Communication difficulties

Communication difficulties are often caused by a stroke and include:

• Aphasia – a form of brain damage which affects your ability to understand or produce words
• Dysarthria – a physical issue where the muscles you use to speak are weak or not working properly
• Cognitive difficulties – changes in how you think may make it more difficult to communicate.

Breathlessness can also make it difficult to speak clearly.

What is aphasia?

Aphasia is a common effect of stroke, affecting around one in three people who have had a stroke.

Aphasia means that a part of your brain which controls language has been damaged. There are two main parts of the brain which may be affected:

• Broca’s area – This part of the brain controls how you produce language and speech. If it is damaged, it may be more difficult to speak or write.
• Wernicke’s area – This part of the brain controls how you understand language. If it is damaged, it may be more difficult to understand spoken or written language.

Either or both of these parts of the brain may be affected by a stroke or head injury.

People with aphasia may find that they:

• Find it difficult to think of the right words
• Use the wrong word, or put words in the wrong order
• Struggle to understand what people are saying
• Slur or mumble
• Spell words wrong, or mix up similar-looking or similar-sounding words

In extreme cases, people with aphasia may be unable to speak at all.

People with aphasia may not be aware that what they say is not what they mean to say.

Managing aphasia

Aphasia can improve over time, especially with support from speech and language therapists. Even if aphasia does not improve, you can learn other ways to communicate.

Aids like a conversation support book [LINK] or a communication app may help if you are struggling to find words. These use images or videos to prompt you to find the word you’re looking for.

You may find it easier to communicate in person if you:

• Avoid background noise. Turn off TVs, radios, etc.
• Face the person you are speaking to, and make sure you can see their face.
• Consider gestures and facial expressions.
• Ask people to speak slowly
• Ask people if you need them to repeat or rephrase something

If you have a conversation planned, such as a doctor’s appointment or interview, it can help to write down what you may need to say.

If you struggle to speak, writing may be easier. If you struggle to write, but can speak clearly, there are apps available which will take dictation for you.

Helping someone with aphasia

If your friend or loved one has aphasia, you can make it easier when communicating with them by:

• Reducing background noise. Turn off any TVs, radios, or music.
• Being patient and waiting for the person to finish.
• Not interrupting or assuming you know what the person intends to say.
• Making sure that your face is clear and that you are looking at the person you’re talking to.
• Speaking slowly and being prepared to repeat yourself if asked.
• Using facial expressions and gestures to help give context.

Always remember that difficulty communicating does not mean difficulty thinking.

What is dysarthria?

Dysarthria is a physical condition where the muscles of the mouth, throat, or face are not working properly. This is often the result of a stroke, but can also be a result of other problems like: nervous dysfunction, brain injuries, or muscle damage.

People with dysarthria may slur, mumble, or otherwise struggle to speak clearly. This is not a problem with language (as aphasia is), but the physical act of speaking.