Enhancing speech and language following stroke

Some individuals will recover well from strokes and within a few weeks are communicating well. Many however, will continue to have difficulties with speech, language and cognitive processing after a stroke. Intervention for individuals that have suffered a stroke can take several routes. Some therapists focus on direct therapy and try and find ways to help the individual overcome some of their word finding difficulties or to use more language, although this sometimes can be partially successful, individuals also need to learn functional strategies as well. Functional techniques can usually be very beneficial for individuals, following a stroke, and involve finding compensatory strategies or technology to overcome communication difficulties.

It is also important for those around the individual to facilitate the process by altering their communication and the communication environment within the home. To achieve this, carers, spouses and relatives have to think about the complexity of their language and give as many cues to the listener as possible. Within the home it is important to remove noise and distractions that may make communication difficult for the individual with difficulties.

Dysarthria and dysphonia

Dysarthria and dysphonia are some of the most common features of stroke, but with an awareness of certain strategies an individual can really improve their chances of being understood. Just having an awareness of your breathing (to improve volume), using shorter sentences, and emphasizing key words can make differences to intelligibility. Using simple communication aids can also give the listener cues and enhance intelligibility. A qualified speech and language pathologist / therapist can help you develop strategies and give you advice on assistive communication. Strategies include:

• Muscle Exercises

• Breathing Exercises

• Compensatory Strategies (such as drawing)

• Gesture or visuals

• Alphabet Charts

• Hi-tech Augmentative / Assistive communication aids

Aphasia

Aphasia or dysphasia is often more difficult to come to terms with and to apply effective rehabilitation strategies. For some adults, understanding language will be an ongoing problem and expressing their needs, just as difficult. For the individuals with these severe problems it is important to focus on a total communication environment. This means using every means possible to help with expression and understanding.

There are different types of aphasia, depending on the area of brain damage, and these aphsia's present with different symptoms:

• A global aphasia where there is a deficit across many cognitive functions and speech, language and literacy skills

• Difficulties with expressing language and words

• Difficulties with understanding words and language

• Difficulties with reading and writing

See our Download Centre for more detailed information sheets relating to Stroke, Total Communication, and strategies to facilitate communication. icommunicate will also provide resources such as picture communication charts to the facilitate communication following stroke.

Dyslexia and dysgraphia

Dyslexia and dysgraphia are also difficulties that can arise from stroke and are often associated with aphasia. Difficulties with reading and writing are sometimes difficult areas to address, but there are a few ways to get around reading and writing problems, by using simple strategies, other people or assistive devices. For instance, write a note or keywords in the margin with a pencil to refer to if you have difficulty remembering what you have just read, or summarise the important aspects of what you have read into a Dictaphone and then play them back next time you open the book. If you have difficulty with writing, get someone else to proof read your work to make sure it is correct and makes sense.

Visit our Download Centre for a free information sheet containing strategies to facilitate reading and writing following a stroke.

Many of the difficulties that occur following a stroke will mean making adaptations to your home to help make communication easier. This may mean simple things like using calendars and visuals for reminders and guides, and eliminating background noise when communicating. As communicators it is important that we are aware of our own communication skills. This means facing the person we are talking to, speaking clearly, reducing our language complexity if the individual has difficulty understanding, and giving the individual time to process and respond.

Visit our Download Centre to see information sheets relating to stroke and improving the communication environment.

Assistive technology is a generic term that includes assistive, adaptive, and rehabilitative devices with a focus on facilitating communication. Modern new electronic machines (hi-tech) have become the new way for many individuals to communicate. However, assistive devices do not have to be expensive or electronic, they can be lo-tech (picture cards or an E-Tran framefor instance), and often the simpler lo-tech option is the better, more functional option depending on the client and their disability. Whatever assistive device is used the end goal is to facilitate communication and independence.

Some individuals with stroke can benefit form assistive communication devices. Lo-tech options can include visual communication books, E-Tran frames and alphabet charts. Hi-tech options can include communication machines with voice output, accessed by switch or eye-gaze, or communication software installed on a laptop.

The use of assistive communication devices, both hi-tech and lo-tech, are very much part the icommunicate philosophy. This website is all about communication and a total communication environment. This means we focus on every modality that can be used to facilitate communication. At icommunicate we plan to have a heavy focus on assistive communication and technology. See our Assistive Technology / AAC section for more information.

To see an icommunicate video about using Picture Charts to facilitate communication following a Stroke or Brain Injury - Click here.