Communication in Children after Brain Injury: FAQs

Communication in Children after Brain Injury

 By Roberta DePompei, Ph.D.

Lash & Associates Publishing/Training, Inc

I often hear the term cognitive communication. What does that really mean?

Communication is much more than words. It involves listening, speaking, and reading, writing and gesturing. Cognitive communication is the combination of thinking skills and language. It is the ability to use language and all the underlying skills for communication.  This includes attention, memory, self-awareness, organization, problem solving and reasoning. When these thinking skills are combined with language, the result is communication.

Our son was doing pretty well in school until he went to junior high school. Now he has a lot more reading assignments and homework. Even though he spends much more time on his homework, he can’t seem to keep up and is falling behind.

As students enter middle, junior high and high school, school work becomes more complex. The student with a brain injury may face new difficulties with reading, writing and thinking. Much of school work now requires abstract reasoning and problem solving. This places new demands on different parts of the brain than were used in earlier grades. Multiple classes and teachers mean different teaching styles and homework assignments.

Any difficulty with these changes is an indication that a student’s cognitive communication abilities need to be reevaluated.

Our son’s speech was really slow and difficult to understand for several months after his brain injury. As he made physical progress, his speech also improved. Is there any reason to have him followed by a speech pathologist now he is back in school?

The ability to speak and hold conversations can be misleading. Language skills often return after a brain injury, but communication can still be affected. While conversation may seem normal in non-stressful situations, this can change when the child or adolescent is tired or under stress.

Changes in communication in youths are mostly likely to show up in school under the pressures of time, being graded, completing assignments and keeping up with classmates. A speech and language pathologist can evaluate ongoing progress, identify problems and help the student develop compensatory strategies. As part of the educational team, the speech pathologist can help others recognize and respond to changes in cognitive communication.

What are some of the changes or warning signs that parents and educators can watch for?

Too often, parents and teachers aren’t concerned until the student is failing or has lowered grades. It is important not to wait until the student is in trouble to get help. Early warning signs that an evaluation by a speech and language pathologist is needed are:

  • speaking or writing that is disorganized
  • difficulty concentrating and paying attentionconfusion when new ideas are introduced
  • confusion when new ideas are introduced
  • slower rate of handling information, and
  • difficulty learning new vocabulary or grasping ideas.

By evaluating these areas every three months during the two years following a brain injury, difficulties can be spotted early and help provided before the student fails.

How do we find a speech and language pathologist who has experience with students with brain injury?

Speech and language pathologists may be licensed in their state and may also be certified by the American Speech-Language-Hearing Association. When choosing any professional, it is important to ask questions to make the right fit between a specialist, your child and your family. Look for a speech and language pathologist who has experience with brain injury and who has worked with children of similar age. If your child is in school, look for a speech and language pathologist who regularly works with schools and is familiar with special education.

For more information by Dr. DePompei, see:

Communication: How communication changes over time 

By Roberta DePompei Ph.D. and Jean Blosser Ed.D.

Brain injury can affect a child’s speech, language and communication. Tip card gives information for parents, educators and therapists to identify changes in language development and learning in school.


All About Me!

By Roberta DePompei Ph.D. and Bob Cluett

Interactive booklet helps elementary school age children identify the physical, cognitive, and behavioral effects of traumatic brain injury and describes help needed in school.


Learning and Cognitive Communication Challenges

By Roberta DePompei Ph.D. and Janet Tyler

Manual with teaching strategies for students with acquired brain injury and challenges with behavior, attention, cognition and language.




Lash Blog Permission

2 responses to “Communication in Children after Brain Injury: FAQs”

  1. Susan Wahl says:

    I survived a TBI, a depressed skull fracture from a MVA and injury to the left parietal lobe of my brain, at age seven. It happened 48 years ago, when kids who survived such an injury were simply considered lucky–otherwise they would have been institutionalized. My parents told me not to feel sorry for myself, not to talk about my “accident,” and I was crying because I wanted attention. I cried a lot, most likely stressed out, and never knew there was a connection. When I look back, there were so many incidents, in employment, choices in personal life, etc., for which I could now say were connected to my brain injury. But I was, and continue to be determined to move on with my life. I probably had developmental delays, and tons of emotional baggage, and now realize all of the attempts to end my life were based in anger I couldn’t control. There were many setbacks, but I succeeded in areas such as education, that I couldn’t have achieved if I thought myself a failure. I wish I could know what problems I have are a direct result of the TBI–and I know there are times I have difficulty with areas of communication–and which are not. I am disabled, and desperately trying to work for pay, with many skills to offer. It’s just difficult for my surviving brothers and sister to understand what happened to me, and can’t handle stress as well as they can.

  2. Magan Recor says:

    I really like this article,because i do believe this will help us to prepare a better project on this topic.I bookmarked the web site so in future i can search it for more article.

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