- Lewis Bartelle
- Mar 22
Updated: Apr 2
Your Complete Guide to Dysarthria Communication
Hey friends, Lewis here.
I want to talk about something that sits at the very core of what makes us human — the simple, profound need to be understood.
When my stroke hit, my mind was initially locked on the big visible challenges. Learning to walk again. Figuring out how to get through a day. Nine months in inpatient rehab, working my way from a pink gait belt and a walker with arm stilts back to something resembling the life I knew. Those were the battles everyone could see.
But as I started to find my footing, something else became impossible to ignore. Something that did not show up on a scan or a progress chart but affected the very core of who I was.
The way I spoke had completely changed.
Words that once came effortlessly — rapid fire, full of jokes and stories — now came out slow, slurred, and sometimes strained. Simple sentences required effort I had never had to think about before. And this new reality had a name I had to learn to say out loud.
Dysarthria.
I know firsthand how isolating this feels. The frustration of having a completely clear thought in your mind and an unclear sound coming out of your mouth is a specific, relentless kind of hard. But I want you to hear this clearly: you are not alone in it. And communication with dysarthria is a two-way street — which means there are real, practical things both speakers and listeners can do to make it work better. That is what this article is about.
My Speech, My Story — Understanding the Challenge
When my doctors first explained dysarthria to me it felt like a heavy clinical term, but the reality underneath it is actually straightforward. Dysarthria is a motor speech disorder. The damage from my stroke affected the part of my nervous system that controls the muscles I use to speak — my tongue, lips, jaw, and breathing. The control panel for producing clear speech got damaged. That is it.
This does not mean I forgot my words or lost the ability to form sentences. The thoughts are there. The intelligence is there. The personality — trust me — is still very much there.
But here is something I want to add that the clinical definition leaves out, because it is important and it is real. For me personally, sometimes thoughts and words get mixed up on the way out. I will mumble out something and then realize it made no sense — and half the time it was hidden behind the slurring anyway so people probably did not even catch it. That disconnect between what I meant to say and what actually came out is its own layer of frustration on top of everything else.
The signs look different for everyone but for me the main ones were:
Slow, slurred words. I often felt like my mouth simply could not move fast enough to keep up with my thoughts. Like a car with a powerful engine and a transmission that would not cooperate.
Breathy, raspy voice and volume control issues. My voice would come out strained and hard to project. I have had more people than I can count assume I was yelling when I was genuinely just trying to speak loud enough to be heard across a table.
Here is something that helped me when I first got this diagnosis: between 30 and 40 percent of stroke survivors experience ranging dysarthria symptoms at some point. That is a significant number of people navigating this same daily challenge. Knowing that did not make it easier exactly — but it reminded me that what I was going through, while deeply personal, was not something I had to figure out alone.
If the emotional weight of living with an invisible symptom like this is something you are carrying right now, go read my article on The Iceberg of Recovery — The Unseen 80%. It covers everything that lives below the surface that the world does not see, including the daily invisible fights that dysarthria is a part of.
The Social Struggle — Assumptions and the Silent Nod
Here is the honest truth about the hardest part of living with dysarthria. It is called the "silent nod".
You know exactly what I am talking about. That moment when you are speaking and the person across from you smiles and nods along as if they understood every word, when it is completely clear they did not. They do not want to make you feel uncomfortable. They do not want to slow things down. So they nod. And the real meaning of what you were trying to say disappears entirely.
I have been through the drive-through more times than I can count and had them guess my order rather than ask me to repeat it — and gotten it completely wrong. That is a small thing in the grand scheme. But small things add up. And each one is a quiet reminder that the world tends to prioritize speed and comfort over genuine understanding.
Here is what I want the silent nodders of the world to know: asking me to repeat myself is not rude. It is respect. It tells me my words matter enough to actually hear. That is all I am asking for.
The Communication Toolkit — Both Sides of the Conversation
Communication with dysarthria works best when both the speaker and the listener show up with intention. Here is the practical toolkit for both sides:
For Me — The Speaker:
Pace myself deliberately.
