Speech Therapy After Traumatic Brain Injury

by Howard Gerber on August 16, 2019

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speech therapy traumatic brain injurySchool-based speech therapists work with children with various types of conditions, such as down syndrome, autism, and cleft-palates. Although it might not be as common, school speech therapists also treat children who have had traumatic brain injuries (TBI). According to the American Speech-Language-Hearing Association, about 18% of speech therapists who work in a school setting treat children with traumatic brain injuries.

Traumatic brain injuries in children may result from car accidents, falls, and sports-related injuries. Non-accidental brain injuries from abuse can also occur in children. Depending on the extent of the injury, children may have cognitive, physical, and speech impairments.

What Is Traumatic Brain Injury?

According to the CDC, Traumatic Brain Injury occurs when normal function of the brain is disrupted by a bump, blow or jolt to the head, or penetrating head injury. There are several possible symptoms that can occur from traumatic brain injury, including problems with speech. Once a SLP has performed tests to determine if this is the case, an individualized treatment will be implemented. It is important to work with a SLP because they will work with the TBI patient in order to improve skills such as language, speech and thinking.

Common Traumatic Brain Injury Symptoms

Several symptoms of a traumatic brain injury may play a role in communication and speech problems. Cognitive deficits and physical effects from a TBI can interfere with speech.

According to ASHA, the Symptoms of a TBI may last for months or years. In some cases, the effects of a brain injury last a lifetime. Possible TBI symptoms in children include:

  • Impaired cognitive ability
  • Memory problems
  • Difficulty speaking
  • Mood changes
  • Confusion

IEP Goals For Students With Traumatic Brain Injury

When developing IEP goals for students with TBI, it’s important to remember that each plan should be customized to accommodate the individual needs of each student. There are several areas that speech-based therapists can focus on including:

  • Self-awareness
  • Goal-setting
  • Planning/Organizing
  • Self-initiating
  • Self-monitoring/Self-evaluation
  • Problem-solving
  • Communication
  • Behavior
  • Cognition
  • Memory
  • Attention

When planning IEP goals for a student, the team may need to make necessary accommodations and modification in order to meet the student’s needs. This may include changes to environment, tasks and mode of response in such a way that does not alter the students assignment/activity.  Modifications may include specific adjustments to activities/assignments in order to meet the needs of the student. All are important to consider when developing IEP goals.

Traumatic Brain Injury Treatment Speech Therapy Considerations

Speech therapy goals for children who have had a traumatic brain injury vary, but may include swallowing, feeding, and word articulation. Goals may also involve vocabulary development and phonological awareness.

The specific interventions implemented depend on the deficits present and the child’s developmental level when the brain injury occurred. Therapy goals may focus on regaining lost function and also developing new skills. When working with children with a traumatic brain injury, school-based speech therapists need to consider the following:

Incorporate varied approaches

Different treatment approaches may be needed. Some children may need a restorative approach, which involves retraining to improve lost function. For other students, a compensatory approach is needed, which focuses on learning new ways of doing things to adapt to deficits from the TBI.

Consider pre-existing conditions 

It’s important to remember that some children who sustain a brain injury may also have a preexisting condition. Deficits and disorders, such as attention-deficit, speech sound disorders, and learning disabilities all need to be considered when developing a treatment plan for a student who also has a TBI.

Use a family-centered approach

The family can play a vital role in the success of a child with a brain injury. Keep parents and caregivers in the loop. Maintain open lines of communication, so parents and caregivers know how they can help and reinforce speech therapy at home. Update parents on the progress their child is making. Be aware that parents may be stressed by the extent of their child’s medical challenges and needs following a TBI and be sensitive to their emotions.

Traumatic Brain Injury Speech Therapy Activities

Developing a treatment plan for a child with TBI will vary on a case by case basis. Various factors to take into consideration include age, previous levels of function, and developmental status. Listed below are a few activity suggestions in order to assist students with TBI:

  • “Cheek Puff” (Facial Strengthening Speech Therapy Activity)
  • Playing the Piano – This is an effective way to teach new skills through a fun activity. It is suggested to label each of the keys and practice beginner level lessons. This activity targets organizational skills as well as short-term memory while learning a new skill.
  • Building Lego sets – This activity focuses on visual directions and problem solving skills. Provide a photo of the lego set that will be built which will help with planning ahead, problem solving in the case that a block is placed incorrectly and overall visual comparison.
  • Plan an event – This activity targets time management, planning and organization. Planning this event can take a few days or a few weeks, depending on the case. During this planning phase, focus on creating to-do lists, creating and sending invitations, setting up the party and conversing with guests. This is a great way to practice decision-making skills.

Working with children with a traumatic brain injury as a school-based speech therapist requires a unique approach. But watching a child overcome their challenges to reach their potential is rewarding. What are some things you have learned about working with children who have had a traumatic brain injury? Share with us in the comments below.

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