Communication Issues: Language and Pragmatics

A brain injury can affect a person’s communication in several different ways.

1. Speech and the way you write and understand language that affect communication.

An individual may develop a condition known as Wernicke’s Aphasia, which means they have difficulty understanding spoken words. They may also have difficult categorizing or naming objects they see or think about.

Broca’s dysphasia (also known as Broca’s aphasia), involves damage to a part of the brain known as Broca’s area. Broca’s area is responsible for speech production. Individuals with Broca’s dysphasia have extreme difficulty forming words and sentences, and may speak with difficulty or not at all.

2. Physical issues that affect communication.

A brain injury can also result in Dysarthria, which is when an individual loses control over the muscles involved in speaking. This can affect the range of movement they are able to produce with their lips and tongue, limiting the number of clearly defined sounds they can make. It can also lead to problems in controlling the airflow from their lungs which would result in difficulty controlling volume and tone of voice. Apraxia is when an individual with a brain injury has issues with planning their motor movements, including movements of their mouth. This makes it difficult to say words correctly or consistently.

3. Pragmatic issues that affect communication.

Pragmatics is the skill of using language socially and being able to adapt it to different situations. It is needed when taking part in conversations and interactions in socially acceptable ways. A person with brain injury may see and hear these non-verbal aspects of communication, but not interpret them correctly. Impairments of pragmatic communication may include disruptions in staying on topic, organizing thoughts when speaking, and taking turns in conversation, among other difficulties.

Effective communication strategies include:

  • Simplify your message by speaking slowly and using familiar language.
  • Ask the person to repeat what you said to confirm they heard you and understood.
  • Allow extra time for them to respond.
  • Emphasize important information with inflection, and order of events.
  • Use non-verbal communication (gestures, eye contact, facial expressions, and posture) to aid understanding.
  • Encourage all efforts to communicate.
  • If someone uses an augmentative or alternative communication system, incorporate this into your conversation.
  • Use direct, specific questions (avoid abstract phrases or concepts).
  • Alert the person to changes in topic or end of a conversation.


A person may nod their head while you are speaking, giving the impression that they understand. Keep in mind they may be too embarrassed or confused to let you know they are having trouble.