Communication is the passing of information between two or more people. It involves a two-way process of giving and receiving information and involves both verbal and non-verbal communication.

Common communication difficulties

Following an ABI, a person may have difficulties with expressive communication such as speech, writing; or with receptive communication i.e. understanding what’s been said or being able to read. A person may also have problems with the rules of conversation, which may lead to problems in work and social settings.

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Dysarthria occurs when the muscles involved in the production of speech are damaged as a result of the ABI. This can result in slurred, slow or low tone speech, which can lead to the person being difficult to understand.

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Dysphasia refers to any impairment of speech, and can be divided into receptive aphasia and expressive aphasia:

  1. Receptive dysphasia: difficulty with language due to dame to the brain in speaking and writing
  2. Expressive dysphasia: difficulty talking and expressing ideas
  3. Global dysphasia: occurs when both condition and present

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Dyspraxia occurs when speech muscles are unaffected but saying words in conjunction with others in a consistent way is difficult.

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Dysnomia is when the person’s speech flows normally but they cannot find the right word.

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Problems with receptive skills may include:

  • Poor recognition of words
  • Requiring things to be repeated
  • Difficulty with the speed, complexity or amount of information received
  • Not paying attention in conversations
  • Not understanding what is said
  • Difficulty understanding instructions
  • Difficulty with abstract skills in understanding humour, puns, sarcasm and metaphors

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Problems with expressive skills may include:

  • Difficulty producing specific words
  • Incorrect use of language – grammar and the order of words
  • Minimal responses when detail is required in an answer
  • Poor spelling and difficulty in learning new words
  • Repeating the same thing over and over (perseveration)
  • Trouble with writing long sentence

A speech and language therapist can help with difficulties in the production of speech by helping to strengthen muscles, increase movement of the mouth and tongue, breathing exercises and slowing down speech. In extreme cases, and alternative means of communication may be provided.

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Strategies for expressive language

  • Speak slowly with long pauses
  • Don’t rush, stay calm
  • Demonstrate your difficulties so that others can be aware and prepared
  • Try to use short sentences with familiar words
  • When stuck for a word, try to think of an alternative or explain it
  • Try to plan what you’re going to say in advance where possible
  • Use gestures, pictures or other non-verbal communication
  • Getting the message across is what’s important, not having the words exactly right
  • Reduce background noise and other distraction

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Strategies for receptive communication

  • Ask people to slow down or simplify what they’re saying
  • Ask people to repeat what they have said or check back to ensure that you have understood the person

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For care givers or partners

  • Give the person time, don’t speak for them
  • Establish eye contact
  • Don’t be afraid to say you have not understood
  • If you understand part of what has been said, repeat the words back so the person does not have to repeat that bit again
  • Always check that you have been understood
  • Include the person in the conversation
  • Avoid speaking loudly
  • Avoid being shocked by swearing as it may occur a lot
  • Remember that a difficulty expressing language, does not mean that the person has difficulty in intellect
  • Use gestures, and other non-verbal communication to aid understanding
  • Encourage all efforts to communicate
  • Alert the person to changes in the topic of conversation
  • Use direct specific questions
  • Don’t force the person to speak
  • Watch the person’s lips carefully as it may help understanding
  • Turn off / avoid distractions especially when discussing important topics
  • Consider the time of the day, some people become fatigued at certain times of the day

Other factors that influence communication are a person’s insight, attention, memory, self-monitoring, rigidity, concreteness and organization.

While all care has been taken to ensure the accuracy of this factsheet the information is intended to be a guide only and proper medical and professional advise should be sought. Elements Support Services are not responsible for any damages or injuries that arise as a result of the information in this factsheet.