Speech Therapy After Stroke: A Home Recovery Guide

Stroke affects speech in about one-third of survivors. The good news: with consistent practice, significant improvement is possible — even months or years after the stroke. This guide covers what to expect, how to practice at home, and how families can help.

How stroke affects speech

A stroke can damage the brain areas that control speech and language. The type of speech difficulty depends on where the stroke occurred:

Dysarthria: difficulty with speech muscles

Dysarthria happens when the stroke affects the parts of the brain that control the muscles used for speaking — lips, tongue, jaw, and breathing muscles.

Signs of dysarthria after stroke:

• Slurred or mumbled speech
• Speaking too quietly or too loudly
• Speaking too fast or too slow
• Strained or breathy voice quality
• Monotone speech without natural rhythm

With dysarthria, you know what you want to say — the challenge is getting your mouth and voice to produce it clearly.

Aphasia: difficulty with language

Aphasia affects the language centers of the brain. It's not about muscle control — it's about finding words, forming sentences, or understanding speech.

Signs of aphasia after stroke:

• Difficulty finding the right word
• Using the wrong word or made-up words
• Trouble understanding what others say
• Difficulty reading or writing
• Mixing up grammar or sentence structure

Some stroke survivors have both dysarthria and aphasia, which requires addressing each separately.

The recovery timeline

Speech recovery after stroke varies widely. Some patterns are common:

First weeks: Often the most rapid improvement as brain swelling decreases and the brain begins to reorganize.

First 3-6 months: Continued significant improvement with active therapy. This is often called the "critical window" — though it's not a hard deadline.

6 months and beyond: Improvement continues, but often more gradually. Research shows people can continue making gains years after stroke with consistent practice.

The key factor isn't time since stroke — it's how much targeted practice you do.

Working with a speech-language pathologist

A speech-language pathologist (SLP) is essential for stroke recovery. They will:

• Assess exactly how the stroke affected your speech
• Create a treatment plan targeting your specific challenges
• Teach exercises and strategies you can use at home
• Adjust your program as you improve

Ask your doctor for a referral to an SLP who specializes in stroke recovery. If you're recovering at home, look for SLPs who offer telehealth or home health speech therapy services.

Recovering from stroke at home: daily practice

What you do between therapy sessions matters as much as the sessions themselves. Here's how to structure home practice:

For dysarthria: focus on clarity and loudness

If slurred speech is your main challenge, these exercises help:

Over-articulation practice: Say phrases while exaggerating each sound. Feel your lips, tongue, and jaw moving more than usual. Start slow, then gradually speed up while maintaining clarity.

Loudness practice: Many stroke survivors speak too quietly. Practice phrases at a volume that feels "too loud" — it probably isn't. Use a feedback tool like Speech Check to verify you're hitting your target.

Rate control: Slowing down often improves clarity dramatically. Practice pausing between phrases. Give your mouth time to form each sound.

For aphasia: focus on language retrieval

If word-finding is the challenge, different exercises help:

Naming practice: Look at pictures or objects and practice naming them. Start with categories (animals, foods, household items).

Word retrieval strategies: When stuck on a word, try describing it, saying a related word, or writing the first letter. These cues often help retrieve the target word.

Reading aloud: Read simple texts out loud. This activates multiple language pathways simultaneously.

Sample daily routine

A 5-minute daily routine might look like:

1. 1 minute: Breathing and vocal warm-up
2. 2 minutes: Over-articulation practice with target phrases
3. 1 minute: Loudness practice at target volume
4. 1 minute: Quick clarity check with Speech Check or recording yourself

Consistency matters more than duration. Five minutes every day beats thirty minutes twice a week.

Tools that help stroke survivors

Several tools can support your home practice:

Speech Check: Gives instant feedback on loudness and clarity — useful for dysarthria practice. Run a 60-second check before important calls to calibrate your speech.

Voice recording: Your phone's voice recorder lets you hear yourself. Record, listen, adjust, repeat.

Mirror practice: Watch your mouth movements while speaking. Visual feedback helps with articulation.

Apps for aphasia: Tactus Therapy and Constant Therapy offer word-finding and language exercises specifically designed for aphasia.

Stroke help for families: how to communicate better

Family members play a crucial role in stroke recovery. Here's how to help a stroke person communicate:

Reduce background noise: Turn off the TV. Move to a quiet room. Competing sounds make speech harder to produce and understand.

Face them directly: Eye contact and facial expressions help communication. Don't talk from another room.

Give them time: Resist the urge to finish sentences or jump in. Waiting — even when it's uncomfortable — allows them to find the words.

Ask yes/no questions when needed: If they're struggling, simplify. "Do you want coffee?" is easier than "What would you like to drink?"

Confirm understanding: Repeat back what you understood. "So you're saying you want to go outside?" This catches misunderstandings without embarrassment.

Don't pretend to understand: It's frustrating for both of you. Instead: "I'm sorry, I didn't catch that. Can you try again?" or "Can you show me?"

Encourage practice without nagging: Support their home exercises. Practice conversations together. Celebrate progress.

When to expect improvement

Progress after stroke is real but often gradual. Realistic expectations:

• Daily fluctuations are normal — fatigue, stress, and time of day affect speech
• Week-to-week progress is more meaningful than day-to-day
• Plateaus happen — they don't mean recovery has stopped
• Even small improvements in clarity can significantly improve quality of life

Track your progress. Use a simple journal, or check your Speech Check scores over time. Seeing improvement — even small amounts — motivates continued practice.

Getting stroke help: resources

Beyond this guide, helpful resources for stroke survivors:

• American Stroke Association — Information and support groups
• National Aphasia Association — Resources specifically for aphasia
• Stroke support groups — Local and online communities of stroke survivors
• Home health services — Some SLPs provide therapy in your home

The path forward

Recovering speech after stroke takes time, patience, and consistent effort. But improvement is possible — often more than you might expect. The combination of professional therapy and daily home practice gives you the best chance at regaining clear communication.

Start with what you can do today. Even five minutes of focused practice is progress.