All of us can experience communication difficulties.

The following exercises help us connect with our experience of different kinds of communication difficulties that mimic the types of communication problems faced by patients with TBI:

a) damage to the communication areas of the brain

• Word finding difficulties (dysphasia): think of a country that starts with the letter 'L'               Do it now!

You may have felt like the word was on the “tip of the tongue”. To get to the word, you would have had to access your stored knowledge about names of countries, and specifically countries starting with “L”. It might have taken some time to come up with an answer. People with word finding difficulties may have difficulty with accessing information about words, and take more time to retrieve the words they want to say.

• Muscle control difficulties (dysarthria): try chewing two minties or other hard lollies while reading this page out loud.       Get some lollies. Do it now!

You probably noticed that it was more difficult to move your tongue when you were talking, and there was more saliva in your mouth. This made your speech difficult to understand.

• Muscle co-ordination difficulties (dyspraxia): say the tongue twister "Mixed Biscuits" 5 times in 4 seconds        Do it now!   

The sequence of mouth movements needed to produce the phrase, “Mixed Biscuits” was difficult. You knew what you wanted to say, but it was difficult to produce the words with sounds in the right order, and you may have produced some sounds incorrectly.

• Non-verbal communication: play a game of charades and describe your favourite food without speaking        Do it now - even if you haven't got an audience

  You were probably able to communicate quite a lot of information about your favourite food, even without using words. A person with severe communication difficulties may need to use non-verbal methods to communicate.

b) damage to the cognitive areas of the brain which may cause:

• Not-thinking as well as you usually do: remember a time when you have been very tired and have had to explain a complex task to someone else.

  When you are very tired and trying to explain something, it may take you longer to what you want to say and the words you need to use. You may also have difficulty with concentration in conversations.

c) damage to the brain's frontal lobe causing which may cause social communication deficits for example:

• Pragmatic / social communication difficulties: try having a conversation with someone about your weekend plans who does not maintain eye contact with you Do it now if you can find someone to talk with

  Eye contact is one skill that is important to good communication. If you are talking to a person who does not have good eye contact, you may feel like they are not really listening, or you may be unsure how they are responding to what you are saying. People with a brain injury may have changes to their social communication skills that make it difficult for others to interact with them.

While we might find some of these tasks difficult, patients with TBI face these types of problems with all their day to day communication. Therefore, it is important that we have strategies for assisting them to get their message across.