What is a Cognitive-Communication Disorder
At Speak and Swallow, our Speech Pathologists provide therapy for a range of communication difficulties. However, one of the areas we work in that you may not yet be familiar with is cognitive-communication disorders.
Cognitive-Communication disorders arise when a person’s cognition – that is, their cognitive abilities like attention and memory – are impacted in some way. This can sometimes occur because of a brain injury or arise due to developmental differences.
In this article we’ll share what a cognitive-communication disorder is and how speech therapists can help to support meaningful communication interactions and communicative function in everyday life.
What is a Cognitive-Communication Disorder?
The term “Cognitive-Communication Disorder” is used to describe when a person’s communicative function in their everyday life is impacted in some way by cognitive differences. These differences can occur as a result of a developmental condition or acute brain injury, and can sometimes be related to progressive neurological changes like in dementia.
A person with a cognitive communication disorder will typically have difficulties with one or more of the following cognitive processes:
- memory
- organisation
- problem solving
- planning
- attention
- information processing
- reasoning
- self-monitoring (and inhibition)
- insight (awareness)
Cognitive communication disorders vary in severity, from mild difficulty following conversations to severe impairment in all communication skills. These communication difficulties can make connecting with others and participating in everyday activities challenging.
Cognitive-communication disorders can occur alone or in combination with other conditions, such as dysarthria (slurred speech), apraxia (inability to move the face and tongue muscles correctly to form words), or aphasia (impaired language).
Why Cognition Is Important for Communication
Because you are such a good communicator, you probably don’t realise just how much you are relying on different aspects of your cognition every time you have a conversation! Each time you go to speak, or listen to someone else talking, your brain is hard at work making things run smoothly in the background.
Here’s a general overview of how cognition impacts communication:
Attention: As you can probably guess, being able to focus your attention is critical in a conversation with anyone! Someone with adequate attention skills can listen to instructions and follow them without getting distracted by other things happening in the immediate environment like loud noises or background music.
Memory: This cognitive skills is often one of the main ones to be impacted by cognitive changes like dementia. Memory is necessary for storing and retrieving information. For example, someone with good memory skills can remember what they learned at a professional development event so they can apply it to their work, or bring up a meaningful topic with someone who they remember conversing about a certain subject in the past.
Organization/planning: This cognitive skill supports our ability to plan and carry out tasks each and every day. For example, when preparing to cook a meal you may start by pre-heating the oven and cutting up the vegetables before preparing later stages of a recipe. You also may choose to do more important tasks earlier in the day, rather than spend your entire workday responding to emails.
Reasoning: The ability to think logically and draw conclusions from information makes use of reasoning skills. For example, someone with good reasoning skills can figure out what someone means by ‘reading between the lines’, or will know not to bring up a sensitive topic around someone who has recently gone through a tough time.
Insight/awareness: This can be one of the most challenging aspects of cognitive-communication disorders for families to deal with. When a person’s insight and awareness is impacted, they typically do not have a good sense of their own thoughts, feelings, and behaviours. This may lead to a person feeling angry or upset and lashing out, when they were previously a very mild-mannered person. In our everyday lives, you use your insight and awareness to manage emotions in a healthy way during challenging communication interactions.
Social Communication: The ability to use language appropriately in different social contexts is what Speech Pathologists refer to as ‘pragmatics’. For example, someone with good pragmatics skills will know it is inappropriate to use a lot of slang or jargon when speaking to someone who doesn’t work in the same industry.
Signs of a Cognitive-Communication Disorder:
If you note any of the below symptoms impacting independent functioning in everyday life, it is worth seeking the support of a qualified Speech Pathologist.
- communicating with unclear or no purposeful speech
- difficulty responding to and/or saying name
- difficulty expressing basic needs to others using simple words and/or gestures (i.e., yes/no, head nod)
- difficulty remembering spouse/caregiver’s name
- becoming agitated when needs are not met
- limited social behaviours (i.e., expressions of courtesy and facial expressions)
- difficulty paying attention while speaking (i.e., does not complete sentences or take turns speaking during conversation)
- difficulty responding appropriately to message of other individual (i.e., delayed, perseverative, or off-topic responses, including inappropriate words)
- limited ability to provide biographical information
- difficulty understanding abstract information; very concrete responses
- difficulty anticipating consequences of own actions
- poor organization, with limited problem solving and judgment
- limited awareness of extent of difficulties; exhibits socially inappropriate behaviour
- difficulty with concepts of time and money
- difficulty self-disciplining and self-monitoring to follow rules
- difficulty changing routine or schedule; difficulty learning new rules
- difficulty selecting appropriate words and remembering names
- limited memory and/or knowledge of current events and/or personal history
- responses in conversation may be verbose, redundant, or tangential
- elaborates on information provided from questions, but cannot appropriately change topic, initiate, or end a conversation
- missing or misunderstanding humor
- difficulty understanding nonverbal communication (i.e., facial expressions and/or body language)
- difficulty understanding abstract information
The Impact of Cognitive-Communication Disorder on Quality of Life
Cognitive-Communication disorders can have a large impact on a person’s ability to interact with others and complete day-to-day tasks. Long-term, this can negatively impact quality of life and even lead to challenges like loss of employment. This is why it is so important if you are noticing changes after an accident, or after receiving a diagnosis of a progressive neurological disorder, that you reach out to a local Speech Pathologist for support.
How Speech Therapy Can Help People with Cognitive-Communication Disorders
If you know someone who has recently been diagnosed with a cognitive-communication-disorder, know that there is support available. Speech Pathologists can provide you with individualised therapy to help compensate for changes in cognition and implement strategies with the individual and key communication partners to support meaningful communication interactions and improve communicative function in everyday life.