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When Someone Can’t Talk After Stroke, Singing Therapy Helps

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If someone cannot speak after a stroke, they may have suffered a severe speech impairment as a result of the aftermath of the stroke. The inability to speak requires special treatment techniques in speech therapy, but the good news is that there is still hope for recovery.

Some types of speech therapy are only effective if you already have speech skills, but there are rehabilitation methods for people who can’t speak after a stroke. Before we go into detail, it’s important to understand the cause of severe speech difficulties after a stroke.

Cause of severe speech difficulties after stroke

A stroke occurs when the supply of oxygen-rich blood to the brain is compromised. When brain cells are deprived of oxygen, they begin to suffer damage and blood flow must be restored as soon as possible to preserve brain tissue. Because of this, prompt stroke treatment is essential to saving lives and reducing potential disability.

Language difficulties most commonly occur after a stroke in the left hemisphere of the brain, where the brain’s language centers are located. If a stroke survivor is unable to speak, it could be caused by intense damage to specific language centers in the brain.

Language is a complex task that requires a variety of skills such as sentence production, word retrieval and more. Different areas of the brain contribute to these different language-related abilities.

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Therefore, depending on which areas of the brain were affected by the stroke, different types of language difficulties can occur, including the inability to speak. There are ways to rehabilitate this effect, but first it’s important to understand the different types of language problems that can occur after a stroke, as there can be co-occurring effects.

Types of severe speech problems after a stroke

For an accurate and appropriate diagnosis of speech disorders after a stroke, it is important to work with a speech professional called a speech pathologist or speech therapist.

A speech therapist can help you assess your cognitive communication skills, language motor skills, and other areas related to communication. They may diagnose you with aphasia, dysarthria, or apraxia of speech.

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  • aphasia: a language disorder that affects your ability to communicate, including written and oral language skills. This can lead to difficulty speaking, reading, writing, understanding, and more.
  • dysarthria: a motor language disorder that causes difficulty in controlling the muscles used to speak. This can cause speech to be constantly slurred or slow.
  • apraxia of language: a language motor disorder that causes difficulty in coordinating the muscles of the mouth to form words. This can lead to inconsistent and unpredictable language errors.
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The symptoms of dysarthria and apraxia of speech are similar, but the main distinguishing feature is that speech defects are consistent with dysarthria and not consistent with apraxia of speech.

Aphasia is the umbrella term for language disorders that affect speaking and understanding. There are many different types of aphasia, and it’s important to have a speech therapist help diagnose any existing conditions.

For example, expressive aphasia involves difficulty producing language while language comprehension remains intact. A person with expressive aphasia can understand what you are saying, but has difficulty forming the words to communicate. On the other hand, fluent aphasia involves difficulty understanding speech with normal ability to produce speech. A person with fluent aphasia often strings words together in an incomprehensible way, but they can say those words without problems.

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If a stroke survivor is unable to speak, they likely experienced severe expressive aphasia. Often these people can hear and understand what you are saying but lack the ability to produce speech and communicate.

However, expressive aphasia does not apply to all individuals who are unable to speak after a stroke. For example, a survivor might have the ability to produce speech, but if their ability to understand is severely impaired, they might not speak because they can’t understand what you’re saying.

Because of this, it’s important to work with a speech-language pathologist to get a formal diagnosis. From there, rehabilitation can begin.

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Rewiring the brain to improve speech after stroke

To improve speech after a stroke, you must retrain your brain to control the skills associated with language. For example, if someone cannot speak after a stroke, they can retrain their brain to perform the ability of speech production. This is an intensive process, but one that is often possible with consistent therapy.

Speech therapy works by harnessing the power of neuroplasticity, or your brain’s ability to create new neural pathways and strengthen existing ones. When language has been affected by a stroke, neuroplasticity allows the brain to create and strengthen new pathways that contribute to language.

Neuroplasticity is activated by “heavy practice” or frequent repetition of a task. The more you practice a particular skill, the stronger these paths become. Hence the saying “practice makes perfect” or “use it to get better”. The same concept applies to speech recovery after a stroke.

To regain the ability to speak after a stroke, you need to regularly do speech therapy exercises. For example, if a person has expressive aphasia, they can practice speaking by repeating single words at a time. Repeating the pronunciation of a single word will help rewire the brain and improve the ability to pronounce that word. Imagining saying a word is also helpful (mental exercise).

With enough time and practice, one can improve overall language production skills. However, individuals with severe expressive aphasia may not be able to speak at all, making these language exercises frustrating. Fortunately, there is another technique that can help, called melodic intonation therapy or singing therapy.

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Singing therapy for patients who cannot speak after a stroke

Singing therapy is a promising treatment for people unable to speak after a stroke. It is well-studied and known that stroke victims with severely restricted speech are better at singing than speaking their words.

The explanation for this phenomenon lies in the differences between the left and right hemispheres of the brain. The right brain contributes to creative skills like music and rhythm, while the left brain contributes to logical skills including language. When a stroke affects the left hemisphere of the brain, it can cause difficulties with speech production, but the ability to sing often remains because it is a creative skill that involves rhythm and music.

To see how this works, watch this video:

Singing is not easy for people who cannot speak after a stroke. However, it is possible; and that alone is enough to give hope for recovery.

An experienced speech therapist can help survivors sing short phrases and eventually move on to saying those phrases. Over time, people can eventually regain some speech in this way, even if they are unable to speak immediately after a stroke.

Continue recovery at home with speech therapy apps

Working with a speech pathologist is essential for stroke patients recovering from severe speech impairments. Singing therapy is a complex endeavor, and one-on-one rehabilitation with an experienced therapist is essential for best results.

Once you’ve regained some language skills, you can start doing some things on your own by doing speech therapy exercises at home. There are mobile apps you can use like the CT Speech and Cognitive Therapy app, developed by two speech therapists to provide access to effective speech therapy right at home.

A home language therapy program is a great way to stimulate the brain between outpatient therapy sessions. Continue working with your in-clinic speech therapist and continue practicing speech therapy exercises at home for best results.

Hope for speech recovery after stroke

Overall, there is hope for speech recovery after a stroke, no matter how severe your language difficulty. Even survivors who are unable to speak after stroke can often improve their speech by starting with song therapy and slowly working up to include speech therapy exercises as well.

We hope this article has helped you understand why some stroke survivors are unable to speak and how language skills can slowly improve over time with the right therapy.

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