Difficulties with communication can occur at various levels. They can be split into speech/articulation and language problems, with the latter being further divided into problems expressing or understanding language. Articulation difficulties often occur together with swallowing problems. Complaints can vary from very mild (only subtle problems when fatigued) to severe. A correct evaluation needs to be made by a speech therapist, so that the right approach can be prescribed. The family and caregivers also need to be involved with this.