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Educating Others About Slurred Speech After Brain Injury

Here is a short Q&A from Janet Brown about slurred speech after brain injury.

Question:

My 25 year-old son had a brain injury two years ago. He received speech therapy for slurred speech. We now can understand almost everything he says, but people who don’t know him think he is either drunk or mentally handicapped because of his speech. What can we do to help him?

Answer:

A TBI can weaken the muscles that control your speech and voice, or affect their coordination. The resulting speech problem is called dysarthria. Here are some tips to help him speak at his best:

  • Stressed or tired muscles don’t work very well. Suggest that he take a break when he is doing a lot of talking.
  • If he speaks more slowly, it will help him produce the sounds more clearly. Let him know when he’s talking too fast. Remind him to pause to take a breath.

People sometimes don’t know how to react to someone who seems different. Ask your son how he would like to handle these situations. Here are some suggestions:

  • He can tell people directly why his speech sounds different: “I was in a car crash and now I have trouble talking.”
  • If you are with him, you can explain why his speech is different, but only if your son is comfortable with this.
  • If he has trouble getting attention from strangers, he can carry a written message: “I have trouble speaking because I was injured in a car crash. It takes me a little extra time to talk to you, but please be patient.”
  • A brain injury or stroke support group might be a good place for him to practice speaking and to get more ideas for handling social situations.

Social Communication Skills After Brain Injury

Here is some great information out of Craig Hospital, Colorado USA, who specialise in spinal cord injury and traumatic brain injury rehabilitation and research. This article covers the impact a brain injury can have on communication, some key things to look out for, and some tips.

Communicating is something that can be difficult for everyone. Often, it is made even more difficult by a brain injury.

Communicating is more than just talking. To actually “communicate” we also must share information with another person. Effective social communication includes:

  1. being able to listen to and remember what you hear
  2. taking turns with the other person, and not interrupting
  3. sharing the information you have accurately and without rambling
  4. saying things in an organized manner and making sense
  5. using tone and emotions that fit the situation
  6. “give and take” with the other speaker. Don’t make the other person do all the work
  7. being aware of how what you are saying is affecting the other person

If we combine all the things that we just listed above, they are part of something called “Social Communication.”

Characteristics of social communication issues

People who have trouble with social communication might have some or all of these characteristics:

  • Their communication is confusing to others.
  • When they talk, they may give too little or too much information.
  • They might be disorganized.
  • They might ramble and repeat themselves.
  • They might not catch and correct errors they make when talking.
  • They may not make sense.
  • They may not stay on the topic.
  • They may not give the listener enough detail.
  • What they say may not be interesting.
  • They may talk or process information too slowly.
  • The other person may have to ask a lot of questions and do more than his or her share of “the work” to keep the conversation going.
  • They may give more information than the other person wants to hear.
  • They may not know how to use “clues” or “hints” from the other person. This includes things like gestures, eye contact, and emotions.
  • They may not be able to tell if they are making the other person uncomfortable.
  • They may fail to read the other person’s emotions. Is he sad? Is she angry? Is he in a hurry?
  • They may not know what the other person is driving at; they may not know what the intent is or where the other person is coming from. For example, if someone found out that his best friend had just lost a job, he would talk one way. If he learned that the same friend had won the lottery, he would talk in a different way. And, if he saw a friend at a party he might talk differently than if he saw the same friend in a library.

What happens when communication skills are not good?

People with brain injury can struggle with social communication right after their injuries, and for months and even years afterward.

Here are some of the things that can happen over time when brain injury makes social communication difficult:

  1. At first, it may just be a lot of work to know what to say and how to interact with others.
  2. Then, some people may just stop trying. They may not want to get involved in conversations.
  3. Others may not want to get involved in conversations with the person who has the brain.
  4. After a while, it may be hard to make or keep friends; it may be hard to find a “girlfriend” or a “boyfriend.”
  5. It may be hard to keep a job.
  6. Eventually, self-esteem may be affected. The person with the brain injury may not feel very good about himself or herself. He or she might have a sense of failure.
  7. As a result, some people may start to feel isolated. This feeling can continue many years after the injury.

