Traumatic brain injury (TBI) causes a variety of deficits, depending on the extent of the injury. The rehabilitation team's job is to help the individual regain independence in activities of daily living (ADL). As a member of the hospital or outpatient team, speech-language pathologists (SLPs) work with individuals on using and understanding communication. They also specialize in muscles of the face, mouth and throat. So patients will find that speech goals for TBI cover speech, language, cognition and swallowing.
Damage to nerves in the brain that control muscle movements can lead to impaired speech. According to the American Speech-Language Hearing Association (ASHA), when speech sounds slurred, soft, slow and mumbled, the condition is known as dysarthria. Goals to improve speech intelligibility for this condition include improving breath support, coordination of tongue and lip movements, and increasing muscle strength. Another condition, known as apraxia of speech, involves difficulty sequencing sounds and syllables. The person knows what to say, but cannot form the word. Goals include exercises to practice saying words correctly and slow the rate of speech. For very severe deficits, individuals may need to use an augmentative or alternative communication device. These range from picture boards to computerized communication systems. The SLP trains patients in the use of these systems.
According to ASHA, persons with brain injuries may need to learn strategies for keeping up with rapid conversations, interpreting nonverbal signals such as facial expressions or body language, and what to say to maintain a conversation. The person with TBI may have a flat affect, showing little expression, and will need goals for how to improve. Good social language can help compensate for speech intelligibility problems. Eye contact, appropriate facial expressions and gesturing establish meaning in addition to speech.
In order to communicate, a person must be able to attend to information and remember events to discuss. Persons with TBI may need goals for improving attention, short-term memory, planning and organizing, and ways to rehearse information to improve processing. Individuals need to be able to return to work or school, if possible, requiring the ability to ask appropriate questions, focus on and recall assignments, phone numbers, names, the sequence of steps in a project and safety issues.