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  • Reema Prakash M.S., CCC-SLP

Cognition and Swallowing Among the Common Challenges Persisting for Many After COVID-19

As the curtain falls on this year that was 2021, we look back and see how the world emerged after the first severe wave of COVID-19. Numbers waxed and waned, statistics and trends were graphed while people on both sides of the fence held their stance on various pandemic grounds. All said and done, as we brace ourselves for 2022 (and its known and unknown variants!) the world continues to hope and heal.

A segment of our population, however, is still grappling in the aftermath of the initial severe wave. The pandemic has posed so many challenges to us all as a society, but one of the persisting and most vexing ones right now is the daunting set of difficulties many people are having for months after contracting COVID-19. An estimated 10 to 30% of COVID-19 survivors are experiencing “long-haul” symptoms including brain fog, swallowing difficulties (difficulty eating and drinking), and speech, language and communication problems. These can affect return to work, the ability to take care of one’s family, and overall recovery and quality of life.


Many COVID-19 “long-haulers” are reporting persistent brain fog as a debilitating symptom after their bout with the virus. This can prevent a return to work and impact their ability to tend to family responsibilities. SLPs can work with individuals to improve their memory, attention, organization and planning, problem solving, learning, and social communication—such as re-learning conversational rules or understanding the intent behind a message or behind nonverbal cues.


People diagnosed with COVID-19 may experience swallowing problems that can put them at risk for choking or aspirating, which is when food goes into the lungs instead of the stomach. This may be the result of time spent on a ventilator, or it may be another side effect of the virus. SLPs use different types of tests to determine what happens when a person swallows and how the related muscles are working and may recommend modified textures of food and drink for patients; therapy exercises to strengthen the tongue, lips, and muscles in the mouth and throat; and strategies to make eating and drinking safer, such as modifying the pace of chewing/eating, size of food bolus, and more.


People diagnosed with COVID-19 are also experiencing speech and language difficulties. Some, such as those who spent a significant amount of time on a ventilator or experienced low oxygen to the brain, may have muscle weakness or reduced coordination in the muscles of the face, lips, tongue, and throat—making it difficult to talk. Others, particularly those who experienced a COVID-related stroke, may experience a language disorder called aphasia—which makes it hard for someone to understand, speak, read, or write. People who have severe speech and/or language difficulties may need to find other ways to answer questions or tell people what they want, such as through gesturing with their hands, pointing to letters or pictures on a paper or board, or using a computer. These are all forms of augmentative and alternative communication (AAC). SLPs help find the appropriate AAC method to meet an individual’s needs.

Where to Find Care

Speech-language pathologists (SLP) are professionals trained in the above areas and can help people with, or recovering from, COVID-19. SLPs work in settings that include hospitals, long- and short-term care facilities, private practices, and patients’ homes. Many SLPs also provide their services via telehealth at this time.

If you or a loved one are experiencing communication challenges, we recommend letting your doctor know. For more information on these areas, please check out the Resources sections at Resonate Therapy Solutions. If you have any concerns or questions, we are happy to help. We can be reached at

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