This is the most important one. I consciously slow down and give my mouth time to catch up with my brain. A deliberate pause between phrases improves clarity more than almost anything else. It is tough when the conversation is moving fast or someone is waiting on me — but rushing always makes it worse. Slow is smooth and smooth is understood.
Use gestures — play a little charades.
I fully embrace body language. Hands, pointing, facial expressions — all of it adds context that my voice sometimes cannot carry alone. Do not be embarrassed by this. It works. Use it.
Manage breath and signal the pause.
Dysarthria affects breath control, and I constantly sound like I am running out of air mid-sentence. I have learned to make a clear physical signal — a hand gesture or a held finger — that says I am not finished, I am just catching my breath. That one habit alone has saved countless conversations from going sideways when someone jumped in thinking I was done.
Own the repeat.
I have learned to say clearly — let me say that again — when I can tell something did not land. No apology, no embarrassment. Just a calm reset. It is always better than letting an assumption take root and grow into a misunderstanding.
For You — The Listener
Patience is not optional — it is the whole game.
Create a calm environment for the conversation. Remove distractions where you can. Do not rush, do not interrupt, and please — do not finish our sentences for us. Even when you think you know where we are headed. Let us get there.
The 3 to 4 second rule.
This one is specific and it matters enormously. When a dysarthria speaker pauses to breathe, that pause looks like the end of a thought. It is not always. Give us a full three to four second count before you respond. That window — small as it sounds — is often the difference between a complete thought and a cut-off one. Rushing in breaks the focused speech pattern we are working incredibly hard to maintain.
Ask, do not pretend.
I promise — I would far rather you ask me to repeat something than nod along and miss the point entirely. A simple “can you say that again?” is one of the most respectful things you can offer someone with dysarthria. It says: what you are saying matters enough to actually hear.
Make eye contact and read the whole picture.
Eye contact lets you pick up on facial expressions and body language that carry meaning my voice sometimes cannot. I had a boss who used to quietly follow my lip movements during conversations — fully present, fully paying attention. That level of care made an enormous difference and I have never forgotten it. Be that person for someone.
Try other channels when needed.
If a conversation is genuinely not getting through, suggest a different mode without making it awkward. Notes app on the phone, pen and paper, a quick text follow-up — these are tools, not failures. They make it a practical challenge to solve together rather than an uncomfortable standoff.
Your Voice Is Still Yours
My journey with dysarthria has taught me something I want to leave you with today.
My voice is a gift. It sounds different than it used to. It requires more effort from me and more patience from the people around me. Some days it cooperates and some days it absolutely does not — and on those days I lean on every tool in this toolkit and remind myself that the thought behind the words is still completely intact.
What I went through with speech is one of the reasons I built "The Word" and the Army of Warriors program at BeyondtheShatter.com. Because dysarthria is one of the most isolating parts of stroke recovery, and survivors living with it deserve a dedicated space to be heard — literally and figuratively.
If you have a story worth telling, we will help you tell it. The program is completely free and your voice — however it sounds — belongs in it. Come find us.
And if you are carrying the full weight of stroke recovery and need the complete roadmap — from the emotional journey through the practical tools — Beyond Shattered is on Amazon and it was written for exactly where you are right now.
The silent nod stops here. You deserve to be understood.
— Lewis
- Lewis Bartelle
- Mar 22
Updated: May 2
SMART Goals: Turning the Overwhelming Into the Achievable
Hey friends, Lewis here.
When I first started my stroke recovery journey, I felt completely lost. Not just physically — although that was its own mountain — but mentally. The whole process felt like staring at a giant, complex map with no destination programmed in. No route. No starting point. Just an overwhelming expanse of everything that needed to happen with no clear idea of where to even begin.
I knew I wanted to get better. But here is the thing nobody tells you: “get better” is not a goal. It is a wish. And wishes do not have action plans.
If you are sitting in that same fog right now — that heavy, directionless feeling where recovery looks like one enormous impossible thing — I want you to know something first. That feeling is completely normal. It does not mean you are weak or behind or doing this wrong. It means you are human, and something enormous just happened to you.
But I also want to hand you the tool that changed everything for me. The simple framework that took the overwhelming and turned it into a sequence of daily, winnable steps.
