- TOOL KITS
- A. The NEXT Step
- B. Promoting Independence
- C. Phone Apps
- D. Return to Work
- E. Motivational Interviewing
- F. Paediatric Brain Injury Rehabilitation Resources
- a) Introduction
- 0. Introduction
- 1. Working together promoting independence
- 2 . Using this kit
- b) Issues, goals, action
- 3. Identifying issues W
- 4. Setting goals W
- 5. Making goals happen W
- 6. Monitoring progress W
- c) Strategies Myself and my relationships
- 7. My behaviour's changed W
- 8. Thinking
- 9. Relationships W
- Managing memory, money and time
- 11. Remembering information and messages
- 12. Finances and handling money W
- 13. Managing time W
- Household tasks
- 14. Food and shopping W
- 15. Food and meals W
- 16. House keeping
- 17. Laundry
- Getting around
- 18. Public transport W
- 19. Accessing the community
- Life tasks
- 20. Self care
- 21. Fitness
- 22. Leisure
- 23. Employment
- 24. Continue learning
- 25. Health and well-being
- 26. Emergencies
I find it hard to follow what people are saying in conversations. How can I follow them better?
10.1 Understanding conversation
10.2 Talking to others
10.3 Speaking clearly
I find it hard to follow what people are saying. How can I listen better?
Sometimes it can be hard to follow what people are saying because what they say doesn't seem to make sense. Maybe their words sound unclear or unfamiliar. Sometimes they seem to talk too fast and keep jumping from topic to topic. Conversation can become a blur.
The environment, as well as the way you listen and involve yourself in the conversation can help you keep up with what is said. Here are a few suggestions to help you understand conversations better.
Strategies for action
How can I change the environment?
Try to get rid of any distractions or unnecessary noise by:
- turning off the TV
- turning off the radio
- closing a window if it's noisy outside
- try to have the room well lit so that others are easy to see
- if possible talk where there aren't many distracting things to look at
- if out with family or friends try to choose quiet places to have your lunch or rests
- ask others to try and talk one at a time
What can I do physically to help conversation?
It can make it easier to listen when you:
- face the person talking to you. Make sure you can both see each other's face
- try to keep eye contact with your conversation partner/s
- lean forward a little towards your conversation partner / s
- make sure you're well rested before planned outings or occasions (eg. picnic). Being tired can make it much harder to listen to people.
These things help you both know when conversation is breaking down. They also let the other person know that you're interested in what they are saying.
What about what is being said? Become an "aerobic listener" - aerobic listening means taking part and being active in the conversation. This can be done by:
- listening for key words
- asking people to repeat what they have said
- asking your own questions to find out more about the topic
- repeating back to the talker what they have said to you to check your understanding. Summarise what they have said and ask "Is that right?"
- nodding your head to let the talker know you are following
- listening for conversation basics:
- who - who is being spoken about?
- where - where did the event happen?
- when - when did/will the event happen?
- what - what actually did/will happen?
- why - why did/will it happen?
A. When I am talking to others, I often find it hard to think of the word I want to say. How can I help this?
Many people who have had traumatic brain injury find it hard to remember specific words for different things. These can be names of people, places, objects, events, actions and so on. This can be really frustrating. A speech pathologist can help you improve in this area, but here are some tips on how to help yourself.
- try to have an image in your mind of the object
- if you know the first letter of the word try saying this
- try to think of things that go together with this word e.g. for 'cream' you may think of 'peaches and cream'
- try writing the word down
- try using other word that means the same thing
- help your listener by giving them clues about the object (eg. "You use it when you make a mistake. It's like white paint" - [Liquid Paper])
- look at the object, touch it or draw it.
Michael often found it hard to remember words he wanted to say. He found that if he could think of the first sound of the word he would often be able to get the whole word. Sometimes he would try to find the object because looking at it also helped. His parents would also help him by suggesting what sound the word started with. This was really helpful. Importantly, Michael felt that he maintained control of his conversation because he wasn't being directly told the word.
B. People often find it hard to follow what I'm talking about. How can I help them understand me better?
Do you get the feeling that people don't understand what you're talking about? Maybe they keep asking what you mean, or look like they're not interested in what you're saying. It can be hard to judge how well your conversation is going at times. A speech pathologist can help your individual needs. Here are some basic suggestions in the meantime.
- Ask yourself "What are the most important things to say?"
- It can be easy sometimes to talk too much. Try to talk to the point. Listeners can 'switch off' if they have to listen to too much information. Ask yourself questions like: " do I really need to say that?" "do they need to know that?" "have I said too much?"
- Give your listener a chance to talk. Try pausing to give them time to join in or ask you questions.
- Watch how your listener is reacting to what you say. Do they look confused? Bored?
Courtney had trouble keeping on track. She would talk on and on about something and sometimes end up asking herself, "Now what was it that I was talking about?" People found it hard to remain interested in what she said. Courtney was able to improve this by asking herself "What does Joe (husband) need to know?" and then trying to tell Joe in as few words as possible. She also asked Joe to put up his hand to signal to her when she was getting off the topic or talking for too long.
