Traumatic Brain Injury and its Effect on Communication and Cognition

There are two main types of Traumatic Brain Injury, or TBI:

When a foreign object (such as a bullet) pierces the brain it can cause damage to specific areas of the brain. This type of TBI is known as a Penetrating Injury. Penetrating injuries result in localized damage along the path that the foreign object traveled through the brain. Damage to different areas of the brain will result in different symptomatology.

Another type of TBI is a Closed Head Injury. A closed head injury occurs from a non-penetrating blow to the head. Closed head injuries could occur from, for instance, striking the windshield during a motor vehicle accident.

Traumatic brain injuries can cause a wide variety of symptoms, including headache, dizziness, nausea and/or vomiting, tinnitus – to name a few. Sufferers may also experience problems with communication and cognition, the severity of which varies widely depending upon the area of injury as well as the extent of the damage.


TBI sufferers may find that they have difficulty finding the right words to articulate a thought when speaking or writing. Sometimes it may feel as though comprehending written and oral information is like trying to understand a foreign language. Often, the ability to spell is affected.

In addition to word comprehension, problems with communication can affect a person’s social skills following TBI. It may become more difficult to hold a conversation, as the sufferer no longer recognizes the cues that enable banter. This can be as rudimentary as no longer recognizing that they must allow others to speak or finish their thoughts, or it could manifest itself more subtly, such as no longer recognizing tone or sarcasm. Additional difficulties that can affect social interaction and conversation include difficulty following or maintaining the topic, inability to use a proper tone of voice, inability to interpret body language, and being unable to keep up with fast-paced discussion.

Moreover, people affected by TBI may experience unusual emotions, in some cases appearing overly dramatic, and at other times exhibiting a flat affect. The sufferer often is unaware that his or her behavior is out of the ordinary, which can be puzzling and frustrating to family and friends.

Finally, in some cases, adding to the difficulties outlined above, weakness or incoordination of the muscles lips and tongue may affect a victim of TBI. This may result in the sufferer speaking unclearly or being unable to project enough in terms of volume to be heard.


One of the most common symptoms following TBI is difficulty with thinking, or cognition. The cognitive effects manifest in myriad ways. These include attention deficiencies, memory loss, problems with reasoning and executive function, decreased ability to problem-solve, decreased awareness, slowed processing of new information. Many of these cognitive issues can be exacerbated in the presence of auditory or visual distractions.

Fortunately, a skilled health care provider, such as an occupational therapist, can provide tools and exercises to those that suffer from TBI that can minimize the effects of the communication and cognitive problems caused by the traumatic brain injury.

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