Re-learning communication skills

If you, or someone you know, has some of these symptoms after a brain injury, there is good news: social communication skills can be improved in many people. Training and practice help – especially when the practice is in real-life situations. One good way to work on your social communication skills is to join a treatment group of people who are working on the same thing. Groups usually have several people with brain injury, and they are usually led by a psychotherapist or speech therapist who is experienced in social communications. But, if there are not any groups near you, you can still practice on your own with a partner, friend, or family members.

Social communication exercise:

  1. Review the issues and symptoms that are described above. Make a list of the ones that you think are problems for you.
  2. Work with a partner, friend, or a family member to get their ideas too. If they listed any different problems, add those to your list also.
  3. Start with the things that are the most significant problems for you or that limit you the most.
  4. Set a goal. Pick one problem that you want to work on. Think about things you can do, when talking, to help this problem.
  5. Tell your partner or family member what your goal is. Ask them to give you feedback about how you are doing. If your goal is to not interrupt others, ask them to let you know when you have interrupted. This should be done in a way that does not embarrass you. For example, they could give you a “secret” signal if you are in public, or they could talk to you privately later on. You may want to have a time each week when you can get feedback on how you are doing with your goal.
  6. Remember that getting feedback on how you are doing can be hard. You may not agree with what the other person is telling you. It may be frustrating. However, becoming aware of your strengths and weaknesses is the first step toward improving your social skills.
  7. Keep practicing your communication skills and goals when you are out in public – when you are shopping, at school, or at a party. If your partner or family member is able to observe you while you are having a conversation with a stranger in the “real-world,” check with them afterwards. Ask them for specific and honest feedback. Be sure to ask them about the particular problem area you were trying to focus on.

Some final tips to remember

  • Keep good eye contact
  • Get to the point, and stay on the topic
  • Take turns talking and listening
  • Remember to ask questions
  • Be friendly and relaxed
  • Be aware of body language – yours and the other person’s

Practice, practice, practice, and then practice some more. It will almost certainly get easier if you do. Good luck!

Welcoming Leisa Aumua – Pou Ārahi Māori Health and Wellbeing Lead

Nau mai, Haere mai, Tauti mai, Leisa Aumua.

Last week, we were thrilled to formally welcome Leisa Aumua as our Pou Ārahi Māori Health and Wellbeing Lead.

During her Mihi Whakatau, we were fortunate to meet and greet Leisa’s Whānau. This was a lovely opportunity for our board and wider teams to welcome Leisa in a culturally appropriate way, that is mana enhancing.

“We are thrilled to welcome Leisa to our leadership team,” says Kathryn Jones, CEO. “I am confident she will lead, guide, coach, support, and teach us how to do better for those we support. Importantly, she will help us reach mana whenua and tangata whenua who may require our assistance.”

The Laura Fergusson Brain Injury Trust is committed to growing and nurturing our staff on their cultural confidence journey. This will imbed and strengthen our services for and with Māori and Pacifica Whānau. The establishment of the Pou Ārahi Leadership role is a pivotal part of our strategic plan and a key component in our cultural development journey.

This will ensure that the needs and perspectives of Māori people are at the forefront of decision-making processes and that the organisation operates in alignment with Māori cultural values and principles.

LFBIT Annual Report 2024

You can now read our 2024 Annual Report by clicking here!

A life well lived – Craig Imlay’s story

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Today we would like to share a very special story about a past resident of Laura Fergusson Brain Injury Trust, Craig Imlay.

 

Craig was born to his parents Robin and Lindsay Imlay in Dunedin on the 5th of June 1960. Five months later, they along with their family became concerned with his health, and after checking in with professionals, it was found Craig had suffered a brain injury caused by Hydrocephalus. This is a rare condition that at the time would not have been able to be treated in New Zealand. However, around the corner at Otago University, an international medical conference was taking place. Craig’s diagnosis was referred to the conference, and incredibly, they found help. Presented at the conference was a brand-new shunt valve to prevent damage to the brain – one that was used on people with conditions like Craig’s. Craig was operated on immediately, and from this, was given a chance at life.

Before Craig, no one in New Zealand with Hydrocephalus had survived past the age of five. After his surgery, he was expected to live into his teens. Later, he was told he wouldn’t live past 40. Craig lived until he was 63.

 

Growing up, Craig had his challenges. As his operation was too late to prevent brain damage, Craig lived with a disability similar to cerebral palsy. While he spent his early years of education in a preschool for disabled children, Craig grew to be dedicated in his efforts to participate in mainstream schooling.

