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After My Brain Injury, Why Is Speaking Harder on Some Days than Others?

Comments [17]

Janet Brown, CCC-SLP, BrainLine

After My Brain Injury, Why Is Speaking Harder on Some Days than Others?

I am 53 and had a TBI more than 14 months ago. Some days I just cannot speak words or make sentences. I still work most days and run regularly to keep in shape … and to keep happy. Recent tests showed that the area of my brain near my left ear is still not normal and I have some hearing problems on that side, too. I don’t take medication of any kind. Are there other strategies I don’t know about that I could use to improve my issues with aphasia?


Aphasia affects your ability to understand as well as to produce language to express yourself and is usually caused by damage to the left side of your brain. A hearing loss adds to the challenge of having aphasia from your TBI, because you have to work harder to hear what is being said in addition to understanding the words. It is wonderful that you are busy and active, but you may need to take a closer look at what causes the differences in your communication from day to day.

  1. Look at your overall health. Are you consistently eating and sleeping well, or do you feel more tired or stressed on some days? Your communication ability is likely to mirror how you are feeling physically and mentally.
  2. On a bad day, try to ease up in what you expect of yourself. Get more rest on those days, and try not to put yourself in difficult communication situations.
  3. Get your hearing checked by a certified audiologist to see if you would benefit from some kind of amplification.
  4. Make sure you minimize other sources of noise (TV, music, crowds) so you can hear and concentrate to your best ability.

And remember that one of the hallmarks of having had a brain injury is inconsistency. You will have good days and bad days but hopefully you will see a pattern of improvement over time.


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 [17]

This answer from "The Expert" is the most "simply" comprehensive "matter of fact" response I've heard in a long time!! Totally "Spot On!" The only thing I'd add as a consideration is acupuncture/pressure as & adjunct. "STRESS" in my "non scientific evidenced based" opinion is the "Mother Lode" of most other problems. It can be experienced in a myriad of ways. The easiest way 2 identify something/one as a "stressor" is your physical response. I cut off cable..Some people & am very selective about who or what I entertain. I made this decision before the 1st of the year & it has been a blessing!! Lastly, when those inevitable days come when my "Get up & go has gotten up & gone" I don't lament nor beat myself up about it any more. I've come 2 see those days as "friends". A good friend saying "Not 2day". There'll be another day 2 attack your "perpetual" To Do List.

Feb 3rd, 2016 1:36am

I have expressive aphasia and have struggled for years to understand why my condition made me hyper vulnerable to exploitation and abuse. I feel as if nothing I say is ever heard and at times have agonized for months attempting to find the words or a phrase to get a point across. My speech disorder seems to irritate my girlfriend and colleagues this has led to the destruction of both personal and professional life it can be amazing how cruel even those who claim to love you can become .

Jan 28th, 2016 2:26am

I have this problem , I suffer with brocca aphasia , I've been called horrible names , people don't give me chance to speak seems like they taking over my life

Sep 29th, 2015 4:37pm

My TBI was in 2008, I still have the issues as well. For me eliminating all other noises surrounding helps only sometimes. Even when I am one on one with a person alone in a room I have these same issues. I think overtime my anxiety about it reduced by speaking slower and taking more time to think ahead about points on certain topics in order to feel prepared for certain conversations, like topics for work.

Aug 20th, 2015 12:04am

I had a bleed on my brain near 2yrs ago now and i also have white matter disease some days i find i can't remember my words so i take longer to search for the word i am looking to say,on a bad day i have what i call like rice in a bottle shaking in my head which makes my head feel really heavy especially on the right side of my brain i am 44 with 2kids and scared to death of what  is coming next.

Jun 8th, 2015 8:07pm

I was told that this was migraine aura for me even after I had a brain aneurysm coiled. Very good info.

Jun 8th, 2015 8:07pm

hey its been 19 months since mine and im still struggling!! if i struggle i get comments like 'dont worry we all do that' or 'thats normal for most people'!! what they dont understand is that your/mine brain is actually struggling to find words and put them in sentences!! be brave. as i always think - im still alive!!

Jun 8th, 2015 5:05pm

My most severe TBI occurred in 1971... to this day I experience problems understanding what I hear & read. I also experience problems expressing my thoughts verbally. Public speaking is a freaking nightmare! Anyway, I've given up on "getting better", I focus instead on doing a better job of dealing with the issues I face every day.

Jun 8th, 2015 4:38pm

In a brain injury i was in coma for 5 days. After 21 days i got relief from hospital. Within 30 days i felt good. But i have a speech problem. Up to day hours of 4 or 5 pm its ok. But after that my tongue dont work properly. If i am busy it may ok for whole day. If i am in tension or in pressure it may start from morning. Pls guide me what i have to do.

Jun 6th, 2015 6:41am

I had a member come to my adaptive yoga class yesterday with Aphagia, he could only hear me when I was looking directly at him. I augmented my speech with hand gestures - I'm wondering if doing so was helpful to the member. He indicated he really did not hear much of what I was saying - but he was following the rest of the class in doing the postures. I'd like to be able to help him develop more, but can we do it in a group setting?  I'd love some input.  Thanks! -=PS=-

Feb 13th, 2014 11:49am

While it is nice to know that there are others with these issues; I just want to get better and be over this. My Tbi was in May of 2010 and all the smart folks are just saying: "hang in there". So I'll continue, but I know there are going to be bad days like yesterday where I really messed up my family. It's great they are all stickng by me but I've got to wonder "for how long?"

Feb 28th, 2012 10:01am

My TBI was in 1986, and it was only a few years ago that I regained my articulate speech, so keep optimistic because you never know how long it will take! Also until a few years ago, I found that I was reading less because life was getting busy. Aphasia-like symptoms resulted, which I think actually were likely as much or more to unfamiliarity instead of the TBI itself, so ... keep reading complicated texts because while the root cause might be Aphasia related, sometimes we can compensate)!

Feb 22nd, 2012 7:47pm

I had a Severe TBI on Feb. 5, 2000.Many times the words just won't come to me, I know what I want to say but can't express it. Drives me nuts, & most of the time just forget what I'm getting at altogether. Used to be slurred speech for a long time, still slurred from time to time or really fast & when I try to slow down to be clear just picks right back up again, people can't understand me half the time. Can't focus for long, frustrated very easily. For a while I felt like things were getting better but, now just seems to have gotten worse. Idk, I could go on, but ... I can't remember right now. Smh...

Feb 22nd, 2012 3:33pm

I too have had these issues with hearing loss, sometimes I just can't find the right word or I jumble a word up. I hate to say I'm glad to hear that this is not unusual, but it helps to know that others have or had the same problems. I just keep telling myself tomorrow is a new day when I have bad days.

Aug 3rd, 2011 2:38pm

My TBI was in 2001 and aphasia is a more recent problem for me. I use my hands more when I can't find the words, and sometimes I get so mad I say a cuss word which I never did before. I was also left completely deaf on my right side. Are there any programs to help with this?

Jul 24th, 2011 11:55am

I had a TBI on Sept 10, 1995 and still have difficulties. I sometimes leave out whole words when I type or write. My speach is slurred at times and I sometimes have difficulty coming up with the proper word to use. My short term memory is better than right after accident, but not anywhere I'd like to be. Being a perfectionist also causes somke depression at times. :(

Jul 6th, 2011 12:46pm

I occasionally have a problem with this; I can write well, but words don't come out orally and conversations get cut short and I lose track. This has been diagnosed as dysphagia. It can be frustrating and maddening when trying to get across an important point.

May 17th, 2011 10:50pm

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