Speech Therapy: Addressing Difficulties Following a Stroke

By Denise Stryker, MA, CCC-SLP/L, Speech Language Pathologist and Sherri Repsher, MS, CCC-SLP/L, Speech Language Pathologist, Clinical Supervisor

One of the most frustrating aspects of suffering a stroke is recovering the ability to communicate. To some patients, who may see more rapid recovery in other areas, the process can seem daunting. Here at Good Shepherd, our speech language pathologists are experts in helping stroke patients reach their full potential to recover from a variety of speech-related problems following a stroke, as follows:
Often a stroke survivor will suffer injury to the language areas of the brain, which may leave them with aphasia. A person can suffer from expressive aphasia (decreased ability to produce language), receptive aphasia (decreased ability to understand language) or both. When either of these impairments occur, speech language therapy will be an integral part of the rehabilitation process. 
Apraxia and Dysarthria
Apraxia and dysarthria are disorders of the motor skills of speech, not language. These disorders can occur independently or along with aphasia.
Apraxia of speech affects the voluntary production of speech movements and is not related to muscle weakness. The patient may have inconsistent production of speech or imprecise ability to produce sounds.
Dysarthria is a disorder that is caused by the decreased strength or paralysis of the speech muscles (lips, tongue, cheeks, soft palate). Speech may become less clear with possible changes in pitch, loudness and/or timing.  
Dysphagia is defined as difficulty swallowing. After a stroke, a person may have difficulty chewing food, moving food from the front to the back of his or her mouth, delayed timing of the swallow initiation, food/liquid sticking in the throat, penetration of food/liquid into the airway and/or aspiration with food/liquid into the lungs. A speech therapist will determine the appropriate diet in which the patient can swallow safely and work with the patient to improve swallowing strength.
Cognitive/Communicative Disorders
In addition to speech/language disorders and swallowing disorders, a stroke survivor may have a cognitive/communicative disorder, which could affect: concentration, orientation, insight, initiation, processing, long-term or short-term memory, numerical reasoning, problem solving, verbal/written expression, social skills, time management, thought organization, reading and/or auditory comprehension. During a therapy program, a patient can learn and practice strategies to compensate in order to improve daily function.
Tips for Patients and Caregivers
Stroke rehabilitation is the process in which a stroke survivor works with a team of health care professionals to regain as much function as possible. The goal of speech language therapy is to help patients communicate and use language again. Therapists can teach stroke survivors, and their families, techniques and treatment methods to regain as much function as possible.
Here are some tips that can help:
  • Speak slowly
  • Speak in simple sentences
  • Use language/vocabulary that is familiar to the patient
  • Repeat information as often as needed
  • Give the patient time to understand and to respond
  •  Use gestures, or write down key words if the patient doesn’t understand words
  • Ask yes/no questions
  •  Encourage the patient to gesture, draw or write words that he/she can’t say
  •  Give the patient written or verbal choices
  • Try to understand that jargon/made-up words hold meaning for the patient
  •  Do not speak for the patient
  • Keep the patient informed and involved in any decision that may need to be made. Do not speak as if the patient is not there. 
  • Remember that speech-related disorders have not changed the person’s intelligence, only his or her ability to communicate
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