“Craig was tremendously determined and spent his life setting out to give things a go,” says Julie, Craig’s sister. “‘Can’t’ wasn’t a word in his dictionary – If he wanted to try something he would give it his best shot. There were many times in his life when he would push back against those who said he probably couldn’t do something.”

At school, Craig would get right into sports days. He would get up for races and run with his crutches. He knew he wouldn’t win, but he tried his best all the same. His mother Robin recalls these times.

“You could never put him down, you know. He was a kid with a perpetual smile. The principal couldn’t get over Craig, he would say ‘we’ve got other kids there that you just cannot get off their back sides, and there’s Craig out on his crutches, lined up, taking part in races.’ He was amazing.”

 

In his teens, Craig headed along to a meeting for disabled people interested in skiing. After more doubt from people around him, Craig got stuck right in. For many winters, Craig would be up on the slopes, loving life. He even won a number of certificates and competitions!

In 1986, Craig was determined to take his independence to the next level, as he moved into a flat in Ilam. Life was very social living in the flat, as Craig had many flatmates and fun times living as independently as possible.

“He had a pretty busy life, he was going out five days a week by bus or taxi, to Handmade Studio and other activities,” says Robin. “He loved his spinning and weaving at the studio. He was just enjoying life. And I think of how hard it was for him, you know, but he just loved everything that he did. He felt as though he was achieving something, being successful.”

After ten years of living independently, Craig’s needs began to increase, and he moved into Laura Fergusson Brain Injury Trust’s residential home in 1996, where he stayed for 25 years. During this time, he made many great friends and was determined to continue exercising and getting out and about independently. He would often head out in his wheelchair to visit his parents who lived in the neighborhood.

“I have not got a single photograph where he hasn’t got a smile on his face,” says Robin. “Nothing would get him down. I would say to him when things were going wrong, ‘oh Craig you just never let yourself get caught up. You’re always smiling.’ And he would say, ‘oh well, Mum, what’s the point of feeling miserable or making yourself feel miserable?’ We were just so proud of him.”

In 2021, Craig’s level of care had increased beyond the capacity of LFBIT, and he had to move to Merivale Retirement Village. Before he moved, he enjoyed a huge 60th birthday celebration with his family and friends at Laura Fergusson Brain Injury Trust.

In December 2023, Craig passed away peacefully.

This year, we were surprised and immensely grateful to learn that Alan Whittaker, Craig’s stepfather, had left a gift in his Will to the Trust. Alan, who passed away a few weeks before Craig in 2023, wanted to acknowledge the support and care Craig received from the Trust and hoped his gift would help provide others with the same opportunity for support.

Craig’s mother Robin told us, “He knew that Craig was very important to me. I was very happy about it. We were just so proud of Craig’s efforts and successes over the years. A life very well lived.”

 

Leaving a gift in your Will is a very special act of generosity. Your legacy helps us empower people with disabilities to live their best lives.

Alan’s gift is already having an impact on the lives of people who are supported by the Laura Fergusson Brain Injury Trust – his kindness and generosity means the world to all of us.

Staff Appreciation Post: Deb Carter

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We have a vast range of disciplines here at the Laura Fergusson Brain Injury Trust, and today we would like to recognise the work of Deb Carter, who has worked with LFBIT for the past eight years as a social worker.

When Deb began work with LFBIT, there was no dedicated role for social work. At the time, she worked part-time as a rehab assistant, and part-time as a social worker. Over time, as more referrals began to come through, Deb shifted into full-time social work. The service has now grown to the point where last December Deb was able to recruit her social work student to join the team as the new social work colleague.

As with many roles at LFBIT, no two days of work are the same. Deb does a lot of work in the community, following clients out of rehab and identifying areas of need. Through this, she can then connect clients with the appropriate resources. This can include things such as secure housing, financial support, family or drug and alcohol services and counselling or psychology services. This work involves a lot of communication between parties, often communication that clients may find difficult or frustrating after a brain injury.

“I work with lawyers, courts, police, WINZ, MSD housing, drug and alcohol, homecare agencies, a huge amount outside agencies,” says Deb. “We know that our clients with brain injury can’t always manage to get across what they want to say, so you’re there to help bridge that gap.”

