Cognitive communication difficulties
Cognitive communication is a term encompassing a large number of language skills, which are more complex than just thinking of the right words or forming grammatically correct sentences. It includes spoken and written language expression and understanding as well as verbal and non-verbal aspects of communication (for instance tone of voice and facial expression). We most often see cognitive- communication difficulties as a result of a brain injury. The difficulties can sometimes be high level and subtle. Sometimes the person who has cognitive-communication difficulties is not aware of these problems and the impact they have.
HOW DO WE USE IT?
There are many different levels of communication in everyday life, for example:
· Social speech: ‘hello’, ‘goodbye’, ‘how are you?’
· Light conversation: at a social gathering
· Language at work: technical, teaching, jargon
· Highly academic language: lecturing
These differing levels mean that we have to use language in different ways depending on the context. We may want to communicate a simple message or explain something which is really complicated and uses lots of technical terms. We need to bear in mind how much knowledge the other person has of the subject or the people being discussed, for example do they know that Rob is your brother?, to ensure they understand the message. We have to be able to understand as well as express ourselves clearly. It is important that the words used are appropriate to the context, for example it may be OK to swear when with your friends but not in a meeting with your doctor.
There are other variables we need to consider when thinking about cognitive communication skills, for example:
As there are so many aspects to our use of language there are many different combinations of problems that can occur when something goes wrong/the brain is damaged.
SYMPTOMS OF COGNITIVE COMMUNICATION IMPAIRMENTS
Naming
There may be problems quickly thinking of more unusual words which we do not use very often (the frequency effect), or thinking of alternatives for words (synonyms). Relationships between words such as opposites (antonyms) or categories (semantic categorisation) may be disrupted.
Explaining (both verbally & in writing)
This is commonly an area of difficulty, as it requires different skills to put a message together coherently and express it clearly. It may result in an inability to explain simple things such as everyday tasks such as making a cup of tea to more complex ideas such as expressing and opinion or the pros and cons of a situation and reasoning our opinions.
Auditory/Reading Comprehension (understanding what is heard and read)
There may be difficulty understanding complex or abstract material which may mean that is misinterpreted. Increasing the speed and length of material can also make it more difficult to understand.
Verbosity
Talking too much about the same topic and not identifying when the listener is bored.
Inappropriate Style or Content
Being over familiar or overly formal in language usage and non verbal skills. Saying things that others may find rude or embarrassing.
Social Skills
Difficulty with knowing how to start, continue or finish a conversation. Poor use of body language and facial expression to assist with getting your message across.
Topic Maintenance
Difficulty staying on the topic when talking. Introducing new, irrelevant topics or ideas into the conversation without warning.
Planning
Difficulty planning and organising a message into a coherent sequence.
Attention/Concentration/memory
Difficulty listening and concentrating on a task, forgetting what has been said or what you are about to say. Being unable to concentrate on what someone is saying usually means it is difficult to remember it.
Lack of insight
Difficulty identifying and acknowledging deficits, even if reminded continuously, may result in added problems for the individual or relatives and friends. Poor insight may make therapy more difficult.
WHAT CAN THE SPECIALIST SPEECH THERAPY PRACTICE DO TO PRACTICE?
A comprehensive speech and language therapy assessment will be undertaken to establish which features of language and communication have been affected. The speech therapist will then discuss goals with the person to ensure that the therapy we provide meets their needs and aspirations. If a client recognises there is a problem and is able to learn, therapy is much more likely to be effective. The person will need to practice the skills and strategies they have learnt outside of sessions within their everyday lives. The family, care givers or other people in the person's life is an important partner in therapy and is provided with education and strategies to help optimise communication effectiveness.
Contact Specialist Speech Therapy for an appointment in Birmingham, Solihull and across the West Midlands.
