Background: Aphasia is a communication disorder caused by brain damage. People with aphasia (PWA) often experience difficulties in interaction. Methods: This study uses conversation analysis (CA) and examines the interactions of 10 PWA (5 fluent and 5 non-fluent speakers) and their healthcare professionals. Aims: The study aims to to explore how Mandarin-speaking PWA adapt to difficulties in initiating responses to questions from healthcare professionals. It also examines how the ways PWA adapt may vary across different types of aphasia. Results: Two adaptive practices were identified: turn initial repeats and turn initial iconic gesture. The findings suggest that fluent speakers with aphasia tended to adapt with turn initial repeats, while non-fluent speakers relied more on iconic gestures in starting a response turn. These practices allow PWA to maintain progressivity in responding to questions and assist them in formulating answers. Conclusions & Implications: The study provides empirical evidence on how linguistic and multimodal resources can enhance everyday interactions and be applied in interaction-focused therapy for Mandarin-speaking PWA.