As well as this work, Deb does single discipline assessments through our assessment team, supervises students and is LFBIT’s care and protection officer.

“You’ve got to be able to adapt really quickly. You could have a day where you come in and you work trying to help people get into housing, or you’re going to WINZ with someone, but then the next thing you get a phone call and that could be around care and protection. The job keeps you on your toes and you need to be able to think on your feet. I’ve got some complex clients, but they’re great. It is about working towards gaining the trust of a client and their whānau, once you get it, that is rewarding.”

Reflecting on these rewarding experiences, Deb notes particular pride in her work with Sarah, whose story you can read here.

“When I met with her it had been a couple of years since her injury, but she was really struggling. She is just lovely, but her situation was very sad as she was living in a shed. Once we got her into a house, her whole demeanour changed. Everything about her changed. It took a while for her to adapt to her home and understand that it was hers. Every time I go out there now, she has really made it her home, where she couldn’t do that before. Many LFBIT staff helped Sarah to furnish her house, and this speaks volumes to the people that work here.”

The LFBIT team, as well as rewarding experiences with clients, is something that Deb appreciates in her work.

“The teams that we’ve got here are amazing. Our managers are so approachable, Kathryn Jones as CEO is just fantastic, and everyone is very down to earth. If you’ve got things going on in your personal life, they’re very supportive and adaptable for you. It’s just a brilliant place to work.”

“Deb is an experienced Social Worker and adds huge value to our team,” says Del Eden, Speech-Language Therapy Clinical Lead. “She willingly offers her advice and expertise, supporting our LFBIT team, as well as clients and their whānau.”

We’d love to give our deepest thanks to Deb for all her work over the years. Your work is so essential and has such a great impact on the lives of our clients, it does not go unnoticed.

Medical Fitness to Drive Assessments

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Are you concerned that a medical condition might be affecting someone’s driving safety?

Many factors influence a person’s ability to drive safely. A Medical Fitness to Drive Assessment ensures they remain safe behind the wheel.

Why consider an assessment?

• Peace of mind ensuring your loved one is driving safely.

• Early detection of medical conditions that may impact driving.

• Evaluate memory loss, confusion, or other cognitive impairments that might affect safe driving.

• Receive expert advice from an occupational therapist specialising in driver assessments.

Who should be assessed?

• People experiencing changes in vision, cognition, or mobility.

• Anyone with a deteriorating medical condition.

If you are interested, contact us today!

Laura Fergusson Assessment Services – part of Laura Fergusson Brain Injury Trust

Ph: 03 351 6047 E: hello@lfbit.co.nz W: www.lfbit.co.nz

Thank you to our patron – Beverly Murray

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On Monday, staff and residents at Ilam Road held a special afternoon tea for Beverly Murray, who after 12 years is stepping down as our patron.

Beverly’s journey with LFBIT began with the Women’s Auxiliary, marking the start of a relationship that has been nothing short of extraordinary. As a Trust Board Member in the mid-1990s and President of the Women’s Auxiliary, Beverly’s leadership and vision have been instrumental in our growth and success.

Beverly’s tenure as Chairperson of the Noelene McIlroy QSO Laura Fergusson Residents’ Trust from 2004 to 2006 was marked by significant achievements and progress, setting a high standard for those who followed.

“On behalf of the Laura Fergusson Trust Board, our residents, client’s family and whānau, I extend our deepest gratitude for your unwavering commitment and invaluable contributions throughout the years and wish to acknowledge your retirement as Patron of the Laura Fergusson Brain Injury Trust,” says Kathryn Jones, CEO.

“Your dedication to the Trust is a testament to your remarkable character and generosity. We are profoundly thankful for the years of service you have so selflessly given and for the support that has been vital to our mission and vision.”

A New Life – Doug’s story

Today we are pleased to be able to share about Doug Lynch, a resident of our Te Orewai community. After Doug’s life was temporarily put on hold after the discovery of a rare genetic disorder, he is thriving living independently and is enjoying life more than ever.

Doug grew up around New Zealand, spending most of his life in Christchurch, where he went on to gain a degree in Mathematics. With this, Doug entered teaching and did so for ten years, before his health suddenly began to deteriorate. Doug was living in South Africa at the time and returned home to New Zealand to figure out what was going on with his health. Here, he discovered that he had wolfram syndrome – an extremely rare genetic disorder that only eight people have in the entire country.

