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Speech and Language difficulties after a stroke

 

 

See our Stroke Home Page for a full list of information relating to Stroke, Dysarthria, Aphasia, and startegies for improving communication.

 

Enhancing speech and language following stroke

There are often speech and language difficulties after a 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. Therapy 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 language difficulties, although this sometimes can be partially successful, individuals also often need to learn some functional communication 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 family members to help 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 individual as possible. Within the home it is important to remove noise and distractions that may make communication difficult, simplifying language and shorten your sentences, and use pictures to help with understanding.

 

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, and using gesture 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 options. Strategies include:

  • Muscle Exercises
  • Breathing Exercises
  • Compensatory Strategies (such as drawing or writing)
  • Gesture or visuals
  • Alphabet Charts
  • Hi-tech Augmentative / Assistive communication aids

See our Dysarthria Section for more information about treatment options.
 

Aphasia

Aphasia or dysphasia can lead to problems with understanding language (the words we listen to) and expressing language (the words and sentences we speak). For the individuals with severe aphasia it is important to focus on a total communication environment. This means using every means possible to help with expression and understanding. See our Downloads Section for more information.

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 the Aphasia Section for more information.

 

There are a number of therapy approaches for Stroke and cerebro-vascular accident (CVA). The success of these approaches may very well depend on the severity of the stroke, the area of brain damage, and the frequency and intensity of therapy. Some therapists may use a combination of approaches. Therapy may help an individual make some progress back towards normal functioning and/or give them other compensatory strategies to help with cognitive tasks and communication.

 

See our Download Centre for more detailed information sheets relating to Stroke, Total Communication, and strategies to facilitate communication. icommunicate also provides 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. There many technological options now to help with writing such as speech recognition software (some versions of Microsoft Windows offer a free version of speech recognition/dictation software)*. Other people use simpler startegies such as writing a note or keywords in the margin of a book with a pencil to refer to if they have difficulty remembering what you have just read. Some people summarise the important aspects of they have read into a Dictaphone and then play them back next time they open the book as a reminder. Or, if you have difficulty with writing, get someone else to proof read your work to make sure it is correct and makes sense.

*To access Microsoft Windows free version of speech recognition/dictation software – Click the “Start” button, choose the “All Programs” Menu, Choose “Accessories”, choose the “Ease of Access” menu and there you will see a number of options that may help including, Magnifiers, Narrators (to read what is on the screen), and Windows Speech Recognition.

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

 

Adapting your home and improving your communication environment 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 skilled 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, using gesture, and giving the individual time to process information and respond.

 

Assistive communication and assistive technology

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. More recently ipads and communication apps have become a cheaper and more portable option for many individuals.

 

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. Visit our Assistive Communication Section to read more.
 

For more information about communication difficulties, and ideas and strategies to help communication, see our Resources, or for specific fact-sheets and picture charts with helpful hints about Stroke and improving communication go to the Downloads Section.

 

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