الفهرس 
COMMUNICATIONOnly 14 pages are availabe for public view
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Abstract
Traumatic brain injury is an important worldwide health problem. Communication challenges following traumatic brain injury are different to those taking place due to a more focal lesion and this is because of the multi-focal nature of traumatic brain injury, leading to a complex interplay between cognitive, linguistic, physical, behavioral, and organic-psychosocial factors that contribute to the experienced communication difficulties. The ability to communicate is crucial and subsequent disabilities will affect work, family life, and everyday lives.
Communication problems experienced after traumatic brain injury can be divided into communicative related disorders and communicative disorders.
• Communicative related disorders
Cognitive communicative disorders; Cognitive-communication disorders are the result of disruption of cognition especially attention, memory, and executive function as they are important contributors to loss of communicative competence.
Discourse impairment; Individuals with TBI demonstrate problems initiating and sustaining topics in conversation and frequently rely on their partner to assume a greater proportion of the communicative burden.
Psychosocial function following TBI; Patients may suffer from personality and psychosocial changes manifested in stressful and unsatisfying communication.
Dysphagia; With TBI, dysphagia presents with an acute onset and is associated with an increase in the risk of aspiration pneumonia, malnutrition and dehydration.
• Communicative disorders
Aphasia; Language and communication problems are common disabilities in TBI patients. Some may experience aphasia which may be in the form of Expressive aphasia’s, Receptive aphasia’s, or Global aphasia.
CAPD; Head injury may cause damage to the central auditory nervous system leading to CAPD.
Dysarthria; Dysarthria constitutes one of the most persistent sequelae of severe traumatic brain injury and it represent more than one third of the communicative dysfunction evident in TBI population
Apraxia of speech; It is a motor speech disorder. It is caused by damage to the parts of the brain related to speaking
Neurogenic stuttering; The term ”neurogenic acquired stuttering” denotes stuttering that appears to be caused or exacerbated by neurological disease or damage such as TBI.
Communication disorders in children who have sustained cerebral injury require some special considerations because, unlike in adults, still developing skills are impaired as injury to the immature brain will have different consequences to the linguistic, academic and social development of children. Communicative disorders in children suffering from traumatic brain injury can be understood by discussing BDMH, communicative associative disorders and communicative disorders.
• BDMH.
TBI in children may cause a condition known as brain damage motor handicap if damage takes place to one or more specific areas of the brain, during postnatal period or during infancy.
• Communicative associative disorders.
Psychiatric disorders; Psychiatric disorders and personality changes may take place after TBI causing distress in social, occupational, or other important areas of functioning.
Educational problems; many children after TBI have learning difficulties and require special education services.
Motor deficits; Focal damage to the motor area can result in hemiparesis in 30-40% of TBI patients. Other motor problems can include spasticity, dystonia, hypotonia and ataxia, all of which can negatively impact motor recovery and function.
Cognitive deficits; Specific neuropsychological processes known to be affected by TBI include memory, attention, executive function, and speed of processing and responding leading to disruption of the communicative competence.
Dysphagia; Swallowing disorders can take place after TBI especially during the oral and pharyngeal phase causing secondary complications contributing to the mortality and morbidity in TBI.
Discourse Impairment; Children with discourse impairment after TBI produce stories that are fragmented and difficult to follow even though they tend to use as much language as normal children.
• Communicative disorders.
DLD; Decreased language performance becomes more evident when the child is placed in stressful situations such as in social interactions at school.
Dysarthria; One of the most common etiologies of acquired childhood dysarthria is TBI causing any of the form of dysarthria.
Apraxia; It is characterized by sensorimotor problems in positioning and sequentially moving muscles for the volitional production of speech.
CAPD; Children with auditory processing disorders appear to be uncertain about what they hear, and may have difficulties listening in background noise, following oral instructions, and understanding rapid speech.