Cognitive Impairment

Cognitive imparmentPeople with a brain injury often have cognitive (thinking) and communication problems that significantly impair their ability to live independently. These problems vary depending on how widespread brain damage is and the location of the injury.

Brain injury survivors may have trouble finding the words they need to express an idea or explain themselves through speaking and/or writing. It may be an effort for them to understand both written and spoken messages, as if they were trying to comprehend a foreign language. They may have difficulty with spelling, writing, and reading, as well.

The person may have trouble with social communication, including:

  • Taking turns in conversation
  • Maintaining a topic of conversation
  • Using an appropriate tone of voice
  • Interpreting the subtleties of conversation (e.g., the difference between sarcasm and a serious statement)
  • Responding to facial expressions and body language
  • Keeping up with others in a fast-paced conversation

Individuals may seem overemotional (overreacting) or “flat” (without emotional affect). Most frustrating to families and friends, a person may have little to no awareness of just how inappropriate he or she is acting. In general, communication can be very frustrating and unsuccessful.

In addition to all of the above, muscles of the lips and tongue may be weaker or less coordinated after TBI. The person may have trouble speaking clearly. The person may not be able to speak loudly enough to be heard in conversation. Muscles may be so weak that the person is unable to speak at all. Weak muscles may also limit the ability to chew and swallow effectively.