Published:
December 15, 2022
“I can talk just fine,” is something people often say when their doctor recommends they see a speech-language pathologist (SLP) after having a stroke. However, an SLP can evaluate and treat a wide range of problems a stroke patient may experience—not just speech. This includes:
- Swallowing (dysphagia)
- Finding the words you want to say (aphasia)
- Speaking clearly (dysarthria)
- Understanding the words you hear (cognition)
We’re explaining each condition and how speech therapy might help.
Dysphagia: “It went down the wrong way. I cough when I drink water.”
Dysphagia is the medical term used to describe difficulty swallowing. Dysphagia can cause coughing, choking, and foods and liquids “going down the wrong way.” A stroke can cause weakness in the muscles involved in swallowing. It can even make a person unable to safely eat or drink and require a feeding tube.
The severity of dysphagia varies from patient to patient, resulting in different levels of swallowing challenges. An SLP can conduct a Modified Barium Swallow Study and/or a Fiberoptic Endoscopic Evaluation of Swallowing to determine the cause of the swallowing problem; if aspiration is present; and the safest diet level. Aspiration is when foods or liquids enter the airway. If left untreated, it can lead to aspiration pneumonia.
An SLP will make recommendations following the testing which could include:
- Consuming different textures of foods or thickened liquids until swallow function can be improved
- Exercises to strengthen your mouth and/or throat muscles
- Strategies such as a chin tuck—an exercise that increases the space at the back of the throat to make it easier to swallow
- Ways to increase your diet level
Aphasia: “I know what I want to say, but can’t think of the word.”
After a stroke, some people may experience difficulty understanding or using language due to something known as aphasia. The severity of the aphasia varies, as does the type, depending on the location in the brain where the stroke occurred. SLPs will complete an evaluation and determine a treatment plan to include exercises and strategies to help with reading, writing, talking, and understanding language.
Some people experience such severe communication impairments that an augmentative and alternative communication (AAC) device is recommended. This could be a low-tech system, such as a page of patient-specific pictures to indicate someone’s wants and needs. Sometimes a therapist recommends a high-tech system on a device such as a tablet with multiple pages of pictures that can speak the name of the picture or phrase to support a person’s verbal expression. Your SLP may trial several different devices to determine the best communication device for you.
Dysarthria: “My speech sounds slurred. I sound like I’m drunk and I haven’t been drinking.”
Dysarthria is the medical term for weakness or loss of control of the muscles used for speech. Sometimes after a stroke, a person’s speech sounds slurred due to weakness and lack of coordination of the mouth muscles. Following an evaluation, a therapist develops a treatment plan of exercises and strategies to help speech sound clearer.
Cognition: “I just can’t remember things. I can’t do my job.”
Following a stroke, some people may experience difficulty with thinking skills such as orientation, memory, attention, safety awareness, reasoning, and problem solving. They may also have emotional changes, like increased crying or laughing at inappropriate times. And sometime people have trouble with tasks at home or at work that they were able to complete before the stroke.
These people would benefit from an evaluation by an SLP to determine a treatment plan to improve these skills and regain their independence.
The after-effects of a stroke can be scary when you don’t know where to turn for help. Whether you or someone you know needs help with swallowing, speaking clearly, finding the words they want to say, understanding the words they hear, or improving thinking skills, a speech-language pathologist is a great resource.