Does aphasia after a stroke mean the person has lost their intelligence?

No. Aphasia is a problem using or processing language – speaking, understanding, reading or writing – caused by damage to the brain’s language areas. It does not affect intelligence, memory or the person themselves. Always treat the person as a capable adult. Some people may also have separate cognitive problems, which need their own support.

What is the difference between aphasia, dysarthria and apraxia?

Aphasia is a language problem (speaking and/or understanding). Dysarthria is unclear or slurred speech from weak face, mouth and voice muscles, with language intact. Apraxia of speech is difficulty planning the movements for speech, even though the muscles are not weak. A speech and language therapist can tell them apart and treat them.

How can I help someone with aphasia communicate?

Reduce background noise, sit close and face to face, choose a time when they have energy, and give plenty of time and patience. Encourage them to spell, write, draw, point or describe a word, and keep pen, paper and photos handy. Listen actively, do not finish their sentences unless asked, and write down key points after appointments.

Communication and Aphasia After Stroke (Singapore)

Q: My relative’s speech suddenly got worse – is this the aphasia?

Not necessarily, and it should not be ignored. The existing aphasia is a known, stable effect, but a sudden new difficulty speaking or understanding, new slurring, or a new facial droop or weakness could be another stroke. Use FAST and call 995 immediately rather than assuming it is the existing condition.

Written & reviewed by the BestDoctors.sg editorial team · Last updated 29 Aug 2026 · General information, not medical advice

Quick answer. A stroke can affect communication in several ways. Aphasia affects the ability to speak and understand, and can also affect reading, writing and numbers – but it does not affect intelligence. Dysarthria is slurred or unclear speech from weak muscles, and apraxia of speech is difficulty planning the movements for speech, with the muscles not weak. A speech and language therapist assesses which difficulties are present and provides therapy. Family can help enormously with simple, patient communication techniques. Crucially, a sudden new communication problem – different from the existing one – could be another stroke: call 995.

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In a medical emergency, or for severe or sudden symptoms such as breathing difficulty, chest pain, fainting or stroke signs, call 995 immediately.

Understanding aphasia

Aphasia affects the ability to speak and to understand what others say, and it can also affect reading, writing, using numbers, gestures and drawing. It happens when the language areas of the brain, usually on the left side, are damaged, and about a third of people have aphasia after a stroke. It can be mild or severe and can change over time. The single most important thing to understand is that aphasia does not affect intelligence – it is a problem using or processing language, not a loss of thinking, memory or the person themselves. The person inside is unchanged, and should always be treated as a capable adult.

The types of aphasia

Aphasia takes different forms. In expressive aphasia, sometimes called Broca’s or non-fluent aphasia, a person knows what they want to say but struggles to get the words out. In receptive aphasia, sometimes called Wernicke’s or fluent aphasia, speech may flow but with wrong or jumbled words, and understanding is reduced. In anomic aphasia, the main difficulty is finding names and words. A person can have more than one type at once, and may have other communication problems alongside. Recognising the pattern helps family understand what the person is experiencing and how best to support them.

Dysarthria and apraxia of speech

Two other communication problems are quite different from aphasia. Dysarthria is caused by weakness in the muscles of the face, mouth and voice box, making speech unclear, slurred, slow, quiet or monotone, and often worse when the person is tired or stressed. Importantly, dysarthria does not affect the ability to use language – the words are there, but the muscles cannot form them clearly. Apraxia of speech is a difficulty with the brain planning and coordinating the movements for speech, even though the muscles are not weak; a person may be unable to say a word on request yet say it automatically without thinking. A speech therapist can tell these apart.

The role of the speech therapist

A speech and language therapist is central to communication recovery. They assess which type or types of difficulty are present, make a diagnosis, and deliver tailored therapy. This might include practising talking, listening, reading and writing for aphasia; sound, word and sentence drills for apraxia; and exercises for strength, pacing and clarity for dysarthria. They also set up communication aids, charts, books and apps. Therapy can be one-to-one or in groups, and progress continues with practice, often over a long period. Getting a referral to a speech therapist early gives you the tools and strategies to communicate as well as possible.

Practical ways to help communication

Family and carers can make a real difference with a few simple habits. Reduce distractions and background noise – turn off the television, sit close and face to face with eye contact, since one-to-one is far easier than a group. Choose a good moment when the person has energy and concentration, as fatigue is common and often worse in the afternoon. Give each other time, be patient, and do not worry about mistakes; conversation is about sharing and understanding, however long it takes. Listen actively, ask questions, and let the person finish rather than jumping in.

Tools that support understanding

When words are hard to find, there are many ways to help meaning come across. Encourage the person to spell a word, write it, draw it, point to it, say the first letter using an alphabet chart, or describe it by talking around it, and use their communication book or aids if they have one. Keep useful resources to hand – a pen and paper, photos on a phone, a photo album, a calendar, magazines – to support conversation. After important conversations, especially medical appointments, write down and share the key points, so nothing vital is lost. These small supports reduce frustration for everyone.

Staying connected

Communication difficulties can be isolating, both for the person and their family, so keeping connection alive matters. Simply spending time together, and doing shared activities that need less talking – cooking, a familiar game, a walk – can maintain closeness even when conversation is hard. Reassure the person that you are not judging their communication, and celebrate the connection rather than focusing only on the difficulty. In Singapore, the Singapore National Stroke Association and the Stroke Support Station run programmes and peer support that can help survivors with communication difficulties and their families feel less alone and build practical skills together.

When a change is an emergency

One safety point is essential for families to understand clearly. The existing aphasia or dysarthria from a stroke is a known, relatively stable effect. But a sudden new communication problem – a new difficulty speaking or understanding, new slurring, or a new facial droop or weakness – is different and could be another stroke. Do not assume it is just the existing condition. Use the FAST signs – Face drooping, Arm weakness, Speech difficulty, Time to call 995 – and call 995 immediately. Also flag any coughing or choking on food or drink to the team, as this can signal a swallowing problem.

Sources

NHS – Aphasia: nhs.uk
NHS – Dysarthria (difficulty speaking): nhs.uk
NHS – Recovering from a stroke: nhs.uk

General information only. This guide supports, but does not replace, advice from your own doctor and stroke care team. Anyone who has had a stroke is at higher risk of another one. Learn the FAST signs and act immediately: Face drooping, Arm weakness, Speech difficulty – Time to call 995. Call 995 at once for any sudden weakness, numbness, drooping face, slurred speech, confusion, severe headache or loss of vision, even if it passes. Never stop medication prescribed to prevent another stroke – such as blood thinners or blood-pressure medicines – without medical advice. If you are struggling emotionally, you are not alone: the Samaritans of Singapore (SOS) are on 1767 and mindline.sg on 1771.

Communication & Aphasia After Stroke