Speech and language difficulties following a Stroke

A stroke occurs when there is a clot in the bloodstream in the brain or following a bleed in the brain.  Both result in brain damage that can cause speech and language difficulties.  Hemiparesis is also a common after effect of stroke.  Some people undergo a change in personality.  See the Stroke Associatio’n’s website for up to date information on stroke and how to make lifestyle changes to cut down your chances of having one. The severity of speech and language difficulties following a stroke depends on the area of the brain affected.  If the stroke is in the left side of the brain speech and language difficulties are likely.  Paresis of the right side of the body will usually occur as well.    

What type of speech and language difficulties to expect after a stroke

Spoken language (expressive) and understanding of language can be expected following a stroke.  Spoken language problems can occur with or without understanding problems.  A common misconception is that people who have had strokes understand everything that is said to them but just can not talk.  This is not the case.  In the early days after a stroke people are often able to mask their lack of understanding by copying facial expressions of the people speaking or by using situational understanding.  Situational understanding can be explained using the following example:

A person who has just had a stroke is asked if they would like a cup of tea.  The person responds in a positive way.  Everyone thinks that the person has understood the question.  However the person asking the questions was holding a cup of tea at the time and offering it the stroke survivor.  The stroke survivor did not need to understand anything just take the cup. 

 

That is just one example of many…..When speaking to someone with language difficulties try to use gesture and pictures to help them understand.  Try not to give too much information at any one time, using short sentences and emphasising the key words.  Also give the person plenty of time to respond. 

 

Spoken language problems can range from dysarthria, where speech is slurred due to facial muscle weakness to only being able to use jargon.  Dysarthria is treated by doing exercises for the facial, tongue and lip muscles to strengthen them.  This improves the clarity of speech.

 

For problems like dyspraxia the person will be given exercises by the speech therapist to retrain the motor programme so that words are produced correctly.  If the person has word finding difficulties techniques such as using the first sound of a word, the written first letter, or the meaning of the word can be used to help access the word.

 

If there are problems with sentence structure the speech and language therapist will carry out assessment to find out where the problem is and then provide a programme of work specifically for this.

 

There are other speech and language problems that can occur following a stroke and we will be adding information over the coming weeks.  The Stroke Association has a lot of information on it and is very useful.

 

Following  a stroke speech and language intervention can be extremely useful.  It can either come in the form of a swallow assessment and/or assessment of communication skills.  After discharge from hospital most people will require on going support.  Most NHS speech and language therapy departments have long waiting list and are only able to offer weekly appointments.  Current research shows that intensive speech and language intervention is of most benefit to try and recover function.  It should be noted that in some cases people will not recover to how they were before the stroke.  In these cases the speech and language therapist will help manage the problem as opposed to cure it.

 

If you would like private speech and language therapy please contact us at sltconsultancy@gmail.com