Total communication strategies

Why might I need to use total communication strategies?

If you or your family member have a communication impairment, you may have difficulty understanding what is being said to you (receptive aphasia), or find it difficult to express what you want to say (expressive aphasia). You may also find it difficult to form the words you want to say (apraxia of speech).

What are total communication strategies?

People with communication impairments can still communicate, especially if they are supported to do so. Total communication strategies involve everyone in the conversation using a variety of methods to support a person's understanding of language, as well as helping them to express their own thoughts and ideas. This can decrease frustration and enable greater participation in conversations.

Total communication strategies may include:

  • Gesture - pointing, facial expression, miming, thumbs up/down, nodding/shaking head
  • Drawing
  • Writing - key words or short phrases can aid understanding 
  • Use of relevant items - maps, pictures, photographs, newspapers, menus
  • Use of communication books.

Remember

Total communication strategies work most effectively when everyone in the conversation uses them. Each person with communication impairment is different and will use total communication strategies differently. The key is to use whichever strategies are most useful to maximise understanding and expression of language.

Tips for using total communication strategies

  • Ensure your surroundings are quiet and limit distractions - turn off the television or radio so the person can hear and focus on you
  • Begin the conversation by stating what you want to talk about. Knowing the topic can help someone understand more of what you're saying
  • If the person with communication impairment is starting the conversation, try to establish the topic of conversation with yes/no questions or by using total communication strategies as described above
  • Try asking closed questions, rather than open questions. For example, instead of: “What would you like to drink?” you could ask yes/no questions such as: “Would you like a cup of tea?”, and work through the options until a decision is made.
  • As you proceed through a conversation, stop now and then to summarise what you've understood. Ask the person to indicate whether your understanding is accurate
  • Speak naturally and don't raise your voice. Use short, simple sentences - but make sure not to speak down to the person you're interacting with
  • Don't make the person try to speak perfectly. Communication impairments can be frustrating and tiring. Give the person plenty of time to express themselves. If they make several unsuccessful attempts to say something, offer to return to the idea later
  • Admit when you don't understand what the person is trying to say - don't try to guess for them unless they find this helpful
  • If the person also experiences unclear speech (dysarthria), encourage them to slow down their rate of speech, over exaggerate each word and use a little more volume as this can improve speech clarity
  • Talk about familiar subjects. Family photos can help start or move a conversation forward.