Stroke

Stroke and Communication Changes

After a stroke, people very frequently experience changes in various areas of communication:

verbal expression (finding words and forming sentences)
understanding others' speech
reading and writing
use of gesture and facial expression
speech production (speech sounds, rhythm of speech)
voice quality
cognitive communication (verbal reasoning, verbal memory, attention)
stuttering

Below are brief descriptions of communication disorders associated with stroke, assessment and treatment options, and informational resources.

Aphasia

25-40% of stroke survivors will acquire aphasia – a reduction in the ability to express and understand language. People with aphasia may have difficulty with word finding and forming sentences, say things that don’t sound like real words, misunderstand what others say, have difficulty reading and writing, and have problems using gestures.

Learn more about aphasia here.

Watch a video of a gentleman with fluent aphasia here:

https://www.youtube.com/watch?v=3oef68YabD0

Watch videos of persons with nonfluent aphasia here:

https://www.youtube.com/watch?v=JWC-cVQmEmY

http://www.stroke4carers.org/?p=5390

Aphasia

On This Page

Aphasia

Cognitive-Communication

Dysarthria

Apraxia of Speech

Right Hemisphere Stroke

Assessment

Consultation

Treatment

Informational Resources

Local Resources

Cognitive Communication

Cognitive-Communication

Cognitive impairment that affects communication may also result following a stroke. Deficits in attention, organizing information, retaining verbal information, and reasoning can have a substantial impact on a person’s daily life, relationships, and functioning.

Motor Speech - Dysarthria and Apraxia of Speech

Many individuals will acquire a motor speech disorder (dysarthria and/or apraxia of speech). About 40% of stroke survivors will exhibit dysarthria – difficulty making speech sounds. It can involve unclear speech, altered vocal quality (e.g., hoarse or breathy), lowered volume, hypernasality, monotone speech, and a rapid or slow rate. Apraxia of speech is difficulty with programming the sequences of movements to produce speech. It often co-occurs with aphasia.

Watch a video of a gentleman with dysarthria here:

https://www.youtube.com/watch?v=SriryvkbU9c

Watch a video of a lady with apraxia of speech here:

https://www.youtube.com/watch?v=bZ7pnmd9UHI

Right Hemisphere Dysfunction

After a stroke, people may have difficulty with attention, visual neglect (impact on reading and writing), reasoning and problem solving, producing and understanding ‘prosodic’ features of language (meaning that is conveyed with changes in stress, rate, rhythm, and intonation), understanding non-literal language (e.g., lies, jokes, sarcasm, idioms), interpreting emotion conveyed verbally and through facial expression, ‘pragmatics’ (communicating appropriately in specific social contexts, such as when speaking with a manager versus a friend), and conversation skills (e.g., maintaining a topic, turn-taking). Such symptoms may not be obvious in brief interactions but can have a substantial impact on social relationships and employment post-stroke.

Assessment

Assessment serves to diagnose communication disorders (e.g., Broca’s aphasia), evaluate specific strengths and difficulties, inform treatment planning, and to make a prognosis about potential for improvement.

Consultation

SLPs work with clients and other professionals to offer recommendations for more effective communication, strategies for coping with a communication disorder, and support with advocating for their needs and rights.

Treatment

During the first year, people make gains most rapidly with treatment. People many years post-stroke, however, also demonstrate improvement. With treatment, people can achieve improved communication skills in many areas such as: