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Speech and language difficulties

If you, or your loved one, have a brain tumour that’s affecting how you communicate, understanding why this might have happened could help you feel more able to cope.

One of the main ways that a brain tumour diagnosis can impact someone's ability to communicate is by causing speech and language difficulties. These can range from having trouble physically producing speech to finding it harder than usual to understand certain words.

It’s important to remember that not everyone with a brain tumour will experience problems with language or speech, or they may be so mild that they don’t greatly affect daily life.

What’s the difference between speech difficulties and language difficulties?

Someone can have difficulties with either speech, language, or both. But these terms can get confused, so you may think you have a speech problem, but actually your language is where you have difficulty.

Speech

This is the physical ability to produce sounds and words using our tongue, lips, jaw muscles and vocal tract. So speech difficulties is the impairment of the physical ability to speak.

Language

This is the words we use and how we use them to communicate meaning, for instance, how we put words together or what those words mean. These can affect you when you're trying to speak, listen, read or write.

Having a difficulty with language means you struggle, cognitively (mentally), with:

  • speaking and producing language (so although you can physically speak, you may have trouble finding the right words or may use the wrong word)
  • your comprehension, understanding language (so although you can hear or read words, you may struggle to understand what people are saying or what you’re reading)
  • reading and/or writing.

How do speech and language difficulties occur?

Whether and how a brain tumour affects you will depend on where it is in the brain. Each section or lobe of the brain is responsible for different functions, some of which are involved in communication.

For example, the frontal lobe is involved in language production (how you express yourself) and the temporal lobe in understanding what others are saying to you and how your thought processes work. As a result, pressure from a tumour in one of these areas of the brain can affect your ability to speak and understand what others are saying.

Areas of the brain controlling language are generally found in the left hemisphere, so if this is where your tumour is, you're more likely to experience language and speech difficulties. However, in some cases they’re found in the right, for instance, with left-handed people.

Because our brains are responsible for controlling the muscles needed to produce speech, a brain tumour can also cause difficulties with speaking by interrupting some signals being sent to the mouth.

Neurosurgery
can also affect speech and language if the area operated on is involved in communication. These changes may be temporary and reduce as you recover, or they can be permanent.

Speech difficulties and slurred speech

There are a range of speech difficulties that can occur as a result of a brain tumour. The nature of the speech difficulty will depend upon the type, size and location of the tumour.

Dysarthria

Dysarthria is a speech difficulty caused by weakness in the muscles needed for speaking and/or difficulty in controlling these muscles. Acquired dysarthria can results from a range of neurological disorders, including brain tumours. This is due to the muscles needed for speech being controlled by the brain and nervous system.

Common symptoms of dysarthria include:

  • Hesitant or slow sounding speech
  • slurred speech
  • an increase or decrease in speech volume
  • strained voice
  • poor intonation, e.g. a monotone quality
  • nasal-sounding speech.

Apraxia of speech

Apraxia of speech is another type of speech difficulty. When we speak, the brain sends signals to our mouth to tell the muscles how and when to move. A brain tumour can cause signals to not get sent properly. This means that the particular motor movements needed for us to be able to speak don’t always happen as intended.

Common symptoms of apraxia include:

  • Slow sounding speech
  • effortful attempts in trying to move the lips, tongue or a jaw (sometimes called groping)
  • unable to pronounce the same word correctly each time
  • difficulty with longer words
  • difficulty saying individual sounds. This could include adding new sounds, omitting sounds or pronouncing the sounds incorrectly

Language difficulties and aphasia

Aphasia (sometimes called dysphasia) is the most common communication difficulty experienced by people with brain tumours. Aphasia is an impairment of language, which affects the production or comprehension of speech and the ability to read or write, due to damage to the brain.

It’s important to note that aphasia doesn’t affect intellect.

Types of aphasia

There are various types of dysphasia (which use the term’ aphasia’). The most common types are: Broca’s aphasia and Wernicke’s aphasia.

Broca’s aphasia

Broca’s aphasia can occur when you have damage to an area of the frontal lobe responsible for language production (Broca’s area).

If you have this, you may find you have difficulty speaking and you may only be able to produce a small number of words in halting sentences, for example “want … tea … sugar”.

It’s usually possible for others to understand your speech, but it may take time to say what you want to.

People with Broca’s aphasia may:

  • Not be able to speak at all.
  • Have difficulties speaking or writing in full sentences and may only use one or two words.
  • Speak with pauses or not be able to say the word they would like to say.
  • Get words muddled up. For example saying “mum” instead of “daughter” and confuse “yes” and “no”.
  • Be able to describe an object, but not name it.
  • Only be able to say a few words, which may be linked to emotions and could be swear words.

If you have Broca’s aphasia, you may not be aware your speech isn’t as you intend, but will be aware you have a speech problem.

Wernicke’s aphasia

Wernicke’s aphasia can occur when there is damage to the part of the temporal lobe responsible for understanding language (Wernicke’s area).

This type of ‘receptive dysphasia’ affects language comprehension and the ability to produce meaningful language. You may have speech that sounds fluent and has a normal rhythm, but consists of ‘made-up’ words.

As a result, other people won’t be able to understand what you’re trying to say. You may also be unable to understand what others are saying.

A person with Wernicke’s aphasia may also:

  • Not understand long sentences and forget the beginning of what has been said.
  • Have difficulty understanding if there’s background noise or several people speaking at once.
  • Be able to read headlines, but not the main body of the text.
  • Be able to write, but not read back what they have written.

In general, someone with Wernicke’s aphasia won’t be aware they have a problem with speech and language.

Get support

If you need someone to talk to or advice on where to get help, our Support and Information team is available by phone, email or live-chat.

If you have further questions, need to clarify any of the information on this page, or want to find out more about research and clinical trials, please contact our team:

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support@thebraintumourcharity.org

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