This chapter adopts the perspective that executive functions are a processing system that regulates language and communication, modulated by conversational competence. In this bidirectional relationship, executive dysfunctions will result in conversational competence alterations of language use (i.e., pragmatics). This chapter examines the relationship between executive functions and conversational competence using examples of spontaneous conversational interactions of patients with language impairments. The authors present didactic proposals to mitigate the effects of the linguistic alterations.