We communicate our thoughts, ideas and feelings to others in many ways. We do it with words — spoken or written. We communicate through the use of voice, hand gestures, face and body movements.

My biggest frustration today is knowing what I want to say and not being able to say it, I now need a script or notes to communicate, I can't be spontaneous.


After a stroke, communication problems are common. You may find yourself using the wrong word or not able to create sentences. Or you may repeat yourself. You may misunderstand what people are saying. You may find that you are unable to read and write. Aphasia is the term given to these problems with communication.

You may also find yourself having slurred speech. Dysarthria is the term given to this problem with speech.


There are two types of aphasia:

Expressive aphasia

You know what you want to say but the words come out wrong. The words may:

  • be jumbled
  • not make sense
  • be totally different from the words you wanted to say.

Receptive aphasia

  • You can hear spoken words and see written words, but have a hard time knowing what they mean.
  • You may also take word meanings very literally and be unable to understand some forms of humour.

Some people with stroke may have both expressive and receptive aphasia. Either type makes it hard to read, write, work with numbers, join in conversation, or share thoughts and feelings.

Aphasia can be mild or severe, depending on your stroke. It may be temporary and improve quickly. For some people, it is long-lasting or permanent.

Aphasia can be very frustrating. You may find it hard to enjoy time with family and friends, or even to ask for what you want or need. You may find that some people treat you differently.

Try to let people know how you feel. Make sure they know you are still able to join in conversations in your own way. Get those closest to you to read this section. This will help them understand what you are experiencing and give them ideas for how to communicate with you.

Your first goal may be to find a way to communicate with your family and team. Right after the stroke, you may need to use other forms of communication such as picture boards, hand signals, or using a pencil and paper to draw or write words.

The Aphasia Institute has more information and tools to help with communication.

Strategies for communicating

Find out what part of your communication is affected. The therapist on your healthcare team who can help you with communication is called a speech language pathologist. If you are not seeing one, get a referral.

Your therapist will help identify what type of communication and speech problem you have. Then they will develop a plan to help you regain communication skills. Here are some areas they may work on:

  • improved understanding in conversation — asking you to match pictures to a spoken phrase
  • improved ability to use the right words — asking you to name things you see in pictures
  • improved ability to read — working with you to read a short paragraph and answer questions about it
  • improved ability to write — practicing skills needed to write
  • improved ability to speak clearly — exercises to strengthen the muscles involved in speech.

Make a plan with your therapist. They can show you how to practice to improve your communication skills. Make sure your family and friends know about your plan and how they can help you communicate with them.

Tips for staying connected
  • Here are some strategies that people with aphasia use to communicate:
  • Focus on one task. Don’t try to multi-task.
  • Write things down before saying them. Try using short written notes. Keep a pencil and paper handy.
  • Try using flashcards with keywords and pictures, like TOOTHBRUSH.
  • When people communicate with you in writing, they should use markers that make it easy for you to see the words. When you are writing, using a pencil is easiest.
  • Use Scrabble™ tiles to spell out words.
  • Not able to write? Try gestures, hand signals and simple picture boards to point at.
  • If you have trouble finding words, try looking around to find clues from your environment.
  • Computers and smartphones have apps to help with aphasia. They speak words that are typed. Or they may help you find the name of an object.
<p>1. Using flashcards can help </p>
<p>2. Use Scrabble tiles to spell out words</p>

1. Using flashcards can help

2. Use Scrabble tiles to spell out words


Tips for family and friends
  • get the person’s attention
  • speak slowly and clearly
  • give one idea at a time
  • use yes or no questions
  • avoid open-ended questions. Instead of asking, “What would you like to drink?” ask, “Would you like tea or coffee?” Ask “Can you show me?” Gesture or point to an item
  • repeat or re-word sentences.
  • write down your message with a black marker 
  • don’t interrupt
  • pay attention to body language

At work, people often bombard me with things to do for them, it sends my stress level through the roof, even today. Let me do it my way at my own pace.


Related information

Speech language pathologists are the team members who specialize in helping you communicate.

Check if there are aphasia support groups that meet in your community.

The Aphasia Institute has more information and tools to help with communication.

Aphasia video series – four practical post-stroke tutorials.

Watch a short animation about communication after a stroke.

Practical communication skills after stroke(video)

Virtual meetups for people with aphasia