Stroke and Communication

How is communication affected by a stroke?

Communication involves understanding what people say to you and being able to talk to them and have them understand you. It is the way we exchange information, express our ideas and opinions and present ourselves to the world.

Aphasia affects about one third of people who survive stroke. Some have little or no speech. Others have a great deal of speech, but it is "empty" -- missing the words that convey information. Difficulty understanding is also present, although for some it only affects more complicated statements. For others, understanding even simple statements is extremely difficult. Since language has been affected, reading and writing are also a problem.

Dysarthria involves only speech and is caused by weakness, paralysis or poor coordination of the muscles of the mouth, throat and breathing mechanism. Speech is "slurred", very soft or even absent. Understanding is unaffected.

Both aphasia and dysarthria can range from mild to extremely severe. Also, a person may suffer from both.

Road to Recovery

In the two or three weeks immediately after a stroke, speech may return spontaneously. Remaining problems may require treatment by a speech pathologist.

Aphasia treatment involves developing ways for people to "find" the words they cannot produce or shape their mouths to the sounds they need. They may need to "rehearse" silently before speaking. Repetition or added information from gestures may aid with understanding. Saying "yes" or "no" at the right time may require waiting a minute to respond. These and other strategies are used by persons with aphasia to access language "locked in" by the stroke. Therapy may continue for many months.

Dysarthria therapy develops ways of speaking to make speech clearer or the voice stronger and to use this way of speaking at all times. People may need reminders from those around them to stay on track.

Communications Systems

• Gestures or simple communication boards can help with everyday needs.
• A portable computerized system may be needed to allow full expression if speech is completely unclear.

Computerized systems are generally usable by people with dysarthria but not with aphasia.

Keeping the Lines of Communication Open

During the difficult period of stroke recovery, communication with family, friends and caregivers is a vital link in returning to everyday life.

Aid communication:

• Talk one-on-one. Avoid large groups of visitors at one time.
• Find a quiet place. Turn off the TV or radio.
• Don't pretend to understand. Ask for clarification.
• Gestures, facial expression, voice inflection and demonstration can help with both giving and receiving information.

With aphasia:

"Take a break":

• Find some activities you can do together without talking, like playing cards, checkers, or dominoes.
• Do a simple jigsaw puzzle.
• Listen to music.
• Sit quietly and relax.