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Regaining language skills after a stroke: Will speech therapy help?

The Bottom Line

  • Approximately one third of people who have a stroke develop aphasia: difficulties with language and communication that can include speaking, understanding, reading and writing.
  • Speech language therapy can help speed up the process of recovery.
  • ‘Higher intensity’ speech language therapy (more and longer sessions) are more likely to lead to greater and faster improvements.
  • Be proactive with the details of your recovery plan: find out if speech language therapy is available to you and options for financial assistance.

Having a stroke can be a traumatic experience. We know that time is of the essence when it comes to getting to the hospital for treatment. But for many people, recovery from the initial event is just the beginning of a longer period of recovery and rehabilitation to restore lost function caused by the stroke.


For at least one third of all people who suffer a stroke, recovery includes problems with communication (1). “Aphasia” is the term for language difficulties – including trouble speaking, listening and understanding, reading and writing – that often result from a stroke. Some or all communication skills may be affected and to varying degrees (2). For patients and their loved ones, it can add another layer of frustration and anxiety to an already difficult situation.


Fortunately, most people recover language and communication skills, though the rate at which they regain abilities – and whether they make a full recovery – varies depending on the individual. For some, it’s a slow and uncertain climb and anything that might help the process is welcome. Speech language therapy is a recommended option.


“If any stroke patient is showing signs of aphasia, speech language therapy should be included in their recovery plan according to the Canadian Stroke Best Practices,” says Dr. Patrice Lindsay, Director of Stroke, Heart & Stroke. “If not treated properly, aphasia can have a negative impact on a patient’s overall recovery, for example, they may become socially isolated. This may affect their desire and ability to actively participate in the rehabilitation process.”


But what does the research say about speech language therapy. Does it really work?


One recent systematic review examined the results of 57 randomized controlled trials involving more than 3,000 people with aphasia (3). In about half of the studies, participants who were offered speech language therapy were compared with control groups who received no specialized or formal language assistance. Other studies compared speech language therapy with social support or stimulation (i.e. opportunities to practice communication skills but not in a structured, standardized way) or compared different types and intensities of speech language therapy.


What the research tells us

Research evidence shows that speech language therapy is an effective way to improve language and communication skills after a stroke (3). It’s clearly better than no therapy at all but comparisons to other approaches like social support and stimulation were hard to make since many study participants withdrew early from the less structured programs.


The evidence also suggested that “higher intensity” speech language therapy, for example more sessions and/or for a longer duration, can contribute to greater and/or faster improvements.


While speech language therapy is a valuable part of stroke recovery, some people may not have easy access to Speech Language Pathologists, particularly outside urban areas and – depending on where you live and your healthcare plan – costs may not be covered. Be proactive about your stroke recovery plan: find out if speech language therapy is available to you and options for financial assistance.


Stroke recovery involves patience, perseverance and understanding on the part of the person affected as well as family and friends. In the meantime, it’s important to keep those lines of communication open, even if aphasia makes it more challenging.



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References

  1. Engelter ST, Gostynski M, Papa S et al. Epidemiology of aphasia attributable to first ischemic stroke: Incidence, severit, fluency, etiology, and thrombolysis. Stroke. 2006; 37(6):1379-1384.                                   
  2. Stroke Recovery Association of British Columbia. Aphasia (speech). [Internet] 2013. [cited March 2017]. Available from http://strokerecoverybc.ca/recovering-from-a-stroke/information/aphasia-speech/
  3. Brady MC, Kelly H, Godwin J et al. Speech and language therapy for aphasia following stroke. Cochrane Database of Syst Rev. 2016; Issue 6. Art. No.: CD000425. doi: 10.1002/14651858.CD000425.pub4.

DISCLAIMER: The blogs are provided for informational purposes only. They are not a substitute for advice from your own healthcare professionals.

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