Everyday communication challenges in aphasia: descriptions of experiences and coping strategies

Background: Everyday communication often occurs in situations that pose high attentional and social demands. People with aphasia have reported perceiving greater challenge communicating in these situations, but more specific information about these challenges could help clinicians and researchers work toward more meaningful intervention outcomes and increased life participation. Aims: To explore the everyday communication experiences of people with aphasia based on their own perspectives and to identify how they report coping with everyday communication challenges. Method: Twenty-one participants with mild or moderate aphasia completed semi-structured interviews that immediately followed the experimental arm of a larger project. Interview questions solicited descriptions and examples of communication experiences from participants' everyday life that related to the situations they experienced during the experiment (retelling stories to responsive and unresponsive communication partners and while completing a concurrent tone discrimination task). Interviews were recorded, transcribed orthographically, then coded using thematic analysis. Results: Qualitative analysis revealed two themes related to participants' communication experiences (i.e., relationships, environmental distractions) and one theme relating to their reactions to challenging everyday communication experiences (i.e., coping). They perceived that they were influenced by their communication partners and the physical environment in which communication took place. Two thirds of participants described implementing behavioral and/or cognitive strategies to cope with everyday communication challenges. Conclusions: Everyday communication is often challenging for people with aphasia when they feel unsupported by communication partners (even close family members and friends), are exposed to background noise, or are performing a concurrent task. One way that participants coped with challenging communication situations was to regulate their thoughts, attitudes, or beliefs. Future research is needed to understand how to appropriately focus on cognitive strategies in aphasia therapy to improve generalization and social participation.