Communication difficulties are a common after a traumatic brain injury or head injury and are usually present alongside other difficulties with memory, fatigue, planning, social skills and behaviour. So when focussing on communication we have to also be aware of these other contributing factors.

Outwardly, it may be the speech and language which is affected when a person has an acquired brain injury. A brain injured person may have a speech difficulty that makes his speech less intelligible or a language problem which means he cannot express his thoughts or find the right words. Inwardly however, he may not be able to attend to, or process information he is hearing, and he may not be able to organise his own thoughts or self monitor.  A brain injured individual may loose the understanding of social skills and rules.  He may interrupt, he may dominate the conversation, change topic or say inappropriate things.

All of these factors may play a part in the communication of a brain injured individual.  In the months after the injury some of these problems will improve as the brain heals. However, some impairments may continue to cause the individual difficulties.  For this reason the speech and language therapist / pathologist and the rehab team will focus on strategies to facilitate communication and interaction. When an individual can learn to use these strategies to compensate for their difficulties they can often manage well in social situations.

Strategies will often focus on self monitoring techniques, word finding and managing fatigue. For those individuals with severe speech difficulties the implementation of assistive technology (AAC) for communication may be the next step.