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Experts Discuss How Brain Injury Affects Communication Skills

Laticia Jackson, health educator at Naval Hospital Pensacola, talks to a patient. (U.S. Navy photo by Jason Bortz)

How a service member communicates with others can change after a traumatic brain injury (TBI).

“People with TBI speak better than they communicate,” said Linda Picon, Department of Veterans Affairs senior consultant and liaison for TBI at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury.

Picon and Inbal Eshel, Defense and Veterans Brain Injury Center senior principal scientist, are a duo with more than 35 years of experience studying and treating TBI patients. They shared with us how TBI can cause communication disorders.

“When TBI patients come to see a speech-language pathologist, they usually don’t have a motor speech disorder,” Picon said. “In other words, they may have trouble communicating, but their mouth movement and their articulation are intact. They often say, ‘The doctor told me to come here, but my speech is fine.’”

Communication Challenges

Symptoms of communication disorders after a TBI can differ depending upon the type and severity of the injury. For many, problems with communication are the result of difficulties with attention and memory, such as not being able to follow a conversation, not with the ability to speak, Picon added.

Picon explained that TBI often affects personality, self-awareness and higher mental processes, such as decision making and planning.

“These brain functions are necessary for people to carry on conversations and interact appropriately in their communities”, Picon said. “Challenges with pragmatics, or social communication, can make it difficult to keep friends or even a job.”

As the level of TBI severity increases, patients with communication disorders may experience more challenges. For example, they may struggle to pick up on body language and other non-verbal forms of communication.

Plan to Recover

Having a plan and sticking to it is important for recovery from any injury. Picon and Eshel said recovering from communication disorders is not something they would recommend doing without seeking the advice of a professional.

“With the support of a speech-language pathologist, a rehab team, and families or caregivers, people will find strategies that work for them,” Eshel said.

The message to patients and their families about recovery is simple: “Things may feel different, but there are strategies and solutions to reach your goals,” said Eshel.

More on TBI

Before joining DVBIC, Eshel was lead TBI speech-language pathologist at Walter Reed National Military Medical Center in Bethesda, Maryland. During her time there she provided interviews related to TBI:


Comments (8)

  • this sounds like a professional panacea and not a solution..rewiring the brain through exercises to create new neural networks is a profoundly superior solution.. acupuncture is one of those tools available

    • Thanks, William, for your feedback and thoughts. There are many treatments available, and we always encourage anyone coping with TBI to work with their providers to find the right fit.

  • I am an employee at LLVMC Loma Linda, CA and I would like to get involved!!! I am a TBI survivor who has gone on to become a productive member of the care/ support team here at the hospital. Please tell me who I can contact to learn of where I might be of service.

    Keri Abbott

  • The difficulty some of us may have is how say and what, how make clear the lived problem and his simptoms. It is why, buddies, we must planify our speech, posing on result what hurt us more, what make us unable to have the same ability or constance we have a time before TBI happened. A thing we must do is annotate all symptoms we have, all sensations we have never had before TBI and stress and be objectif, the more possible, for aid all of us on the same situation and build a dates bank on matter, for make possible adeguate and prompt cares for all. It is true we mantain our ability on speaking but we must rationally accorpate all sensations and symptoms so to offer to caregivers the possibility to apply the adeguate treatment also before the subjectivity of our situation. It is an essential one and we must not avoid to speak also of symptoms that may appear irrilevant. All must be accorped and referred when we are called or go to speaking of TBI and all related problems we live, remembering that also a little sensation may be of high utility and usefull for a right treatment. What is relevant is be more rational and communicate all we must, with essentiality, never lossing our rationality, never avoiding to speak of all symptoms we may have as all is vital for the related treatment. Be sure so doing we are aiding more other than us, we are building the way by means of more shall be adeguately cared on future.

    • Claudio, thank you for your feedback. Communicating your concerns and TBI symptoms with your health care provider is always important.

  • I`m 71. Most of my concussions happened by the time I was 23. Since about 65 yrs. old, I`ve been having problems with starting a serious conversation with a family member without laying the proper ground work. I say about half of what I`d wanted to say, and I can tell I`m missing the mark. Again! I`ve realized that I tend to start in the middle, or even close to the end, without having spent any thought to an introduction. Then I have to explain how I should have started the conversation in the first place. I don`t realize I`m doing it until it`s too late. I`ve handled this by warning my loved ones to not hesitate interrupting me, to say if I`m talking about what they think I`m talking about, etc.

  • Ms. Picon was my TBI USN boyfriend Al's SLP at the James A. Haley VA in Tampa. She has worked with hundreds of TBI survivors. In addition to cognitive function and communication, Linda Picon worked with Al especially in the area of swallowing disorders. Dedicated to her profession and compassionate with veterans and their caregivers like myself. She really understands TBI at all levels...the veteran, the families and the caregivers. She saved my sanity more times than I can count. Great work, my dear friend. Congratulations on your success.

  • This IS my daughter.
    Teachers and Health Care providers and family need this education and how to keep TBI's safe from scams.

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This page was last updated on: September 14, 2017.