeting, one piece of family news, photos, plans for the next few days, then goodbye. Predictability frees attention for the content rather than the rules of the conversation.
Keep calls short enough that they can end while communication is still going well. A 15-minute enjoyable call can be more valuable than a 45-minute call that becomes exhausting.
This article provides general communication ideas. A speech-language pathologist can recommend individualized strategies and communication technology based on the person’s specific strengths and needs.
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FAQ
Should captions be turned on?
They can help some people, but aphasia can also affect reading. Try captions and keep them only if the person finds them useful rather than distracting.
Is a phone screen good enough?
It may be, but a tablet or computer can make faces, chat text and shared visuals easier to see. Choose the device that the person can operate most confidently.
What if video calls are always exhausting?
Shorten them, reduce the group size and simplify the setup. If communication remains very difficult, ask a speech-language pathologist about other supported options.