- Area: Social Sciences
- Program: Psychology
- Type of Writing: Essay (Analytical, Interpretive)
- Type of Writing: Review
- Course Level: 2000
- English Speaking Nativeness: Native
- Paper ID: SS.P.E.R.2.N.3
Effects of Traumatic Brain Injury on Speech and Physical Ability
Have you ever had those days that you just don’t feel like yourself, or that you feel like you can’t take on everything on your plate? For everyone it is normal to feel overwhelmed from time to time. But those with a traumatic brain injury or TBI it is a completely different world. Their cognitive ability is no longer the same. Because of that some people with TBI can no longer speak full sentences without stuttering or pausing because they forgot a word. Also when someone has a TBI, their mental state is changed that they may not even be the same person they were before the accident they had that made the TBI happen. It even can affect their loved ones around them. Within this paper we will discuss more fully what is signified as a TBI, how it affects the persons physical and cognitive ability; and how it can affect their loved ones.
A traumatic brain injury “is an injury that disrupts the normal function of the brain” (Siters, Carlozzi, Cernich, Velozo, Pape, Gulliver, et. al., 2012, 140). TBI’s severity ranges from mild to severe. A severe TBI means that there was a longer period of unconsciousness. Along with the severity a TBI is also “often classified as either closed or penetrating” (Siters, W., et. al., 2012, 140). Sometimes depending on the severity of the injury the patient may not even know that they have a TBI, just because it is a very new thing. But it can affect your physical and cognitive ability.
Just in the U.S. it is estimated that around “1.2 million to 2.4 million persons [are] experiencing TBI each year” (Siters, W., et. al., 2012, 140). But a large percentage of those people are able to be treated and released from hospital care. It is even suggested that about 70,000 of 1.6 million service members have a TBI. But still some say that up to 320,000 service members have had a TBI. It has been stated that TBI is the biggest contributor to wounded soldiers in the Iraq and Afghanistan war (Keltner, & Cooke, 2007, 223). At the Walter Reed Army hospital “it has been found that almost 60% of those with blast injuries suffer from TBI” (Keltner, & Cooke, 2007, 223). This is because a lot of times things may be wrongly diagnosed while in the field so they were not identified as wounded.
TBI is not always physically noticeable, this is at times where the problem lies. Also at times those people who have a TBI may not realize that they are impaired. What can be done to help bring awareness to an injury that sometimes is unseen? A group called Join Forces has been created to answer such a question. It is their goal to “educate [military family] members on how to recognize PTSD, TBI, and post-combat depression” (Polovoy, C., 2012, 9). Not only are they teaching family members of veterans, they are also creating conferences for public and private organizations to help raise awareness of TBI so no one goes un-helped (Polovoy, C., 2012, 9). On top of trying to raise awareness of TBI and other diseases, Join Forces is trying to improve medical assistance to help the disabled.
When it comes to speech and language impairments they are placed into two main categories. Those two categories are organic communication disorders and neurogenic disorders. There is nothing else written about organic communication disorders, but a neurogenic disorder is when the central nervous system is involved. A neurogenic impairment not only involves the central nervous system, it is a “result of confirmed neurologic disease” (Roth, C.R., Micaela, C.P., & Beach W.A., 2015, 416). Which a neurologic disease could be a stroke, Parkinson’s. Multiple Sclerosis, etc. But having a neurologic disease does not always mean that your stuttering is neurogenic. When there is neurogenic stuttering there tends to be a pattern and it is not very sporadic.
When these two disorders can’t explain the impairments, there is another category called psychogenic or non-organic, which is “when there is no clear organic basis for the compromised communication” (Roth, C.R., Micaela, C.P., & Beach W.A., 2015, 415). Or there are no direct effects from the central nervous system. A scientist by the name of Duffy reported that approximately 4% of all speech/language impairments are psychogenic (Roth, C.R., Micaela, C.P., & Beach W.A., 2015, 416). When someone does have a psychogenic it is harder to diagnose, because stuttering is inconsistent and may be the result of multiple behaviors.
