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Communication after stroke

About 1 in every 3 people who have a stroke has some difficulty communicating after their stroke. A stroke can affect your ability to understand, speak, read or write.  As a result people often find everyday activities such as going shopping or keeping in touch with friends can become difficult.

The main conditions that happen as a result of a stroke are called aphasia and dysarthria.

Aphasia occurs when the parts of the brain responsible for communication are damaged. Aphasia can affect your ability to:

  • Speak the right words
  • Understand what other people are saying
  • Read and write

Aphasia is different for each person. Some people may only have difficulty finding words or understanding. Others may have difficulties across all areas.

When speaking to a person who has aphasia you may notice that they have difficulty finding the right words and they speak very slowly taking time to think between words. People with aphasia often find it difficult to follow conversations.

Dysarthria happens when you can't control the muscles in your face, mouth or throat that you need to be able to speak. This can make your speech appear slurred, slow or unclear.

If you have dysarthia you are able to make sense and use the correct words, but your speech will not sound clear. You will be able to understand and follow conversations and reading and writing are not affected.

Dysarthria can sometimes occur alongside aphasia.

These types of communication difficulties do not affect your intelligence and it is not the same as being confused. It is simply that you may be having difficulty with the process of speaking and understanding language.

Most communication problems do improve but the extent of recovery is different for everyone.

If your ability to understand, speak, read or write is affected by your stroke, a speech and language therapist (SLT) should do a full assessment. This will help to identify how your communication is affected. The SLTwill work with you to help you find new and different ways to communicate. These could range from supported conversation (such as use of gestures, writing, pictures and facial expressions), to picture cards and boards, through to computer and electronic communication aids.

Helping communication

You can help someone with communication difficulties by knowing how to support them in conversation:

  • Reduce any background noise. For example, turn off the TV or radio.
  • Use short simple messages or key words.
  • Consider using yes/no questions.
  • Give the person plenty of time.
  • Recap regularly during the conversation to check they have understood.
  • Support your speech with appropriate gestures.
  • Always have a pen and paper available to write down or draw key information as you go along.
  • Use relevant resources to support the conversation, such as photos or a communication support book.

You may get stuck. Always be honest if you haven’t understood. Acknowledge the difficulty and then decide if you are going to continue or try again later.

For more information on supporting people with communication difficulties after a stroke, see the CHSS factsheet Helping communication after a stroke (PDF). We also have booklets for people with aphasia: Your Stroke Journey: In hospital (PDF) and Your Stroke Journey: At home (PDF) and Conversation Support Books.