Understanding Cognitive-Communication Difficulties After an Acquired Brain Injury

An acquired brain injury (ABI) can affect many areas of life, including the ability to communicate effectively. Beyond speech and language, people may experience cognitive-communication difficulties, which impact how they think, process information, and use language in daily life.

What Are Cognitive-Communication Difficulties?

Cognitive-communication difficulties occur when changes in thinking skills affect communication. Common challenges include:

• Difficulty organising thoughts and expressing ideas clearly

• Trouble following conversations or understanding complex instructions

• Problems with memory, attention, or problem-solving during communication

• Challenges with social communication, such as interpreting tone, facial expressions, or sarcasm

These difficulties may be subtle or more obvious, and they can affect relationships, work, and participation in the community.

How Speech Pathologists Can Help

Speech pathologists support people with cognitive-communication difficulties following ABI. Therapy may involve:

• Memory and attention strategies – using notes, visual cues, or routines to support daily communication

• Problem-solving and organisation skills – breaking tasks into steps and practising sequencing information

• Social communication support – role-playing conversations, interpreting social cues, and practising turn-taking

• Compensatory strategies – using apps, diaries, or checklists to support independent communication

• Family and caregiver education – teaching strategies to support communication at home and in the community

Speech pathology interventions focus on improving functional communication in real-life situations. Even small improvements can enhance independence, confidence, and participation in social, work, and community activities.

Cognitive-communication difficulties after ABI are common but manageable. With tailored support, individuals can develop strategies to communicate more effectively, maintain relationships, and engage fully in daily life.