Conversation practice for aphasia

Why conversation is a separate skill

Most aphasia practice works on single words: name this picture, match this word, finish this sentence. That work matters, because finding words is at the heart of aphasia. But conversation asks for more. A person has to decide what to say, find several words in a row, put them in order, and do it while keeping up with someone else.

Gains on word drills do not always carry over to everyday talking. Speech-language pathologists call this the problem of carry-over, or generalization. The most direct way to address it is to practice conversation itself, as well as words.

Three ways to practice conversation at home

1. Supported conversation with family

Supported conversation is a set of techniques developed at the Aphasia Institute in Toronto that help a conversation partner make talking easier: asking yes/no questions, offering written choices, using gestures and drawing, and checking what was meant before moving on. In a controlled trial, trained conversation partners improved how well people with aphasia could take part in conversation. Our guide to communicating with someone who has aphasia covers the techniques.

2. Practicing short scripts

A script is a short, personal piece of conversation practiced until it comes out easily: introducing yourself, ordering a coffee, explaining that you had a stroke. Script training has research support, including computer-based versions in which a person rehearses with an on-screen partner. Pick a few situations that matter to the person, write a few lines for each, and practice them daily.

3. Conversation groups

Many community aphasia centers and stroke support groups run conversation groups, in person or online. They add something no exercise can: talking with other people who understand what aphasia is like. Ask a speech-language pathologist or a local hospital’s stroke program what is nearby.

Live conversation practice in Parrot Software

Family members cannot be available for every practice session, and many people feel pressure talking with someone they know. So we built a way to practice conversation alone, at any hour. As far as we know, Parrot Software is the only aphasia practice program in which a person holds a live, unscripted conversation with a realistic talking person on screen.

• Real topics. The person on screen asks about the day, family, and interests. You can add the names of family and friends and favorite topics, so the conversation is about your own life.
• Help when a word is hard to find. It responds the way a speech-language pathologist would: guessing the word the person is reaching for, offering two choices, or saying back what it understood in one full sentence.
• No pressure. It waits, never gets impatient, and nobody else is listening. If speaking is hard that day, the person can type an answer instead.
• Works in a web browser on a computer or tablet with a microphone. There is nothing to install.

For speech-language pathologists, it gives clients a way to carry conversation goals over between sessions, at home.

Watch a short video of a conversation.

Conversation practice is included with every Parrot Software subscription, along with 94 programs for speaking, understanding, reading, writing, memory and attention. The first week is free, with no credit card.

Its limits

• It has to understand the answer. Speech recognition is less reliable for very limited, highly variable, or hard-to-understand speech. See speech recognition in aphasia therapy for where recognition struggles and how to get better results.
• It is practice, not therapy. It does not replace a speech-language pathologist, and it is not a substitute for talking with real people. It is a way to get more practice in.
• A quiet room helps. Background noise and a microphone far from the mouth cause most misunderstandings.

Common questions

Is there an app where someone with aphasia can practice conversation?

Yes. Parrot Software includes live conversation practice: a realistic talking person on screen asks about the person's day, family and interests, listens to the spoken answer, and helps when a word is hard to find. As far as we know, it is the only aphasia practice program that holds a live, unscripted conversation this way. It works in a web browser and is included with every Parrot Software subscription.

Why practice conversation if naming exercises are already helping?

Naming a picture and taking part in a conversation are different skills. In conversation a person has to choose what to say, find several words in a row, put them in order, and keep up with another speaker. Gains on single-word drills do not always carry over to everyday talking, so it helps to practice conversation directly as well.

What does the program do when a word will not come?

It uses the kind of help a speech-language pathologist gives. It may guess the word the person is reaching for, offer two choices, or say back what it understood in one full sentence so the person can confirm or try again. It waits rather than rushing, and the person can type an answer instead of speaking if speaking is hard that day.

Does it work for severe aphasia?

It depends. The program has to understand the spoken answer, and very limited or hard-to-understand speech is difficult for any speech recognizer. People whose speech is mostly single words may do better starting with supported conversation and short scripts with a family member. Typing is available as an alternative to speaking.

Does conversation practice replace a speech-language pathologist or real people?

No. It is a way to get more practice between sessions, at any hour, with no pressure. Conversation with family and friends is still the goal, and a speech-language pathologist is still the right person to assess speech and set goals.