Let’s look at some of the things the brain normally does when we communicate. What must happen if, for example, someone asks a question, and you answer?
- You hear the speaker’s voice and focus on it.
You create meaning from the speech sounds.
- You match the meaning of what you’ve heard with information stored in your brain.
- You make a mental image of your reply.
- In your mind, you put your response into words.
- You activate the muscles controlling voice and speech.
- You hear your answer and judge if it is what you wanted to say.
The brain usually does these functions quickly.
A person with a brain injury may find it harder to use speech or language. This can be very frustrating for him. It also makes it harder for others who are trying to help.
We know that more than one part of the brain can be injured. This means that there could be more than one issue affecting communication at the same time. For example, the person may have damage to the language areas of his brain or damage to the area that controls pronunciation.
Damage to other brain areas may cause issues with the thinking skills you need to be a good communicator. The person may be confused, disoriented, and impulsive, talk too much, or be withdrawn and silent. These cognitive and behavioural issues can make conversation sound inappropriate. He may have trouble staying focused on an appropriate topic and his speech may ramble disconnectedly (language of confusion). He may repeat his speech (can’t control this) or activity. This is called
Of course, not many people will have all of these issues at once, but it is possible for several to be combined, especially early in recovery. If the person a lot of trouble communicating, he may need another way to communicate, such as using a computer or picture board.
Please speak with your healthcare provider, such as a speech-language pathologist, for tips on how you can help with communication problems.
Changes in Understanding (comprehension)
It’s very hard to understand what is being said if, because of a brain injury a person can’t:
- hear the speaker’s voice and focus on it
- get meaning from words or use speech sounds to make words
- match the meaning of that being heard with information stored in the brain
Problems understanding can range from only affecting the person at certain times (like when he’s tired) to being very bad. A person with a comprehension problem may have trouble reading.
Changes in Expression
To communicate with others we need to be able to:
- come up with what we want to say
- put our response into words in our mind
- activate the muscles controlling voice and speech
- judge whether we are being appropriate
It’s important to be able to form words to share thoughts. If the brain injury has damaged the part of the brain responsible for expressive language the person may have trouble making sentences or finding the right words.
Changes in Speech and Voice
Sometimes all stages of communication work as they should, except the process of making the sounds of speech. Damage to certain areas of the brain can interfere with messages to the muscles of the tongue, lips, jaw, voice box, and other areas. The result may be a weak, breathy voice, or slurred speech sounds. Sometimes the brain gets a mixed message of how a word should sound. The person might struggle to get the right sounds in order or have trouble speaking at all.