Speech Trouble After Brain Damage or Stroke?

By AASLMay 28, 2018


A person with aphasia can have problems speaking, reading, understanding, or writing. Speech-language pathologists can help.

What is Aphasia?

Aphasia is a language disorder. It typically happens when someone experiences brain damage, due to an injury, stroke or another cause.  The brain has the left half and the right half, and in most people, the left half of the brain is responsible for language skills. Damage on this side can lead to language problems.

Someone with aphasia may find it hard to understand, speak, read, or write, but it doesn’t make a person less intelligent or less able to think. Someone with aphasia from brain damage can experience other problems like muscle weakness in the mouth, called dysarthria. If you have dysarthria, you may have trouble getting the muscles of your mouth to move the right way to say words, called apraxia. You can also have swallowing problems, called dysphagia.

Aphasia Signs

Aphasia can lead to a number of different problems. You may have trouble talking, understanding, reading, and writing.


You may find that, when you’re talking, you:

  • Can’t think of the words you’re trying to say.
  • Say the incorrect words, like “fish,” when you mean “chicken.” You may also say a word that does not make much sense, like “radio” for “ball.”
  • Mix up sounds in words like, for example, saying “wish dasher” for “dishwasher.”
  • Use made-up/nonsense words
  • Have difficulty saying sentences and prefer saying single words
  • Combine made-up words and real words into sentences that do not make sense


You may:

  • Not be able to understand what others say, especially when they speak fast
  • Have more difficulty with longer sentences
  • Be unable to understand what others say with background noise
  • Have trouble understanding jokes.

Reading and Writing

You may have difficulty with the following:

  • Reading forms, books, and computer screens.
  • Spelling and forming sentences
  • Doing math or using numbers  – for example, telling time, counting money or doing arithmetic


Aphasia is often caused by stroke, but any type of brain damage can cause aphasia. This includes brain tumors, traumatic brain injury, and brain disorders that get worse over time.

Aphasia Testing

If you or a loved one has trouble speaking or understanding what people say, see a doctor…or bring your loved one to see a doctor. Doctors will be able to tell if there’s a medical cause for your problem. A speech-language pathologist, or SLP, will test your speech and language skills, and ask you about your problems and your goals.  The SLP will test how well you:

  • Understand words, directions, stories and questions,
  • Say words and sentences, name objects, describe pictures, and answer questions.
  • Read and write – specifically write letters, words, and sentences. You will probably be asked to read short stories and answer questions about them too,
  • Find different ways to share your thoughts when you have trouble talking – for example, pointing or using other gestures and drawing pictures.


There are many ways to work on your language. The type of treatment you receive depends on what you need and what your goals are. You may work with an SLP on your own or in a small group, and you may want your family or loved ones to be a part of your treatment. If your family is involved, they can help you use the skills you learn with the SLP at home. You may also join a support for social activities.

If you’re multilingual, you may find speaking easier in one language and have more trouble in the other…or you may have difficulty in both. If you speak multiple languages, you should work with an SLP who speaks those languages too.

In severe cases, someone with Aphasia you need to find non-verbal ways to communicate.  These may include simple hand gestures, writing, pointing to letters or pictures, or using a computer. This is augmentative and alternative communication, or AAC.

If returning to work or school is your goal, your SLP can help you get ready to do that. You may need to change how you do your work or may need equipment to help you communicate. Your SLP can also work with your boss or teachers to make these changes.

See ASHA information for professionals on the Practice Portal’sAphasia page.

Tips For Communicating With a Person Who Has Aphasia

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