How to care for someone with communication difficulties

The adult or child you're caring for may find it difficult to communicate because of a physical health problem – such as a hearing difficulty, a problem with their eyesight or a developmental disorder – or because of a disorder affecting their brain, such as Alzheimer's disease or stroke.

Communication problems can come on gradually or happen overnight. If they're sudden, you will need to re-evaluate how you communicate with the person you care for.

Consider your tone of voice, how quickly you speak, and how you use body language and gestures to emphasise what you are saying. Find out what helps them or makes your communication clearer.

Someone who has a physical or mental illness or disability may be affected by your own and other people's reactions to their condition. This could change their ability to communicate.

Types of communication problems

Speech problems can happen for no clear reason or because of a:

Language disorders

Language disorders are problems understanding or using words. They can be triggered by a stroke or brain injury.

Children learn to talk by listening to the people around them, and mimicking sounds and mouth shapes. It helps to talk to your child, and encourage sounds and speech from an early age. If their progress seems to be delayed, take them to a doctor for a check-up.

Some people grow out of these disorders during childhood, while others live with them throughout their adult life.

Speech and language therapy can help, particularly in younger people. You can access this through your child's special educational needs co-ordinator or a GP.

Selective mutism

Selective mutism, sometimes described as a "phobia of talking", is an anxiety disorder that stops children speaking in certain social situations, such as in school lessons or in public.

However, they're able to speak freely to close family and friends when nobody else is listening – at home, for example.

If your child is selectively mute, be patient. Don't put pressure on them or bribe them to speak.

Find out more about selective mutism.


Deafblind people have a sight and hearing impairment. Some people are born deafblind, while others become deafblind in later life through an accident or old age.

People who are deafblind may not use words, and it can be difficult to work out the best way to communicate with them.

Find out more about deafblindness.

The charity Sense supports and campaigns for children and adults who are deafblind.

Communication problems after a stroke

A stroke can cause mental and physical impairments, and make communicating with someone difficult.

The person who has had the stroke may find it hard to form words or understand what you say to them. This may make it difficult for you to work out what they want.

If the person has problems with speech, language, writing or swallowing, they can be referred for speech and language therapy to help them regain those skills.

When you communicate with someone who is recovering from a stroke, it's important to give them your full attention and try to avoid any background distractions. Try to speak clearly and at a normal volume.

Make sure you're listening and watching for the person's reactions, as not all communication is verbal. It's also important that you don't pretend you've understood them if you haven't. Don't try to speak for them.

You can get support with stroke-related illness and disability from the Stroke Association. It also has volunteers who work to improve the communication skills of people who have had a stroke.

Communication aids

Some people with communication problems may find communication aids helpful.

These are also known as augmentative and alternative communication (AAC) devices and can include anything from picture books to personalised technology.

AACs are most often used by people who have problems with speech, including those with autism, learning disabilities, cerebral palsy or deafblindness.

Read more about communication aids on the Sense website.

Sign language

Sign language is a way of communicating visually, using hand gestures, facial expressions and body language. There are hundreds of different types of sign language in use across the world.

British Sign Language

British Sign Language (BSL) is the sign language used by deaf people in the UK. BSL uses hand gestures, finger spelling, lip patterns and facial expressions.

Sign Supported English

Sign Supported English (SSE) is a variation of BSL. It uses BSL signs, but the structure and grammar are based on spoken English. This means the signs follow the exact order they would be spoken in.

SSE doesn't require any knowledge of BSL grammar structure, so is easier for hearing people to learn. It's often used in schools where deaf children are taught alongside hearing children.

Tactile signing

Some deafblind people prefer to use tactile signing, such as the deafblind manual alphabet and Block, where words are spelled out on the individual's hand.

Sense has more information about tactile alphabet-based communication, including the deafblind manual and Block


Makaton is used by adults and children with learning disabilities and communication problems. It uses a combination of picture symbols and hand gestures that are similar to BSL and speech.

The Makaton website has more information about the Makaton language programme and how it works

Getting help

The Ace Centre offers help and support for children who have complex physical and communication difficulties, and for their parents, carers or therapists.

The charity I CAN helps children develop speech, language and communication skills, with a special focus on children with a communication disability.

The Carers Direct helpline offers advice and support with communication issues over the phone on 0300 123 1053.

If you are deaf, deafblind, hard of hearing or have impaired speech, you can call Carers Direct using the textphone or minicom number on 0300 123 1004.

Page last reviewed: 11 April 2024
Next review due: 11 April 2027