Aphasia is caused by damage to parts of the brain responsible for language, usually due to stroke or brain injury. How severe the aphasia is relates to how much a person’s language is affected. A person with mild aphasia might have word finding difficulties, problems explaining complex information, or difficulties understanding complex information. Even though the diagnosis is “mild”, there can still be significant communication disruption and people with mild aphasia report a loss of independence.

This evidence-based summary addresses treatments for people with mild aphasia. It focuses on five main treatment approaches that were either specifically designed for mild aphasia, or were modified for this group: word retrieval, sentence building, response elaboration, constrained summarising, and communication partner / conversation training.

Speech pathology intervention in mild aphasia: a quick snapshot of treatment options

# Treatment type Description
#1 Word retrieval Semantic feature analysis within a picture description or procedure activity; orthographic and phonemic cueing within conversation
#2 Sentences Using joining words to create longer sentences, which convey more complex ideas
#3 Response elaboration Increasing the content and length of sentences using Modified Response Elaboration Training (M-RET)
#4 Constrained summarisation Attentive Reading with Constrained Summarisation (ARCS)
#5 Communication partner training Teaching the person with aphasia and a main communication partner to have better conversations, together.

#1 Word retrieval

A common treatment for aphasia of all severities, including mild aphasia, is semantic feature analysis. This treatment helps a person with aphasia to strengthen word connections, with the goal of making those words easier to retrieve. It usually involves naming and describing WORDS, so it is a ‘word retrieval’ therapy.

During this treatment, the person with aphasia fills in a “feature analysis chart”. Objects have six features: category, action, use, location, properties, and associations. Actions have these six features: subject, purpose of action, part of body or tool used to carry out the action, description, usual location and associated objects or actions (Efstratiadou et al, 2018).

Usually, the person with aphasia is shown a picture of a single object or action, and they fill in the feature chart to describe it’s features. In mild aphasia, the treatment can be modified so that the person with aphasia is asked to describe a picture scene or tell a procedure. They then use use semantic feature analysis to address any word retrieval problems that happen during this talking. We call this semantic feature analysis within discourse.

What are semantic features?

Object naming

  • Category

  • Action

  • Use

  • Location

  • Properties

  • Associations

Action naming

  • Subject

  • Purpose of action

  • Part of body or tool that is used to carry out the action

  • Description

  • Location

  • Associations

Phonological and orthographic cueing

Another word retrieval treatment involves phonological and orthographic cueing. This sounds fancy, but it simply means that we use the first sound, letter, or syllable in a word to help a person with aphasia to retrieve it. So if the person was trying to say ‘rubbish’ we could say ‘r’, write ‘r’, or say/write ‘rub___’.

In mild aphasia, this treatment can be modified. The person with aphasia describes a picture or has a conversation on a topic that interests them. These tasks should includes words that the person with aphasia would like to treat. When word retrieval problems occur, sound and letter cues are used to help retrieve the word.

Example of a semantic feature analysis treatment in mild aphasia:

#2 Sentences

For some people with mild aphasia, the communication breakdown occurs when they are putting sentences together. The person with mild aphasia might use simple sentence joiners, such as “and, but”. The issue is that adults need to use a wide range of sentence joiners. We need words like “because, before, after, however, although” to fully express ideas and relationships.

In mild aphasia, there are a small number of treatment studies that have treated sentence formulation. These have involved teaching the person with mild aphasia to produce longer sentences so they can express more complex ideas. The person with mild aphasia might be taught to put two shorter sentences together to make a longer sentence. They learn to use sentence joining words such as ‘because, however, before’. These words can result in richer spoken language and conversations.

Example of a sentence treatment in mild aphasia:

#3 Response elaboration

Response Elaboration Training (RET) is an established treatment for people with aphasia of different severities. The person with aphasia is asked to describe a picture, and then to elaborate on their description. When elaborating, the person with aphasia is encouraged to say more words and/or longer sentences.

The treatment has been modified for people with mild aphasia. Rather than describing pictures, the person with mild aphasia is asked to retell stories or describe the steps in a procedure. These are more complex tasks. It has the same loose approach as ‘standard’ RET, with treatment focused on what the person with aphasia says, and no right or wrong answers.

Example of a Modified-Response Elaboration treatment in mild aphasia:

#4 Constrained summarisation

Attentive Reading With Constrained Summarisation (ARCS) is a relatively newer treatment, which is suitable for people with mild aphasia. The person with mild aphasia reads a short news article with the intent to summarise it. They can summarise it verbally, in writing, or both. When summarising the article, the person with aphasia must follow 3 rules. These features of the treatment (intent and constraint) are borrowed from Constraint Induced Aphasia Therapy. ARCS is suited to people with mild aphasia because it involves a number of steps that can be challenging to the person’s language and thinking skills. First, the person must read a news article. Second, they must pay attention to key words in the article, and not get distracted by less relevant words. Third, they must hold these key words in their memory, as well as remembering the 3 summarisation rules, when they produce the summary. Fourth, they must say words relating to news and current affairs, which may be ‘low frequency words’ and harder for some people with aphasia to retrieve. And finally, the article summary must be precise, requiring the person to explain new ideas with as clear and specific expression as they can manage.

