Cognitive Communication Disorder

If the damage is to the areas of the brain that control memory, attention, concentration, reasoning, planning, organization and/or insight, the resulting communication problems are sometimes labeled Cognitive Communication Disorder. This condition is often the result of a traumatic brain injury sustained in a motor vehicle collision. Some of the characteristics of a Cognitive Communication Disorder are as follows:

• Lack of insight – the person is unaware or denies having any communication problems, even if reminded continuously
• Difficulty listening or concentrating on what is being said, or forgetting what was said
• Talking too much and not recognizing when the listener is confused or bored
• Difficulty knowing how to start, continue and/or finish a conversation
• Difficulty staying on topic
• Inappropriate or lack of facial expression or body language
• Saying things that are embarrassing, rude or otherwise inappropriate to the situation
• Difficulty organizing a message into a coherent sequence, such as explaining how to make coffee
• Frequent requests for repetition due to difficulty following the conversation in a group setting or following the story line on television
• Unfinished sentences or thoughts
• Numerous pauses or frequent use of filler words such as “um”

Caregivers can support individuals with cognitive-communication disorder by using the following conversational strategies:

• Tell individuals in a non-confrontational manner that you are having difficulty understanding what they are trying to say
• If you think you know what individuals are trying to say, help them to communicate their message
• Encourage individuals to use a different word if they are stuck
• Encourage individuals to take a brief rest if they are feeling overwhelmed in a group discussion
• Go over everyday activities, such as sorting laundry or making a sandwich, using short phrases and the correct sequence of steps in the procedure
• If planning is required to complete an activity, have individuals create an outline of what needs to be done
• Provide individuals with corrective feedback in a gentle manner when they say something rude or offensive. They may be disinhibited because of their injury and need to become aware of their inappropriate behavior.
• Remind individuals to watch others for signs of confusion or boredom when they are speaking.
• Encourage individuals to do simple crossword or word search puzzles as a fun way to work on vocabulary and categories.
• Be patient, even when it is difficult.