Traumatic Brain Injury
According to ASHA (2017), Traumatic brain injury is a form of brain injury that is caused by sudden damage to the brain. Depending on the location and source of the trauma, the TBI can be a closed head injury, a penetrating head injury, or a deceleration injury.
|Type of injury||Definition||Example|
|Open Head Injury||When the skill is penetrated with direct injury to the brain||Wound to the head|
|Closed Head Injury||No penetration to the skill but indirect force to the head caused by rotation and deceleration of the brain||Motor vehicle accident, fall
|Penetrating Head Injury||When the brain continues to move inside the brain as it moves at a different rate than the skill||Head-on motor vehicle accident|
The most common causes of TBI are motor vehicle accidents, recreational accidents that typically occur during sports and acts of violence. The risk of TBI is greater in males between the ages of 15 and 19 and for children of either gender between 0 to 4 years of age. It is recommended that the individual is observed for any abnormalities for 12 to 24 hours. When a TBI occurs, it is typical for individuals to experience either retrograde amnesia or anterograde amnesia. Retrograde amnesia refers to the loss of memory for the events directly before the injury. In contrast, anterograde amnesia refers to the loss of memory for events directly after the injury. TBI is diagnosed by clinician presentation, signs and symptoms, and brain imaging studies.
Some clinical signs that medical personnel utilize to determine the occurrence of TBI are:
- Short term memory loss
- Physical signs of trauma
Communicative Deficits Associated with TBI
- Physical deficits
- Swallowing difficulties
- Behavioral issues
- Confused language
- Articulatory or phonological disorders
- Auditory comprehension difficulties
- Naming difficulties
- Pragmatic language difficulty
- Repetitive verbal responses
- Reading and writing difficulties
First the speech-language pathologist (SLP) will assess the patients cognitive-communication skills, such as attention and orientation. The SLP will then assess recent memory skills and the patient’s ability to plan, organize, and attend to details.
A treatment plan will be developed depending on the stage of recovery. The treatment plan will always focus on increasing independence in everyday life and functional communication skills. According to ASHA (2017):
- In the early stages of recovery (e.g., during coma), treatment focuses on:
- getting general responses to sensory stimulation,
- teaching family members how to interact with the loved one.
- As an individual becomes more aware, treatment focuses on:
- maintaining attention for basic activities,
- reducing confusion,
- orienting the person to the date, where he or she is, and what has happened.
- Later on in recovery, treatment focuses on:
- Finding ways to improve memory (e.g., using a memory log);
- Learning strategies to help problem solving, reasoning, and organizational skills;
- Working on social skills in small groups;
- Improving self-monitoring in the hospital, home, and community.
- Eventually, treatment may include:
- Going on community outings to help the person plan, organize, and carry out trips using memory logs, organizers, checklists, and other helpful aids;
- Working with a vocational rehabilitation specialist to help the person get back to work or school.
-Lauren LaGreca, M.A, CF-SLP