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Home > Services > Stroke unit > Stroke Therapy: Life after stroke > Communication difficulties

Communication difficulties

Silhouettes of two heads with different coloured question marks going between the two heads

You may find you have communication difficulties following a stroke, this might include aphasia, dysarthria and apraxia of speech.

Aphasia (also called dysphasia)

Aphasia is a language disorder (not intellect) caused by damage to the language centre of the brain.

Important advice:

You may have difficulty with

  • Expressing yourself
  • Understanding what others say
  • Reading
  • Writing

Current figures show there are about 58,000 people living with aphasia in the North East. About a third of all people with stroke will have aphasia. There are 350,000 people living with aphasia in the UK.

Aphasia and understanding

  • You may recognise the words but not always understand what they mean.
  • You may understand short, simple sentences but not understand long conversations or complicated language.
  • You may be able to read words aloud but not understand them.

Aphasia and expression

Image of two speech empty bubbles on a blue background
Important advice:

You may experience

  • Word finding difficulties – you know the word you want to say but are unable to find it.
  • Word errors – you may say words which are similar in meaning, e.g. table for chair, or sound similar, e.g. tat for cat.
  • Jargon speech – you may say some real words but also words/phrases that aren’t real (non-words).
  • Perseveration – you may say the same word or phrase over and over again, instead of the word you want.
  • You may only be able to say the main words, e.g. ‘I home’ instead of ‘I want to go home now’.

Aphasia may make you feel

  • Irritated when the words won’t come out
  • Angry when other people do not understand what you are saying
  • Frustrated when other people speak on your behalf
  • Embarrassed with an altered style of communication
  • Sad due to the loss of language, communication and connection with people

Aphasia can affect

  • Changes in job and social identity
  • Role changes with partner/family members
  • Breakdown in emotional and physical relationships
  • Friendships
  • Anxiety about meeting strangers

Dysarthria

Dysarthria is the disturbance in muscular control of speech.

Important advice:

You may

  • Have difficulty with articulation, pronunciation and voice production.
  • Find your speech is slurred and slow.
  • Find your voice is weak or strained sounding.
  • Have the inability to speak louder than a whisper or speaking too loudly.
  • Have abnormal speech rhythm.

Apraxia of speech (AoS)

Apraxia of speech is difficulty coordinating the lip/tongue muscles used to form words.

Important advice:

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.
  • Say a word the right way once but be unable to say it the next time.
  • Also have aphasia and/or dysarthria.

Tips to help

Help you express yourself
  • Take your time
  • Write it down
  • Draw it
  • Point or gesture
  • Describe what you are trying to say
  • Try not to get frustrated
  • Come back to it later if you can’t get to the word

Help others (expression)
  • Give time
  • Listen carefully
  • Encourage other communication, e.g. writing, drawing, gesture
  • Check things out, especially yes and no
  • Stay calm and relaxed
  • Come back to things later if you can’t work it out.

Tips to help you understand
  • Listen carefully
  • Ask for things to be written down, sometimes key words help
  • Keep a sense of humour
  • Ask people to repeat themselves
  • Ask people to show you what they mean
  • Ask people to break the information into chunks to help you understand

Tips to help others (understanding)
  • Slow down
  • Write key words down
  • Chunk information into small pieces
  • Check they have understood you
  • Don’t assume
  • Be clear – one subject at a time
  • Keep a sense of humour

More resources

Visit our Stroke Services Information page for more information about local services for people with communication difficulties after a stroke in the North East and North Cumbria.