Signs to look for
- Knowing what you want to say but not finding the words
- Using the wrong word or a word that sounds similar
- Difficulty following conversations, especially fast or group ones
- Reading or writing that has become slow or difficult
- Trouble staying on topic, organizing ideas or following a story
- Difficulty with attention, memory for conversations or planning since an injury
- Avoiding phone calls, meetings or social events since the event
What it is
Aphasia is a language disorder caused by damage to the parts of the brain that handle language, most often after a stroke. It can affect speaking, understanding, reading and writing. The person still knows what they want to say, and their thinking and personality are typically intact. What changes is access to language.
Aphasia looks different from one person to another. Some people speak slowly and with effort, in short phrases, while understanding stays stronger. Others speak fluently, but their sentences carry less meaning and understanding is more affected. Two people with similar strokes can have very different profiles.
Other acquired communication disorders
After a stroke or a traumatic brain injury (TBI), communication can also change in other ways:
- Cognitive-communication disorders, where changes in attention, memory, organization or reasoning affect conversation. A person may speak fluently but lose the thread, go off topic or miss what others imply.
- Dysarthria, which affects the muscles of speech. See our page on dysarthria.
- Apraxia of speech, which affects planning the movements for speech.
These can occur together, and an assessment helps sort out what is contributing to the difficulty.
Sudden new trouble speaking or understanding is a medical emergency, often a sign of stroke. Call 911 right away.
Who we see
We work with adults at different points after a stroke, brain injury or other neurological event:
- Adults who have recently left hospital or rehabilitation and want to continue therapy.
- Adults months or years after a stroke who feel their progress has stalled or who have new goals, like returning to work.
- Adults with cognitive-communication changes after a concussion or more serious brain injury.
- Spouses, adult children and caregivers who want support communicating with the person they love.
How we assess it
The assessment looks at speaking, understanding, reading and writing, as well as how the person communicates in real life. For cognitive-communication concerns, we also look at attention, memory for information, organization and reasoning as they affect communication.
We ask about your history, previous therapy and goals. If you have reports from a hospital or rehabilitation team, bring them; they help us build on what has already been done. We also talk with family members, with your permission, about what they notice at home.
The aim is not just a label. It is understanding what is most affected, what is preserved, and what will be most useful to work on. Learn more about our assessment process.
How therapy works at VoxLingue
Therapy is built around the situations that matter to you: calling a pharmacy, following a family dinner, reading the news, returning to a meeting or telling a story to a grandchild.
Language-focused therapy
Depending on your profile, therapy may include word-finding practice, sentence building, comprehension work, and reading and writing rehabilitation. Research supports sustained, goal-directed practice, and your clinician will explain how often to meet and practise for your goals.
Functional and conversation-focused therapy
We practise real conversations and use script training for high-value moments, such as introducing yourself, ordering at a restaurant or speaking with a doctor. We also use total communication: gesture, drawing, writing key words, photos and phone apps. These are not a sign of giving up; they protect the message while language continues to recover.
Cognitive-communication therapy
After a brain injury, therapy may target strategies for attention, organizing ideas, following conversations, using memory aids and managing communication at work or school. We coordinate with other professionals, such as occupational therapists or neuropsychologists, when they are involved.
AAC when helpful
For people with severe aphasia, AAC tools such as communication books or apps can support daily life alongside speech.
Your role at home
Families and close friends shape recovery more than they often realize. We offer coaching so you can:
- Keep adult topics and an adult tone. The person is still who they were.
- Reduce background noise, use shorter sentences and ask one question at a time.
- Wait. A few seconds is often enough for a word to arrive.
- Offer help with a word only if the person wants it.
- Confirm what you understood by rephrasing, not by testing.
- Watch for fatigue, and keep important conversations for times of better energy.
Frustration, grief and low mood are common after a stroke or brain injury. If you notice signs of depression, speak with the medical team; it is common and treatable. Caregivers need support too.
Bilingual and multilingual families
Many of the adults we see spoke two or more languages before their stroke or injury. Research shows that languages can be affected and recover differently, and the language that returns first is not always the one used most before.
Our team works in English and French, and clinicians on the team speak many other languages. Your clinician will help you decide which language or languages to focus on, based on your relationships and daily life. Availability of specific languages varies, and we will match you as closely as we can.
In person or by telepractice
You can see us in person at our Marché Central clinic in Montréal, or by telepractice anywhere in Quebec and Ontario. Telepractice can reduce travel fatigue, simplify scheduling and allow a family member to join from another room or another city. Your clinician will help you decide what works best given your needs and comfort with technology.
Getting started
You do not need a physician referral. Whether you have just come home from hospital or are years after a stroke with new goals, an assessment is a good place to start.
Call our Marché Central clinic at 514-467-9132, or request an appointment through our contact form. Family members are welcome to call on behalf of the person. We will match you with a clinician whose experience and languages fit your needs.
Frequently asked questions
Is aphasia a loss of intelligence?
No. Aphasia affects language, not intelligence. Memory of loved ones, personality and judgment are typically preserved. Aphasia is also different from confusion or dementia.
Can someone still improve months or years after a stroke?
Research shows that meaningful gains can continue long after the first months, particularly with sustained, goal-directed therapy. Progress is rarely linear, and new goals often bring new progress.
What is a cognitive-communication disorder?
It is a communication difficulty caused by changes in thinking skills such as attention, memory, organization or reasoning. It is common after traumatic brain injury and some strokes. A person may speak fluently but struggle to follow a conversation or stay on topic.
We finished therapy at the hospital. Can we continue privately?
Yes. Many adults continue therapy after discharge from hospital or rehabilitation. Bringing your reports helps us build on the work already done.
Which language should therapy be in?
In bilingual and multilingual families, the languages may recover differently. Your clinician will help you choose which language or languages to focus on, based on the people and situations that matter most.
Can family members take part?
Yes. Family coaching is an important part of therapy. Small changes in how people talk with the person can make conversations easier right away.
Related areas of care
- Dysarthria therapy for clearer speech after neurological conditionsTherapy for motor speech difficulties caused by neurological conditions, focused on clearer, more effective communication with the people you talk to every day.
- Swallowing and feeding therapy for children and adultsAssessment and therapy for swallowing difficulties in adults and feeding difficulties in children, carried out with safety first and in collaboration with physicians.
- Augmentative and alternative communication (AAC)Support for people whose speech does not yet meet all their communication needs, using signs, pictures or speech-generating devices alongside speech.
- Speech therapy by telepractice across Quebec and OntarioAssessment and therapy by secure video, from home, with the same clinical approach as our in-person sessions, across Quebec and Ontario.
