Communication

We communicate our thoughts, ideas and feelings to others in many ways. We do it with words — spoken or written. We communicate through the use of voice, hand gestures, face and body movements.

After a stroke, communication problems are common, and it can be hard to join in conversations and share your thoughts and feelings. For many people this affects socializing with family and friends because of difficulties in understanding what people are saying and/or saying what you want to say. People may not understand that you know what you want to say and treat you differently.

There are many things that you and your family, friends and caregivers can do to support your communication. Your speech-language pathologist can work with you to develop these strategies.

Aphasia

Expressing yourself

You may find yourself having difficulty saying words; you may use the wrong word or not be able to say sentences. You may say one word when you mean another word, for example saying “yes” when you mean “no”.

Understanding what others say

You may misunderstand what others are saying because the words don’t make sense.

Reading and writing 

You may find that you are unable to read, write, and work with numbers, as well as you once did.

Dysarthria and apraxia of speech

Dysarthria

You may find yourself having slurred speech, which means difficulty producing clear speech sounds, caused by weakened muscles of the face, lips, tongue and vocal cords.

Apraxia of speech

If you have poor coordination of the muscles responsible for speech, this may cause your speech to sound jumbled or you may make mistakes in pronunciation.

Communication challenges can be mild or severe, depending on your stroke. They may be temporary and improve quickly. For some people, they are long-lasting or permanent. It can be very frustrating to not be able to communicate easily and accurately.

Your first goal may be to find a way to communicate with your family and team. Right after the stroke, you may need to use other forms of communication such as picture boards, hand signals, or using a pencil and paper to draw or write words. The speech language pathologist on your team can work with you to develop a plan so that you can participate in conversations and communicate, as best as you can.

Try to let people know how you feel. Make sure they know you are still able to join in conversations in your own way. Get those closest to you to read this section. This will help them understand what you are experiencing and give them ideas for how to communicate with you.

The Aphasia Institute has more information and tools to help with communication.

Strategies for communicating

Find out what part of your communication is affected. The therapist on your healthcare team who can help you with communication is called a speech language pathologist (SLP). If you are not seeing one, get a referral.

Your therapist will help identify what type of communication and speech problem you have. Then they will develop a plan to help you regain communication skills. Here are some areas they may work on:

• improved understanding in conversation — asking you to match pictures to a spoken phrase
• improved ability to use the right words — asking you to name things you see in pictures
• improved ability to read — working with you to read a short paragraph and answer questions about it
• improved ability to write — practicing skills needed to write
• improved ability to speak clearly — exercises to strengthen the muscles involved in speech.

Make a plan with your therapist. They can show you how to practice to improve your communication skills. Make sure your family and friends know about your plan and how they can help you communicate with them.

Tips for staying connected

Here are some strategies that people with aphasia use to communicate:

• Focus on one task. Don’t try to multi-task.
• Write things down before saying them. Try using short written notes. Keep a pencil and paper handy.
• Try using flashcards with keywords and pictures, like TOOTHBRUSH.
• When people communicate with you in writing, they should use markers that make it easy for you to see the words.
• Use Scrabble™ tiles to spell out words.
• Not able to write? Try gestures, hand signals and simple picture boards to point at.
• If you have trouble finding words, try looking around to find clues from your environment.
• Computers and smartphones have apps to help with aphasia.

Tips for family and friends

• get the person’s attention
• speak slowly and clearly
• give one idea at a time
• use yes or no questions
• avoid open-ended questions. Instead of asking, “What would you like to drink?” ask, “Would you like tea or coffee?” Ask “Can you show me?” Gesture or point to an item
• repeat or re-word sentences.
• write down your message with a black marker 
• don’t interrupt
• pay attention to body language
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Related information

Speech language pathologists are the team members who specialize in helping you communicate.

Check if there are aphasia support groups that meet in your community.

The Aphasia Institute has more information and tools to help with communication.

Aphasia video series – four practical post-stroke tutorials.

Swallowing and communication after stroke (video)

Practical communication skills after stroke (video)

Virtual meetups for people with aphasia