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)
cognitive communication (verbal reasoning, verbal memory, attention)
Below are brief descriptions of communication disorders associated with stroke, assessment and treatment options, and informational resources.
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.
Watch a video of a gentleman with fluent aphasia here:
Watch videos of persons with nonfluent aphasia here:
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:
Watch a video of a lady with apraxia of speech here:
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 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.
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.
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:
speech clarity, rhythm, and rate
understanding of spoken language
reading and writing
use of strategies
attention and verbal memory
activities of daily living (eg. paying bills)
social interactions with friends and family
Treatment for aphasia can be provided remotely through telepractice.
Contact Shoreline for information.
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Aphasia Institute (Toronto, Ontario)
Aphasia Etiquette (BBC)
NIDCD Fact Sheet - Aphasia
National Aphasia Association (USA)
Aphasia Nova Scotia
Dalhousie University Aphasia Group