Communication Deficits after Stroke

Aphasia and Apraxia are among common communication deficits resulting from a stroke. Other post-stroke communication deficits may include decreased attention, distractibility, inability to understand the emotional context of a message and the inability to understand body language. The location of the stroke decides how an individual’s ability to comprehend or process language will be affected.

Aphasia, which results from the damage to the left side of the brain (the area responsible for language) make it hard for stroke survivors to understand written or spoken language, read or write, or express their own thoughts. On the other side, due to Apraxia, the stroke survivor faces difficulty with the motor planning to perform tasks or movements when asked, even if the command is understood and the patient is willing to perform the task.

Dysarthria (weakness or paralysis in the muscles used for speaking) and Dysphonia (weakness or paralysis in the muscles in and around the vocal chords) often complement stroke-led communication impairments. Dysphagia, the difficulty or discomfort in swallowing (common in stroke patients) may enhance such communication challenges.

Apart from speech, communication problems can negatively affect an individual’s reading and writing abilities. The treatment approach for stroke-led communication deficits can be either restorative (aimed at improving or restoring impaired function) or compensatory (aimed at compensating for deficits). Treatment selection depends on a number of factors, including stroke severity, communication needs of the stroke survivor, and presence and severity of associated language deficits or any progressive neurological diseases. Treatment may include a combination of techniques to restore function, compensate for deficits, and educate the stroke survivor about the disorder.

Options to treat Communication Deficits after Stroke

People with stroke-led cognitive-communication disorders often benefit from personalized treatment by a speech pathologist. A speech pathologist assesses the stroke survivor’s talking, listening, reading, writing and understanding competency to suggest ways to communicate more easily and aids (such as voice amplifier) that can help.

If the victim has Apraxia, treatment will focus on helping his muscles to work together for making accurate sounds and improving the speed and rhythm of the speech. In case the patient is suffering from Dysarthria, he may do exercises to improve the strength and coordination of his speech muscles. He may practice speaking slowly or loudly and exaggerate his speech.

Interventions such as Multiple Input Phoneme Therapy (appropriate for individuals with severe apraxia of speech), Script Training and Sound Production Treatment (SPT) use exercises or software to retrain discrete cognitive processes such as attention. Certain Sensory Cueing and Visual Cueing techniques can also be useful to teach the right movement or sequence for speech.