Acquired cognitive-communication deficits may occur after a stroke, tumor, brain injury, progressive degenerative brain disorder, or other neurological damage. These deficits result in difficulty with thinking and how someone uses language.
There are several potential areas where deficits may occur:
- Social Communication (pragmatics): Difficulty following the rules of both verbal and non-verbal communication. Includes difficulty with understanding jokes, saying inappropriate comments, jumping into the conversation at the wrong time, or not using facial expressions.
- Reasoning: Inability to think of and apply solutions to problems. May also include decreased ability to come up with multiple solutions and indicate what solution is the best.
- Attention: Difficulty concentrating or focusing on a task, especially when it’s noisy or when multiple things are happening at once such as talking on the phone with the TV is playing in the background.
- Memory: Difficulty recalling short term or long term information. May also include difficulty learning new information including names, places, situations, and instructions.
- Organization/Planning: Difficulty putting details or events in order, thinking though what step needs to come before another one, or telling a story in the correct sequence.
- Insight/Awareness: Difficulty recognizing something is wrong either in the environment or with oneself. For example, the client might not recognize that they have thinking impairments even after education.
Assessment of cognitive-communication deficits includes the use of standardized tests and/or informal evaluation along with client and family/caregiver interview. This identifies strengths and weaknesses along with outlining areas for treatment and the need for additional services.
Treatment works to address impairments and provide strategies to support areas impacted. The focus is on functional outcomes, making an impact in quality of life and helping clients return to activities they love, preserving optimal participation in the game of life, and providing supports and resources for the individual and their family/caregivers.