Communication problems are very common after a stroke. Around one-third of stroke survivors have problems with speaking, reading, writing and understanding what other people say to them.
When we communicate, our brain has to complete a series of tasks. Different parts of our brains are responsible for each of these tasks. If one of these parts is damaged by a stroke, it can cause problems with communication.
What kind of communication problems do people have?
- Aphasia affects your ability to speak and understand what others say. It can also affect your ability to read and write. It happens when you’re no longer able to understand or use language. Aphasia is a common problem after stroke and around a third of stroke survivors have it.
- Dysarthria happens when you’re not able to control the muscles in your face, mouth and throat very well, so it's difficult to speak clearly. This can mean that your speech becomes slurred or slow or that your voice sounds quiet.
- Apraxia of speech is when you can’t move the muscles in your face, mouth or throat in the order you need to when you’re speaking. This can make it difficult for other people to understand you.
Although some people assume that they do, communication problems do not affect your intelligence. If you have communication problems you simply have problems with the process of speaking and understanding language.
Most communication problems do improve, but it’s difficult to predict how much they’ll improve or how long it will take, as it’s different for everyone. Problems tend to be worse in the first few weeks and will improve quite quickly within the first three to six months. However, people continue to recover for months and even years after this.
For most people, getting better is about returning to the way they were before their stroke. Being able to speak again is particularly important for a lot of people.
But even if you don’t recover completely, there are many ways to communicate that don’t rely on speaking. Lots of stroke survivors continue to live full and happy lives, even though they still have problems with communication.
Are there treatments that can help?
Communication problems can be treated using speech and language therapy.
A speech and language therapist can help you to improve your speech, reading and writing as much as possible.
They can also help you to learn other ways to communicate. These are known as compensation or coping strategies. They include anything from gestures to electronic devices – anything that can help you get across what you want to say.
If you have communication problems you should be referred to a speech and language therapist for an assessment whilst you’re in the hospital. Using the results of the assessment, the therapist will set up regular sessions to work with you. This may start in the hospital, or be arranged for when you return home.
Speech and language therapy isn’t just about the time you spend with your therapist. Your communication will only improve with practice, so the work you put in outside of your therapy sessions is just as important.
Physically and mentally and verbally, you need to just practise and practise and practise.
Where can I get further information and advice?
Afasic
Supports children and young adults with a communication disability, as well as their parents and the professionals working with them. Has a network of support groups, publications, training and online message boards.
Aphasia software finder
This website has information about software programs and apps for people with aphasia in the English language.
Association of Speech and Language Therapists in Independent Practice (ASLTIP)
Allows you to search for a local speech and language therapist within the UK. Also offers useful resources, materials and therapeutic ideas for people with aphasia.
Aphasia Alliance
Offers information, top tips and useful resources. The website also provides links to UK aphasia organisations.
By Jamie Eske on March 21, 2019
- Overview
- Types
- Symptoms
- Causes
- Diagnosis
- Treatment
- Summary
Speech is the process of producing specific sounds that convey meaning to the listener. A speech disorder refers to any condition that affects a person’s ability to produce sounds that create words.
Speech is one of the main ways in which people communicate their thoughts, feelings, and ideas with others. The act of speaking requires the precise coordination of multiple body parts, including the head, neck, chest, and abdomen.
In this article, we explore what speech disorders are and the different types. We also cover the symptoms, causes, diagnosis, and treatment of speech disorders.
Share on PinterestA speech disorder is not the same as a language disorder.
Speech disorders affect a person’s ability to form the sounds that allow them to communicate with other people. They are not the same as language disorders.
Speech disorders prevent people from forming correct speech sounds, while language disorders affect a person’s ability to learn words or understand what others say to them.
However, both speech and language disorders can make it more difficult for a person to express their thoughts and feelings to others.
Speech disorders can affect people of all ages.
Some types of speech disorder include stuttering, apraxia, and dysarthria. We discuss each of these types below:
Stuttering
Stuttering refers to a speech disorder that interrupts the flow of speech. People who stutter can experience the following types of disruption:
- Repetitions occur when people involuntarily repeat sounds, vowels, or words.
- Blocks happen when people know what they want to say but have difficulty making the necessary speech sounds. Blocks may cause someone to feel as though their words are stuck.
- Prolongations refer to the stretching or drawing out of particular sounds or words.
The symptoms of stuttering can vary depending on the situation. Stress, excitement, or frustration can cause stuttering to become more severe. Some people may also find that certain words or sounds can make a stutter more pronounced.
