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Communication after an Acquired Brain Injury Communication is the passing of information between two or more people. It involves a twoway process of giving and receiving information and involves both verbal and non-verbal communication. Common communication difficulties Following an ABI, a person may have difficulties with communication. These can include problems with expressive communication such as speech, writing; or with receptive communication i.e; understanding what’s been said or being able to read. A person may also have problems with the rules of conversation which may lead to problems in work and social settings. Dysarthria occurs when the muscles involved in the production of speech are damaged as a result of the ABI. This can result in slurred, slow or low tone speech which can lead to the person being difficult to understand. Dysphasia refers to any impairment of speech, and can be divided into receptive aphasia and expressive aphasia: Problems with receptive skills may include: • Poor recognition of words • Requiring things to be repeated • Difficulty with the speed, complexity or amount of information received • Not paying attention in conversations • Not understanding what is said • Difficulty understanding instructions • Difficulty with abstract skills in understanding humour, puns, sarcasm and metaphors Problems with expressive skills may include: Difficulty producing specific words Incorrect use of language – grammar and the order of words Minimal responses when detail is required in an answer Receptive dysphasia – difficulty with language due to dame to the brain in speaking and writing Poor spelling and difficulty in learning new words o Expressive dysphasia – difficulty talking and expressing ideas. Repeating the same thing over and over (perseveration) o Global dysphasia - occurs when both conditions are present. Trouble with writing long sentences o Dyspraxia – occurs when speech muscles are unaffected but saying words in conjunction with others in a consistent way is difficult. Dysnomia is when the person’s speech flows normally but they cannot find the right word. A speech and language therapist can help with difficulties in the production of speech by helping to strengthen muscles, increase movement of the mouth and tongue, breathing exercises and slowing down speech. In extreme cases, an alternative means of communication may be provided. Copyright Headway Ireland, 2007. This is one of a range of factsheets made available by Headway. We have taken great care to ensure all information is accurate but these factsheets are only intended as a guide and recommend that medical or professional support should be sought. Headway will not be held responsible for any injuries or damages that arise from following the information provided in these factsheets. Information and Support Helpline 1890 200 278 Mon-Fri (9am to 5pm) Strategies for expressive language • • • • • • • • • Speak slowly with long pauses Don’t rush, stay calm Demonstrate your difficulties so that others can be aware and prepared Try to use short sentences with familiar words When stuck for a word, try to think of an alternative or explain it Try to plan what you’re going to say in advance where possible Use gestures, pictures or other nonverbal communication Getting the message across is what’s important, not having the words exactly right Reduce background noise and other distractions • Always check that you have been understood • Include the person in the conversation • Avoid speaking loudly • Avoid being shocked by swearing as it may occur a lot • Remember that a difficulty expressing language, does not mean that the person has difficulty in intellect • Use gestures, and other non-verbal communication to aid understanding. • Encourage all efforts to communicate • Alert the person to changes in the topic of conversation • Use direct specific questions • Don’t force the person to speak • Watch the person’s lips carefully as it may help understanding • Turn off / avoid distractions especially when discussing important topics • Consider the time of the day, some people become fatigued at certain times of the day Strategies for receptive communication • • Ask people to slow down or simplify what they’re saying Ask people to repeat what they have said or check back to ensure that you have understood the person For carers or partners • Give the person time, don’t speak for them • Establish eye contact • Don’t be afraid to say you have not understood • If you understand part of what has been said, repeat the words back so the person does not have to repeat that bit again. Other factors that influence communication are a person’s insight, attention, memory, selfmonitoring, rigidity, concreteness and organisation. Copyright Headway Ireland, 2007. This is one of a range of factsheets made available by Headway. We have taken great care to ensure all information is accurate but these factsheets are only intended as a guide and recommend that medical or professional support should be sought. Headway will not be held responsible for any injuries or damages that arise from following the information provided in these factsheets. Information and Support Helpline 1890 200 278 Mon-Fri (9am to 5pm)