Changes to receptive language abilities will affect the person’s ability to understand language. This includes spoken, written or signed language. These changes to the ability to understand language are not because of physical changes (e.g. hearing or visual impairment, or visual perceptual difficulties but may co-occur with these problems. 
Receptive language characteristics of dysphasia can include:
- Difficulty understanding even single spoken/signed/written words.
- Misinterpreting a word and believing it to mean something else.
- Only being able to understand short and simple sentences (spoken, signed or written).
- Misunderstanding instructions and information.
- Being only able to understand a small part of what has been communicated to them.
- Struggling to follow conversations. This difficulty is increased in noisy, busy environments and when there are more than two people in the conversation.
- Struggling to understand word based humour/jokes, though may respond well to more visually based humour.
- Appearing confused during interaction.
It is important to remember that the person with dysphasia may not indicate that they cannot understand what is being said or signed to them. The reasons may include one or more of the following:
- They may believe they have fully understood.
- They do not want to appear ‘stupid’ and therefore they mask their difficulty and try to give the impression of fully understanding.
- They may lack the confidence to indicate they do not understand.
- They may not want to ‘make things difficult’ for the person trying to communicate with them as they may feel it is impolite.
- They are feeling unwell, anxious or depressed and it is feels too difficult/effortful or anxiety provoking for them.
- The dysphasia may be so severe that the person may not know how to indicate that understanding is difficult for them.
Sometimes the person with impairment of the ability to understand language may give the impression of fully understanding what is said to them when they actually do not. This can be because:
- They are ‘mirroring’ non-verbal communication (e.g. nodding and smiling when the person speaking with them nods and smiles). This gives the impression of understanding and following conversation.
- They are using non-verbal communication to help support their ability to decode what is being said to them i.e. they understand gesture and tone of voice rather than the words.
- They have got used to a particular routine e.g. if in hospital and lunch is always at 12.30 they do not have to understand ‘come for lunch’ to know that they need to go to the table.
- They pick up on environmental cues e.g. if they are given a towel, this can make it very clear that someone has prepared a bath for them.
- Some people with receptive dysphasia may still appear to read the paper, look at menus etc. This does not mean they can read with full understanding – they may be only taking in headlines, a few words, looking at the pictures or trying to do something ‘normal’.
How to Help the Person with Receptive Language Impairment