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How to Avoid Being Tongue-Tied After a Brain Injury

Comments [6]

Janet Brown

Ask the Expert: How to Avoid Being Tongue-Tied
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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-SLPJanet Brown, MA, CCC-SLP, Janet Brown, MA, CCC-SLP 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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Comments [6]

I was hit by a 4 wheeler. I suffered a Traumatic Brain Injury. I hit the frontal lobe of my brain. It's been over 10 years. I still have issues pronouncing certain words and when I speak I tend sometimes to get tongue twisted. I never took rehab so that might be a major factor too.

Dec 29th, 2016 10:36am

I had a TBI in June this year (2016) during auto accident. Initially for a week or so speaking seemed normal. As time lapsed I knew something was very wrong. I had trouble saying many words, as the day wore on my speech declined. I also have trouble speaking on the phone, recently I had a customer ask me to put someone on who could talk. Several people I hadn't seen from before my auto accident got teary eyed, and one cried after hearing my labored speech for the first time since my accident. For some reason I didn't realize just how bad it was. I do have some hope for others, I've been noticing improvement during morning hours and lately into afternoon hours. My Dr prescribed a non narcotic sleep aid which has made a great impact. Now I'm sleeping 8+ hrs at night rather than a couple hrs, I wake more clear headed and speaking somewhat better, at least until I get mentally tired. Rest has been key in my personal circumstance, prior to sleeping 8+hrs I would struggle with words as soon as I awoke. Since the sleep aid I've experienced a noticeable improvement. Although I might not ever be the good speaker I once was I have improved resulting from 8+hrs of sleep nightly.

Oct 16th, 2016 2:32am

I have that problem and I can sometimes whisper the words, this brain shearing takes on different issues and I find myself constantly saying "I'm Sorry" when on the phone.. I have actual had people tell me to call back when I'm sober. It hurts, but they don't understand.

Apr 17th, 2016 11:14pm

Thank you for the much needed reminder, to read slower. Even in day to day activities I have to remind myself "slow is fast", because once I get discouraged it is a difficult hole to get out of.

Sep 16th, 2015 10:05pm

My brain has a tuff time when I hear numbers or have to count , anything with numbers . My brain repeats and adds extra and I get overloaded . I am in Speech Therapy now trying to quit repeating, so hard . I am exhausted after an hour . Thanks for sharing . G.L.F.

Sep 16th, 2015 2:34pm

ABI or TBI no matter which, is an awful lot of work to overcome, I know because I've been working on getting better too! Keep up the good work everyone!

Aug 18th, 2015 8:22pm

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