Speech-Language Therapy & Traumatic Brain Injury
Traumatic Brain Injury (TBI), also called head injury, occurs when a blow or jolt to the head damages the brain. TBI’s range in severity from mild to severe. Some effects can sometimes be permanent. TBI is the second highest cause of mortality, specifically in young men, in South Africa.
Problems that may follow a brain injury can include:
- Poor attention and memory
- Partial or complete loss of reading and writing skills
- Difficulty learning new things
- Swallowing problems
- Muscle weakness and coordination problems
- Seizures (also called traumatic epilepsy)
- Sleep problems
- Difficulty understanding spoken language
- Speech problems
- Difficulty with social skills
- Difficulty with controlling one’s emotions
- Irritability, frustration, and aggressive behaviour and mood swings
- Depression
What can the family do when caring for someone who has had a TBI?
- Don’t expect the person to be the same as before the brain injury.
- Develop a positive attitude.
- Don’t take their aggression or anger personally.
- Remember that it’s their injury talking, not the person.
- When they are angry, step back and walk away – it is best not to argue back.
- Don’t challenge the person directly.
- Encourage the person and praise them for every small improvement.
- Listen carefully to them when speaking without interrupting.
- Remember that they need lots of rest.
- Most importantly, be patient.
Speech-Language Therapy can help by:
- Assisting with feeding and swallowing difficulties
- Providing cognitive rehabilitation to improve thinking and memory skills
- Providing therapy to improve understanding of language
- Providing therapy to improve speech production
- And most importantly, providing family counselling and education
It is important to remember that rehabilitation is a long term process that can take months and sometimes even years.
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Samantha de Freitas
Speech and Language Therapist
Samantha de Freitas is a Speech and Language Therapist qualified at UCT in 2012. Currently she specialises in AAC
[/fullwidth_text]- Published in Articles, Speech Therapy News
Stroke and Its Effect on Communication
A stroke occurs when a blood vessel supplying oxygen and nutrients to the brain either bursts or becomes clogged with a blood clot. The effects of a stroke can range from mild to severe. One of the biggest effects is on the individual’s ability to communicate after the stroke. The three most prominent effects that a Speech-Language Therapist deals with include: Aphasia, Apraxia, and Dysarthria.
Aphasia is a disorder that results from damage to the language areas of the brain. This means that the stroke most likely occurred in the left hemisphere of the brain. Aphasia can disrupt receptive language, expressive language, or both. Receptive language is the ability to understand what is being said or to understand what one is reading. Expressive language is the ability to express one’s thoughts and feelings through speech or through writing.
Apraxia is a motor speech disorder that is caused by damage to the parts of the nervous system that are related to speaking. It is characterised by problems sequencing the sounds in syllables and words. People with Apraxia know what words they want to say, but their brains have difficulty co-ordinating the muscle movements necessary to say those words and they may say something different and even non-sensical.
Dysarthria is a speech disorder that is due to a weakness or incoordination of the speech muscles. People with Dysarthria will have slow, weak, imprecise or uncoordinated speech. Their speech often sounds effortful and depending on severity, unintelligible. Drooling is also a common occurrence in those with Dysarthria.
If you suspect that someone you are caring for has any of these conditions with their communication, it is important that they be referred for assessment by a Speech-Language Therapist. Once the individual is attended to and receives therapy, these conditions can improve.
Apart from trouble speaking or understanding, other warning signs to look out for that indicates a stroke may be occurring include: headaches; dizziness; loss of balance; difficulty walking; sudden confusion; sudden trouble seeing in one or both eyes; sudden numbness or weakness in the face, arm or leg, especially on one side of the body only.
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Samantha de Freitas
Speech and Language Therapist
Samantha de Freitas is a Speech and Language Therapist qualified at UCT in 2012. Currently she specialises in AAC
[/fullwidth_text]- Published in Articles, Speech Therapy News, Voice Disorders
Meaningful Milestones
The range of development is wide. Every child is unique in their stengths and weakness in their development. It is of little significance if one or two areas are delayed. Professional opinion should be sort after if there is a delay in a number of areas such as a lack on comprehension, absence of play and no interest in the environment.
At 1 year
- Understand what the word “NO” means and regularly obeys it
- Understand his/her name and turns head or makes eye contact when it is used.
- Babbles in a foreign language
- Understands “Give to mummy/daddy” when it is accompanied by a gesture.
- Uses one or two words with meaning and says “Da da”.
- Is able to wave “bye-bye” and enjoys playing Peek-a-boo
Seek expert advice if:
- If there is no babbling
- It appears as if the child cannot hear.
- Disinterest in the environment
- The child is not developing to the brother and sister at the same age.
At 18 months
- Talks to himself/herself in his/her own language
- Use 6-20 appropriate words (appropriate words doe not include repeating what mommy or daddy has said)
- Is able to point to feet, nose, shoes and hair when requested to do so.
- Can follow one word verbal command
- Is able to point to pictures in a book e.g. banana
- This is not the age to reason with them. They do not know what they want.
At 24 months/ 2 years
- Loves looking at picture books
- 50 words in vocabulary and understands many more
- Occasionally uses 2-3 word sentences
- Call himself/herself by Name
- Sings along in nursery rhymes and song
- Is able to deliver short messages such as “Mummy give”
- Says when wants to use the potty
- Plays beside and not directly with others
Seek expert advice if:
- There is very little speech or no speech at all
- Mouthing of toys still occurs
- Toys are thrown in an unlikely way
- If play is repetitive
- There is a disinterest in the environment
- Body language is absent
- Strange irritability
At 28 months/ 2 years 6 months
- Makes use of 200 words and more
- Makes use of “I”, “Me” and “You”.
- Knows his name and surname
- Stuttering may occur due to eagerness to speak
- Play next to other children and not with them.
- Does not understand the concept of sharing
- Cannot wait for things, expects everything immediately
At 3 years
- Stranger is able to understand the child
- Use plurals correctly e.g. dogs, cats etc
- Will volunteer to give name, surname and sex
- Talks to himself/herself while playing
- In a simple but reliable manner able to describe an event.
- Starts asking question like “what?’, “why?”
- Enjoys listening to stories and loves hearing a favourite story told over and over again.
- Recites nursery rhymes
- Can count to 10 in rote.
Seek Professional Advice if:
- He/she she is unable to communicate using speech
- Poor body language
- Shows little imagination and makes use of repetitive play
- Behaviour is similar to that of a 18 month old e.g. refuses to share and senseless behaviour.
At 4 years
- Is able to name 4 primary colours
- Grammar and speech is used correctly
- A sounds are pronounced incorrectly e.g. the /r/ sound is produced as a /w/. He or she may /wabbit/ instead of /rabbit/
- Is able describe an event accurately and logically
- Can provide address and age
- Constantly asking question: What? Where? What? How?
- Enjoys listening to stories
- Confuses facts and fiction when telling stories
- Understands today, yesterday and tomorrow
- Enjoys listening to joke.
- Is able to count en rote till 20 and is able to count till 5 objects meaningfully.
Reference: Children’s Developmental Progress, Mary Sheridan (N.F.E.R. Publishing Co.,UK)
- Published in Articles, Development, Speech Therapy News