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The Voice: Brain Injury Speaks Newsletter




Issue No. 36 | June 2024

Communication Strategies After Brain Injury


Dear Brain Injury Speaks Members,


What are some things that come to mind when you hear the season ‘summer’? It could be the warmer temperature and long sunny days, or looking forward to activities such as picnics and barbecues outdoors with friends and family. However, activities like these can be affected in people who have sustained a brain injury, and having a deeper understanding of this is crucial.


When we think of brain injury symptoms, all are equally important as each survivor has a unique experience after sustaining a brain injury. One of the types of symptoms or changes that someone can experience is in their communication1.


In last month’s issue of The Voice, we discussed communication challenges after a brain injury including the causes and what these challenges may look like, specifically touching on speech, language, social cues and literalism, self-regulation, preservation, and disinhibition. If you would like to read this article if you haven't already, you can click here to view. In this month’s article, we are going to build upon this and discuss what communication strategies there are after brain injury, talking about resources and communication tips.


Whether you are living with a brain injury, or are a family member/caregiver of someone with a brain injury, you are not alone on this journey.


***June is Aphasia Awareness Month, Stroke Awareness Month, and Brain Injury Awareness Month!***

JUNE’S AFFIRMATION

“I believe in myself and I am brave.”


Communication Strategies After Brain Injury

After someone sustains an acquired brain injury, the impairments to their communication can be devastating and frustrating as it impacts multiple aspects of their life. This can look like disruptions to communication within families, academic achievements, participating socially, returning to competitive work successfully, and much more. Experiencing communication challenges following a brain injury is very common and even those who have sustained a mild brain injury should undergo evaluation and screening for any communication disorders5.


It can be difficult to know where to start when looking for resources and additional information on communication challenges following a brain injury. As mentioned earlier, each person has a unique experience with their symptoms meaning they require different support.


●     Care Team

○     There can be multiple individuals that are part of the care team based on each individual’s needs. Each survivor has specific needs, and interventions for service providers can differ from person to person. You may encounter multiple providers, or you may encounter few. The following providers are included to provide a general idea of their possible involvement with survivors who are experiencing communication challenges.

○     Speech Language Pathologist

■     When experiencing communication challenges after a brain injury, working with a Speech Language Pathologist can be very helpful and beneficial as they are professionals that help people with speech, language, swallowing, and cognitive-communication difficulties. They can be consulted immediately/shortly after injury or later during rehabilitation. These professionals can make a plan and assist in getting you to reach specific communication goals

○     Occupational Therapist

■     Evaluates many skills and formulates a plan and implements specific activities to develop, maintain and/or restore the ability to complete activities of daily living which includes eating.

■     Occupational Therapists can provide help with assistive feeding devices

●     Conversation groups

○     By participating in or joining conversation groups, you are able to practice using your communication skills

○     Groups can be found and offered at hospitals, community centers, and local brain injury associations; they can also be facilitated by your Speech-Language Pathologist

●     Augmentative and Alternative Communication

○     Augmentative and alternative communication technology and devices can be a useful method to communicate

○     Options can include communication boards or electronic devices

○     Smartphones, tablets, etc. have applications that can be used to convert text to speech, create sentences, and more

○     Your healthcare team (for example: occupational therapist, speech-language pathologist, etc.) can decide if devices like these are appropriate for your specific needs6


Tips when speaking with a survivor experiencing communication challenges


When communicating with someone who has sustained a brain injury, it is important to be respectful of what they need at that moment and that may mean using strategies when communicating with them. Please be aware that some strategies may work better than others and it will take time to gain comfortability in using them. Tips to use when communicating with someone who has sustained a brain injury can include:


  1. Use a slow pace when talking. This allows you to speak clearer and will be less overwhelming for the person listening.

  2. Use plain language. This will ensure that the information you are relaying is conveyed in a way that can be understood easily.

  3. Use external materials. This can include drawing or showing pictures, written materials or writing notes down, electronic devices, books, boards with text, and more.

  4. Be respectful. Sustaining a brain injury does not mean the individual is any less than before - you must be respectful and patient to the person you are speaking with.

  5. Avoid making things unclear or vague. Avoid using things such as acronyms and jargon, or talking at a fast pace - this can make it hard to follow along and understand.

  6. Avoid providing too much information at once. Rather than providing an overload of information which can be overwhelming, it is important to be concise2.

  7. Avoid rushing. Take time to pause at the end of sentences and allow the person to respond. If needed, take the time for periods of rest as well.

  8. Remove any distractors if possible. It is helpful to decrease the number of noises around such as others talking, outside noises, televisions, and music.

  9. One topic or question at a time. Rather than skipping from one topic to another, only discuss one topic at a time, or only ask one question at a time3. When questions are asked, try to ask yes/no questions.

