Stroke rehabilitation in speech therapy for communication difficulties

Communication difficulties are very common after a stroke. This factsheet explains how stroke affects your communication and how speech therapy can help in your recovery.

How does stroke affect my communication?

There are specific areas of our brain that controls our speech and communication. If these parts of the brain are affected by a stroke, it can be difficult to:

These challenges may affect the way you communicate with the people around you. For example, it may take longer for others to understand what you wish to express.

What are the types of communication difficulties?

Depending on the parts of the brain affected, you may have one or more communication difficulties.

Common difficulties include:

Dysarthria is a difficulty with speech production. It is due to muscle weakness or incoordination. You may sound unclear. People might not understand your message.

Aphasia is a language disorder. It affects speaking, listening, and the ability to read or write. 

This can include difficulties:
1. finding the right words to say
2. forming sentences
3. or understanding what you hear or read.

Dysphonia is a difficulty with producing a clear voice. The voice may sound strained, breathy or hoarse. It can be difficult to control their voice. 

Apraxia of speech is a speech disorder. It affects the planning of muscle movement used for speech (e.g. tongues, lips, jaw). The speech muscles cannot move correctly at the required timing. Therefore, saying words can be effortful.

How can Speech Therapy help?

Speech therapy includes the assessment and treatment of communication difficulties. 

The speech therapist will assess and work with you to customize treatment according to your needs and goals.

Speech therapy can help improve communication and facilitate better interaction by:

• Retraining your speech and language functions
• Teaching you specific communication strategies
• Developing alternative ways of communication such as gesturing or using communication charts or devices
• Training a loved one or caregiver to support your communication at home

Where will I have Speech Therapy?

If you are observed by the medical team to be having difficulties with communication, you may be referred to a Speech Therapist at the acute hospital or community hospital.

After your discharge, therapy may continue in the hospital outpatient clinics, in the community, or with home-based therapy services. You should discuss with your speech therapist to determine the most suitable option for you.

What are my chances of recovery?

Recovery from any communication problems is variable and often takes weeks to months. 

Your active participation is vital to the rehabilitation process. With regular practice and a supportive network of family and friends, the speech therapist will be able to work with you to develop ways for you to meet your communication needs.

Tips for recovery

• Actively participate in speech therapy
• Get your family and friends to attend therapy sessions together with you so they can also learn strategies to help you communicate better
• Take every opportunity you can to practice communicating with others
• Keep your speech simple by using keywords or short sentences
• Ask one question at a time
• Indicate to others when you do not understand
• Use gestures or drawing to help support your communication where necessary
• Join and participate in therapy groups available in the community

Where can I get support? 

	Singapore National Stroke Association (SNSA) organises stroke clubs about once every two months.   Stroke clubs are a platform for stroke survivors and their caregivers to meet, support and learn from invited speakers on topics relevant to them, such as dysphasia.
Website: www.snsasg.org Email: contact@snsa.org.sg Hotline: +65 8125 1446
	Aphasia SG is a not-for-profit organisation supporting persons with aphasia and their caregivers.   Aphasia SG runs various programmes to provide opportunities for supported conversations, social interaction and singing in aphasia-friendly environments.
Website: www.aphasia.sg

Article available in Chinese, Malay and Tamil. 

For more information on how to better manage your stroke recovery journey, visit Stroke E-Resources.

StrokeHub Video: 

Speech Therapy (Extended Version) 

Speech Therapy