Acquired brain injury is any damage to the brain that happens after birth. It can be caused by accident or trauma, stroke, brain infection, brain tumour, or a disease like Parkinson’s disease.

Traumatic brain injury is when an accident damages the brain. This could be a car accident, a fall, or being hit on the head.

More than 700,000 Australians have a brain injury. Three-quarters of Australians with brain injury are under 65.

How acquired brain injury affects communication

All people with acquired brain injury are different. Some people have very mild communication changes. Other people have real trouble communicating.

The types of communication difficulties depend on which part of the brain is affected.

Communication difficulties can include:

• dysarthria (trouble speaking)
• aphasia (a language impairment)
• apraxia of speech (difficulty planning the movements for clear speech)
• cognitive communication disorder (changes to thinking processes that affect communication).

We talk about dysarthria, aphasia and apraxia of speech in other fact sheets.

About cognitive communication disorders

If you have a cognitive communication disorder, you might have problems with:

• remembering things, like facts and past events
• concentrating on a conversation
• insight and judgement, such as understanding when something is challenging for you
• planning things, like organising an event or completing a task
• solving problems
• processing information more slowly than other people
• knowing when to talk and when to listen.

Some signs of cognitive communication disorders include:

• going off-topic or being hard to follow
• talking too much and not giving other people the chance to respond
• not talking enough and giving one-word answers, or relying on others to start conversations
• not understanding what others say, being too literal and not understanding humour or sarcasm
• using the wrong type of language for the situation, like telling strangers personal information
• not recognising the social ‘rules’ of communication, like when someone is trying to end a conversation
• taking time to respond, or responding to a question after the conversation has moved on
• having emotional outbursts, like suddenly crying or yelling in conversations.

How cognitive communication disorders can affect your life

Cognitive communication disorders can make it hard to do every day things like shopping and talking to family, friends and workmates. Problems can be more obvious in ‘demanding’ situations, such as discussing complex topics.

This can be very frustrating, especially if the people you are talking to (like your family and friends) don’t know how to support you.

You might start avoiding social situations or stop doing hobbies and other activities.

You might lose friendships or have trouble at work or with relationships.

How to help someone with acquired brain injury

Family, friends and workmates can get better at communicating with someone with acquired brain injury.

One approach is to do training in supported communication. This might include:

• helping the person remember things – write down instructions, use reminder systems
• reducing distractions – limit background noise and face each other during conversations
• sticking to one topic at a time - give the person a chance to process information
• keeping the conversation on track – comment on what the person says, and try not to let them talk too much
• making sure you understand the person – summarise key points to check you understand what they mean
• keeping it relaxed – use humour and avoid putting the person ‘on the spot’.

How a speech pathologist can help

A speech pathologist can help by:

• finding out about your strengths and challenges
• giving you ways to work around the challenges
• helping your family and friends communicate with you
• giving you information and counselling
• helping you relearn skills so you can get back to everyday activities like socialising, leisure or work.

Conclusion

People with acquired brain injury can have trouble communicating in daily life. Many of these difficulties can be overcome when friends, family and community members learn how to communicate in a supportive way. A speech pathologist can help people with acquired brain injury to get better at doing everyday activities.

Find out more

Brain Injury Australia (http://www.braininjuryaustralia.org.au/)

Social Brain Toolkit (https://abi-communication-lab.sydney.edu.au/social-brain-toolkit/)

Interact-ABI-lity – a program that provides information and strategies to improve interactions with people with a brain injury (https://abi-communication-lab.sydney.edu.au/courses/interact-abi-lity/)

ASSBI – Australasian Society for the Study of Brain Impairment, inc. (www.assbi.com.au/)

Original: March 2023