Download Frequent Communication Difficulties Following A Brain Injury

Communication is the passing of information between two or more people. This involves verbal
communication (either spoken or written), how we give and receive information and also nonverbal communication which involves the messages we give out to people by our gestures, eye
contact, appearance and body language.
Verbal communication skills;
Our selection of words.
How we put words together in a sentence.
The clarity of our speech.
The music and loudness of our voice (intonation).
The speed of our voice.
Our ability to understand other speech.
Frequent Communication Difficulties Following A Brain Injury
After a brain injury an individual can experience any of the following communication
difficulties, you may be given the following diagnostic terms.
DYSPHASIA – of which there are two forms,
Expressive Dysphasia is when an individual has difficulty finding the right words or
in making a sentence. This can affect speaking and writing.
Receptive Dysphasia is when the individual has difficulty understanding words,
sentences or symbols. This again can affect speaking and reading.
DYSARTHRIA – occurs when there is a weakness or paralysis in the muscles we use for
speaking. This can cause disruptions to the movements of the mouth and tongue and can
lead to difficulties in pronouncing words, and speech can become slurred or unclear.
DYSPRAXIA – occurs when the co-ordination of the muscles used for speech breaks
down. This causes difficulties in producing fluent, clear speech.
Sarah Gwilliam, Speech & Language Therapist, CBIT
Communication
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Features of the Above Communication Difficulties Following Brain Injury
1. Finding the right words – Normally in a conversation the words flow and each person
generally knows what they are going to say without too much effort. After brain injury
this can be difficult as there is often a feeling of having the words on the ’tip of the
tongue’ but without being able to find them in time. This may interrupt the flow of the
conversation and can be very frustrating.
2. Putting sentences together – Putting words in the right order when speaking or writing
can be an important part of communication.
After brain injury, people can have
difficulties in getting words in a sentence to fit together so that they make sense. At other
times memory or concentration difficulties can mean that people lose track of what they
wanted to say in mid sentence or forget the topic they were thinking about.
3. Overloading – The topic in conversation frequently change as people contribute their
opinions and experiences. After a brain injury this can be overwhelming, as too much
information is needed to be processed too quickly. This can be particularly difficult if a
number of people are talking at once or the conversation is moving too fast. It can easily
lead to losing track of conversations and feeling unable to contribute.
4. Constant talking – Conversation is a two way activity involving turn taking. There are
often natural pauses in speech and listening can be as important as speaking. Following
brain injury a person can be less aware of the need for pausing or taking turns when
speaking, or of the need to just listen.
5. Taking things literally – When people use expressions like ‘I’ll be back in a few
seconds’ it is not usually meant literally. After a brain injury these types of expressions
can be taken to mean exactly what they say. This can be confusing because different
meanings are taken from the same sentence.
6. Inappropriate responses – Knowing when it is alright to laugh, cry, talk about personal
information or swear etc is an important part of communication. After a brain injury this
can be less easy to do and these things can be done in the wrong place. This can lead to
embarrassment or difficulty with relationships.
Sarah Gwilliam, Speech & Language Therapist, CBIT
Communication
2
7. Inappropriate eye contact – Maintaining an appropriate amount of eye contact lets us
know people are interested in and listening to what we are saying. However after a brain
injury individuals can experience difficulties monitoring their eye contact. Therefore,
this can lead to people not giving enough / or giving too much eye contact during a
conversation which can be distracting or uncomfortable for the conversation partner.
8. Lack of Insight – Individuals may have a variety of communication difficulties, but may
not be aware of these.
Experiencing any of the above communication difficulties can lead to the individual feeling
frustrated, anxious, stressed and reduced self esteem.
These feelings can make their
communication difficulties worse, leading to a vicious cycle of more stress / frustration, anxiety
and therefore more communication difficulties.
Strategies to Improve Communication
The following ideas may help for the brain injured individual.
Ask people to slow down their rate of speech or ask them to simplify and be more
concise when they are speaking.
If you get stuck on a word, try to think of another word that means the same or try to
explain / describe what you are trying to say.
Plan your sentence in your mind before you say it, to ensure the words are in the right
order.
Allow yourself plenty of time to get your message across.
If you don’t understand what someone has said to you, ask them to repeat or rephrase
what they said.
Be open to others about communication difficulties you experience and inform them of
things that aid your communication so that they are more prepared and aware and can
make adaptions to their speech.
Sarah Gwilliam, Speech & Language Therapist, CBIT
Communication
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When Communicating With an Individual With a Brain Injury
Ask them if there are changes to your communication you can make to help them
understand you.
Give the individual plenty of time to get their message across, do not finish off their
sentences for them / or rush them in any way.
It may be useful if you slow down your rate of speech, to allow them extra time to
process and understand what is being said. Check with the individual to see if this helps
them.
If you have not understood what someone has said, don’t be afraid to ask them to repeat
themselves.
Reduce background distractions / noise as much as possible when communicating.
Ensure that your face is visible to the individual when you are communicating.
Adapted from ‘Headway’ and Aylesbury NHS Trust information leaflets.
Sarah Gwilliam, Speech & Language Therapist, CBIT
Communication
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