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Traumatic Brain Injury Communication Disorders: Diagnosis, Types, and Treatments

Therapist teaching man how to manage traumatic brain injury communication disorders

Traumatic brain injury communication disorders are complex issues that involve both cognitive and physical processes.

Fortunately, with the help of speech-language pathologists, most communication disorders can be effectively managed.

Today’s article will discuss the various communication disorders a person can experience after brain injury. We’ll also look at some of the best treatment approaches available.

Diagnosing Traumatic Brain Injury Communication Disorders

To make an accurate diagnosis and find the best treatment option, speech therapists will separate TBI communication disorders into three categories:

  • Speech disorders. These impair a person’s ability to physically produce speech. They affect articulation, fluency, and voice.
  • Language disorders. These disorders affect the cognitive side of communication. They impair a person’s ability to understand and use language correctly.
  • Hearing disorders. These affect not only the person’s ability to listen, but they also impact the ability to filter and process sounds. People with hearing loss after a head injury have difficulty recognizing which sounds make words and which do not.

Sometimes a person will only have one type of communication disorder, but more often than not they will have a combination of them. That’s why it is crucial to get evaluated by a professional before trying any treatments.

We’ll examine each disorder in the sections below.

TBI Speech Disorders

Speech disorders, as defined above, affect the physical side of communication: the ability to form and produce words with your mouth. There are several disorders that occur after brain injury that fall into this category.

Dysarthria (Slurred Speech)

Woman coughing because of dysphagia after head injury

Dysarthria arises after you damage the nerves or brain regions in charge of the oral-facial muscles. This damage can cause muscle weakness or even paralysis in the face, which will impact speaking abilities.

Features of dysarthria include:

  • Reduced strength and movement of lips, tongue, and soft palate.
  • Problems swallowing (also known as dysphagia)
  • Drooling
  • Slurred speech
  • Difficulty controlling airflow from the lungs when speaking

Most people with dysarthria have no cognitive impairments, so caregivers and friends should speak to the person as normally as possible. They can understand you fine; they just take longer to respond.

Apraxia of Speech

Apraxia causes problems with coordinated muscle movement. It can affect any muscle, including facial muscles.

People with apraxia of speech do not slur their words. Instead, they might make odd, exaggerated movements with their lips and tongues. They also pronounce some words strangely.

In some cases, apraxia only appears when the person must think about what they want to say. Otherwise, if they speak spontaneously, there is no issue.

Treatment: For both apraxia and dysarthria, speech therapy exercises are an effective treatment.

You must do them every day to ensure maximum progress. Mobile apps like the CT Speech & Cognitive Therapy App can walk you through each exercise. The app can also send reminders to your phone, so you never miss a session again.  


singing to eliminate dysprosody, one of several traumatic brain injury communication disorders

This disorder can follow a right-side brain injury. People with dysprosody have a monotonous voice, even when they are excited or happy.

Sometimes dysprosody accompanies a condition known as “flat affect.” Flat affect causes a person to lose all emotional feelings. They struggle to interpret the emotions of others.

However, not all people with dysprosody experience flat affect, even if they seem emotionless to an outside observer. Rather, they simply cannot control the pitch and volume of their voice.

Treatment: Music therapy can help patients relearn the natural melody and pitch of everyday speech.  

Spasmodic Dysphonia

Spasmodic dysphonia causes spasms in the vocal cords, which leads to problems with how the voice sounds.

People with spasmodic dysphonia can either have a weak, breathy voice or a harsh, choppy voice, depending on how it affects the throat muscles.

Treatments: Most doctors recommend treating dysphonia through a Botox injection directly into the larynx.

Vocal therapy can also help you retrain your throat muscles and reduce spasticity. However, if the dysphonia is severe, you may need Botox first before you can even begin therapy.

Traumatic Brain Injury Language Disorders

Language disorders impair a person’s ability to understand the finer aspects of language, such as grammar and syntax. They can also make it almost impossible for people to produce words or coherent sentences.  


woman biting lip looking frustrated because she has a left-side brain injury

Aphasia occurs after a left-side brain injury. The left hemisphere is where the two regions of the brain in charge of language reside.

However, aphasia is actually more of an umbrella term that encompasses several types of impairments. These include:

  • Global aphasia. The most severe form of aphasia. The person with global aphasia can neither speak nor understand others.   
  • Expressive aphasia.  This affects a person’s ability to produce words. Speech is usually clumsy and requires maximal effort. People with expressive aphasia can still read and understand others fine.
  • Receptive aphasia. Patients with receptive aphasia cannot understand spoken language. They can usually still speak fluently, but their speech is garbled and filled with nonsense words. They sometimes cannot read or write.
  • Anomic aphasia. This type of aphasia affects a person’s ability to find the right words, even though they know what they want to say. Their speech is more rational than receptive aphasia is, but they use vague and wordy expressions. For example, rather than saying “toaster,” they might say “metal thing that you put bread into.”  

Treatment: Depending on the type of aphasia you have, speech therapists will take a variety of approaches.

One useful technique for treating aphasia is called constraint-induced language therapy. With this technique, the patient must find the correct words by avoiding any compensatory tactics they might rely on. These include gestures, drawings, or writing. Instead, the person can use only their words.

CILT is an intensive therapy and might be too difficult for some patients. Still, it’s an ideal way to activate neuroplasticity, which allows your brain to rewire itself and regain lost functions.

Neurogenic Stuttering

Neurogenic stuttering is a TBI communication disorder that causes difficulty in smoothly producing words.

This form of stuttering differs from developmental stuttering in that it directly results from brain trauma. Children with stuttering problems rarely have any brain damage.

Neurogenic stuttering also has some unique symptoms, including random repetition of words and rapid bursts of unintelligible speech, similar to certain types of aphasia.

Social Communication Problems

two friends sitting on bench laughing and socializing

Finally, some brain injuries make it nearly impossible for the patient to understand social norms and pick up on the subtle aspects of a conversation. People with this communication disorder tend to display the following symptoms:

  • Difficulty understanding when to let the other person speak
  • Fixating on a single topic
  • Inappropriate behavior
  • Literalistic thinking

In addition, brain injury can cause cognitive fatigue, which will make every part of communication more burdensome. As a result, some people might come across as rude and impatient when, in reality, they are only tired.

Treatment: Along with knowing how to treat aphasia and other speech disorders, speech therapists are trained to help people improve their social skills.

Therefore, treatment will focus on teaching patients how to recognize non-verbal cues and how to start and stop a conversation. Therapists often role-play different social situations with their patients, which allows survivors to practice their responses in a judgment-free environment.

TBI Communication Disorders

Traumatic brain injury communication disorders can make connecting with others much more difficult, if not impossible.

But with the right diagnosis and treatment, you can have a real hope of regaining your ability to speak again.

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