Top 10 Stroke Speech Therapy Exercises Recommended by Clinicians

Stroke can impact nearly every aspect of life – movement, communication, cognition, and even autonomic functions, such as swallowing and breathing. According to the Centers for Disease Control and Prevention (CDC), approximately 87% of all strokes are ischemic, meaning they occur when blood flow to the brain is blocked.

Research consistently shows that early, specialized rehabilitation can significantly improve both physical and cognitive recovery after stroke, while also enhancing overall quality of life. In this article, we highlight the most recommended post-stroke speech therapy exercises within Constant Therapy.

The Goal of Stroke Therapy: Regaining Lost Skills

Stroke rehabilitation is designed to help individuals recover lost abilities and develop strategies to compensate for ongoing challenges.

According to the CDC, about 87% of strokes are ischemic. Additionally, the American Speech-Language-Hearing Association (ASHA) reports that individuals with aphasia or other cognitive-communication disorders make up as much as 20% of the adult caseload for speech-language pathologists (SLPs) in the United States.

Common goals of post-stroke therapy include:

• Restoring physical function and improving independence in daily activities
• Building strength, balance, and mobility
• Improving communication skills, including speech, language, cognition, and swallowing
• Developing compensatory strategies and adaptive behaviors

How Constant Therapy Supports Stroke Recovery

Constant Therapy uses artificial intelligence and data-driven analytics to deliver personalized brain-training programs. These programs target a wide range of cognitive and communication skills, including memory, attention, problem-solving, math, language, reading, and writing.

A study published in Frontiers in Human Neuroscience reported significant improvements on standardized assessments among stroke survivors using Constant Therapy’s iPad-based rehabilitation platform.

To better understand how clinicians use the platform in practice, we analyzed usage data from:

• 18,230 users who identified a diagnosis of stroke
• An average of 572 tasks completed per user
• A total of 837,700 tasks completed

The following are the 10 stroke speech therapy exercises most frequently assigned by clinicians to individuals recovering from stroke.

Best Speech Exercises for Post-Stroke Recovery

1. Follow Instructions You Hear
This exercise targets auditory comprehension and auditory memory by requiring users to follow spoken directions of increasing length and complexity.

This task is especially helpful for individuals with aphasia or reduced auditory processing, as it strengthens the ability to understand everyday instructions (e.g., “Pick up the pen and place it next to the book”). Clinicians can use it to target multi-step direction following, working memory, and attention to linguistic detail. It also supports functional communication needed for daily activities.

Number of post-stroke users completing the exercise: 10,207
Percent of post-stroke users completing the exercise: 56%

2. Find the Same Symbols
This exercise addresses attention, visuospatial processing, and executive functioning by requiring users to identify matching symbols within a field of distractors.

After stroke, patients often experience difficulty with visual attention and scanning (especially with right hemisphere damage or neglect). This task helps improve visual discrimination, sustained attention, and processing speed. It can also be used to support visual field awareness and reduce errors in real-world tasks like reading or navigating environments.

Number of post-stroke users completing the exercise: 9,216
Percent of post-stroke users completing the exercise: 51%

3. Put Steps in Order
This exercise focuses on executive functioning skills such as planning, sequencing, and organization by asking users to arrange steps of everyday activities in the correct order.

This task is highly functional, as it mirrors real-life routines like making coffee or getting dressed. It supports independence by helping patients relearn how to sequence tasks logically. Additionally, it can be used to target sentence-level reading comprehension and narrative organization.

Number of post-stroke users completing the exercise: 8,814
Percent of post-stroke users completing the exercise: 48%

4. Match Pictures
This exercise supports visual memory and recognition by asking users to match identical or related images displayed on a grid.

For individuals with language impairments, this task can be paired with naming to target word retrieval and semantic processing. It is also useful for patients with cognitive deficits, as it strengthens attention, memory, and visual organization skills. Clinicians often use this as a foundational task before progressing to more language-heavy activities.

Number of post-stroke users completing the exercise: 7,629
Percent of post-stroke users completing the exercise: 42%

5. Remember Pictures in Order (N-Back)
This exercise targets working memory – specifically the ability to continuously update and manipulate information – by requiring users to recall items presented earlier in a sequence.

This task becomes progressively more challenging across levels, requiring recall from 1, 2, or 3 steps back. Working memory is critical for conversation, problem solving, and comprehension, making this a key exercise for higher-level cognitive rehabilitation.

Related tasks include Remember Spoken Word Order (N-Back) and Remember Written Words in Order (N-Back)

Number of post-stroke users completing the exercise: 7,213
Percent of post-stroke users completing the exercise: 40%

6. Do Clock Math
This exercise addresses attention, working memory, numerical reasoning, and problem solving through time-based calculations involving analog clocks.

Time-telling and time-based reasoning are essential for independence (e.g., managing schedules, appointments, etc.). This task helps patient reconnect numerical concepts with functional contexts, while also supporting language skills such as number retrieval and comprehension of time-related vocabulary.

Number of post-stroke users completing the exercise: 6,701
Percent of post-stroke users completing the exercise: 37%

7. Name Pictures
This exercise improves word retrieval (anomia) by prompting users to name pictured objects, with multiple cueing options available.

This task is a core intervention for individuals with aphasia. Cueing hierarchies – including semantic (meaning-based), phonemic (sound-based), graphemic (letter-based), and whole-word cues – allow clinicians to scaffold support and promote successful retrieval. Repeated practice helps strengthen neural connections for vocabulary access and expressive language.

Number of post-stroke users completing the exercise: 6,635
Percent of post-stroke users completing the exercise: 36%

8. Repeat a Pattern
This exercise targets attention, visual working memory, and visuospatial processing by requiring users to observe and replicate patterns.

This task is particularly beneficial for individuals with right hemisphere damage or broader cognitive impairments. It supports skills needed for everyday tasks such as organizing objects, following visual sequences, and completing multi-step nonverbal activities

Number of post-stroke users completing the exercise: 6,433
Percent of post-stroke users completing the exercise: 35%

9. Understand Voicemail
A functional, real-world task that strengthens auditory comprehension and memory by asking users to listen to and answer questions about voicemail messages.

This exercise bridges the gap between structured therapy and real-life communication demands. It helps patients process natural speech, retain key details, and interpret meaning in context. Higher-level variations (e.g., Infer from Voicemail) target inference and abstract reasoning.

Number of post-stroke users completing the exercise: 6,085
Percent of post-stroke users completing the exercise: 33%

10. Remember the Right Card
This exercise targets attention, inhibitory control, and processing speed by requiring users to monitor a sequence and respond only when a target card appears.

This task strengthens cognitive control and the ability to suppress incorrect responses – skills that are often impaired after stroke. It is particularly useful for improving focus, reducing impulsivity, and enhancing accuracy in both cognitive and communication tasks.

Number of post-stroke users completing the exercise: 5,690
Percent of post-stroke users completing the exercise: 31%

References
Des Roches, C., Kiran, S., & Balachandran, I. (2015). Effectiveness of an impairment-based individualized rehabilitation program using an iPad-based software platform. Frontiers in Human Neuroscience. doi:10.3389/fnhum.2014.01015
Centers for Disease Control and Prevention (2018). Stroke Facts.
American Speech-Language-Hearing Association (2025). SLP Healthcare Survey: Caseload Characteristics.

Medically reviewed by Zach Smith, MS, CCC-SLP