Treating Children with a Traumatic Brain Injury as a School-Based Speech Therapist

by Howard Gerber on April 5, 2018

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speech therapy traumatic brain injurySchool-based speech therapists work with children will 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.

Common TBI 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.

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

Common Speech Therapy Goals for Children with a TBI

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.

Treatment Considerations

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.

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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