While some communication disorders are present in people throughout their entire lives, others can come on suddenly, as the result of a traumatic brain injury. It is important to think about the best ways to treat and help people who have sudden onset communication disorders as their experience can vary greatly from someone who has a disorder from childhood, and even from others who have different types of brain injuries.
Oftentimes, communication difficulties are the worst immediately following the accident, because that is when brain swelling is the greatest. For many people, as the injury heals the cognitive and communication problems go away; unfortunately for many others some permanent damage results from the injury. These permanent damages can include a variety of communication problems, language problems and speech problems.
In the most severe brain injuries, swelling puts pressure on the brainstem, causing individuals to fall into a coma. Someone in a coma may be completely unresponsive or may move, make noise, or respond to pain but be unaware of their surroundings. Because these people are unconscious, they are unable to communicate, but recovery is possible if the swelling goes down and the brainstem regains function.
In conscious sufferers of brain injury language problems can vary significantly. Patients may have difficulty finding the right words, may be unable to form complete sentences, and often give lengthy and often faulty descriptions or explanations to cover for a lack of understanding or inability to think of a word. Many people with brain injuries also have difficulty understanding multiple meanings in jokes, sarcasm, and adages or figurative expressions. Also, individuals with traumatic brain injuries may not know that they are having problems communicating and may become frustrated or angry and place the blame for communication difficulties on the person to whom they are speaking. Finally, reading and writing abilities are often significantly worse following a brain injury.
Sometimes people who suffer traumatic brain injuries develop dysarthria. In people with this disorder speech may be slow, slurred, and difficult or impossible to understand. Others may have what is called apraxia of speech, which means they will experience difficulty saying words correctly in a consistent way.
The communication problems that result from traumatic brain injury are best treated early, and often begin while the individual is still in the hospital. This early therapy will frequently center on increasing skills of alertness and attention. Longer-term therapy can occur in a brain injury rehabilitation facility and allows for intensive therapy by speech-language pathologists, physical therapists, occupational therapists, and neuropsychologists. Individuals might also receive therapy at home by visiting therapists.
The goal of rehabilitation is to help the individual become as independent and functional as possible. Some people work to express needs verbally, other work to express needs by pointing to pictures, still others work to improve their ability to define words or describe consequences of actions or events. Therapy focuses on regaining lost skills as well as learning ways to compensate for any permanent changes that resulted from the injury. Most individuals respond best to programs personally tailored to their backgrounds and interests and involve family members. Computer-assisted programs have also been used with some success.
Added by Jennifer Kirmes