Aphasia Speech Therapy: What Helps and What to Expect
Aphasia speech therapy helps people speak, understand, read, and write again after a stroke or other brain injury. In a Cochrane review of 57 trials and 3,002 people, speech and language therapy improved everyday communication compared with no therapy. The biggest language gains in later research came with about 20 to 50 total hours of therapy.
Families often tell us the hardest part is not the stroke itself. It is the moment their husband, mother, or brother knows exactly what he wants to say and cannot get the words out. This guide explains what aphasia is, how much therapy helps, what a speech-language pathologist (SLP) does, and how to get aphasia therapy at home in Burbank and across Los Angeles County.
Quad Therapy Inc. is a California therapy company founded by a licensed physical therapist. We provide in-home therapy so patients can get care without clinic wait lines, and we place qualified therapists with clinics, schools, and facilities that need staff.
Key facts
About 1 in 3 people who have a stroke develop aphasia, according to the Cochrane review.
About 2 million Americans live with aphasia, and about 180,000 more get it each year, per the National Aphasia Association.
57 trials and 3,002 people: speech and language therapy improved functional communication, reading, writing, and speaking compared with no therapy.
20 to 50 hours of total therapy were tied to the largest gains in overall language in a 2022 study of individual patient data.
10 or more hours a week for 3 weeks improved everyday communication even years after a stroke in a Lancet trial of 156 people.
What is aphasia?
Aphasia is a language disorder caused by damage to the parts of the brain that handle language. It can affect speaking, understanding speech, reading, and writing. Stroke is the most common cause, but head injury, brain tumors, and brain infections can cause it too, according to the National Institute on Deafness and Other Communication Disorders (NIDCD).
There are several types. The NIDCD groups them into two broad categories:
Nonfluent aphasia, such as Broca's aphasia. Speech comes out in short, effortful phrases. Understanding is often better than speaking, and many people are aware of their mistakes, which can be very frustrating.
Fluent aphasia, such as Wernicke's aphasia. The person may speak in long sentences that do not make sense and have trouble understanding others.
Global aphasia comes from damage to large parts of the language areas and affects both speaking and understanding.
Anomic aphasia is a milder type where the main problem is finding the right word.
Aphasia can also come on slowly. When language problems are the first sign of a dementia-type illness, it is called primary progressive aphasia (PPA). Aphasia may also appear together with other speech problems, such as weak speech muscles (dysarthria) or trouble planning mouth movements (apraxia of speech).
Does speech therapy help aphasia after a stroke?
Yes. The 2016 Cochrane review by Brady and colleagues found that speech and language therapy improved functional communication, which means using language in daily life, along with reading, writing, and expressive language, compared with no therapy. That finding came from 27 comparisons with 1,620 people.
To be fair about the evidence, most trials were small, and there was not enough data to show that the benefits lasted at later follow-up. That does not mean the gains fade. It means more long-term research is needed.
Major guidelines agree that people with aphasia should get therapy. The 2016 American Heart Association and American Stroke Association rehabilitation guideline recommended speech and language therapy for aphasia at its highest level of evidence. In August 2026, the two groups published an updated stroke rehabilitation guideline that supports computer-based aphasia treatment as an add-on to traditional therapy.
How much speech therapy does aphasia need?
Most people need at least 20 hours of therapy, and the best results in research came with 20 to 50 hours. The RELEASE study, published in Stroke in 2022, pooled data on individual patients from many trials. The greatest gains in overall language and understanding came with more than 20 and up to 50 hours of therapy, with home practice built in.
Timing matters too. In a second RELEASE analysis:
People within 3 months of the stroke did best with lower intensity, about 2 hours a week or less, for a total of 20 to 50 hours.
People more than 3 months out did best with 3 to 4 hours a week and 50 hours or more in total.
The 2025 European Stroke Organisation guideline on aphasia recommends at least 20 hours of therapy and suggests therapy at least 4 days a week and at least 3 hours a week. It also says therapy can be delivered in person or digitally. One caution from the Cochrane review: more people dropped out of very high-intensity programs, so the schedule has to be one the person can keep up with.
Is it too late for aphasia therapy 6 months after a stroke?
No. Many people improve the most in the first few months, but therapy still helps later. The FCET2EC trial, published in The Lancet in 2017, included 156 people aged 70 or younger who still had aphasia 6 months or more after a stroke. Three weeks of intensive therapy, at least 10 hours a week, improved how well they communicated in everyday situations, such as calling to change a doctor's appointment.
People who stayed on a waiting list with about 1 hour of therapy a week did not improve during those 3 weeks. The improvement in the therapy group held at 6 months. The upper age limit of 70 means we cannot say for sure how well this works for older adults.
What does a speech-language pathologist do in aphasia therapy?
The SLP starts with an evaluation of speaking, understanding, reading, writing, and how the person communicates at home. The physician diagnoses the medical cause, such as a stroke. The SLP's job is to find out which parts of language are affected and build a plan around the person's own goals.
Therapy often includes:
Word-finding practice, such as naming pictures and objects from the person's own home.
Understanding practice, from simple yes and no questions up to following longer directions.
Reading and writing practice, such as reading a text message or writing a grocery list.
Practiced scripts for real situations, like ordering coffee or answering the phone.
Other ways to communicate when speech is limited, such as gestures, drawing, a picture board, or a tablet app.