It is called the SMART method. And it became one of the most important pieces of my entire recovery puzzle. Determination)
Why “Get Better” Is Not a Goal
Before we get into the framework itself, let me explain why vague goals do not work — because understanding this is half the battle.
Saying “I want to walk better” is like saying “I want to drive somewhere nice.” It sounds good. It feels motivating in the moment. But how do you know when you have succeeded? How do you track progress? How do you know what to actually do today?
You don’t. And that uncertainty is exhausting.
Recovery is fueled by progress. Progress requires clear targets. And clear targets require a plan specific enough that you know exactly what you are doing, when you are doing it, and how you will know when it is done.
That is where SMART comes in. Think of it as programming the GPS. You still have to drive — but now you know where you are going.
I lay out the full goal setting framework in Beyond Shattered, including how I used it to work back from nine months in inpatient rehab toward getting behind the wheel again. If you want the complete roadmap, grab your copy on Amazon. But right now let me walk you through each piece of the framework and show you exactly how to apply it to your recovery today.
S — Specific: What Exactly Will I Do?
Your goal needs to be precise. Not a direction — a destination.
Instead of: “I want to improve my arm.”
Try: “I will practice lifting a coffee mug to my mouth three times during my morning routine.”
See the difference? The second version tells your brain exactly what pathway to rebuild. It eliminates the daily question of what am I supposed to be working on right now. You wake up and you know.
That clarity alone removes a layer of mental load that stroke survivors simply cannot afford to waste.
Specific goals move the needle. Vague goals move nothing.
M — Measurable: How Will I Track It?
If you cannot measure it, you cannot manage it. And more importantly — you cannot celebrate it.
Instead of: “I want to read more.”
Try: “I will read one paragraph without losing my place, three days this week.”
That second version gives you something concrete to mark done. And marking things done matters enormously in stroke recovery — because the Victory Journal principle I talk about throughout The Word is built on exactly this. Daily, specific, irrefutable proof that the work is paying off. Numbers you can point to on the days when everything feels like it is standing still.
When the numbers go up — even slightly — that is neuroplasticity doing its job. And seeing it happen is one of the most powerful motivators on this entire journey.
A — Achievable: Is This Realistic Right Now?
Here is where a lot of survivors accidentally set themselves up for frustration rather than momentum. We all want to run before we can walk — sometimes literally. But a goal that is out of reach today does not inspire you. It defeats you.
Your goal needs to be challenging enough to matter and realistic enough to actually happen today.
If lifting the coffee mug is too much right now, your goal becomes: “I will move my hand two inches closer to the mug during my practice session.”
That is not settling. That is smart. That is the car guy in me talking — you do not rebuild an engine by trying to install the transmission before the block is ready. You work the process. You honor where you are right now and build from there.
Small wins create mental momentum. Mental momentum creates the confidence that carries you to the bigger wins. Every single piece matters.
R — Relevant: Does This Goal Actually Matter to Your Life?
Your goals need to be connected to something that genuinely matters to you — your real life, your real people, your real Why.
If being able to talk to your grandkids on the phone is your biggest motivation, your speech goal should reflect that.
Try: “I will practice my articulation exercises for ten minutes before I call my grandkids on Saturday.”
Now that goal has a face on it. It has a reason. And on the days when the exercises feel pointless and frustrating and endless — that face, that Saturday phone call — is what keeps you at the table.
Relevance is the bridge between effort and commitment. Build your goals on things that genuinely matter to you and they will hold up under pressure. Build them on things that do not and they will collapse the first time recovery gets hard. Which it will.
T — Time-Bound: When Will You Do This and By When?
A goal without a deadline is just a wish with better vocabulary.
Instead of: “I’ll try to walk more this week.”
Try: “I will walk twenty feet using my cane by Friday.”
The deadline creates urgency. Urgency creates focus. Focus creates action. And at the end of Friday you know exactly where you stand — you either hit it, or you learn something useful about what needs to adjust. Either outcome moves you forward. That is the point.
