Strokes and Communication – Aphasia

Hold on to your hats! We’re doing a crash course in communication-related problems following a stroke!

Following a stroke, a person will experience any number of difficulties and deficits, some more severe than others. Strokes can cause physical, cognitive, behavioral, and communication and swallowing issues. For the sake of time (and for the sake of my readers’ time), I’m going to stick with talking about symptoms related to communication.

Aphasia is a common language disorder that arises following a stroke. Aphasia, in the most basic sense, is an impairment in any and all areas of language – speaking, listening, reading, and writing. Depending on where the injury is in the brain, the amount of damage incurred by the stroke, and a whole host of other factors, symptoms and severity can vary.

Sometimes aphasia is classified by fluent (can speak, might not make sense) or non-fluent (halting or no speech) or Broca’s or Wernicke’s aphasia. For the purposes of this blog post, though, I’m just going to talk about the impairments that can occur in each of the areas of language mentioned above.


In some forms of aphasia, people may be completely “fluent,” meaning that they can speak just fine, though the content of their speech might be nonsensical. Here’s a good video example. Others may have difficulty speaking, or may not speak at all. For those with difficulty, they may have word finding issues (anomia), substitute words, or drop out words completely. Here is a good video example. Depending on where the stroke occurred in the brain and the extent of physical impairments, a person’s speech might be very difficult to understand due to nerve damage.

Listening Comprehension

Comprehension of spoken language can be really impacted by a stroke. Some people may not comprehend anything that is said to them. As a result, it can be really difficult for the person to answer questions, even simple yes/no or basic information questions. Sometimes, (like in the video above), the person may lack awareness of their deficits because their comprehension is so impacted.

Reading Comprehension

 A writing example from a patient with Broca’s aphasia (non-fluent). Example was found from this  presentation .
A writing example from a patient with Broca’s aphasia (non-fluent). Example was found from this presentation .

Reading comprehension deficits are somewhat similar to listening comprehension. Following a stroke, a person may not recognize words or might substitute them for another word. The individual might not understand the material they read or may need significant time to process the information. Some people may lose their ability to read at all. Depending on the extent of the injury, the person’s vision may be impacted, which can impact reading comprehension.


Overall, writing impairments following a stroke are similar to the person’s spoken language. Visual and physical impairments might affect the person’s overall ability to write and copy letters and numbers. Sentences might lack grammatical structure or miss words altogether. They might be completely non-sensical or run-on. Depending on the severity of the injury, the person may not be able to write at all.


This is why speech-language pathologists are a part of the rehabilitation team for patients following a stroke. We work with the patient and their families to help retrain the brain and recover skills to the best potential. These speech-language pathologists work in hospitals for care directly after the stroke. Others work in rehabilitation facilities, home health care, and private practice. They work closely with the family to help teach tips for care giving and to provide ideas for compensatory strategies.

Questions? Your friendly, neighborhood SLP is here to help!

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