University project by Maude Gauthier, speech-language pathology student at Université de Montréal.
An officer responds to a call: an individual seems disoriented, wanders through a building swearing, and cannot explain why they are there. Lost? Intoxicated? In crisis? Through this scenario, Maude Gauthier invites us to consider another explanation: what if the person simply had trouble communicating? Aphasia is an impairment of the ability to speak, understand, read or write, most often caused by a stroke, and it presents differently in every person.
The video stresses an essential point: aphasia does not affect intelligence. People with aphasia know what they want to say; it is the delivery of their ideas that is impaired. Automatic language — the “hello”, “thank you” or swear words that come out spontaneously, sometimes out of context — can lead to serious misunderstandings, particularly during encounters with security guards or police officers who do not recognize the disorder.
To prevent these situations, the video presents the SCA approach (Supported Conversation for Adults with Aphasia): acknowledging the person’s competence and helping them reveal it by removing barriers to communication. In practice: speak slowly using short sentences and gestures, use visual aids, ask one yes/no question at a time, allow time to answer, confirm your understanding by restating their response — and never pretend to have understood.
Transcript
Translated from the original French video.
You respond to a call about an individual who seems disoriented and is wandering through a building using swear words. When you arrive, the individual cannot explain why they are there. They remain silent and utter a few swear words. What is your first impression? They seem lost, confused, under the influence of substances. Perhaps they have mental health issues. So you decide to escort them out, assuming their presence is not justified. Could there be other possible explanations? What if the person actually had difficulty communicating?
Aphasia is an impairment of the ability to speak, understand, read or write. Aphasia is often caused by a stroke, but it can also occur after other incidents or illnesses that damage the brain. Depending on the location and extent of the injury, aphasia presents differently in each person, with difficulties ranging from searching for words more often to producing no words verbally at all.
Aphasia does not affect a person’s intelligence. People with aphasia know what they want to say. What is affected is the way they convey their ideas: language itself. Sometimes a person with aphasia cannot say words voluntarily, yet spontaneously says common expressions. This is called automatic language. People with aphasia may say hello, thank you or even swear words without thinking about it, sometimes in inappropriate contexts.
Communication difficulties can be dangerous for a person with aphasia, since they may struggle not only to express themselves in general, but also to explain their aphasia, on top of using automatic language at the wrong moments. This can cause serious misunderstandings, such as during a confrontation with security guards or police. Now let’s go back to the opening scene. Aphasia awareness is essential to prevent these misunderstandings.
In such a situation, you can use communication strategies. The SCA approach, or Supported Conversation for Adults with Aphasia, aims to acknowledge the person’s competence — assuring them that we know they know what they want to say — and to help them reveal that competence by removing as many barriers to communication as possible.
To convey a message, speak slowly and use short sentences and gestures. Visual aids can also help you make yourself understood. Remove distractions as much as possible. Remember to stay natural and not to infantilize the person with aphasia.
To get their message, ask questions that can be answered with yes or no, and ask one question at a time. You can ask them to point at objects or pictures, or to write key words. Make sure to give them enough time to answer. Check your understanding by restating their answer and asking them to confirm it. Never pretend to understand their answer. Keep the previous techniques in mind to support better communication.
People with aphasia have the right to communication and respect, like everyone else. When you recognize the signs of aphasia, be patient and remember to apply these communication strategies.