Home practice between visits, which the RELEASE study linked to better results.
How can family members help someone with aphasia?
Family members can learn ways of talking that make conversation easier, and this is part of good aphasia care. It is called communication partner training. The 2016 AHA/ASA guideline recommended including it in treatment, and a 2016 systematic review by Simmons-Mackie and colleagues found it is probably effective for improving conversation for people with long-term aphasia. The evidence for people in the first few months is limited.
A few habits help in most homes:
Turn off the TV and talk in a quiet room.
Use short sentences and ask one question at a time.
Give the person time to answer, and do not finish their sentences unless they ask.
Ask yes or no questions when they are tired.
Write key words, point, or draw to support what you say.
Talk to them as the adult they are. Aphasia affects language, so keep including them in decisions.
Can I get aphasia speech therapy at home in Burbank?
Yes. In-home speech therapy lets the SLP practice with the person's own phone, kitchen, mail, and family members, which keeps therapy close to real life. It also helps when getting to a clinic is hard after a stroke. Quad Therapy Inc. serves Burbank, Glendale, Pasadena, and the San Fernando Valley.
Medicare Part B covers speech-language pathology services when they are medically necessary and a doctor certifies the plan of care. If the person is homebound, Medicare home health may cover therapy at home at no cost. Our guide Does Medicare Cover In-Home Physical Therapy? explains how Part B and home health work, and the same two paths apply to speech therapy. Many stroke survivors also need help with movement and daily tasks, so read Occupational Therapy vs Physical Therapy and Home Safety Evaluation in Occupational Therapy.
If someone suddenly has trouble speaking or understanding, with a drooping face or weakness on one side, call 911. These can be signs of a stroke, and every minute counts.
Frequently asked questions
Can aphasia go away on its own?
Many people improve a lot in the first few months after a stroke, even before therapy starts, as the brain recovers. In many cases some aphasia remains after that early recovery, which is where speech therapy helps most.
How long does aphasia therapy take?
Research points to at least 20 hours, with the best results between 20 and 50 hours. At 3 hours a week, that is about 7 to 17 weeks, though each plan depends on the person's goals and progress.
Is aphasia a sign of dementia?
Most aphasia comes from a stroke or other sudden brain injury, not dementia. When language problems start slowly and get worse over time, it can be primary progressive aphasia, and a physician should evaluate it.
Do speech therapy apps help aphasia?
Computer-based therapy can help as an add-on to therapy with an SLP. Both the 2016 and 2026 AHA/ASA guidelines support it as a supplement, not a replacement.
Does Medicare cover speech therapy for aphasia?
Yes, when it is medically necessary and a doctor certifies the plan of care. Part B covers outpatient and in-home outpatient therapy, and home health covers therapy at home for people who are homebound.
About Quad Therapy
Quad Therapy Inc. is a therapy company in Burbank, California, founded by a licensed physical therapist. We go to the patient. Our licensed therapists provide [SERVICES] in the home, and we staff clinics, schools, and facilities with qualified therapists. Every service is provided by a clinician licensed by the matching California board and stays within that board's scope of practice. To schedule a visit or ask about staffing, call (855) 313-3201 or visit quadtherapy.com. Our office is at 455 N Moss St, Suite 102, Burbank, CA 91502.
Next step: write down 3 things your loved one wants to be able to say or do again, like making a phone call or ordering at a restaurant. Then call us at (855) 313-3201 to schedule an in-home speech therapy evaluation in Burbank, Glendale, Pasadena, or the San Fernando Valley.
This article is for education. It is not medical advice. Talk with a licensed clinician about your situation.
Sources
Brady MC, Kelly H, Godwin J, Enderby P, Campbell P. Speech and language therapy for aphasia following stroke. Cochrane Database of Systematic Reviews. 2016;6:CD000425. cochrane.org
RELEASE Collaborators. Dosage, intensity, and frequency of language therapy for aphasia: a systematic review-based, individual participant data network meta-analysis. Stroke. 2022;53(3):956-967. doi.org
RELEASE Collaborators. Precision rehabilitation for aphasia by patient age, sex, aphasia severity, and time since stroke? International Journal of Stroke. 2022;17(10):1067-1077. eprints.gla.ac.uk
Breitenstein C, Grewe T, Flöel A, et al. Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting. Lancet. 2017;389(10078):1528-1538. evidence.nihr.ac.uk
Brady MC, Mills C, et al. European Stroke Organisation (ESO) guideline on aphasia rehabilitation. European Stroke Journal. 2025;10(4):1189-1220. pmc.ncbi.nlm.nih.gov
Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery. Stroke. 2016;47(6):e98-e169. pubmed.ncbi.nlm.nih.gov
Richards LG, Ifejika NL, Stein J, et al. 2026 guideline for adult stroke rehabilitation and recovery. Stroke. 2026. Summary by NeurologyLive, August 27, 2026. neurologylive.com
Simmons-Mackie N, Raymer A, Cherney LR. Communication partner training in aphasia: an updated systematic review. Archives of Physical Medicine and Rehabilitation. 2016;97(12):2202-2221. apps.asha.org
National Institute on Deafness and Other Communication Disorders. Aphasia. nidcd.nih.gov
National Aphasia Association. How common is aphasia? aphasia.org