Neurological communication disorders

Neurological communication disorders most often occur in adults. One or multiple functions of communicating are impaired after acquired brain injury (stroke, head trauma, tumor, etc.) or neurodegenerative diseases (Parkinson’s, dementia, MS, ALS, etc.). The functions that are affected depend on the localisation of the problem in the brain or peripheral nervous system.

People with neurological communication disorders often receive their diagnosis in the hospital or with their neurologist, but sometimes, the cause of the communication problems is not identified yet.

Depending on the cause, type of disorder(s), and severity, speech and language therapy will look very different. Assessment and treatment are always tailored to the individual’s specific communicative needs.

I also value close cooperation with other healthcare providers and encourage the person's environment to participate actively. This way, we create a multidisciplinary treatment plan.

Neurological communication disorders often co-exist with swallowing disorders or ‘dysphagia’. Read more about it here.

Common types of neurological communication disorders

  • An acquired, neurological language disorder.

    Depending on the localisation of the brain lesion(s), aphasia can affect different regions in the language areas of the brain. This means there can be difficulties understanding written or spoken language, speaking, writing, or multiple functions.

    For example, someone with aphasia may have a clear idea of what they want to say but may not find the words or have trouble putting them together to form correct sentences.

  • An acquired, neurological motor speech disorder.

    In dysarthria, one or more body parts needed for speaking are weak or hard to control, often making the person difficult to understand. Some symptoms include imprecise or weak articulation, insufficient breath support, a very soft or strained voice, and problems with prosody, such as speech rate and intonation.

    Acute dysarthria is often caused by acquired brain injury, while chronic dysarthria is a result of neurodegenerative disorders, such as Parkinson’s disease. Sometimes, dysarthria presents with a form of facial paralysis. Speech therapy will look differently based on the cause of the dysarthria and the affected speech muscles.

  • An acquired, neurological speech planning disorder.

    Apraxia of speech occurs when the part of the brain that plans and sequences speech movements is damaged. In a stand-alone diagnosis, the person still has the necessary language skills and muscle function to talk, but the words come out differently than the person intended. Consequently, this affects intelligibility.

    Symptoms include variable, distorted speech sounds, continuous searching for the right sound, trying to correct a word multiple times, and unreliable prosody such as variable speech rate and rhythm.

  • Acquired, neurological communication problems due to an underlying cognitive deficit.

    Communication is more complex than a combination of just the language and speech areas of the brain. You need many parts of the brain to communicate, like those responsible for thinking, social, and conversation skills. When one or more of these regions are impaired, this will reflect to a greater or lesser extent on the person’s communication. 

    Possible cognitive communication problems include difficulty maintaining attention during a conversation, remaining on topic, remembering what was said, responding accurately, or following instructions.

Because brain areas lie close together, it is usual for someone to receive more than a single diagnosis after brain injury.