Example of a constrained summarisation treatment in mild aphasia:

#5 Communication Partner / Conversation Training

Mild aphasia can have a significant impact on relationships and conversation. For this reason, some treatments include both the person with aphasia and an important communication partner, such as a family member or friend. In these treatments, the person with aphasia and their partner are taught skills to improve their conversations together. The partner can offer better communication support. The person with aphasia can improve their participation. This treatment is considered a form of ‘environmental modification’, because changing the way the partner communicates can have a positive impact on how the person with aphasia communicates.

Example of a conversation treatment in mild aphasia:


Mild aphasia is sometimes overlooked when treatments are being designed for people with aphasia. It makes sense that a lot of focus is given to people with significant difficulty understanding and using words (severe aphasia). However, people with mild aphasia still have problems communicating, and it still affects their lives. This article provides a snapshot of some evidence based treatments for those people with mild aphasia. It shows that there are a range of treatments available, so the speech pathologist can find a good match for an individual’s goals and needs.

The article is not a comprehensive analysis of treatment findings and study design. Speech pathologists are encouraged to do further reading into the treatment that interests them.

Where can I find out more about speech pathology intervention in mild aphasia?

To read more, take a look at these links:


  • Efstratiadou, E. A., Papathanasiou, I., Holland, R., Archonti, A. and Hilari, K. (2018). A Systematic Review of Semantic Feature Analysis Therapy Studies for Aphasia. Journal of Speech, Language, and Hearing Research, 61, pp. 1261-1278. doi: 10.1044/2018_JSLHR-L-16-0330
  • Richard K. Peach & Katherine A. Reuter (2010) A discourse-based approach to semantic feature analysis for the treatment of aphasic word retrieval failures, APHASIOLOGY, 24:9, 971-990, DOI: 10.1080/02687030903058629
  • Alison Greenwood , Jennie Grassly , Julie Hickin & Wendy Best (2010) Phonological and orthographic cueing therapy: A case of generalised improvement, APHASIOLOGY, 24:9, 991-1016, DOI: 10.1080/02687030903168220
  • Lucy Dipper, Jane Marshall, Mary Boyle, Nicola Botting, Deborah Hersh, Madeleine Pritchard & Madeline Cruice (2021) Treatment for improving discourse in aphasia: a systematic review and synthesis of the evidence base, Aphasiology, 35:9, 1125-1167, DOI: 10.1080/02687038.2020.1765305
  • Julie Hickin, Beejal Mehta & Lucy Dipper (2015) To the sentence and beyond: a single case therapy report for mild aphasia, Aphasiology, 29:9, 1038-1061, DOI: 10.1080/02687038.2015.101047
  • Sarah Fox , Elizabeth Armstrong & Larry Boles (2009) Conversational treatment in mild aphasia: A case study, Aphasiology, 23:7-8, 951-964, DOI: 10.1080/0268703080266952
  • Richard Peach & Patrick Wong (2004) Integrating the message level into treatment for agrammatism using story retelling, Aphasiology, 18:5-7, 429-441, DOI: 10.1080/0268703044400014
  • Nicholas, L. E., & Brookshire, R. H. (1993). A system for quantifying the informativeness and efficiency of the connected speech of adults with aphasia.Journal of Speech and Hearing Research, 36(2), 338-350. https://www.health.gov.au/topics/aged-care/advice-on-aged-care-during-covid-19/coronavirus-covid-19-helping-to-stop-the-spread
  • Wambaugh, J. L., Nessler, C., & Wright, S. (2013). Modified response elaboration training: Application to procedural discourse and personal recounts. American Journal of Speech-Language Pathology, 22(2), S409-S425. https://doi.org/10.1044/1058-0360(2013/12-0063)
  • Julie L. Wambaugh & Aida L. Martinez (2000) Effects of modified response elaboration training with apraxic and aphasic speakers, Aphasiology, 14:5-6, 603-617, DOI: 10.1080/026870300401342
  • Obermeyer, J. A., Leaman, M. C., & Edmonds, L. A. (2020). Evaluating change in the conversation of a person with mild aphasia after attentive reading with constrained summarization-written treatment. American Journal of Speech-Language Pathology, 29(3), 1618-1628. https://doi.org/10.1044/2020_AJSLP-19-00078
  • Obermeyer, J. A., & Edmonds, L. A. (2018). Attentive reading with constrained summarization adapted to address written discourse in people with mild aphasia.American Journal of Speech-Language Pathology, 27(1S), 392-405. https://doi.org/10.1044/2017_AJSLP-16-0200
  • DeDe, G., & Hoover, E. (2021). Measuring change at the discourse-level following conversation treatment: Examples from mild and severe aphasia. Topics in Language Disorders, 41(1), 5-26. https://doi.org/10.1097/TLD.0000000000000243