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Posted on: November 1, 2021
Patients are often confused when referred to meet with a speech-language pathologist (SLP) after sustaining a concussion. As clinicians, we hear it all the time: “Why do I need speech therapy? My speech is fine.” It is not well-known that speech therapists have a wide scope of practice and can assist with much more than simply talking.
Mild traumatic brain injury (mTBI), or concussion, has been referred to as a ‘silent epidemic.” Concussions account for 75% of the more than 1.7 million TBI cases occurring in the United States every year. Symptoms such as headache, dizziness, fatigue, irritability, insomnia, and decreased tolerance for noise and light may result from metabolic or neurological changes throughout the brain.
Lesser-known complications include cognitive and communication deficits. For example, language deficits may include skills such as naming (word-finding) and verbal fluency. In conversation, patients can display difficulty transitioning between topics and using clear referents. Even auditory processing can be impacted. Cognitive impairments often include deficits in attention, working memory, delayed recall, and executive functioning or problem-solving.
SLP’s are recognized as one of the specialized groups of professionals trained to care for patients with a concussion. They often provide care as part of an interdisciplinary team by assessing and treating cognitive communicative disorders, identifying symptoms, making referrals, and providing support and encouragement.
Speech-language therapy treatment is aimed at “reducing the impairment and increasing participation.” Treatment approaches are based on neuroplasticity and include direct training of cognitive-communication skills such as attention, working memory, processing speed, executive functioning and word-finding through a high rate of practice.
Cognitive strategy training may also support patients with a mild traumatic brain injury by helping them to develop internal strategies, use assistive technology, or implement appropriate environmental modifications. Further, speech-language pathologists can train task or process-specific strategies such as goal management training, structured problem solving, or verbal rehearsal to both school-aged and adult clients.
In the concussion program at Sheltering Arms, speech services begin with a clinical interview and thorough assessment of memory, attention, and language to identify any impairments. Then, our SLP’s work closely with each patient to develop an individualized plan of care that focuses on patient goals—whether it be improving grades in school or returning to work. In every case, treatment sessions are designed to optimize patient outcomes for a successful return to daily tasks.
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