Promising Treatments for Aphasia

Imagine developing a communication disorder that prevented you from expressing yourself in speech, understanding others’ speech, reading or writing, due to changes in your brain. People with aphasia experience these challenges. But a number of treatments may help them regain the ability to communicate.

Some people develop aphasia suddenly after a stroke. Others lose their communication abilities gradually from brain tumors or degenerative diseases. Regardless of the cause of aphasia, people often face similar communication challenges.

“People with aphasia, regardless of the type, come to us saying, ‘I know what I want to say, but I just can’t say it,’” said Maya Henry, PhD, associate professor in the department of speech, language and hearing sciences and director of the Aphasia Research and Treatment Lab at the University of Texas at Austin.

Therapy is the mainstay of treatment for aphasia, regardless of the cause, but the expected outcomes are different.

“The main aim in aphasia after a stroke or brain injury is to try and restore lost skills,” said Sara Pillay, PhD, a clinical neuropsychologist and associate professor of neurology at Froedtert and the Medical College of Wisconsin. “In primary progressive aphasia, the therapy aim is to preserve communication abilities and teach compensatory techniques as things decline over time.”

Researchers don’t fully understand how therapy helps people with aphasia communicate more effectively, but they believe that it prompts activity in the brain.

“What therapy contributes to recovery, we believe, is stimulation of brain regions that mediate language. This functional stimulation either reestablishes connections that are not completely lost or forges new pathways in the brain that support language abilities,” said Nadine Martin, PhD, CCC-SLP, director of the Aphasia Rehabilitation Research Laboratory and Laura H. Carnell professor of communication sciences and disorders at Temple University in Philadelphia. “You ask someone to repeat a sentence, and they can’t do it at first, but later, with some practice and assistance, they can. You’re helping the brain do what it was once unable to do.”

How Neuropsychologists Can Help People with Aphasia

Neuropsychologists work with speech-language pathologists to diagnose people with aphasia and identify additional challenges. “Very rarely do we see that a person has a language problem and nothing else is going on with cognition,” Dr. Henry said. “Our neuropsychology colleagues help us get that bigger-picture characterization that can help us to design a therapy regimen that’s going to be appropriate for that person’s skills.”

Additionally, neuropsychologists collaborate with speech-language pathologists to determine the most effective treatments for each person with aphasia.

“We’re not just assessing language; we’re also looking at other cognitive functions like memory, attention, executive functioning, mood and how all of those can get impacted by disruption in the language system,” Dr. Pillay said. “We can take a more nuanced look at where the bottlenecks might be that are impacting communication. We work in concert with the therapist so that we have the best individualized treatment plan possible.”

Approaches to Aphasia Therapy

These treatment plans may involve multiple different approaches and techniques depending on individual patients’ need. People with aphasia may benefit from individual therapy, group therapy and family-centered care. Therapy may be offered in person or via telehealth. Each type serves different purposes.

One-on-one therapy helps identify a patient’s communication abilities and challenges. Together, patients and speech-language pathologists create meaningful, personalized goals to focus on.

In group therapy sessions, social interaction may help people with aphasia feel less isolated. Group therapy also lends itself to collective problem-solving.

“Somebody says, ‘I was at the grocery store and needed to find something but couldn’t get my words out,’” Dr. Henry said. “Other people say, ‘Me, too, and here’s what I did.’ A speech therapist can suggest strategies to get out of a tricky communication situation, but hearing what’s worked for another person with aphasia is even more powerful.”

During family-centered care, a therapist, patient and family member work on strategies to facilitate communication. Family members may gain a better understanding of aphasia and the most effective ways to interact. Relatives may also learn about their loved one’s communication preferences.

“Families involved may ask, ‘Should I be finishing their sentence if they can’t come up with a word, or should I wait?’” Dr. Pillay said. “What does the patient want? Maybe they’ll say, ‘If I’m one-on-one, I want to try and get the words out myself, but if we’re in a social setting, I want some help.’”

Therapy is often offered face-to-face, but teletherapy is a helpful alternative. It makes therapy more accessible for patients living in rural areas, as well as patients with mobility challenges, cognitive issues or other problems that make it difficult to go to in-person appointments. In a 2025 study, researchers confirmed the efficacy of teletherapy for people with primary progressive aphasia (PPA), using a video-based tool called Communication Bridge. The clinical study is the first global randomized controlled trial for speech–language intervention for people with PPA. 

