Communication with others is somewhat tricky to handle. It’s not only pronouncing the words, but it involves a huge responsibility for listening to others, understanding what one says, keeping in their memory, and then responding.
But because of the injury in the brain, it becomes difficult to do all these tasks. That is where cognitive speech therapy comes in. This is a special way to help those with traumatic brain injuries to help them communicate better and sharpen their thinking skills.
Disorders of Cognitive-Communication: What are the Causes?
In the human brain, there are different parts, subparts, and areas responsible for discontinuing our thinking processes. But when an injury to the brain is a heavy blow, these may get damaged. It results in a disorder well known as the communication disorder.
Individuals with this problem might be unable to maintain attention in a discourse, remember specifics, and follow commands. They can have the disorder alone, or the condition can occur along with other language disorders like aphasia, dysarthria, or apraxia of speech. That, of course, would depend on which areas of the brain were affected.
Take the case of Wernicke’s area. When it is damaged, one may end up with a certain type of language difficulty known as fluent aphasia. In this condition, though one can talk smoothly, what one says may not make sense.
They may make up words or string words together that don’t make any sense. The Wernicke’s area is usually found in the left cerebral hemisphere and, more specifically, within the posterior part of the temporal lobe. Destruction here leaves an individual with the inability to comprehend the meaning of words, whether spoken or printed.
Frontal Lobe and Communication
Inside the brain, there is a section which is found in the frontal, lobe-usually situated on the left side-which governs our capability to communicate vocally. Traumatic brain injury commonly causes damage to this part of the brain. It may consequently cause a disorder known as expressive aphasia. This is a disorder characterized by a severe impairment in our capability to put thoughts into words.
What is interesting, however, is that people with this type of expressive aphasia are usually able to understand most of the spoken words of others. It is the responding verbally that becomes daunting. In other words, it is like fumbling around for words to send across a message.
However, it does not affect the physical aspects involved in speaking, such as the vocal cords. The primary interference takes place with the cognitive aspect of communication. In this, it is meant that the thought process where one interprets and communicates speech gets disrupted leading to a situation where a person does not manage to express him or her as he or she intends to.
Symptoms of Cognitive-Communication Disorder
No two brain injuries are the same, and thus, symptoms of cognitive-communication disorders also vary widely. The type of TBI will influence these differences, and some symptoms may appear like other medical conditions.
So, what can these symptoms of cognitive communication disorder look like?
You may have difficulties in remembering or learning anew. Then there is the problem of executive function, like initiatives, planning, and decision making. Other problems involve one’s memory and concentration. You also may have difficulties in social relations or have trouble with speech and understanding.
New cognitive and communication problems deserve the help of a speech-language pathologist. SLPs diagnose and differentiate the disorders of cognition, language, and speech.
More importantly, they can devise an individual rehabilitation plan for you specifically. This includes cognitive speech therapy exercises that are planned with your needs and ability in mind.
Aims of Speech Therapy in Traumatic Brain Injury
Speech therapy in patients with traumatic brain injury helps develop their conversational skills. It further spreads to the areas of language and speech. Speech therapists help to treat the patient’s fluency, articulation, and learning of a language. They also train them with tips that are helpful during communication in social settings.
Speech therapists also help TBI patients build their vocabulary to be utilized appropriately. They also help with adaptive technologies like computers, tablets, and voice recognition software. Moreover, they help TBI patients plan strategies for problem-solving and decision-making skills. These are the strategies that help them feel more in control of their lives.
Communicating as simply as possible helps take pressure off when dealing with the complexities of a TBI. Some helpful tools in simplifying communication are visual aids such as flashcards or picture boards. The tools assist the person with communicating his thoughts and negate the need to have to rely on memory or cognitive skills.
Where communication is still not certain, the provision of alternative ways of expressing oneself should be assisted. These would be the methods of signing and using technical equipment, such as a computer system.
Other than speech, the sharpening of cognitive skills such as memory, attention, and problem-solving should also be a point of focus. Since TBIs usually leave one with reduced cognitive abilities, sharpening such skills can greatly help in the recovery process.
Speech Therapy and Brain-Training Activities
Cognitive-communication therapies thus form the premise for enabling people to improve in communication abilities, which are cognitive-based within the realm of their capabilities. This, however, calls for regular practice so as to maintain the adaptability and flexibility of our brains. Some practices major in improving language, while others major in strengthening cognition.
Let’s review some brain-training speech therapy practices designed for the adult population:
Task Sequencing
Organizing activities in order can help you sharpen your ability to plan, understand, and deduce. To practice this mental exercise you will want someone, perhaps a friend or caregiver, to write down for you how to do something.
That would be as simple as how to turn on your TV and change to your favorite program. Then, they should shuffle the steps around and return the list to you.
It’s your job to reorder it by selecting the steps in the appropriate order. Gradually, as your skills grow sharper, you may tackle a harder task such as dinner preparation: an exciting way to challenge your brain and keep your working memory in top condition.
One slick trick, if you trip over the process along the way, is to have the helper shoot pictures of each step of the process. Then, you can use the pictures to get the steps of the process in the right order.
Response Elaboration Speech Therapy
Now, imagine you’re going to do some Response Elaboration Training-that’s RET for all of you acronym lovers. You’re with a speech therapist who presents you with a set of pictures, which, for this example, we’ll say is a man mowing the lawn. The therapist asks you questions: Who, what, when, where, and why, to elaborate on your initial response.
RET is helpful in allowing an individual, more so the survivor, to develop his expressive ability. It’s all about broadening a simple idea into an elaborated one with practice. Often, you’ll hear RET being termed as ‘loose training,’ and that’s because there’s no correct or incorrect response. For instance, you might say, “The man is mowing the lawn because it’s too long.”
In light of the explanation given above, let us paraphrase this response, keeping RET in mind: “The man is using a lawnmower because his lawn has grown tall over the weekend due to heavy rainfall.” This can make your vocabulary grow larger and help you to explain more in a conversation.
Naming Therapy
Another cognition targeting brain-enhancing activity is naming therapy, a widely adopted technique in speech therapy. It is a great asset for patients with aphasia, who have a condition that requires them to improve in word recall to a great extent, along with their memory strength.
The most simple approach is to write down broad categories like that of animals, countries, or sports. Next, it’s your turn to exercise one’s memory by naming as many items in that category as possible, either orally or in writing.
Don’t be disheartened if this seems all a bit tricky at first. You may remember that the easy way to start could just be to identify objects around your house or in a picture book by saying their names.
Want to push your skills a bit further? Try comparing and contrasting apples with oranges or trumpets with clarinets- and express your thoughts about them. This is a good method to organize your thoughts and communicate more effectively.
Remember, it’s okay to ask for help, but allow yourself not to lean on your caregiver during this activity too much; make a habit of asking for occasional hints when you get stuck.
Conclusion
Speech therapy forms an important part of the rehabilitation process in cases of traumatic brain injury. It increases not only the communicative power but also the cognitive powers and brings about independence. These activities challenge the brain and instill a sense of achievement and encouragement to proceed further for improvement.