Stroke

A stroke is caused by a sudden interruption in the blood supply to parts of the brain, preventing adequate provision of oxygen and nutrients to those parts. Strokes can take the form of an haemorrhagic stroke (bleeding on the brain) or an ischemic stroke (a blockage of an artery feeding into the brain).

Given one side of the brain controls the opposite side of the body, a stroke on the right side of the brain may affect control or sensation of the left side of the speech mechanisms (and vice versa). When a stroke occurs on the left side of the brain, this often results in an impairment in language functioning (since this is usually where the "language centre" of the brain is located).

Speech Difficulties following a Stroke

Speech difficulties following a stroke is most often called "dysarthria". This usually results in weakness or imparied control of muscles used for breathing, producing voice, and producing speech. Sometimes, an individual may have difficulty with sequencing and coordination of these same muscles and structures - this is known as "apraxia of speech".

Language Difficulties following a Stroke

A language difficulty following a stroke is known as "aphasia". There are a number of different types of aphasia, but an individual may have difficulty with language expression and/or comprehension, reading, writing, or using numbers. Individuals may have difficulty with music, including reading, performing, or listening to music.

Characteristics of Speech Difficulties

Because speech involves muscles for breathing, and producing voice and speech sounds in a rapid and accurate way, dysarthria or apraxia may cause an individual's speech to sound:

• "slurred" or distorted
• too fast or too slow
• breathy
• hoarse
• harsh or strained
• nasal

Characteristics of Language Difficulties

A stroke may affect an individual's ability to use and understand language in a number of different ways. These may include one or more of the following:

• difficulty understanding what is being said - it may appear as if the person has not heard or misheard you, or it may take them a long time to respond
• difficulty understanding stories, jokes, or general conversation
• difficulty "finding" words, especially people's names or names of places
• difficulty telling stories or holding a conversation
• written and verbal sentences may be "jumbled"
• difficulty reading or understanding what has been read
• difficulty spelling
• repeating a word or phrase over and over again (this may be a real or a nonsense word)

Role of the Speech-Language Therapist

Speech-Language Therapists play an important role in the assessmnt and treatment of communication disorders following a stroke. Some of their tasks may include:

• assessment and diagnosis of speech and/or language difficulties
• liaising with the individual, their family/carers, and the rehabilitation team
• establishing treatment/management plans specifically for the individual
• maximising the person's ability to communicate independently
• referring to other organisations or agencies where appropriate
• advising on the best way to communicate with the person who has had a stroke

What you can do

There are a number of strategies you can use to facilitate communication with individuals who have suffered a stroke. These include:

• provide opportunities for one-to-one conversation
• keep background noise to a minimum
• face the person when speaking to them
• allow the person plenty of time to respond
• avoid speaking quickly
• talk to the person, rather than about them
• accept and encourage all means of communication, including gesture and facial expressions
• find out from your Speech-Language Therapist about the person's communication difficulty and the best way to communicate with them

More Information

For more information about speech and/or language difficulties following a stroke, or to contact a Speech-Language Therapist, contact the following:

• your doctor
• your local District Health Board or hospital
• the Yellow Pages
• Massey University Speech-Language Therapy Clinic: (09) 414 0800 ext 41290 / 41277
• the University of Auckland Speech-Language Therapy Clinics: (09) 303 5979
• the University of Canterbury Speech and Hearing Clinic: (03) 364 2408
• the NZSTA Private Practice Register

For more general information or support, contact:

• the Stroke Foundation of New Zealand

strokenz@stroke.org.nz

0800 78 76 53

http://www.stroke.org.nz/