Some neurological diseases are slowly progressive so the individual has time to prepare for his impairment and can have strategies ready. However, the impairment is often sudden after a stroke and both the patient and family may be disorientated and not sure what to do next.  Despite the debilitating nature of stroke much can be done to support and improve communication with speech therapy. 

Recovery from a stroke can take time, and the early period following the stroke can be a difficult time for the individual and his family. At first, it is probably best to try and take stock of the situation and ideally consult a Speech and Language Pathologist / Therapist (SLT). The SLT should be part of the hospital team and will initially assess swallowing and communication. Sometimes the patient will be very confused and disorientated, and initially it may be a matter of just being there for support. The individual with a stroke may appear to understand things, but this may be because he is picking up key words and contextual cues. When assessed it often becomes apparent that his understanding is severely compromised.  Once the nature of the communication delay presents you can begin to look at strategies. A SLT will be able to assess, diagnose and suggest appropriate strategies and/or therapy.

Often in the first few weeks following a stroke the brain will, to some extent, repair itself and heal. This may mean that initially the individual appears to have quite a severe communication difficulty but over the first few weeks improves well. However, this is not always the case and improvement may be slow and limited.

If speech and language is compromised when a stroke first occurs, it may be worth using a visual chart with pictures of important and common things so the individual has more chance of understanding and expressing some basic needs. Sometimes a pencil and paper may be handy as the individual may not be intelligible following a stroke, but still have writing skills.  Initially though it is important to be patient, make your language short and simple, and back your language up with visuals and gesture.