I practiced this principle in one of my favorite recovery wins — I had a goal of getting back behind the wheel. Specific, measurable, achievable in stages, deeply relevant to my independence, and time-bound by the milestones I set with my care team. I even used a PlayStation with a steering wheel controller and racing games as a driving simulator to practice coordination and reaction time between sessions. Unconventional? Maybe. Effective? I drove myself to an appointment and traded in my wheelchair for four wheels. So yes.
The Power of Small Goals Adding Up
Here is what happens when you start building your recovery around SMART goals: the whole thing transforms.
Suddenly you are not failing to “get better” — a target so vague it is impossible to hit. You are succeeding three times a day by lifting that mug. You are winning on Tuesday by reading that paragraph. You are making measurable, trackable, moments to celebrate progress every single day — progress your brain can feel and your confidence can build on.
That is neuroplasticity at work. Every small, specific, repeated effort is laying down new pathways. Every win — however modest it looks from the outside — is a piece of the puzzle clicking into place. And pieces add up. I know because I counted mine, one by one, over thirteen-plus years.
Be patient with yourself. Be kind to yourself. Give yourself the grace of starting smaller than feels significant — because consistency beats intensity every single time in stroke recovery.
And when you are ready to go deeper — when you want the full framework, the self care strategy, the visualization practice, and every other tool that helped me go from a six week coma and nine months in inpatient rehab to walking, driving, and building a life beyond the stroke — Beyond Shattered is waiting for you on Amazon.
Every chapter was written for the person who needed a roadmap and could not find one.
You are not lost anymore. You have a map. Now let’s program the GPS and get moving.
If you want to share your recovery journey with a community that truly gets it, come find us in Beyond The Shatter on Facebook. And if you are ready to let your story inspire someone else who is right where you were — the Army of Warriors program at BeyondtheShatter.com will give it a home. Always free. Always yours.
I am right here with you.
— Lewis
- Lewis Bartelle
- Mar 21
Updated: May 2
Why Recovery Is an Inside Job
Hey friends, Lewis here.
When a stroke first hits, you rely completely on the outside world. Therapists, doctors, medication, equipment — all of it is vital, all of it matters, and none of it should ever be taken for granted. These people are the experts, the map-makers, and the safety net. For everything they gave me — including my life — I am grateful every single day.
But here is the hard-earned truth that took me time to fully accept, and that I now believe with everything I have:
The ultimate progress has to come from within.
Nobody can want your recovery more than you do. Nobody can do the internal work for you. The best therapist in the world cannot rewire your brain — only you can, through focused, deliberate, daily effort that you choose. Not because someone scheduled it. Because you decided.
Recovery is an inside job. And the mindset that drives it is what I call The Hustle.
What The Hustle Actually Means
The Hustle is not about grinding yourself into the ground or showing up to every session with something to prove to the room. It is about something deeper and more sustainable than that.
It is about total ownership.
Ownership means you are not a passenger in your own recovery. You are not simply showing up and waiting for progress to be delivered to you. You are the CEO of your care — the one person in the room with the most at stake, the most to gain, and the most responsibility for what happens next.
I did not always operate this way. In the early months — six weeks in a coma, nine months in inpatient rehab, learning to shuffle ten feet in a pink gait belt while my daughters waited at the end of the hall — I was focused on survival. And that was exactly right for that season.
But at some point the season changes. And when it does, you have a choice to make. Are you going to keep waiting for recovery to happen to you? Or are you going to go get it?
Here is what total ownership actually looks like in practice:
Be the CEO of your care. Know your goals. Track your own progress. Ask your therapy team the hard questions — not just how did I do, but what should I be doing between now and next session to make the most of this? You are not just a patient receiving treatment. You are an active participant directing your own recovery. Nobody has more skin in this game than you do.
Practice on the off days. This is critical. Real gains do not only happen in the therapy room — they happen in between, in the quiet unseen moments when nobody is watching and you choose to do the work anyway. If your goal is hand mobility, pick up the TV remote with your affected hand. Wipe the counter. Reach for the glass yourself. Neuroplasticity does not have office hours.
