define cognitive-communication disorder
reduced ability in language skills due to impairments in one or more areas of cognition
Common cognitive communication deficits
-attention
-long-term memory
-dysfunctional behaviors
-poor self-regulation of emotions and behaviors
-limited insight
Attention deficits
difficulty in
-focusing
-easily distracted
-switching tasks
-responding to simultaneously presented stimuli
Long-term memory deficits
Relatively uncommon but could be deficits in learning new info and retaining info about recent events
Dysfunctions behaviors
inappropriate
-time management
-planning daily tasks
-difficulties with maintaining a schedule
Poor self-regulation of emotions and behaviors
sudden or frequent episodes of anger, aggression, possible physical harm
Limited insight
is common among people with moderate to severe TBIs
Characteristics of Cognitive-Communication Deficits
Macrolinguistic Processing
Topic selection and maintenance
Coherence and cohesion
grammar
-deficits in inclusion and formation of key ideas and characters of story
- deficits in story organization
sometimes have adequate knowledge of the characters but may not be able to apply them due to high cognitive load
gist comprehension
Characteristics of Cognitive-Communication Deficits
Microlinguistic Processing
verbal production
Word selection and retrieval
deficits with word selction and retrieval are very common in people with TBIs
Characteristics of Cognitive-Communication Deficits
Extralinguistic contributors
affect
gestures
deficits in appropriate use of gestures during conversations
Characteristics of Cognitive-Communication Deficits
Paralinguistic contrbutors
May include changes in the supra-segmental features of language
- vocal tone
- rhythm
- stress
- intonation
Initial assessments of acute care
Bedside assessment
very common during the initial stages of hospital admission and may include administration of some of the cognitive screeners
Functional assessment
may use functional assessments (FIM and FAM) to determine the person’s level of functioning with ADLs
Residual deficits
Patterns of Recovey for Mild TBI