When we talk to each other, a number of things happen in your brain. For example, when someone asks a question:
- You hear the speaker’s voice.
- You make sense of the sounds they say.
- You match the meaning of what you hear with information stored in your brain.
- You make a mental image of your reply.
- Your brain organizes your response into words.
- You use the muscles of your throat, tongue, and mouth to speak.
- You hear your answer and decide if it’s what you wanted to say.
The brain does this all very quickly. But a person with a brain injury may find it harder to talk or use other language. This can be very frustrating for them. It also makes it harder for others who are trying to help.
When there’s a brain injury, more than one part of the brain can be injured. This can cause more than one issue with communication. For example, there may be damage to the language areas of the brain and the area that controls our accent or tone (pronunciation).
Damage to other brain areas may cause:
- issues with thinking skills that you need to communicate well
- confusion, talking too much, or being withdrawn and silent
- trouble staying focused, which may lead to talking about things that aren’t related to the conversation
- repeating what was just said or doing something that was just done (This can’t be controlled and is called perseveration.)
Most people won’t have all of these issues at once. But it’s possible to have more than one, especially early in recovery. If they have a lot of trouble communicating, they may need a different way to communicate, such as using a computer or picture board.
Ask to talk to a speech-language pathologist for tips to help with communication.
Changes in understanding
A brain injury can make it very hard to understand what’s being said if 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 what they hear to information stored in their brain
Problems understanding can happen only at certain times (like when they’re tired) or happen often. When someone has trouble understanding, they may also have trouble reading.
Changes in expression
To communicate with others, we need to:
- form what we want to say
- put this into words in our mind
- move muscles that control voice and speech
- decide if what we said is OK
It’s important to be able to form words to share thoughts. If the brain injury has damaged the part of the brain that does this, a person may have trouble making sentences or finding the right words.
Changes in speech and voice
Damage to certain areas of the brain can cause problems with the messages that are sent to the muscles of the tongue, lips, jaw, and voice box that allow us to talk. This can make the voice sound weak, breathy (needing to take lots of breaths), or hard to understand (slurring of speech).
Sometimes the brain gets a mixed message of how a word should sound. This can make it hard to get the right sounds in order or talk at all.