Occasionally I’ll get a patient with aphasia. They can be so fun or very frustrating to work with. Aphasics are like a box of chocolates… haha. The last one I worked with was a global aphasic, but did have a least a little understanding. She didn’t have much output beyond repeating, “Si, Si… apple.” Sometimes she would even sing those words!
I find giving a person with any type of aphasia extra time to speak or understand is very important. Watch facial expressions too. Sometimes they can communicate better with their faces than words. Also keeping it simple: so for receptive challenged people using small words or for expressive challenges when asking questions giving them two choices for answers or playing “20 Questions” works well. Above all, don’t get yourself frustrated. Take a break if you need to. If you get frustrated, the patient will too, because more often than not, they will at least understand that they are the ones causing frustration. Nobody feels good when you know you are the root cause of another’s frustration.
Collaborate with your speech therapists on these people to ascertain just how much they understand or can communicate. That way you know just how to challenge them, yet keep it workable for the patient. I find putting myself in their shoes often opens doors and/or windows for me– I better understand why they are doing what they are doing and can help me develop reasonable goals and treatment strategies.