💬 It’s Not Just About Language: 🧠 Supporting Executive Functions in Aphasia

When we hear “aphasia,” we think of language problems—like trouble speaking or understanding. 🗣️👂 But for many people with aphasia, that’s only part of the story.

In fact, research shows that 79% of people with severe aphasia also have problems with something called executive functions (Olsson et al., 2019).

🧠 What Are Executive Functions—and Why Do They Matter?

Executive functions are thinking skills that help us manage everyday life. These skills allow us to plan, stay focused, identify problems, adjust, and follow through—whether we’re making a phone call or organizing a trip.

There are 3 core executive functions:

🧠 Working memory – holding onto and using information
🔁 Cognitive flexibility – adjusting plans when things change
🚫 Inhibition – staying focused and avoiding distractions

👉 In speech therapy, these skills are needed to recall and use strategies, stay focused, and adjust/switch strategies in real time.

🤝 Supporting Executive Functioning in Aphasia

When your loved one with aphasia gets stuck, or repeats the same word over and over, it’s not always just a language issue. It may be a sign that they’re having trouble with executive functioning.

💡 These skills help us realize there's a problem and figure out what to do next: Should we try a new word? Write something down? Gesture?

That kind of problem-solving and flexibility can be challenging—and that’s where you can help! Here are a few ways to support executive functioning skills and communication:

📝 Before a Conversation: Support Planning

Make a plan. Talk about what might help if communication breaks down.
Set up supports. Keep a whiteboard, notebook, pictures, or a communication app nearby.

🔄 During a Conversation: Encourage Flexibility & Problem-Solving

Model strategies to support working memory. Try writing down the topic that you are talking about. Print keywords as you go.
Encourage flexibility. When your loved one is unable to find the word, say things like, “Can you try showing me?” or “Can we find another way?” If there's no paper around, type it out on a phone or use a whiteboard app like Alphatopics.

🧠 After a Conversation: Reflect & Review

Reflect together. Ask: "How did that conversation go?", “Did any strategies help?”, “Should we try something different next time?”, "Were there too many distractions?"
Use visuals. Pictures can make talking about talking easier. Try using simple drawings to show two choices (e.g., Was that easy or hard? Which was more helpful - paper or phone?)

Need More Practice?

📱 Use the Conversation Therapy app to practice using strategies. Try another word, a gesture, a drawing, or a visual support.
🔠 Use the AlphaTopics app to help think of the first letter or establish the topic, then use the whiteboard to write or draw when you get stuck!

📚 Want to Learn More About Executive Functions and Aphasia?

Learn more about executive functioning, research, and treatment approaches that speech therapists use in our latest blog. Or listen to my new podcast interview discussing how aphasia and cognition go hand-in-hand.

❤️ Working on thinking and communication takes effort and time—but you can do it. With support, people with aphasia can build confidence and flexibility in communication—one strategy at a time.

Keep practicing, stay patient, and don’t forget to celebrate the wins!

Warmly,

Megan

P.S. Want to practice at home, but not sure where to start? Use our App Finder tool - it will match you with the right tools for your goals.

Megan @ Tactus Therapy