Around 2 in 3 people have communication difficulties immediately after a stroke and 1 in 3 will continue to have long term difficulty. Communication difficulties are varied, dependent on the type and severity of the stroke but they can improve with time and the right support. If you have communication difficulties, you may experience more problems when you feel tired, stressed, or unwell. There are four main types of communication difficulties:
- Aphasia (also called dysphasia)
- Dysarthria (changes in the muscular control of speech)
- Apraxia of speech
- Cognitive communication difficulties
The Stroke Association provides further detailed information on managing communication problems. They also provide a free communication pack with information on communication difficulties following stroke and a basic communication aid. You can order or download a copy via their website.
Aphasia (also called dysphasia)
A language disorder caused by damage to the language centre of the brain. If you have aphasia you may have difficulty:
- Expressing yourself
- Understanding what others say
- Reading
- Writing
Dysarthria
A change in the muscular control of speech which can cause:
- Difficulty with how you articulate, pronounce words and produce voice
- Speech can be slow or slurred
- Voice can sound weak or strained
- An inability to speak louder than a whisper or speaking too loudly
- Abnormal speech rhythm
Apraxia of Speech (also called AOS)
A difficulty coordinating the lip / tongue muscles used to form words. If you have AOS, you may:
- Find it difficult to say a word correctly
- Swap, miss or repeat sounds
- Be able to say some automatic phrases such as counting, greetings, saying your name
- Also have aphasia
Cognitive Communication Difficulties
These vary in severity and are caused by problems with thinking skills. A cognitive communication disorder can be caused by difficulties with cognitive processes such as:
- Impulse Control: Stop and think
- Task Initiation: Ability to start something
- Organisation: Keep track of information and tasks
- Emotional Control: Manage your emotions to direct your behaviour
- Planning and Prioritising: Plan steps to reach goals
- Self Monitoring: Self evaluate your own behaviour
- Attentional Control: Regulate and direct your attention
- Working memory: Hold information in your mind to complete tasks
If you have a cognitive communication disorder, you may have difficulty paying attention to a conversation, staying on topic, remembering information, responding accurately, understanding jokes or metaphors, or following directions. See the Thinking Skills topic page for more information.
Friends, family and carers can help you with understanding and expression. Below are some tips to help them:
- Write it down
- Slow down
- Give time
- Treat me as an equal
- Be clear – one subject at a time
- Look at me as you speak
- Don’t make assumptions
- Keep a sense of humour
- Take pressure off speech, encourage drawing, writing and gesture
- Reduce distractions
- Check things out, especially yes and no
- Accept that conversations will get stuck, leave it and come back to it later
- Stay calm and relaxed
Computerised therapy may help you make improvements with your communication skills. This could be apps or software on a tablet or computer.
Speech and Language Therapists can advise on appropriate apps/software suitable for you.
The Aphasia Software Finder website gives general guidance on apps/software available for specific areas of language difficulty.
SLT aims to improve your ability to communicate whilst also helping you to adapt to life with communication difficulties. SLT’s often work with family and carers to help them adapt their communication style.
They often work with other therapists to support you with your communication difficulties, to access other therapy and to express your wants and needs. Therapy may be time-limited, but rehabilitation continues after therapy ends, through independent practice of exercises, daily communication activities or perhaps a communication group in your local area.
Speech and language therapists can provide communication aids; these can be paper based or computer based e.g.:
- Letter charts
- Picture dictionaries
- Apps on smartphones and tablets
- Video calling
If you are already under the care of your local community stroke team, you can ask them more about this topic at your next visit.
Aphasia Support is a Yorkshire based charity supporting people with aphasia to access therapy apps/software to improve their communication. They also run social groups known as ‘Aphasia cafes’ in areas across the region to provide opportunities for you and people supporting you to meet others in the same position. More information on Aphasia Support.
Or to access one to one computer therapy or Community-based SLT Sessions, Call: 0300 102 3500 or Email: info
Chest Heart and Stroke Scotland are Scotland’s largest stroke charity working to help people with chest, heart and stroke conditions to live life to the full. More information about Aphasia and communication difficulties.
Stroke Association is England’s largest stroke charity with lots of useful resources and support.
Stroke4Carers online offer advice and videos to support carers.
Tactus Therapy (app developer) offer information and advice on communication difficulties.
The Tavistock Trust for Aphasia – is an organisation which may be able to support with small grants towards equipment, therapy apps and courses for people with Aphasia: More information on Tavistock Trust for Aphasia grants.
The Aphasia Recovery connection – an American resource for people with Aphasia, has a Facebook group for people across the world to share experiences and tips with each other.
Aphasia Support run Cafés at the following locations :
- Leeds - Rothwell Baptist Church
- Wakefield- West Wakefield Methodist Church
- Harrogate - Knaresborough Road Health Centre
- Calderdale - Holy Trinity & St Jude’s Church
- Huddersfield - Kirkheaton Community Centre
- Bradford – Church of God of Prophecy
Aphasia Support website
Call: 0300 102 3500 or Email: info@aphasiasupport.org
Barnsley Assistive Technology hub provide information on communication aids,
Website
Bradford Speakability – Is a communication group run by the Stroke Association at the Thornbury Centre
Website
Say Aphasia Skipton - Skipton town hall
Website
Call: 07796 143118
If you have any concerns about communication difficulties, please contact your GP who can refer you to Speech and Language Therapy if this is available in your area.