Association of Speech Therapists in Private Practice
Speech Therapy

Acquired Brain Injury (ABI) including Stroke

Acquired Brain Injury (ABI) includes: (a) traumatic brain injury (TBI) which describes head injury such as might be caused by a fall or a road traffic accident; and (b) non-traumatic brain injury which includes damage caused by strokes, tumours, lack of oxygen following surgery, infectious diseases, etc. Acquired Brain Injury can affect adults and children.

  • The communication problems resulting from damage to the brain are described as 'acquired' (i.e. not pre-existing). All aspects of communication may be affected including speech, understanding, reading and writing. This communication problem is known as dysphasia (or aphasia). The level of difficulty is very variable. In severe cases people may not understand even simple language, and are unable to put a sentence together.
  • Swallowing problems (dysphagia) are also common after Acquired Brain Injury. People may cough or choke when eating and drinking. In more severe cases chest infections can develop as food has gone down the 'wrong way' and entered the lungs.
  • Muscle weakness or lack of coordination (dysarthria) is common and can cause speech to be slurred and monotonous. People may have difficulty with the control of pace and volume of their speech. Writing and gesture can also be affected by muscle weakness.
  • Sometimes people have no weakness, but have difficulty planning and carrying out the complex movements needed for speech (dyspraxia).
  • The language difficulties after brain injury can be more subtle (cognitive communication disorders). For example, poor memory prevents people recalling what has been said, or what they have just read. Poor concentration and attention may also make it difficult for them to follow conversation. Although communication seems normal, there may be serious difficulties maintaining relationships or holding down a job.

Speech and language therapists are often involved with multi-professional teams working with Acquired Brain Injury. Therapy may begin after consultation with a neurologist or stroke specialist. A team may look at each person's ability to cope with the physical actions of daily life, alongside the communication necessary to express individual needs.

The following may form part of therapy input for people with language impairment following Acquired Brain Injury:

  • Working with both the client and their family to assist effective communication.
  • Assessment of the strengths and weaknesses of each aspect of communication (e.g. word-finding, reading, understanding situations of various complexity).
  • Assessment of ability to interpret more subtle communication (e.g. humour).
  • Work on turn-taking in conversation and taking part in a group.
  • 'Tabletop' activities (worksheets etc.)
  • Tasks to complete in-between sessions.
  • Appraisal of confidence and emotional health.
  • Liaising with employers regarding return to work.
  • Referrals to voluntary organisations (e.g. Stroke Association).
  • Referrals to Headway, Rehab UK, etc.

Some points you may wish to discuss with any therapist you contact:

  • The therapist's specialist credentials in the area of Acquired Brain Injury (e.g. participation in the British Aphasiology Society, Connect, or Headway).
  • If you are already involved in a special programme or group, you may wish to talk to the therapist about that.
  • How much experience the therapist has with Acquired Brain Injury.
  • Where the therapist sees people for assessment/therapy.
  • How much the therapist charges for assessment and/or regular therapy.

Click here to search for Speech Therapists in your area with ABI (including Stroke) as a specialty.