Right Hemisphere Damage

The scope of this Practice Portal page is deficits and disorders associated with damage to the right hemisphere of the brain in adults with acquired brain injury (including stroke and traumatic brain injury [TBI]).


See ASHA’s Right Hemisphere Disorders Evidence Map for summaries of the available research on this topic. See also ASHA’s Evidence Maps on Stroke and Traumatic Brain Injury for research related to right hemisphere damage in these populations.

The right hemisphere of the brain participates in many communication skills, primarily at the semantic (word and discourse) and pragmatic levels.

Right hemisphere damage (RHD; also known as “right hemisphere disorder” and “right hemisphere brain damage”) is an acquired brain injury—usually secondary to stroke or TBI—that causes impairments in language and other cognitive domains that affect communication.

Syntax, grammar, phonological processing, and word retrieval typically are not affected. However, RHD can affect

  • semantic processing of words;
  • discourse processing (including narratives);
  • prosody; and
  • pragmatics.

RHD can also cause impairments in other cognitive domains—including attention, memory, and executive functioning—that can interfere with communication abilities. Impairments can include anosagnosia (reduced awareness of deficits) and visual neglect (aspects of visual stimulus are ignored), both of which can significantly affect spoken and written language.

Deficits associated with RHD may be more evident during the performance of multidimensional, complex tasks such as conversation (Ferré, Ska, Lajoie, Bleau, & Joanette, 2011) and can have a significant impact on functional performance in social and vocational settings (Blake, 2006; Lehman & Tompkins, 2000).

In a very small proportion of right-handed individuals, the language centers are located in the right hemisphere of the brain, rather than in the left hemisphere. In these individuals, damage to the right hemisphere may result in symptoms of aphasia similar to those normally associated with a left hemisphere lesion. This condition is known as crossed aphasia (e.g., Coppens, Hungerford, Yamaguchi, & Yamadori, 2002).

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