Wolfram syndrome can have a number of effects on the body. For Doug, this involved deteriorating eyesight, complete colorblindness, balance issues, depression, bladder and kidney issues, and other issues that made work impossible to maintain. It has been fifteen years since Doug’s diagnosis, and for the majority of this time, he lived with his parents. Deciding it was time to find more independence, Doug found a home in Te Orewai, where he has lived for the past two years.

“It’s like a new life,” says Doug. “It was so quiet, my life, when I was living with my parents. Now I’m just here and I’m a completely new person. It’s been absolutely fantastic.”

While his condition began to restrict parts of life for Doug, he found living at Te Orewai opens up many new opportunities. He spends time out and about, down at Richmond Club playing Euchre, at Step Ahead events, and out for walks, which he tries to do every day.

“I’ve really apricated the fact that they trying to encourage us to communicate and get on with each other, and I’m loving that. I’ve built so many great relationships with people here.”

Doug enjoys cooking and cooks his meals twice a week. Outside of this, there is a Sunday party meal each week, which many of the Te Orewai residents attend. Doug enjoys spending time with the group, playing Monopoly, and engaging with the staff.

“Doug is proactive, he thinks ‘outside the box’ and can improvise when the arises,” say staff at Te Orewai. “He Has a very good sense of humour and a very youthful spirit.”

Perhaps Doug’s greatest life passion is art. Since his diagnosis, he has invested much time into his paintings. He loves drawing people, pop culture like Star Wars, and especially loves paining cats. One cat that gets a lot of portraits is Gary, who lives at Te Orewai. With the loss of his colour vision, Doug enjoys painting in grayscale. Although, that doesn’t mean he can no longer work with colour.

“It’s very interesting because I started off life and I could see colours. It wasn’t until my 30s that I lost all my colour vision. Now I’m basically living in a grey blurry world, but I can remember what colour things were. If somebody can tell me, hey, look that’s red paint, then I know to put it in the top strand of the rainbow.”

Recently, Doug has loved painting stones, and has enjoyed placing them around the gardens at Te Orewai for those with a keen eye!

“I also enjoy painting portraits of those with wolfram syndrome around the world. I get in contact with them, ask for their permission. Then once I finish the painting, I send it to them.”

You may have seen some of Doug’s artwork at LFBIT, including our most recent Christmas Fete! Doug has plenty of paintings ready to go for the future, so be sure to check them out if you get the chance!

Thank you again for sharing your story with us, Doug! We are looking forward to seeing new artwork, and where your journey takes you!

Speech-Language Therapy Awareness week 2024

This week (23-29 Sept) is Speech-Language Therapy Awareness week. The theme is celebrating difference, inspired by the whakataukī E koekoe te tūī, e ketekete te kākā, e kūkū te kererū. Every voice is unique and we believe that diversity in communication enriches our world. We want to celebrate the power of diversity and the incredible ways we all express ourselves!

At Laura Fergusson Brain Injury Trust, we have a team of five Speech-Language Therapists who do an amazing job working with our clients who have brain and/or spinal injuries. We support clients who have a variety of communication difficulties, including cognitive-communication (difficulties with thinking skills), social communication (difficulties with social interactions), aphasia (difficulties understanding and expressing language), dysarthria (difficulties with speech), voice, stuttering and more.

One of our Speech-Language Therapists, Laura, has been working with Missy, who has had a stroke and has aphasia. Aphasia impacts the ability to express and understand language. Missy shares “I couldn’t speak at first, I tried to use different ways of communicating, now I use gesture and body language. It takes me ages to communicate my feelings. I want to talk and be better. People feel sorry for me, but I don’t feel sorry for me – I’m alive and I’m doing well”

Missy knows that Speech-Language Therapy has helped her to improve her communication “I try to be positive, you need help to better yourself”. Missy also attends an aphasia group, with other people who have similar communication challenges “I love it there, it’s a place where I can be positive…be myself”. Missy’s advice to others is to ‘be kind’; everyone communicates in different ways.

For further information, check out the New Zealand Speech Therapy Association (NZSTA) online awareness campaign with daily posts of stories celebrating communication difference.

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