Aphasia Help in the UK: Speech and Language Therapy and Support

The NHS describes aphasia as a condition that makes it difficult to communicate. It affects people in different ways, and symptoms may include:

• not being able to find the right words, or speaking very slowly or with long pauses
• speaking in very short or incomplete sentences
• repeating, mixing up or missing out words, or making up words or sounds
• not understanding what other people are saying, particularly if you cannot see them
• difficulty reading or writing

Aphasia is caused by damage to the parts of the brain that deal with language. The NHS lists stroke as the most common cause, followed by severe head injury, a brain tumour, bleeding or infection in the brain, and conditions that damage the brain over time, such as dementia. Anyone can get aphasia, but it is more common in people over 65. Source: NHS: aphasia.

Aphasia is different from dysarthria, which affects the muscles used for speech, so words can sound slurred or unclear. Some people have both, and a speech and language therapist can assess which is which.

The NHS says aphasia is treated with speech and language therapy. A speech and language therapist can assess your symptoms and work with you to improve speaking, reading and writing, and help you find different ways to communicate. Depending on your symptoms, therapy can include:

• matching words to pictures, or sorting words into categories
• repeating words or rhyming tasks
• practising ways to communicate without words, such as drawing, gestures and facial expressions
• using technology, for example a voice-activated phone or photos of things you find hard to name
• apps or computer programs to practise between sessions

Therapy can be one to one or in a group, face to face or online, and it usually involves family, friends or carers too. Source: NHS: aphasia.

The NHS says there is no cure for aphasia, but if it was caused by a stroke, head injury or brain tumour, most people improve with treatment, especially in the first few months, and people can still improve months or years later. If it is caused by a condition that gets worse over time, such as dementia, therapy may focus on other ways of communicating.

If you are in hospital after a stroke, the stroke team usually arranges speech and language therapy; see speech and language help after a stroke. Otherwise, the Royal College of Speech and Language Therapists (RCSLT) says you can:

• ask your GP or another health professional for a referral, or
• refer yourself to your local NHS speech and language therapy service. You do not have to wait for someone else to refer you.

The RCSLT says services are organised differently across the UK and demand can be high, so a therapist or assistant may phone you first. You can ask what happens next and how long the wait may be. If the wait seems too long, contact the speech and language therapy department. Source: RCSLT: how to find a speech and language therapist.

The RCSLT says independent (private) speech and language therapists can usually offer an assessment soon, followed by therapy. You can search for one through the Association of Speech and Language Therapists in Independent Practice (ASLTIP) by postcode, age range, languages and conditions, or search speech and language therapists on Therapist Circle. Some people see a private therapist alongside NHS care or after it ends; tell your NHS team if you do.

Speech and language therapist and speech therapist are protected titles, so anyone using them must be on the Health and Care Professions Council (HCPC) register. Before you book, it can help to ask:

• what experience they have of aphasia, and of its cause in your case (for example stroke, head injury or dementia)
• whether they visit at home, see you in a clinic or work online
• how they will involve your family or carers
• the full cost, how many sessions they suggest and how you will review progress

Whoever you choose, check their register and ask about fees, session length and how you will review progress together. See questions to ask before you book and how much therapy costs. On Therapist Circle, each practitioner's registration is checked when they join, and their profile shows the register and number so you can check it yourself.

The NHS says aphasia can be frustrating, confusing and difficult, can affect relationships and independence, and can lead to anxiety, low mood, depression, loneliness or isolation. It says talking therapies and support from your care team can help. If you would like this kind of help, see our guides to psychologists, counsellors and feeling lonely. Ask whether the practitioner has worked with people with communication difficulties, and whether your speech and language therapist can suggest ways to make sessions easier.

After a stroke or brain injury, rehabilitation may also involve other professionals, such as occupational therapists for everyday tasks and physiotherapists for movement; see therapy after a stroke.

For family and friends, the Stroke Association suggests going to speech and language therapy sessions if you can, asking the therapist about communication partner training, giving the person time, and making sure they are included in conversations and decisions. Source: Stroke Association: communication problems.

Support organisations named by the NHS and the Stroke Association include:

• the Stroke Association, helpline 0303 3033 100, for anyone affected by stroke
• Say Aphasia, in-person and online groups for people with aphasia
• Headway, for communication problems after a brain injury