A 38-year-old man by the name of J.B. received a TBI after being in an automobile accident. After being discharged from rehabilitation he went back to work. But while at work he kept losing track “of his place when stocking shelves, having been distracted by the background noise of customers moving about and talking” (Turkstra, L.S., & Kennedy, M.R., 2008, 11). He could not at times remember where products belonged and when they changed spots around the store. Because of that he could not help customers find the items they wanted. From time to time he would even lose his temper because of frustration, which never happened before. This came as a great surprise to his boss because “the accident did not change J.B.’s appearance and he had no medical or physical needs” (Turkstra, L.S., & Kennedy, M.R., 2008, 11). Because of J.B.’s TBI he had a lower cognitive ability than before. This just shows you that not all injuries are physical or not easily noticeable just from appearances.
As part of their research Roth, Micaela, and Beach studied a 27-year-old Marine who sustained a mild TBI after an IED [improvised explosive devise] struck his vehicle. After this experience he had a hard time being able to communicate with the people that he worked with. He found that it was very difficult to find appropriate words to use, and even had a hard time with sustaining attention. In conducting a study on him, it was found that when he talked about being a Marine, he talked with pride he had no problems with stuttering, but when he became more emotional or talked about the events leading up to his accident his speech became more stuttered. In his speech therapy the goal for him was “to master fluent speech by substituting a new speech pattern for his current stuttering-like speech” (Roth, C.R., Micaela, C.P., & Beach W.A., 2015, 421). To do this they first focused on individual words, then moved to full sentences, then to open-ended questions, then finally worked with conversational speech. After about 6 months of therapy he was reporting that he was reading, writing, and speaking very fluently. He still has, from time to time trouble retrieving words in conversations but over all he had no troubles speaking and he even felt more like himself. Through this study it is believed that he had a psychogenic stuttering, because of how well he recovered from his stuttering and everything that led up to the stuttering. Even considering the time between the sustained injury and when stuttering occurs.
For some people things get easier like the 27-year-old Marine. But not everyone can get back to their full level of cognition and ability to do things. For example, another military member by the name of Joe Johnson received a TBI during his tour in Iraq. But before receiving this wound he had been around multiple explosions and saw his friends and team get killed in very gruesome ways. The final explosion that he was in was the one to knock him unconscious. He was then “discharged from the military with diagnoses of PTSD and TBI” (Keltner, & Cooke, 2007, 223). In coming home, he found it very difficult to live the life he had been living before his tour of duty. He had a difficult time with memory, cognition, and even controlling his temper. These are just the few things that affected him. Because of all that has happened to him it is very difficult to be able to combat with it to help him become better and more like who he was before the accident. Not only did the PTSD and TBI affect him, it even affected his wife of over 20 years and other family members around him. His wife had a hard time dealing with “his irritability and his angry outbursts” (Keltner, & Cooke, 2007, 225). The family members even felt like they didn’t know him anymore.
There is still much that needs to be researched on TBI. We have come a long way from our previous knowledge on TBI, but we still have a long way to go to help those in need. Just like in the examples given, those with a TBI do not know how to handle themselves and need outside help to preform daily tasks that are easy for the everyday person. On top of this need not a lot of people know what to do or why the person they love is acting weird. Just like Join Forces there is a great need of awareness with this type of injury. With more people aware of TBI the more money that will be invested in research and improving technology. With this research and advanced technology, we can better improve the lives of those with a TBI and help them to become better contributors to society.
Keltner, N.L. & Cooke, B.B., (2007). Traumatic brain injury-war related, Perspectives in psychiatric care, 43(4), (223-226). 10.1111/j.1744-6163.2007.00138.x
Polovoy, C., (2012). Asha joins forces to help wounded warriors, Asha leader, 17(13), 8-9.
Roth, C.R., Micaela, C.P., & Beach W.A., (2015). Examination of validity in spoken language evaluations: Adult onset stuttering following mild traumatic brain injury, Neuro rehabilitation, 36(4), (415-426). 10.3233/NRE- 151230
Siters, W., Carlozzi, N., Cernich, A., Velozo, C., Pape, T., Gulliver, S., …, Whiteneck, G., (2012). Measurement of social participation outcomes in rehabilitation of veterans with traumatic brain injury, Journal of rehabilitation research & development, 49(1), (139- 154). 10.1682/JRRD.2010.07.0131
Turkstra, L.S., & Kennedy, M.R. (2008). Traumatic brain injury and cognitive rehabilitation, Asha leader 13(9), (10-13).