Ways to help manage speech and communication difficulties

• Where possible, plan important conversations, meetings and events for times when you have the most energy and are the most alert.
• Try to get rid of any distractions and background noise.
• If you are reading, use a blank piece of paper to cover information below the line you are on, to help you focus. Highlight or underline keywords as you read.
• Silently prompt yourself to pay attention.
• If you are listening, ask the speaker to slow down or to take more pauses.
• Repeat back the information in your own words.
• Ask questions to confirm or clarify information.
• Record yourself saying important information or messages using your mobile phone.
• Write notes, keep a diary, use a mobile phone, iPad or other device to record information. Keep whatever you use in the same place so you can always find it.
• If it is hard to write full sentences, use short keywords.

• Try to get rid of any distractions and background noise.
• Review your notes, diary or recorded messages.
• Visualise where you were when you received the information.
• Think around the subject. What people are involved? What related information do you know? What other messages can you recall?
• Try to have a set routine and time of day for remembering and reviewing information you have received that day.
• To help remember things you have to do in the day, use lists or set reminders on your phone, such as for appointments.

Make phone calls when you are relaxed. Be prepared with:

• pen and paper
• the other person's name and phone number
• questions or points you want to make — it may help to use a written script
• all the information you need
• things the other person might say and ideas of how you will answer them.

When you are on the phone:

• make sure there is no background noise
• take your time
• tell the person you have difficulty speaking
• ask them to bear with you
• ask them to speak slowly
• if you get stuck, think of another word.

• Get rid of any distractions so you can focus on what you are reading.
• Large print might be easier to read.
• Plan when you are going to read important documents. Do it at the time of day when you have the most energy.
• Use a blank piece of paper to cover all the text under the line you are reading. This helps you keep your place. Using your finger or a ruler can also help you keep your place.
• Make links between what you are reading and what you already know.
• Underline or highlight keywords, headings and sentences as you read them. This helps you process and retrieve them better.
• Write brief notes in the margin or on your blank piece of paper.
• If you cannot write, record a summary on a voice recorder.
• Take breaks — at the end of a chapter or the end of a section. Read your notes or listen to your voice recorder before you start reading again.
• Other people may be able to read aloud to you.
• You might enjoy audiobooks, online news bulletins, podcasts or software that reads the text on screen out loud.

• Try drawing or using visual images to help get your message across.
• Review what you write for mistakes.
• Use computer spell checkers.

Being able to pay attention means we can process all kinds of information. It means we can focus on things, concentrate and ignore distractions. We can also do two things at once and switch between tasks.

You might find it has become difficult to stay focused. There are things you can do that will help you pay attention to the task at hand.

Managing fatigue

• Know your limit and watch for signs that you need to take a break.
• Plan rest times every day — using an electronic organiser might help.
• Plan to complete demanding tasks during the time of day that you are most alert — perhaps in the mornings.

Managing distractions

• Arrange your home environment to minimise any distractions. Make sure you can turn off the TV or radio when you are talking.
• If other thoughts keep interrupting, write them down so you know you can deal with them later.
• Silently tell yourself to pay attention when you are listening or reading.

Managing more than one task

• When possible, give yourself time to adjust when you are changing tasks.
• When changing tasks, say out loud what you are currently doing.
• If you must do 2 things at once, do one thinking task, such as talking, and one automatic physical task, such as folding the laundry.

It can be frustrating when you cannot find the words. But there are things you can do to make it easier.

Get others on board

• make sure the people you talk with most often know what is difficult, so they can help you
• set some rules for them — if you cannot find a word, do you want them to help you find it, or do you just want them to give you more time?

General tips to help you communicate

• Choose a time and place to communicate that suits you, and when you are not tired.
• Make sure you have your listener's undivided attention. Try to be close to them. It is good to be face-to-face.
• Have a pen and paper handy. Stay calm and show people what helps. Have a go and do not be too hard on yourself.
• Let the person you are talking with know if you do not understand something.

Use conversation props such as:

• books
• your communication book
• the internet
• magazines
• music
• a personal portfolio
• photos
• television
• texting.

If you cannot find a word:

• Can you describe it? For example, 'library' is 'the place where you borrow books'.
• Can you talk around the word? For example, 'Europe' is 'the place where tourists visit, Italy, Germany, all of it together'.
• Can you show it (gesture)? For example, demonstrate playing a piano instead of saying 'piano'.
• Can you think of a similar word? For example, 'sad' is 'unhappy'
• Can you spell the word or part of it?
• Can you write the word or part of it?
• Can you draw a picture?
• Can you point to it or a picture of it?

When you meet someone for the first time, say their name back to them, such as 'Hello John', or 'I will just check we have got your name right in the computer. Is it Mary?'

Make a link between the person's name and their mannerisms, physical characteristics, job or company, such as 'Mike is the physio with blond hair'.

Write down a memory cue on their business card or in your notebook, such as 'Sarah has a loud laugh'.

If you are having trouble retrieving a person's name, try 'thinking around' them:

• when did you meet them?
• when did you last see them?
• what is their job?
• what are the names of other people they know?
• what letter does their name start with?

When you find their name, use it in conversation again ('I agree, Ray'). The more times you use their name, the better the chance you will retrieve it next time.

Look at the person's business card, on which you have written memory cues, before you meet them. You will then be prepared to retrieve their name.

It is important to take care of your voice — especially if you use it a lot for work or as a hobby. The following tips can help.

Use good voice production techniques. Try to:

• gain the listeners' attention before speaking
• look at the person you are speaking to
• speak with your head up (this makes it easier for your listener to hear your voice)
• keep your hands away from your mouth
• speak at a comfortable pitch (not too high, not too low)
• speak at a comfortable level of loudness.

Other tips

• Drink at least 8 cups of fluid a day. Water is best.
• Limit alcohol as it can lead to a dry or scratchy voice. If you do have alcohol make sure you drink plenty of water as well.
• Treat your voice with care if it sounds different. This could be because you are developing a cold or the flu. Or perhaps you are run down.
• Rest your voice regularly. Stop talking whenever possible.
• Try not to clear your throat. Have a sip of water or try swallowing instead.
• Do not shout or scream, and try not to use your voice loudly, such as talking against loud background noise.
• Do not whisper. You are still using your vocal muscles when you are whispering, so it is best just to stay quiet.
• See your healthcare provider if your voice does not improve.
• Ensure your home is not too dry and avoid other environments that might harm your voice. These include smoky rooms and air-conditioned buildings. If you cannot avoid them, limit the time you spend in them.
• Tension in your body can affect your voice. Gently stretch your shoulder and neck muscles throughout the day.