Brain injury and the role of the Speech-Language Pathologist 

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BY: DANIELLE-HYDE, SPEECH-LANGUAGE PATHOLOGIST

Acquired Brain Injuries (ABI) can be caused by motor vehicle accidents, falls, sports injuries, strokes, tumours, infections, or other trauma to the brain. The impacts of a brain injury are complex and vary significantly from person to person but often affect how they think, feel, and act. 

Individuals with a brain injury often experience physical, emotional, sleep and cognitive changes that impact their ability to successfully return to the activities that are important to them.

Changes in the way we think (i.e. cognitive skills) impact our ability to communicate effectively. This may include understanding information, expressing oneself, reading, writing, and even participating in social interactions. These difficulties are called cognitive-communication deficits. Speech-Language Pathologists help individuals with these difficulties.

So, what do these difficulties look like?

AUDITORY COMPREHENSION

  • Difficulty concentrating on what is being said 
  • Trouble understanding long statements
  • Difficulty understanding implied information or jokes
  • May misunderstand conversations or discussions

VERBAL EXPRESSION AND DISCOURSE

  • Trouble finding the right word or a good substitute quickly
  • Difficulty generating ideas or topics of conversation
  • Difficulty elaborating or having an in-depth conversation
  • Disorganized conversation or jumping around topics
  • Vague language, missing important details

READING AND WRITING

  • Difficulty reading and understanding sentences, paragraphs, or long texts
  • Attending to what is read, may need to reread everything
  • Retaining read information over time
  • Spelling difficulty 
  • Difficulty formulating and organizing ideas in writing
  • May take substantially longer to write as compared to before

PROBLEM-SOLVING, REASONING AND EXECUTIVE FUNCTIONING

  • Difficulty identifying important information and irrelevant information
  • Trouble generating alternative solutions
  • Difficulty with planning, organizing, and prioritizing tasks
  • Struggling with weighing options and decision-making
  • Trouble with summarizing or identifying the main point

SOCIAL COMMUNICATION

  • Difficulty perceiving nonverbal cues (gestures, facial expressions, tone of voice, body language)
  • Trouble taking turns, interrupting, or dominating a conversation
  • Long-winded, rambling, or verbose conversation
  • Tangential or often goes off-topic in a conversation
  • Socially inappropriate topics or comments

These challenges impact our ability to complete daily tasks, return to work or school, or participate in social or leisure activities. 

In addition to cognitive-communication challenges, individuals who have sustained a brain injury may also have difficulties with speech, fluency, voice, or even swallowing problems. These are all areas that SLPs can assist with!

So, how do Speech-Language Pathologists (SLPs) help?
Speech-Language Pathologists
are uniquely qualified to help people with the complex communication issues that often arise as a result of changes in cognitive functioning following a brain injury.

SLPs provide assessment and personalized treatment that may include: education, goal-setting, strategy instruction, direct training and practice, communication partner training, and metacognitive strategy instruction with ongoing feedback and support. 

Treatment may focus on the following:

  • Improving speech to make it clearer or more fluent
  • Improving attention during daily tasks and activities
  • Enhancing memory through techniques or strategies
  • Improving problem-solving, reasoning, planning or organizational skills
  • Improving the ability to understand information
  • Expressing thoughts more effectively
  • Improving social skills and interactions such as taking turns in a conversation or understanding nonverbal cues
  • Enhancing vocal quality
  • Improving swallowing function and safety

Brain injury rehabilitation and recovery is a marathon, not a sprint. The process takes time and usually requires a team of collaborating professionals to maximize healing and outcomes. Speech-Language Pathologists play an important role in regaining cognitive and communication skills in order to successfully return to the activities and interactions that are important to each individual.


Danielle is a licensed Speech-Language Pathologist and owner of a private practice called Neuro Connections in Toronto, Ontario. Follow her at @neuro.connections on Instagram to learn more about cognitive-communication and the SLP’s role in brain injury recovery.