Consistency is the currency of recovery and you are the one who decides how much to spend. I write about the full self-care and exercise approach in Beyond Shattered — including the bodyweight routines I used to shed 70 pounds and rebuild my strength from scratch. It is all in there if you want the complete picture.
Find your Why. Not the surface answer — the real one underneath it.
Not I want to get better, but the specific, deeply personal reason that makes getting better matter. For me it was getting back behind the wheel. Visiting survivors in that hospital as someone who had walked the whole path. Building something that could help the next person who wakes up in that bed with no roadmap. Write your Why down. Put it somewhere you will see it on your worst days. That Why is the engine — the thing that keeps the motor running when willpower alone runs dry.
Embrace the Fall — The Power of Failure
Now I want to talk about something that sounds completely backwards. Something that took me a while to make peace with and that I now consider one of the most important mindset shifts in all of recovery.
We have to learn to fail.
I know. You are exhausted by failing. You are tired of the gap between what you are trying to do and what your body will cooperate with. The last thing you want is someone telling you to lean into it.
But hear me out — because this reframe changes everything.
Think about a toddler learning to walk. They fall constantly. They wobble, they crash, they sit there looking confused, and then they get right back up and try again. Nobody calls it failing. We understand instinctively that the falling is the learning. Every crash is the brain and body figuring out something they will use on the very next attempt.
That is exactly what is happening when you fail in recovery. Failure is not an endpoint. It is feedback. It is the signal that you found the edge of your current capacity — which is precisely where growth lives. You cannot build a new road without first finding out where the old one ends.
Honestly? I want to see you fail. Because failure means you are pushing past comfortable. And comfortable is not where the progress is.
Here is what the real progression looks like — and I have lived every single step of it:
Try — and fail completely. You found the limit. Good. Now you know where to work.
Try again — and fail a little less. You adjusted. The brain took notes.
Try again — and stumble. You are almost there. Keep going.
Try again — and own it. Progress unlocked.
That chain — that persistent, stubborn, refuse-to-quit drive to be even slightly better than you were yesterday — that is what progress is actually made of. Not the big dramatic breakthroughs that make for a good story. The quiet, daily, cumulative result of choosing to try one more time when everything in you wants to stop.
Warriors and Gladiators — What Are Your True Colors
Every single person navigating stroke recovery is a Warrior. Let me say that clearly and mean it — just showing up for this journey, just getting out of bed and facing another day of this, is warrior-level courage. Do not let anyone tell you otherwise, and do not tell yourself otherwise on the hard days.
But Warriors have levels.
Think of it on a scale of one to ten. Every survivor starts at baseline — a Warrior simply by virtue of still being in the fight. But some Warriors decide at some point that they want more than survival. They want mastery. They want to look back at what tried to take them out and say — not only did I survive that, I came back stronger because of it.
That is where Warriors become Gladiators.
A Gladiator does not just endure the arena. They own it. They are not defined by the circumstances that brought them there — the stroke, the diagnosis, the limitations, the loss. They are defined by the ferocity of their comeback. A Gladiator takes full ownership of their effort. They practice on the off days. They ask the hard questions. They see failure as feedback and use it to go further. They never quit.
Moments of crisis reveal true colors — how people respond when things get genuinely hard, how much they actually have in them when the pressure is on. This journey has put real pressure on you. And the fact that you are still here, still trying, still reading this and looking for ways to move forward — that tells me something important about what you are made of.
The Gladiator is already in you. I know it because you are still in this fight.
So here is my invitation: step into the arena. Take total ownership of your recovery. Demand daily progress from yourself — not because anyone is watching, not because it is scheduled, but because you have decided that you are worth the fight.
And when you are ready to go beyond the articles and get the full roadmap — every strategy, every tool, every honest account of what this journey really requires — Beyond Shattered is waiting for you on Amazon. I wrote it for the person sitting exactly where you are right now.
Own the Hustle. The arena is yours.
If you want to stand alongside other survivors who are in it with you every day, come find us in the Beyond The Shatter community on Facebook. And if you have a story worth telling — which you absolutely do — the Army of Warriors program at BeyondtheShatter.com will give it a home. Free, always.
— Lewis
