National Stroke Week: the S in FAST stands for speech

This week is National Stroke Week, and the Stroke Foundation is asking all of us to know the signs of stroke and act fast. The 2026 theme celebrates F.A.S.T. heroes: the everyday people who spotted a stroke and called triple zero straight away. As a speech pathologist who works with adults after brain injury, I want to talk about the letter that often gets overlooked. The S. It stands for speech, and it is one of the clearest early warnings a stroke gives.

You have probably seen FAST before. Face: has their face drooped on one side. Arms: can they lift both arms. Speech: is their speech slurred, or are they struggling to find words. Time: if you see any of these signs, it is time to call triple zero. It is a simple checklist, and it saves lives, because the faster someone gets to hospital, the more brain can be protected.

Speech changes during a stroke can look a few different ways. Some people slur their words, as if they have had a few too many drinks. Some reach for a word and it will not come. Some say a sentence that comes out jumbled, with the wrong words in it, even though they have no idea it sounded that way. Some understand far less of what you are saying than usual. Any sudden change like this, in someone who was fine an hour ago, is a reason to call an ambulance. You do not need to work out what kind of change it is. That is our job later. Your job in the moment is to call.

I say later, because this is where speech pathology comes in. Stroke can affect communication in lasting ways, and the two you might hear named are aphasia and dysarthria difficulty. Aphasia is trouble with language itself: the words, the sentences, the reading and writing. Dysarthria is difficulty with articulating speech. Both are common. Both are treatable. Neither means the person has lost their intelligence or their personality, even though it can feel that way to a worried family in the first weeks.

Here is the part I most want families to hear. Recovery does not stop at the hospital door, and it does not stop after the first few months. There is good Australian work happening right now on intensive, group-based stroke rehabilitation, where people practise for hours a day across several weeks and make real gains in function, sometimes years after their stroke. The brain keeps learning. The right practice, at the right intensity, keeps helping. If you or someone you love is living with communication changes after a stroke, it is worth asking what therapy could still offer, no matter how long ago it happened.

If you take one thing from Stroke Week, let it be the checklist. Face, Arms, Speech, Time. Put it on the fridge. Teach it to your kids. Sudden slurred speech or sudden trouble finding words is not something to wait out or sleep off. It is a reason to call triple zero.

For anything about your own health or a family member's, please see your GP, who can guide you and refer on. If communication has changed after a stroke or brain injury, a speech pathologist can assess what is going on and build a plan with you.

Dr Anna Copley is a Brisbane speech pathologist with a PhD in brain injury.