  10. Use facial expressions and gestures. Doing this can help in expressing what you are saying.

  11. Stay aware. Make sure to be observant and aware of the survivor; look out for if they are displaying signs of being confused, overwhelmed, tired, etc4. If you are speaking over the phone and cannot see body language and facial expressions, be aware of any signals that the survivor may be conveying, such as fatigue, while using the above strategies.


Remember to be patient. No two brain injuries are the same.


How family members can support themselves


When you are a family member or caregiver of someone who is a survivor, you are a part of the care team as well. You may however forget that you yourself need to be supported throughout the process. Some tips to support yourself can include:


●     Ask for help. Being a caregiver and seeing a loved one experience the effects of a brain injury can be overwhelming, and it is okay to ask for help or allow others to help from others such as family and friends. Asking for help can also prevent the chances of experiencing burnout.

●     Take care of yourself. When being a caregiver, you can experience high levels of stress. This can lead to increased blood pressure, anxiety, and much more. Because of this, it is important to see your doctor regarding your own health as well.

●     Join educational or support groups. You can gain a lot of knowledge on what resources are available within your community and learn strategies to cope by joining and participating in these groups, as well as receive support and encouragement through what you may be experiencing.

●     Remember it is a brain injury. Your loved one is experiencing challenges that are due to their injury; keep this in mind to avoid misunderstanding them or becoming unsupportive or judgemental. If behaviours begin to get out of your control, you may need to seek help professionally.

●     Counseling. Seeking counseling can help on an individual level with the emotions you are experiencing, as well as help within the family unit so that everyone can maintain good communication between each other, understand how roles are changing, and much more.

●     Continue daily activities. Be sure to continue to take part in work and doing things you enjoy such as hobbies or attending social outings7.


Citations


In The News


The Heart & Stroke Foundation is celebrating one decade of the FAST campaign - CTV News


Each year in Canada 108,707 strokes occur, and numbers are on the rise due to Canada’s population aging. New data has suggested that the FAST campaign from Canada’s Heart & Stroke Foundation is helping in saving lives. This campaign encourages Canadians to familiarize themselves with the signs and symptoms of stroke, and since it has launched awareness of stroke has significantly increased.


FAST is an acronym, which stands for Face, Arms, Speech, and Time.


Using the FAST acronym can help in recognizing stroke and allows those who know the symptoms to act fast. By acting fast, this can have a huge effect on someone's recovery, and determine if it is a life or death situation. Although over the past decade there have been significant improvements, there is still room for more Canadians to be aware of signs and symptoms (FAST) and call 911 as quickly as possible if someone is having a stroke.


Within the article is a story of a Calgary couple, Jennifer and Mike, showing the importance of recognizing the signs of stroke. To read this story, or the full article:


Ontario making it easier and quicker for youth in Thunder Bay to connect with substance use and mental health services - Ontario Newsroom


The Government of Ontario is making efforts to allow youth in Thunder Bay and neighboring areas to connect with substance use and mental health services with the launch of the new Youth Wellness Hub. This hub, along with nine others are being added to the current 22 hubs that have opened since 2020.


Starting in 2025, this hub will allow young people between the ages of 12 and 25 in Thunder Bay (and neighboring areas) as well as their families to have access to services related to substance use, mental health, primary care and Indigenous well-being and healing. The model of the hub will be designed by Indigenous service providers and local youth partners in the community with the lead of the Children’s Centre Thunder Bay. This will be a place for Indigenous youth as well as their families that is culturally appropriate and provides cultural supports and teachings.



Research


Social Media Building Blocks (SMBB): Surveying computer-mediated communication (CMC) use among adolescents with an acquired brain injury (ABI) - Holland Bloorview Kids Rehabilitation Hospital


A research study at Holland Bloorview Kids Rehabilitation Hospital is looking to investigate how youth who have sustained an acquired brain injury utilize digital communication such as texting, gaming, and social media. The goal of this study is to understand the challenges and benefits of digital and online communication following an acquired brain injury and how social connections may be supported by them.


If you meet the following criteria, you can participate!

-       Youth between the ages of 13 and 21 who have sustained an acquired brain injury at any severity level

-       Use texting, gaming and social media prior to injury and after injury

-       Are fluent in English

-       Currently or have previously received rehabilitation in a community or outpatient environment


What the study involves:

-       One study session (90 to 120 minutes) where you complete surveys that are based on your use of online platforms such as online games and social media, how you communicate, and your social activities

-       Can be through a virtual Zoom meeting or in-person at Holland Bloorview


If you are interested in participating in this study or have any questions, you can contact Lisa Kakonge by email at lkakonge@hollandbloorview.ca or by phone at (416) 425-6220, extension 6426.



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