Most Common Etiologies
- Alzheimer’s disease
- Dementia
- Brain tumors
- Stroke
- Traumatic brain injury (TBI)
- Other neurogenic disorders or diseases
Potential Consequences/Impact of Cognitive-Communication Impairment Can Include:
- Reduced awareness and ability to initiate and effectively communicate needs
- Reduced awareness of impairment and its degree (i.e., loss of ability to assess one’s own communication effectiveness)
- Reduced memory, judgment, and ability to initiate and effectively exchange routine information
- Difficulty performing personal lifestyle management activities effectively (i.e., pay bills)
- Reduced ability to anticipate potential consequences, with reasonable judgment and problem solving
- Reduced social communication skills and/or ability to manage emotions, often causing loss of relationships
- Disruption of ability to fulfill educational or vocational roles, including potential loss of employment
- At risk for injury due to inability to communicate in an emergency and/or anticipate the consequences of own actions
Behaviors that should trigger an SLP referral
Difficulty functioning independently due to:
- unresponsiveness to all external stimuli
- may open eyes, suck, and/or yawn
- does not attend to others
- no purposeful speech
- extremely impaired attention and memory with impulsivity
- extremely limited communication:
- difficulty responding to and/or saying name
- difficulty expressing basic needs to others using simple words and/or gestures (i.e., yes/no, head nod)
- difficulty saying greetings (i.e., “hi” and “bye”) on own
- difficulty remembering spouse/caregiver’s name
- difficulty counting to 10
- becomes agitated when needs are not met
- limited eye contact
- limited social behaviors (i.e., expressions of courtesy and facial expressions)
- very limited communication:
- difficulty paying attention while speaking (i.e., does not complete sentences or take turns speaking during conversation)
- difficulty responding appropriately to message of other individual (i.e., delayed, perseverative, or off-topic responses, including inappropriate words)
- limited ability to provide biographical information
- difficulty understanding abstract information; very concrete responses
Difficulty functioning independently due to:
- difficulty anticipating consequences of own actions
- poor organization, with limited problem solving and judgment
- limited awareness of extent of difficulties; exhibits socially inappropriate behavior
- difficulty with concepts of time and money
- difficulty self-disciplining and self-monitoring to follow rules
- difficulty changing routine or schedule; difficulty learning new rules
- limited communication:
- difficulty selecting appropriate words and remembering names
- limited memory and/or knowledge of current events and/or personal history
- responses in conversation may be verbose, redundant, or tangential
- elaborates on information provided from questions, but cannot appropriately change topic, initiate, or end a conversation
- missing or misunderstanding humor
- difficulty understanding nonverbal communication (i.e., facial expressions and/or body language)
- difficulty understanding abstract information
Difficulty managing home or maintaining a job or business due to:
- difficulty planning and completing necessary daily activities
- difficulty following directions
- difficulty comprehending or applying abstract written information
- difficulty analyzing personal and/or business problems, identifying and applying solutions
- difficulty assessing own strengths and weaknesses, developing effective plans to improve weaknesses
- difficulty managing multiple responsibilities simultaneously
- difficulty managing emotions (especially anxiety, frustration, or anger) related to performance difficulties
- difficulty making, following, and modifying plans as needed
- difficulty understanding and managing personal legal or financial matters (i.e., taxes, buying or refinancing a home, etc.)
- difficulty effectively communicating with colleagues and/or customers, especially initiating effective responses, interpreting combined verbal and nonverbal responses during conversations to determine strategic communication action; modifying responses when feedback indicates it has not been successful