Right Hemisphere Brain Damage

Right Hemisphere Brain Damage

Right Hemisphere Brain Damage, also referred to as Right Hemisphere Disorder or RHD, is the result of sustaining head trauma or a brain injury that can often be secondary to a stroke. RHD can affect the ability to understand others and to speak clearly and appropriately. It can also affect other cognitive areas related to communication.

The brain is divided into two sides, known as the right and left hemispheres. The right hemisphere of the brain is in charge of executing such functions as functional communication, and more specifically things like problem-solving, reasoning, and memory. Also in the domain of the right hemisphere are things such as emotions, imagination, visual awareness, face recognition, and interpreting social cues.

The right hemisphere of the brain is also in control of the left side of the body. Challenges and deficits related to right hemisphere brain damage can vary depending on the severity and location of the trauma. RHD can also cause impairments in other domains such as attention, memory, and executive function. Speech therapy can be invaluable to someone who is recovering from a traumatic brain injury.

Click here to schedule a free introductory call with Great Speech. This way, you will know you are addressing concerns related to a right hemisphere brain injury in the most effective way possible with our online speech therapy program.

Signs and Symptoms

The signs and symptoms of RHD usually include deficits in the Cognitive and Communication arenas. While not everyone who is diagnosed with RHD has significant or pronounced symptoms, most people exhibit some impairment related to their speech and/or communication abilities. One’s ability to recognize, interpret and express emotions can also be affected, adding to communication and social challenges. 


Most notably, RHD affects three major elements of speech and communication; Prosody, Pragmatics, and Theory of Mind.

  • Prosody – Prosody refers to the “melody of speech” the notes, cadence, emphasis, and volume of one’s speech. These elements change to add or infer meaning to what we are saying. An example might be speaking more quickly and loudly when we are excited versus speaking slowly and quietly when we are sad. Words can convey different meanings depending on emphasis and tone. RHD can often result in difficulty controlling or utilizing one’s prosody, or understanding the prosody of another. This is called Aprosodia. It can also result in the absence or limitation of facial expressions and body language.
  • Pragmatics – The other element of speech most commonly affected by RHD is called Pragmatics. This refers to social interaction, the many different ways we communicate with each other, word choice, topic or subject choice, as well as what we choose to talk about in various scenarios. All of these things can be affected by damage to the right hemisphere of the brain. Sometimes, those affected by RHD can come off as inappropriate, rude, or may appear to behave inappropriately relative to the situation or place they are in. Pragmatics also refers to the flow of conversation, the give and take, which can often be a challenge for those with RHD.
  • Theory of Mind – This is the ability to comprehend that others have feelings, knowledge, beliefs, and individual perspectives. Some people affected by RHD struggle to see things from another person’s view, understand others’ feelings, and exhibit empathy. They could be perceived as rude, uninterested, aloof, or insensitive to other people’s moods and emotions. They may also struggle to understand and appreciate certain elements of humor or storytelling.
  • Linguistic impairments – Some people with RHD experience other communication or linguistic impairments. These can include issues with such things as syntax, semantics, as well as the presence of other discourse impairments.
  • Cognitive – Some of the signs and symptoms of RHD relate to cognitive functions, affecting such areas as attention, memory, learning, and information retention. There can also be issues of self-awareness and emotional indifference, with those affected often unaware that they are missing half the picture. They may also initially deny that they need help and support and refuse treatment.


The most common cause of damage to the right hemisphere of the brain is a stroke. For RHD to occur, the stroke must occur on the right side of the brain. Other causes of right hemisphere brain damage can include traumatic brain injuries, seizure disorders, tumors, and infections. 


Brain damage is typically diagnosed by a medical doctor. This can be an ER doctor who is treating someone who has suffered head trauma, or a stroke for example. The speech therapists on our virtual team can also help to identify the presence and severity of brain damage, and how it affects speech and communication, through a series of regulated tests and assessments.

Whatever your needs are, Great Speech has got you covered. Click here to schedule a free introductory call to get matched with an online speech pathologist from our team, so you can start regaining any lost skills and feeling more confident communicating. 


The unique combination and severity of challenges and deficits will vary between persons, with no two cases being the same. As a result of these differences, no treatment plan will look the same either. Working with a speech pathologist, a custom treatment plan will be established, usually involving a combination of scheduled therapy appointments, as well as tasks and exercises to do daily at home are recommended. 

Speech and Language Therapy 

Speech therapy can be an incredibly valuable resource for those recovering from a brain injury. Improvement depends significantly on the dedication and commitment to daily practice and effort by the affected person. 

The major goals of speech therapy when treating someone with RHD are to increase independence and help regain lost skills. They may also aim to bring awareness to problems and deficits that they may be unaware of or in denial about.

A speech therapist will suggest and demonstrate exercises and tools that can be practiced at home and will help in the challenges of everyday life.

In the weeks and months following the onset of symptoms, some spontaneous recovery can be expected, especially if the RHD is the result of a stroke. Over time, with dedication and the right support, most people with RHD can make a complete recovery. 

Caring for Someone with RHD

When supporting someone with RHD, there are a few simple things caregivers can do to help their loved ones reach their goals. Some of these include:

  • Establish Routines and Plan Ahead – Routines help the person affected to know what to expect, what’s coming next, and when therapy and rehab will occur each day.
  • Caregiver Approach – A caring, patient, and loving approach is very important when working with someone affected by RHD.
  • Keep it Simple – It is very important to keep directions simple. It is also very helpful to break down tasks with multiple steps into smaller, more manageable parts.
  • Use Tools – Employing the use of tools such as clocks, notepads, lists, and calendars can be very helpful when working on memory and retaining important information.
  • Use Straightforward Language – Try to avoid the use of sarcasm, turns of phrase, euphemisms, or abstract language as this may be confusing to someone with RHD. It is important to remember that they may not understand or remember the meanings of common phrases or wordplay.
  • The Right Environment – When working on rehab or speech therapy exercises, make sure you are in a quiet space, with no audio distractions such as music, radio, or television. This will help to maintain attention and focus.

 Many experts agree that more research is needed when it comes to RHD and how its effects can be treated and ideally reversed over time. One certain thing is that Speech Therapy is an incredibly important and valuable resource when it comes to helping those affected by RHD.

If you or someone you care about needs support related to RHD, click here to schedule a free introductory call and get matched with one of our highly specialized online speech therapists and begin your speech therapy program.

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