Helping Brain Injury Survivors with Communication Problems

Helping Brain Injury Survivors with Communication Problems

After a person has a stroke or a traumatic brain injury (TBI), they may face several new challenges. One of those is often in the way they communicate.


According to the American Speech-Language-Hearing Association (ASHA), the communication problems following a stroke could appear in the form of aphasia or with the motor functions the body uses to speak.

When a person has aphasia following a stroke, they may experience:

  • Difficulty putting thoughts together in a sequence to tell a story
  • Switching topics without warning, or seeming to "go off on tangents" without telling the person who is listening
  • Difficulty taking turns in conversation
  • Problems maintaining a topic of conversation
  • Trouble using an appropriate tone of voice
  • Difficulties interpreting the subtleties of conversation (e.g., sarcasm, humor)
  • Problems "keeping up" with others in a fast-paced interaction
  • Reacting inappropriately; seeming overemotional (overreacting), impulsive, or "flat" (without emotional affect)
  • Having little to no self-awareness of inappropriate actions or responses

If they have oral motor function problems, it could include:

  • Muscles of the lips and tongue may be weaker (dysarthria) or less coordinated (apraxia).
  • Speech may be unclear.
  • Breathing muscles may be weaker, affecting a person’s to speak loudly enough to be heard in conversation.

A person’s facial muscles may be weak, so they may not be able to speak. To help them recover, a certified speech-language pathologist (SLP) can become involved. This treatment focuses on both expressive and receptive language skills. The rehabilitation may include participation in group therapy discussion with other stroke survivors. This means they get to practice conversational skills together.

The SLP may also hold structured discussions. These focus on the structure of conversations, i.e. initiation, taking turns, clarifying ideas, and ways to solve breakdowns in conversation.

The SLP may also role-play common communication situations. This role-playing could synthesize situations that take place in the community or at home, such as talking on the phone, placing an order in a restaurant, or asking questions from a salesperson in a store.

TBI Brain

ASHA says those who experience a TBI often have similar issues with communication. A person living with a brain injury may have trouble finding the words they need to express the correct idea or explain what they mean either through speaking or writing. Experts say spoken or written messages may suddenly present themselves as if they are in a foreign language.

One of the most frustrating issues to a person’s family and friends is that the brain injury survivor may not be aware of how inappropriate they may be acting in certain situations. For example, they may not understand they are talking very loud in a quieter environment and it can be frustrating to those around them.

Like a stroke survivor, a person with a brain injury may also experience weakness in the muscles that work the lips and tongue. These muscles may also be less coordinated. Furthermore, these issues could mean a person cannot chew or swallow effectively.

To help a person with TBI, an SLP may spend time re-developing social skills, and helping out with problem solving, reasoning, and organization.

In the case with a stroke or a TBI, the goal is to get a person back to a place where they are comfortable communicating as much as possible. While full recovery is not possible in every situation, an SLP can make a big difference in a recovering person’s life.

Many SLPs have an incredible amount of patience that provides support to their patients and their patients’ families. It is often very frustrating for a person recovering from a stroke to cope with communication challenges. By staying patient, an SLP can both sympathize and ease tensions. It’s helpful for family members of a person who survived a stroke to strive for this same sort of patience.

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