Contextualized Speech–Language and Swallow Rehabilitation Post Stroke in Low-Resource Settings: Strategies for Aphasia, Dysarthria, Apraxia of Speech, Right Hemisphere Language Disorder, and Dysphagia

Stroke is a leading cause of communication and swallowing impairments globally, disproportionately affecting individuals in low- and middle-income countries (LMICs). Despite the rising prevalence of stroke-related disabilities, access to speech–language–swallowing rehabilitation remains limited due to multidimensional systemic, cultural, and resource-related constraints. This chapter explores context-specific challenges and evidence-based interventions for managing neurogenic communication disorders such as aphasia, dysarthria, apraxia of speech, right hemisphere language disorder, and neurogenic dysphagia in LMICs. Barriers such as shortages of trained speech–language pathologists (SLPs), limited access to cutting-edge diagnostic and therapeutic tools, cultural–linguistic diversity, financial constraints, and the lack of governmental policy support for the integration of SLP services into stroke rehabilitation programs are discussed. To constructively address these challenges in LMICs, the chapter sincerely puts forth evidence-based pragmatic rehabilitation approaches based on principles of neural plasticity, motor learning, and exercise physiology for neurogenic communication disorders and neurogenic dysphagia. The chapter also discusses low-cost, culturally adapted interventions such as communication partner training, group therapy, task shifting to community health workers, and the use of regionally available materials in LMICs. The untapped potential of telerehabilitation as a scalable solution for SLPs is also highlighted in the chapter. Lastly, the chapter emphasizes the need for innovative, sustainable, and culturally responsive solutions to improve communication and swallowing outcomes in stroke survivors, ultimately enhancing their quality of life and societal reintegration in LMICs.