Stuttering can cause both behavioral and physical symptoms that occur at the same time. These can include:
- tension in the face and shoulders
- rapid blinking
- lip tremors
- clenched fists
- sudden head movements
There are two main types of stuttering:
- Developmental stuttering affects young children who are still learning speech and language skills. Genetic factors significantly increase a person’s likelihood of developing this type of stutter.
- Neurogenic stuttering occurs when damage to the brain prevents proper coordination between the different regions of the brain that play a role in speech.
Apraxia
The brain controls every single action that people make, including speaking. Most of the brain’s involvement in speech is unconscious and automatic.
When someone decides to speak, the brain sends signals to the different structures of the body that work together to produce speech. The brain instructs these structures how and when to move to form the appropriate sounds.
For example, these speech signals open or close the vocal cords, move the tongue and shape the lips, and control the movement of air through the throat and mouth.
Apraxia is a general term referring to brain damage that impairs a person’s motor skills, and it can affect any part of the body. Apraxia of speech, or verbal apraxia, refers specifically to the impairment of motor skills that affect an individual’s ability to form the sounds of speech correctly, even when they know which words they want to say.
Dysarthria
Dysarthria occurs when damage to the brain causes muscle weakness in a person’s face, lips, tongue, throat, or chest. Muscle weakness in these parts of the body can make speaking very difficult.
People who have dysarthria may experience the following symptoms:
- slurred speech
- mumbling
- speaking too slowly or too quickly
- soft or quiet speech
- difficulty moving the mouth or tongue
Share on PinterestSymptoms of a speech disorder can include repeating or prolonging sounds, rearranging syllables, and speaking very softly.
The symptoms of speech disorders vary widely depending on the cause and severity of the disorder. People can develop multiple speech disorders with different symptoms.
People with one or more speech disorders may experience the following symptoms:
- repeating or prolonging sounds
- distorting sounds
- adding sounds or syllables to words
- rearranging syllables
- having difficulty pronouncing words correctly
- struggling to say the correct word or sound
- speaking with a hoarse or raspy voice
- speaking very softly
A speech-language pathologist (SLP) is a healthcare professional who specializes in speech and language disorders.
An SLP will evaluate a person for groups of symptoms that indicate one type of speech disorder. To make an accurate diagnosis, SLPs need to rule out other speech and language disorders and medical conditions.
An SLP will review a person’s medical and family history. They will also examine how a person moves their lips, jaw, and tongue and may inspect the muscles of the mouth and throat.
Other methods of evaluating speech disorders include:
- Denver articulation screening examination. This test evaluates the clarity of a person’s pronunciation.
- Prosody-voice screening profile. SLPs use this test to examine multiple aspects of a person’s speech, including pitch, phrasing, speech patterns, and speaking volume.
- Dynamic evaluation of motor speech skills (DEMSS) manual. The DEMSS is a comprehensive guide for helping SLPs diagnose speech disorders.
The type of treatment will typically depend on the severity of the speech disorder and its underlying cause.
Treatment options can include:
- speech therapy exercises that focus on building familiarity with certain words or sounds
- physical exercises that focus on strengthening the muscles that produce speech sounds
We discuss some of the treatment options for speech disorders below:
Target selection
Target selection involves a person practicing specific sounds or words to familiarize themselves with particular speech patterns. Examples of therapy targets may include difficult words or sounds that trigger speech disruptions.
Contextual utilization
For this approach, SLPs teach people to recognize speech sounds in different syllable-based contexts.
Contrast therapy
Contrast therapy involves saying word pairs that contain one or more different speech sounds. An example word pair might be “beat” and “feet” or “dough” and “show.”
Oral-motor therapy
The oral-motor therapy approach focuses on improving muscle strength, motor control, and breath control. These exercises can help people develop fluency, which produces smoother speech that sounds more natural.
Ear device
Ear devices are small electronic aids that fit inside the ear canal. These devices can help improve fluency in people who have a stutter.
Some ear devices replay altered versions of the wearer’s voice to make it seem as though someone else is speaking with them. Other ear devices produce a noise that helps control stuttering.
Medication
Some speech disorders can cause people to develop anxiety disorders. Stressful situations can trigger anxiety, resulting in more pronounced speech disorder symptoms. Anxiety medications may help reduce symptoms of speech disorders in some people.
Speech disorders affect a person’s ability to produce sounds that create words. They are not the same as language disorders, which make it more difficult for people to learn words or understand what others are saying to them.
Types of speech disorder include stuttering, apraxia, and dysarthria. There are many possible causes of speech disorders, including muscles weakness, brain injuries, degenerative diseases, autism, and hearing loss.
Speech disorders can affect a person’s self-esteem and their overall quality of life. However, speech therapy, breathing exercises, and, sometimes, anti-anxiety medications can help improve speech and reduce symptoms.