How to Avoid Being Tongue-Tied After a Brain Injury Janet Brown

Multimedia

• 
  Listen to Kathy Manning, a speech language pathologist and a member of the American Speech-Language-Hearing Association discuss issues particular to people with TBI. From the American Speech-Language-Hearing Association. Used with permission. www.asha.org. Transcript of this audio program.
• ASHA Podcast: Kathy Manning on Traumatic Brain Injury

More Information

• Apraxia of Speech in Adults
• Apraxia of Speech
• NINDS Apraxia Information Sheet

With my TBI, I have trouble pronouncing longer words now. When I'm reading something out loud, I hit a certain word and sometimes I have no problem the first time, but when I see that word again, I get tongue-tied. It's almost as if I'd never heard the word pronounced before.

Speech is an amazingly complex activity. You have to coordinate your breathing, your voice, and all the muscles of your lips, tongue, and throat to say a word or sentence. Reading out loud adds yet another step to the process. After a TBI, your brain may have more difficulty programming all these steps. This is called apraxia. Words that are long ("hippopotamus") or less common ("pagoda") can be harder to say. Some sound combinations are harder to say than others (for example, "splinter" may be harder than "better"). This problem is even more frustrating because it doesn't happen every time you say the word — it's unpredictable.

Try some of these tips to get "unstuck":

• Go slowly. Your brain needs more time to program your speech muscles.
• Rehearse. If you have to read something out loud, read it silently first.
• Break it down. Divide a long word into smaller parts and say each part before putting it back together.
• Take a break and try later. If you're tired or can't say a word after several tries, go back to it later.

Click here to go to About Ask the Expert.

Janet Brown, MA, CCC-SLP is a certified speech-language pathologist who spent twenty years in practice at the Veterans Administration Medical Center and at the National Rehabilitation Hospital in Washington, DC. She is the current director of Health Care Services at the American Speech-Language-Hearing Association.

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