10 Ways to Communicate Better With Someone Who Has Dysarthria
You've asked "sorry, what was that?" twice already……..You don't want to ask a third time. You can see it in their face, the flicker of forget it, it doesn't matter. But you also didn't catch a word of it, and nodding along feels worse than asking again.
If that scene is familiar, you're not doing anything wrong. Dysarthria doesn't come with a manual, and most people are left to figure out communication on the fly. Usually in the middle of a hospital corridor or over a kitchen table, under pressure, with everyone trying not to show how hard it is.
Dysarthria happens when the muscles used for speech the (tongue, lips, breath, vocal folds) don't move the way they used to, because of a stroke, Parkinson's, ALS, MS, a brain injury, or a number of other conditions. The words are still there. Getting them out clearly is the hard part. And here's the thing that surprises most people: how a conversation partner responds changes how well it goes almost as much as anything happening with the speech itself.
These ten strategies are the ones speech-language pathologists actually teach communication partner, partners, spouses, adult kids, close friends, carers. Nothing here requires training. Most of it just requires knowing what to do instead of guessing in the moment.
1. Deal with the noise before you deal with the words
Turn the TV off. Step away from the traffic, the running tap, the kids' cartoon in the next room. It sounds almost too obvious to write down, but background noise is one of the biggest, most fixable barriers there is — and it's the one people forget about because they're focused on listening harder, when the real problem is everything else competing for the same ears.
2. Get close, and let them see your face
Sit across from them, not beside them. Good light on your face, not behind you. Close enough that lip patterns and facial expression can do some of the work that the voice can't always do alone. This isn't about hovering — it's just physics. Speech carries information in more than sound.
3. Let them set the pace
The instinct is to fill silence, finish the sentence, keep things moving. Resist it. Match their speed instead of pulling them toward yours. A conversation that takes longer isn't a conversation that's going badly.
4. Let the pause be a pause, not a problem
This is the hardest one, honestly. A gap opens up and every instinct says jump in, help, finish it for them. Try to sit in it instead. Most people can find their own word given a few extra seconds — what they can't do is find it while someone's already talking over them with a guess.
5. Ask for a rephrase, not just a repeat
"What?" gets you the same unclear sentence a second time, at the same speed, with the same trouble spots. Try "can you say that a different way?" or "can you show me?" instead. A different route to the same idea is often much easier to follow than the original one repeated louder.
6. Say back what you heard
"So you want the blue one, not the grey?" takes two seconds and heads off a much longer misunderstanding ten minutes later. It also tells them clearly: I'm actually listening, and I want to get this right — not just nodding to move things along.
7. Let the context do some of the work
You don't need every single word to get the meaning. If you know you're talking about the weekend, or dinner, or the grandkids, use that. Guess the topic before you guess the word. It narrows things down fast, and it's a much kinder kind of guessing.
8. Any signal counts
Pointing, writing a word down, a thumbs up, a head shake, a gesture roughly in the right direction — none of it is a consolation prize. It's communication. If speech is tiring in a particular moment, welcoming these other channels takes the pressure off without taking the person out of the conversation.
9. Don't fake it
This is the one people feel most guilty about, and also the one that does the most damage. Nodding along when you didn't catch it feels kind in the moment. It backfires almost every time — wrong medication, wrong plan, wrong everything, and now they've learned that talking to you doesn't actually work. Asking again, even a third or fourth time, is always the better option.
10. Encourage the strategy, not just the sound
If a speech-language pathologist has given them something to work on; slowing down, taking a bigger breath first, over-pronouncing a tricky word then your job isn't to correct their speech! It's to notice when they use the tool, and say so. That was really clear just then. People keep doing the thing that gets a response like that.
None of this is complicated. It's just easy to forget in the moment. That is exactly why we put these into a one-page sheet you can actually keep somewhere useful: on the fridge, in a bag, propped up during a video call, printed and laminated on a little card. Download the free reminder sheet here and you'll always have it when you need it, not just when you happen to remember reading this.
And if you're looking for structured ways to actually build speech clarity alongside all this (not just work around it) that's what our Dysarthria Bundle is built for: seven interactive practice tools covering pacing, loud voice, overarticulation, and more, the same strategies referenced above, expanded into real practice you can do together.
