Excerpted from "Strategies to Improve the Communication of People with Dysarthria," Stroke Connection Magazine January/February 2003 (Science update August 2009)

Dysarthria is a speech impairment that sometimes occurs after a stroke. It can affect the precision of speech sounds (pronunciation), the quality and loudness of the voice, and the ability to speak at a normal rate with normal intonation. The exact speech problems will differ from person to person, depending on the location and severity of the stroke.

People with dysarthria often benefit from speech therapy. Because they can have markedly different problems, it’s not possible to provide general suggestions for speech improvement that will work effectively for everyone. It’s best to work with a speech-language pathologist certified by the American Speech-Language-Hearing Association to develop an individualized treatment program.

However, anyone with dysarthria can use relatively simple strategies to improve the likelihood that his or her speech will be understood.

• Avoid talking in noisy environments. If your speech is hard to understand when it’s quiet, noise will make it even harder.
• If possible, move away from the noise source before you start talking.
• Reduce or eliminate the noise. Turn the volume on the television or radio down (or turn it off).
• Choose quiet restaurants.
• Communicate face to face if possible. It’s much easier than talking from another room or on the telephone.
• Eliminate visually distracting backgrounds to force your conversational partner to focus on your face. We all get a lot of cues about what a person is saying from lipreading, even though we may not know it.
• If you’re talking in a visually distracting environment, position yourself so that few or no visual distractions are behind you (e.g., with your back to the wall).
• Provide some context before you start talking, especially if you’re switching topics. Saying, “I’d like to tell you about my dog,” before launching into your story will “prime” your listener to expect certain words. Those words will be easier to understand when you say them.
• Carry a pencil and small notepad or a small index card with the alphabet printed on it. If you listener can’t understand what you’re saying despite repeated attempts, try writing or pointing to the first letter of each word as you say it. (This is a surprisingly effective technique and not as laborious as writing each word or pointing to each letter in every word you’re saying.)
• Consider using the Telecommunications Relay Service (TRS) to communicate by phone.
• Ask people to be patient with you!

The Americans With Disabilities Act mandates that all telephone companies provide TRS for no charge, except the usual price of the phone call. A communication assistant, specially trained to understand the speech patterns of people with speech disabilities, relays the message to the person on the other end of the call. Your phone company can tell you how to access this service.