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Brain Injury and Speech Disruptions


Speech problems from brain trauma are common, and vary in severity from mild and temporary to debilitating. Among the possible speech problems from brain trauma, stuttering, slurring, and slow speech are prevalent. A contributing factor to many of the speech problems from brain trauma is the loss of common words or inability to form sentences correctly.

From The National Aphasia Association:

Phil G. was lucky to have survived his auto accident. He recovered nicely from his various physical injuries, but was unprepared for aphasia, the speech and writing difficulties that persisted after the swelling of his brain subsided. As a single young man and a journalist, Phil depended both socially and vocationally on his way with words. Now he found himself continually at a loss for words. His speech was slow and deliberate, often marked by an inability to think of or say the right words. When listening to others he had difficulty keeping up with the speaker, and when trying to take notes he often could not remember how to write certain words. …The speech of a person with aphasia may also become slurred and riddled with mispronounced words, as if the speaker were drunk.

From The Stuttering Foundation:

Neurogenic stuttering is a type of fluency disorder in which a person has difficulty in producing speech in a normal, smooth fashion. Individuals with fluency disorders may have speech that sounds fragmented or halting, with frequent interruptions and difficulty producing words without effort or struggle. Neurogenic stuttering typically appears following some sort of injury or disease to the central nervous system i.e. the brain and spinal cord, including cortex, subcortex, cerebellar, and even the neural pathway regions.

What are the primary symptoms of neurogenic stuttering?

Because it results from a very diverse set of diseases and disorders, the symptoms of neurogenic stuttering may vary widely between different individuals. Neurogenic stuttering might be considered as a possible diagnosis if one or more of the following symptoms are observed:

  • Excessive levels of normal disfluencies or interruptions in the forward flow of speech, such as interjections and revisions;
  • Other types of disfluencies, such as repetitions of phrases, words, and parts of words (sounds or syllables, prolongations of sounds), etc;
  • Hesitations and pauses in unexpected or inappropriate locations in an utterance;
  • Cessation of speech during the production of a word without finishing the word;
  • Intrusive or extraneous additional sounds during speech production;
  • Rapid bursts of speech which may be unintelligible;
  • Extraneous movements of lips, jaw, or tongue while attempting to speak, including posturing.

Many individuals may appear to be unaware of or at least unconcerned about the disruptions in their speech. Others may show awareness, and possibly express anxiety and even depression about the difficulty they encounter in speaking. This may be accompanied by other behaviors, which may include:

  • Secondary or associated behaviors, such as obvious tension and struggle in speech production; movements of head or limbs while speaking; reduced eye contact;
  • Postponement or delay in attempting to say a word or avoidance of words or speaking situations.

Some of the patterns that set the it apart from other types of stuttering:

  • Neurogenic stuttering may occur at any point in the production of a word, rather than primarily at the beginning, as is common with developmental stuttering.
  • Neurogenic stuttering often occurs on any type or class of word anywhere in a sentence rather than being linked to content words such as nouns, verbs, adjectives and adverbs.

About ilanaturgy

Ilana Brownstein is a dramaturg and director specializing in new play development, based in Boston.

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