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Acquired Brain Injury

What is an acquired brain injury?

This term means that there has been an injury to the brain some time after the person was born. Sometimes the term “head injury” is used for traumatic brain injuries caused by accidents such as motor vehicle accidents, bicycle and pedestrian injuries, falls, and assaults. In acquired brain injury, the person’s condition is not expected to get worse over time.

What difficulties might someone have following an acquired brain injury?

A person may experience problems in the following areas: 

  • attention
  • reasoning
  • social skills
  • understanding
  • awareness
  • problem solving
  • speech/pronunciation
  • speaking
  • memory
  • judgment
  • voice
  • reading
  • learning
  • planning 
  • eating/swallowing
  • writing
  • organization
  • self-monitoring
  • self-inhibiting
  • goal setting
  • orientation
  • self-evaluating
  • word finding
  • self-initiating
  • information processing (i.e. time efficiency

The problems may or may not be subtle. They may be apparent immediately after the accident or at a later time. 

How can a speech-language pathologist assist?

Many people with acquired brain injuries have problems with thinking and this can interfere with their ability to communicate effectively. This is an example of a cognitive-communication difficulty. A speech-language pathologist can assess all aspects of the person’s communication (listening, speaking, reading, and writing) as well as cognitive or thinking skills that may influence the person’s communication (e.g. attention, memory, organization, reasoning, judgement). The speech-language pathologist can also assess swallowing as needed. The important part of this assessment is to determine the extent to which these cognitive-communication difficulties may affect the person’s return to work, school, family interactions, and/or return to activities in the community. The speech-language pathologist then develops a treatment plan, which lists therapy goals, procedures, and strategies, to help the person and their family cope with the problem in manageable steps. The speech-language pathologist then provides therapy either in a hospital, the person’s home, school, community, or place of employment depending on their personal needs and stage of recovery. Treatment may include:

  • educating the person with the brain injury and significant others about the nature of the person’s strengths and weaknesses, and how to help the person cope.
  • changing or modifying the environment – e.g. reducing background noise so the person can listen more effectively.
  • providing the person with exercises to improve his/her cognitive-communication, speech, and/or swallowing skills.
  • providing the person with opportunities to practice communicating in a variety of settings and situations.
  • teaching the person strategies to help compensate for or deal with their difficulties.
  • working closely with all of the professionals who are assisting the person with brain injury (e.g. Occupational Therapists, Physiotherapists, Psychologists, Social Workers).

How can I find a speech-language pathologist?

  • Ask your family doctor.
  • Find a private practitioner in your area here.
  • Contact your local brain injury association (1-800-263-5404) to see if they can recommend someone 
  • Contact your local hospital, rehabilitation centre or Community Care Access Centre’s rehabilitation department, to find out what services are available in your area.

Some things you can do to help communicate with the person who has a brain injury 

  • Treat him/her with respect & remember the person is as intelligent but is perhaps less efficient.
  • Minimize distractions while talking such as turning off the T.V. and/or radio, and closing the door.
  • Make sure you have the person’s attention before speaking.
  • Have one person at a time talk to the person.
  • Pause after each point, and allow the person adequate time to process spoken information.
  • Repeat spoken information as often as needed.
  • State things directly and avoid the use of abstract language such as sayings, jokes, asides, proverbs, or figures of speech. 
  • Encourage the person to write information down to help him/her remember it.
  • Summarize the key points of important discussions or meetings on a piece of paper and give it to the person.
  • Encourage the person to note key appointments or messages in a daily planner or memory book.
  • Allow the person to use a tape recorder, calculator, computer, etc. as needed.
  • Give the person one activity/task to do at a time.
  • Give the person as much responsibility as he/she can handle.
  • Provide feedback gently regarding cognitive-communication difficulties in a nonjudgmental manner. Be specific and use clear examples.
  • Suggest what the person might try next time rather than focusing on what they did wrong. 

More on Acquired Brain Injury and Cognitive Communication 

Acquired brain injuries range from mild to catastrophic. The type of brain injury could be traumatic - the result of a trauma such as a car accident or near drowning - or non-traumatic, caused by a stroke or heart attack, tumour, drug abuse, or infection.

Many different problems can result from a brain injury, depending on the part and amount of the brain that is damaged. No two brain injuries are exactly alike.

Treatment is often needed to help the person with a brain injury to regain regular functions, including the ability to communicate. Brain injuries can affect a person's ability to speak, understand, write, and read.

Cognitive-communication impairments are difficulties in communication (listening, speaking, reading, writing, social interaction) that may result from generalized cognitive deficits (attention, memory, organization, reasoning, problem solving, and/or executive functions such as goal setting, planning, initiation etc.) as well as from more specific linguistic, motor or pragmatic (social-communication) deficits.

Cognitive-communication difficulties impact individuals in many ways. Some practical examples include:

  • At work (e.g., following directions from a supervisor, filling out forms, reading procedural manuals, speaking appropriately with colleagues, etc.)
  • At school (e.g., reading and analyzing a novel, writing an essay, taking notes in class, writing a test, reading a textbook, doing an oral presentation, etc.)
  • At home and in the community (e.g., retelling events of the day, understanding humour and sarcasm, interpreting the intended meaning of communication partners, composing an email, following a television show, participating in a group discussion, enjoying a novel, helping children with homework, behavioural management of children / functioning in a parenting role, etc.) 
Communication Skills Treated by Speech-Language Pathologists
  1. Auditory Comprehension / Information Processing
  2. Verbal Expression
  3. Reading
  4. Writing
  5. Social Skills and others such as Attention, Memory and Reasoning


Click here for our brochure on Learning About Acquired Brain Injury and Cognitive Communication.

    
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