Talk About the Picture

Aphasia often makes short answers much easier than full sentences. This activity starts from whatever the person can already say — even one word — and builds outward from there, instead of asking for a "correct" sentence from the start.

Because every response is accepted and built on, there's no wrong answer at the first step. The wh-questions (who, what, where...) give a gentle nudge toward the extra detail a fuller sentence needs, and the final repeat-after-me step gives one more chance to practise saying it.

Good candidates can usually get out single words or short phrases but find full sentences hard, and can understand simple spoken questions.

Less suitable for people with very limited single-word speech to begin with, or very limited understanding of spoken language — other approaches may be a better starting point there.

Response Elaboration Training has a long research history in aphasia rehabilitation, with studies reporting increases in the length and informativeness of spoken utterances — including for people who had not responded well to more structured naming drills.

Kearns & Yedor (1991), Clinical Aphasiology · Kearns (1985), J. Speech Hear. Disord. · Wambaugh & Martinez (2000), Aphasiology

• 1. Say what's happening — look at the picture, say what you see in your own words
• 2. Hear it as a full sentence — your helper repeats it back as a complete sentence
• 3. Answer a few questions — who, what, why, where, when, how — to add more detail
• 4. Say it together — your helper says the full sentence, you try saying it too

• Accept whatever comes first — even one word is a real answer worth building on
• Don't correct, build — turn what they said into a full sentence rather than pointing out what was missing
• One question at a time — ask a single wh-question, give time to answer, before asking another
• Little and often — a handful of pictures per session, repeated regularly, works better than one long session