C. How can I explain things better to people?
- Try to think about what your listener needs to know. Are you talking about an experience you shared together or are you talking about something only you have seen or done? If it's something that only you know about you will need to fill in the details.
- Write or draw what you are talking about.
- Use gestures.
- Think about the important things to tell your listener.
Some of these cues may help you explain things:
- what type of thing is it? - e.g. a piece of clothing, a movie, a place, an event, a piece of furniture
- what is it for? - why do people use it? e.g. to clean, to cook, to repair, to show something
- what does it look like? - talk about its main parts e.g. "It had big yellow petals"
- what size is it? - e.g. "It's about the size of a shoe box"
- who is involved? - who were/are the people there? e.g. "You can get it from a locksmith"
- what is it made of? - e.g. wood, plastic, cotton, glass.
Justin had difficulty explaining things to people. This was important because he was still studYing at TAFE. Justin found it useful to use the above questions in his written answers to help him give more relevant information.
D. I find it hard to ask strangers for information, such as on the telephone or at the shops. What can I do to make this easier?
Do you find any of these situations difficult? - ringing up a place to get information - ordering food at a restaurant or cafe - ringing up to make an appointment - explaining a problem or needs to a professional (eg. doctor, mechanic, hairdresser, police officer, manager) A speech pathologist can help you deal with these situations, but here are some strategies which may help:
- think about what you want to say before you speak to the person
- write down what you need to say first
- practise what you are going to say first
- if possible have what you are talking about in front of you.
E. How can I join in with conversations? How can I start a conversation?
It can be hard to know what to say to join in a conversation. What do you say? How do you let people know you have something to say? Here are some general strategies to help you out.
- If people are already talking about something, it is important that what you say keeps with the topic. Listen carefully to what they are saying.
- Listen to key words of what others are saying.
- Try to make a comment on what someone says. Example: Friend: "We thought Bondi would be a good place to go': You: "Yeah, it is. I went there for a picnic one time':
- Try asking questions about what is said. Example: Friend: "We're going to go to Bondi on Sunday." You: "Do you think you'll go swimming?"
- To start a conversation try to ask "WH Questions" eg
'where ... are you going on holidays?'
'what. .. are you doing on the weekend?'
'why ... did you move to Australia?'
' when... did you start work at....?'
Deborah found it hard to interact at all in conversation. To involve herself just a little she made sure she used familiar and automatic phrases with people. For example when meeting friends she said, "Hello, how are you?" and responded with phrases such as "I'm fine". When offered something she responded with "Yes thanks" or "No thanks" and when guests were over she would ask, "Can I get you anything?".
I find it hard to speak clearly. People find it hard to understand me. How can I speak more clearly?
Do you find that people have difficulty understanding you? Do people continually ask "Pardon?", "What did you say?" or look at you with obvious confusion?
When you speak do you find that:
- your words sound slurred
- you know in your mind how something should sound, but what your mouth says is very different
- you struggle to make your mouth say the right sounds
- words just won't come out and seem almost 'stuck'
- your voice is very soft and hard to hear
- you sound like you are mumbling
- your speech gets worse as you say more (eg. the words at the ends of your sentences are really slurred).
People who have had a traumatic brain injury can experience any combination of these difficulties. It can make talking to others very tiring and frustrating. If you experience any of these symptoms it can be extremely useful to contact a speech pathologist. A speech pathologist can help you improve your speech through a carefully planned and individualised program. In the meantime, however, here are some useful tips to help make your speech that little bit clearer.
- speak in short sentences (imagine 'full stops' in your conversation)
- speak slowly
- pause to allow your listener time to think about what you are saying
- try to talk louder - if your speech is quiet
- take regular deep breaths to make sure you have good breath support across your whole sentence
- try to exaggerate your words. Sometimes your muscles need that extra push and exercise. This can take a little more concentration and effort but will help others understand you.
- listen to yourself. Do you sound clear? Give yourself a rating from 1-5 (1 = not understandable, 5 = very clear). Do this frequently with different conversation partners at different times. Ask yourself questions like: "Was that a 2?".
- watch others. Do they look like they are following what you are saying? Do they look confused? Ask them e.g. "Did you understand ?"
- try to repeat what you said. If it's still unclear the second time, try to say it in a different way.
- have what you are talking about in front of you. This gives your listener more context and greater expectations of what you may say.
- write down what you are trying to say when others still can't understand you. This can ease frustration.
- keep a communication or speech book. This can be filled with pictures, words or topics that are important to you. It can be used to show others when you need to tell them something. A speech pathologist can help you create and organise this book.
- minimise background noise and distractions. Turn off things like the TV or radio. Close a window to a noisy outside environment.
- face the person you are talking to. It makes it a lot easier for someone to understand you if they can see your lips and facial expressions.
- try to have plenty of rest before occasions where you know you will be talking more (eg. a planned BBQ). Fatigue can often make people even less intelligible.
Who can I contact?
At the Brain Injury Rehabilitation Unit you can contact:
- Speech Pathologist