“Interventions for primary progressive aphasia had previously shown promise but lacked gold-standard clinical trial evidence and focus on goals that were important to the individual living with PPA and their families,” said study author Emily Rogalski, PhD, Rosalind Franklin professor neurology at the Alzheimer’s Research Care Center at the University of Chicago.

“The Communication Bridge intervention showed superiority over traditional impairment-focused intervention approaches,” she said. “Participants showed greater gains in communication goals, as well as improvements in word retrieval and script performance that were maintained over a 12-month period. This is a true clinically meaningful change with lasting power.”

Aphasia Therapy Techniques

Speech-language pathologists teach aphasia patients different strategies, based on their needs. Some people want help finding the correct words to describe things. Others want to re-learn how to speak in complete sentences. Still others need assistance with reading or writing.

“Word-finding is a really common target for treatment,” Dr. Henry said. “When people can’t find a word, they still know a lot of things about that word; they have the concept. For a phone, I can say, ‘It’s the thing I carry in my purse, and I use it to call people, and it’s got a screen.’ Describing it sometimes helps people to self-cue. But they’ve given a nice description, so you know what they’re talking about.”

Another word-finding strategy focuses on a word’s sound attributes, not its definition. “What’s the first sound? What’s the last sound? How many syllables does it have? What does it rhyme with?” Dr. Pillay said. “You’re trying to activate sound-based knowledge to come up with the word.”

Script training helps someone with aphasia become able to speak fluently about a meaningful topic, allowing them to more easily engage in conversation. The patient and their speech-language pathologist collaborate on a script, and then the patient rehearses it until it becomes ingrained.

“Some people with aphasia who can’t say very much can recite the Pledge of Allegiance or the Lord’s Prayer, because it’s overlearned and automatic language,” Dr. Henry said. “With script training, we’re taking a chunk of language that you want to use and overlearning it, so that it becomes more automatic. Then you’re able to speak fluently and intelligibly about something that’s important for you.”

A life participation approach to aphasia helps patients create therapy goals to reengage in activities meaningful to them. “If you have a son or daughter and can’t say their name, it can be really important for you to say their name properly,” Dr. Pillay said. “Or if you want to go to a restaurant and order for yourself, therapy might involve using menus, role-playing and practicing.”

Augmentative and Alternative Communication for Aphasia

Many people with aphasia incorporate augmentative and alternative communication (AAC) into their lives to improve communication. This broad category encompasses everything from pointing at things to scrawling notes on paper to using a dedicated speech-generating device. A technique called voice banking allows people who still have verbal skills to record their voice, which can then be used to create a synthetic voice that sounds like that person’s natural voice.

Dedicated AAC devices can be expensive and complex to personalize, however, so many people with aphasia use their smartphones instead.

“There are apps that do a lot of the same things, maybe not in a sophisticated way, but it makes AAC accessible and affordable in a way that it hasn’t been before,” Dr. Henry said.

Brain Stimulation for Aphasia

Some research has shown that non-invasive brain-stimulation techniques such as transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) may enhance the benefits of speech-language therapy. These are types of neuromodulation, which is a technique that stimulates your nerves through painless electrical pulses.

“The important thing to remember is that this typically isn’t neuromodulation in isolation; it’s ideally paired with an effective speech-language treatment,” Dr. Henry said. “We think of the speech-language treatment as the critical component and the brain stimulation potentially adding potency to that.”

Before tDCS or TMS is offered to aphasia patients in a clinical setting, more evidence is needed. “I collaborate with people who assess effects of tDCS and TMS in combination with therapy,” Dr. Martin said. “The positive evidence is increasing for these effects, but it’s still inconsistent.”

Medications

Medications may be used to address mood or behavioral symptoms such as depression that people with PPA may have, but no medications have been approved to prevent or cure the diseases causing PPA.

“They’re addressing the symptoms, but there are no medications to prevent, halt or reverse the neurodegenerative diseases that cause PPA,” Dr. Rogalski said.

Medications are being developed that could become available in the future. “They’re studying different medications to improve language, or improve focus and attention, or trying to prevent further decline,” Dr. Pillay said. “It’s a developing field, and the evidence is still a little mixed.”