Traumatic brain injury, or TBI, can cause a number of physical, emotional and social difficulties, including problems with communication. If you or a loved one has speech or language difficulties following a head injury, a speech-language pathologist can evaluate strengths and weaknesses and suggest therapies and coping strategies. No two people are affected by brain injury the same way, and treatments should be designed to address your specific concerns.
Word Finding
Everyone has trouble thinking of the word they're looking for from time to time, but traumatic brain injury patients can have more trouble than most. Not being able to think of the right word to express yourself can be frustrating, and the Traumatic Brain Injury Survival Guide recommends practicing circumlocution to get around word finding limitations. Whenever your relative or friend can't think of a word, encourage him to talk around it. For example, if he can't think of the word "television," get him to describe what a television does and what it looks like. "It's rectangular, there are moving pictures on it, you watch shows on it." Doing this description exercise even when you aren't having a word-finding problem makes you more effective at it when you're having trouble retrieving a word from memory.
Organization and Planning
Although some people might not think of organization and planning problems as language-related deficits, speech-language pathologists help people with them because they signal a more general problem with mental organization. People with TBI often have trouble describing sequences, which makes it hard to plan, give verbal directions or talk about stories involving cause-and-effect relationships. Planning a trip, including reading brochures and making a written travel plan, can help a loved one with TBI work on these skills. The website SpeechTX suggests working on word-finding at the same time by asking questions. For example: "If you get tired while driving, where could you stop for a rest?" Cooking with the person practices life skills, mastery of step-by-step procedures and literacy skills.
Discuss and Tell Stories
Talking about current events not only helps a person with traumatic brain injury improve her expressive abilities, but it gives the person practice with acting appropriately in social situations. According to the American Speech-Language-Hearing Association, people with brain injuries often have trouble understanding what's polite and impolite in social situations, and debating with others helps people learn what's appropriate and what isn't in a controlled setting. The website SpeechTX suggests talking about relatives and friends. People with motor speech disorders need practice with clear articulation, and appreciate bring able to talk about important people in their lives and say their names clearly. Try playing a storytelling game. Start with a sentence like "Once upon a time, there was a boy playing in the park." Take turns offering sentences to complete the story. This exercise can help to improve word pronunciation, mental organization and expressive abilities.
Finer Points of Communication
Your relative or friend with traumatic brain injury may have trouble understanding non-literal forms of communication -- jokes and idioms, for example. The website SpeechTX suggests working on this skill using cards with common sayings. Include multiple choice answers on the back of each. One should be the correct interpretation of the phrase, while the others are incorrect. For example, for the phrase, "A bird in the hand is worth two in the bush," you could provide the following options. A. It's better to appreciate what you already have than to risk it for something uncertain, B. A pet bird from the store is more fun than wild birds, or C. If you want something in life, you need to go after it. Stick up correctly answered cards on the wall. To practice literacy, you could also help your loved one make her own cards.
References
- SpeechTX: Teen and Adult Activities
- The Traumatic Brain Injury Survival Guide; Memory; Dr. Glen Johnson; 2010
- The Traumatic Brain Injury Survival Guide; Problems Getting Organized; Dr. Glen Johnson; 2010
- The Traumatic Brain Injury Survival Guide; Word-Finding; Dr. Glen Johnson; 2010
- American Speech-Language-Hearing Association: Traumatic Brain Injury