For an appointment from Elizabeth's Harley Street Speech Therapy Practice in London see www.harleystreetspeechandlanguagetherapy.com
Cognitive communication is a term encompassing a large number of language skills, which are more complex than just thinking of the right words or forming grammatically correct sentences. It includes spoken and written language expression and understanding as well as verbal and non-verbal aspects of communication (for instance tone of voice and facial expression). We most often see cognitive- communication difficulties as a result of a brain injury. The difficulties can sometimes be high level and subtle. Sometimes the person who has cognitive-communication difficulties is not aware of these problems and the impact they have.
HOW DO WE USE IT?
There are many different levels of communication in everyday life, for example:
· Social speech: ‘hello’, ‘goodbye’, ‘how are you?’
· Light conversation: at a social gathering
· Language at work: technical, teaching, jargon
· Highly academic language: lecturing
These differing levels mean that we have to use language in different ways depending on the context. We may want to communicate a simple message or explain something which is really complicated and uses lots of technical terms. We need to bear in mind how much knowledge the other person has of the subject or the people being discussed, for example do they know that Rob is your brother?, to ensure they understand the message. We have to be able to understand as well as express ourselves clearly. It is important that the words used are appropriate to the context, for example it may be OK to swear when with your friends but not in a meeting with your doctor.
There are other variables we need to consider when thinking about cognitive communication skills, for example:
- Everybody’s language is different according to his or her level of education, age and life experience.
- It may be appropriate to be loud and boisterous with a group of friends, but inappropriate to behave like this at work.
As there are so many aspects to our use of language there are many different combinations of problems that can occur when something goes wrong/the brain is damaged.
SYMPTOMS OF COGNITIVE COMMUNICATION IMPAIRMENTS
Naming
There may be problems quickly thinking of more unusual words which we do not use very often (the frequency effect), or thinking of alternatives for words (synonyms). Relationships between words such as opposites (antonyms) or categories (semantic categorisation) may be disrupted.
Explaining (both verbally & in writing)
This is commonly an area of difficulty, as it requires different skills to put a message together coherently and express it clearly. It may result in an inability to explain simple things such as everyday tasks such as making a cup of tea to more complex ideas such as expressing and opinion or the pros and cons of a situation and reasoning our opinions.
Auditory/Reading Comprehension (understanding what is heard and read)
There may be difficulty understanding complex or abstract material which may mean that is misinterpreted. Increasing the speed and length of material can also make it more difficult to understand.
Verbosity
Talking too much about the same topic and not identifying when the listener is bored.
Inappropriate Style or Content
Being over familiar or overly formal in language usage and non verbal skills. Saying things that others may find rude or embarrassing.
Social Skills
Difficulty with knowing how to start, continue or finish a conversation. Poor use of body language and facial expression to assist with getting your message across.
Topic Maintenance
Difficulty staying on the topic when talking. Introducing new, irrelevant topics or ideas into the conversation without warning.
Planning
Difficulty planning and organising a message into a coherent sequence.
Attention/Concentration/memory
Difficulty listening and concentrating on a task, forgetting what has been said or what you are about to say. Being unable to concentrate on what someone is saying usually means it is difficult to remember it.
Lack of insight
Difficulty identifying and acknowledging deficits, even if reminded continuously, may result in added problems for the individual or relatives and friends. Poor insight may make therapy more difficult.
WHAT CAN THE SPECIALIST SPEECH THERAPY PRACTICE DO TO PRACTICE?
A comprehensive speech and language therapy assessment will be undertaken to establish which features of language and communication have been affected. The speech therapist will then discuss goals with the person to ensure that the therapy we provide meets their needs and aspirations. If a client recognises there is a problem and is able to learn, therapy is much more likely to be effective. The person will need to practice the skills and strategies they have learnt outside of sessions within their everyday lives. The family, care givers or other people in the person's life is an important partner in therapy and is provided with education and strategies to help optimise communication effectiveness.
Contact Specialist Speech Therapy for an appointment in Birmingham, Solihull and across the West Midlands.
For an appointment from Elizabeth's Harley Street Speech Therapy Practice in London see www.harleystreetspeechandlanguagetherapy.com