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Communication after stroke

What you need to know

  • After a stroke, you may have difficulty speaking. It may also be difficult to understand others when they speak or gesture to you.
  • Reading and writing may be difficult.
  • Your speech pathologist will work with you to develop a rehabilitation program. They can also suggest ways to communicate more easily, and aids that can help.

How a stroke can affect communication

One in three stroke survivors experience difficulties with communication. After a stroke, it is quite common to experience more than one type of communication difficulty. These difficulties affect everyone differently. Communication difficulties include:

Aphasia. Difficulty talking, reading, writing or understanding other people when they speak. It can happen even if your thinking, memory and judgement are unaffected by your stroke. This is also called dysphasia.

Apraxia. Difficulty coordinating the muscles for speech. Your brain has trouble planning the movements, making it difficult to say words. This is also called dyspraxia.

Dysarthria. Weakness or paralysis in the muscles used for speaking. Your speech may become slurred and difficult for others to understand.

Dysphonia. Weakness or paralysis in the muscles in and around the vocal chords. Your voice might sound like a whisper, or it might sound hoarse or rough. If you cannot make any sound at all, it is called aphonia.

Cognitive difficulties. Your memory, thinking and judgement is affected. It may be difficult to pay attention when people talk to you. It may be hard to understand or speak complex sentences. Your conversation may seem inappropriate to other people.

Treatment 

Communication difficulties affect everyone differently. A speech pathologist will assess your talking, listening, reading, writing and understanding. They will work with you to develop a rehabilitation program to meet your needs and goals. They can suggest ways to communicate more easily, and aids that can help.

If you have aphasia, your rehabilitation program may include practising talking, listening, reading or writing. You may work with the speech pathologist on your own or in a group. You may use a computer to work through exercises. You may practise using gestures or aids to get your message across.

If you have apraxia, treatment will focus on helping your muscles to work together. You may work on making sounds accurately and improving the speed and rhythm of your speech. You may practice using words and sentences that gradually get longer and more complex.

If you have dysarthria, you may do exercises to improve the strength and coordination of your speech muscles. You may practise speaking slowly or loudly and exaggerating your speech. You may use a voice amplifier to make your voice louder.

Recovery 

While most recovery takes place in the first few months, you can continue to improve for years. After you leave hospital, you can join an aphasia group to practice your communication. The more you practice, the more you will improve.

Communication difficulties after a stroke can make it hard to connect with the people around you. It can be difficult to provide information to your treating team and to ask questions. It can be difficult to communicate how you are feeling. Communication difficulties can be frustrating and isolating, and people with communication difficulties are at even greater risk of depression than other stroke survivors. If you think depression or anxiety may be an issue for you, speak to your doctor.

Communication tips for family and friends

Your family and friends can help you communicate:

  • Make sure you are face-to-face when speaking.
  • Talk in a quiet place with no distractions.
  • Make sure only one person speaks at a time.
  • Speak slowly in short, simple sentences.
  • Use gestures, writing or pictures.
  • Make it clear when the topic has changed.
  • Check to make sure you have correctly heard and understood.
  • If you are not understood the first time, try a different way.

More help 

StrokeLine’s health professionals provide information, advice, support and referral. StrokeLine’s practical and confidential advice will help you manage your health better and live well.
Call 1800 STROKE (1800 787 653).
Email strokeline@strokefoundation.org.au

Join Australia’s largest stroke community for information and support.
EnableMe: stronger after stroke
enableme.org.au

To find a speech pathologist
Speech Pathology Australia
Call 1300 368 835
speechpathologyaustralia.org.au

Australian Aphasia Association
Call 1800 274 274
aphasia.org.au

Download the Communication after stroke fact sheet (PDF 192 KB)

For more information visit the EnableMe resource topic on Speech and language.