Speech and communication after a stroke

Initial stroke symptoms

Problems with speech were a common early symptom of a stroke (see 'The event: A stroke or TIA'). People often recalled that their speech had been slurred or occasionally that they could not make sounds that were understandable as speech. This was usually due to weakness of the muscles that are crucial for speech production on one side of the face. Some had resorted to writing to communicate what was happening to them and had initially used writing and simple hand signals to communicate in hospital. 

A few people had damage to areas of the brain in the left hemisphere which are chiefly responsible for language production and experienced immediate problems with talking, understanding, reading and writing. Speech was either jumbled, was affected by word finding difficulties, or the person found that they could not speak at all.

Losing the ability to communicate completely could be very frightening. One woman described losing her speech after a stroke in the left hand side of her brain following an operation as like being trapped in a box.

Speech problems following stroke sometimes recover within hours or days, however, some communication problems are more permanent. Some people had help from a Speech and Language Therapist to aid their recovery (see 'Stroke recovery: Communication disorders'). The amount of recovery that can be achieved varies depending on the area of the brain that has been affected and the extent of the damage.

Types of speech and communication problem following stroke

Speech problems due to muscular weakness usually recovers within a few days or weeks, however, a few people we spoke to had ongoing problems known as dysarthria. Speech could continue to be slightly slurred and people sometimes experienced problems regulating the volume and speed of their speech.

One man we spoke to had problems with speech due to difficulty organising and sequencing movement. This is known as dyspraxia.

A few people we spoke to had ongoing problems with speaking and or understanding people because of the damage to the language areas of their brain. These problems are known as aphasia or dysphasia. These included: 

  • being unable to find the occasional words;
  • speaking in jumbled sentences;
  • not being able to make proper sentences because of difficulty finding connecting words;
  • only being able to use a few words;
  • having problems understanding other people.

Reading and writing could also be affected by this kind of damage (see below).

Damage to speech and communication areas of the brain is sometimes very selective meaning that aspects of language are preserved. The wife of one man whose first language was Tamil explained that he was more able to speak Tamil than English. He found this very frustrating because he wanted to speak in English so he could become more independent. He was also still able to sing and pray because these long-established functions of language are controlled by a different part of the brain.

Coping with speech problems in social and family life

Coping with communication problems in daily life was often difficult. A woman initially found it difficult to talk to people on the phone and in shops and asked others to speak for her instead.

People could learn ways of getting around their problems by using notebooks to write in (although often the ability to write is affected too). Understanding could be helped by asking other people to speak more slowly, to write things down or draw. Some made a point of explaining to others that they had a problem.

One man had been initially been reluctant to tell people that he had a problem but others encouraged him to and he found that people were sympathetic.

Family members reacted differently to people with communication problems and most were very sympathetic and helpful. Family and friends were often the ones to notice that the person's speech or ability to write had changed. Whilst some people preferred not to be told that there had been a change in their speech or writing others were grateful that their friends had been honest. One woman spoke regularly to her father on the phone to practice her speech.

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Children were often very open about a person's communication problems, which one man found refreshing but others found hard to deal with sometimes. One man said that his grandson did not want him to read to him. However, he had been able to involve his grandchildren in word games to help him with his speech.

A few people found it frustrating that they could not engage in conversations about current affairs or other meaningful subjects with their friends and families. One man commented that although he could now have simple exchanges in shops he found anything deeper difficult. He found that his family did not always give him enough time to respond which made it difficult to enter into conversation. Sometimes other people would help out by finishing a word or sentence for people. Whilst some found this helpful others found it annoying and preferred people to be patient.

Reading and writing

Reading and writing could also be affected by stroke. Some people were unable to write because of weakness or paralysis in the upper limbs. Reading and writing could also be affected by damage to the language areas of the brain. Those who had previously read a lot or regularly read a newspaper found it difficult to be reduced to struggling to read even simple children's books. Others found using children's books a helpful way to re-learn reading and writing skills (see 'Stroke recovery: Communication disorders'). One woman wrote letters to her aunt which helped her practice writing with her non-dominant hand.

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Last reviewed June 2017.
Last updated August 2011


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