Many people benefit from cognitive rehabilitation after brain injury. Cognitive rehabilitation can help with many skills including:
Building mental stamina
Attention and processing speed
Working memory (what used to be called short-term memory)
Math and reading fluency
Executive functioning: planning, organization, sequencing, decision-making, judgment, doing, evaluating, and adjusting.
But where, oh, where can you get cognitive rehabilitation?
From Speech Therapists!
Now that you know that, you can educate your care coordinator and your health care providers. This is a little-known fact!
Speech therapists do help with swallowing and eating and forming words and sentences, but they do so much more. They address just about everything that goes into thinking and communicating. So you may be able to talk and you may benefit from speech therapy. A speech therapist is also known as a “speech language pathologist.” These are two names for the same rehabilitation therapist.
So if you need help with any of these skills, ask your primary care provider to consider providing a referral to speech therapy. All insurance companies pay for speech therapy including Medicaid, Medicare, and private insurance.
Below are examples of skills you can find on the speech therapy checklist provided by the Brain Injury Alliance of New Mexico. Feel free to follow that link and print out the speech therapy checklist. Fill it out, or get someone to help you fill it out, and then show it to your primary care provider. Many primary care providers are unfamiliar with the benefits of speech therapy after brain injury. If you have trouble getting a referral, consider reaching out to the NM Brain Injury Resource Center at 505-292-7414 for problem-solving help.
Not recognizing humor or sarcasm
Believing all people are friends or a threat
Feelings of not belonging
Feeling that you don’t understand others or that they don’t understand you
Getting fired for inappropriate behavior, but not knowing what that behavior was
Misunderstanding the intentions of others
Feeling socially disconnected
Conversation (speech therapists call this “communication discourse, but you can call it “talking to people”).
Difficulty understanding what others are saying
Not following abstract thought
Internal and external distractions
Others complain that you are not paying attention
It seems others don’t follow the rules of conversation
Changing topics unexpectedly
Not understanding information that before the injury was easily understood
Afraid to participate in conversations
Appropriate Use of Language (speech therapists call this “social pragmatics”)
Difficulty with interacting with other people
Being socially unacceptable
Overly trustful or paranoid
Feeling out-of-step or being told by family that you are out-of-step with others
Unable to control anger
Not remembering family members
Not remembering names as you could before the injury
Not remembering phone calls or appointments
Not recalling how to do all or part of your job
Not completing or turning in assignments
Not understanding a 30 min TV show
Not finding common household items
Unable to concentrate on reading
Not finishing a work project
Having a flat tire & you don’t know what to do
Overwhelmed by too many choices
Unable to explain a simple problem to a child
Unable to follow a recipe if the directions don’t match what you are using
Difficulty with initiating activity or the opposite, hyperactivity
Not being able to make a phone call or request help
Making the call, finding the line busy and not following through to call again
Not asking the questions you want to ask, or asking them and not listening to the answers
No food in the house, but going to the store is too difficult, or going to the store with a grocery list but not getting anything on the list.
Forgetting to bring the groceries home or leaving them on the counter at home and forgetting to put them away
High-level sequencing (bring the coffee pot to the cups or the cups to the pot)
Recognizing success vs failure accurately
Unable to start tasks
Executing the task
Monitor the passage of time (recognizing time restraints prior to running out of time)
Inflexible thinking or behavior
Unable to complete simple household chores
Unable to balance a checkbook
Unable to follow simple work procedures (ex: when to clock in or out)
Unable to remember the order of numbers like in an address or phone number
Support to family and friends (not all speech therapists have experience with these needs)
Return to work or school
Understanding the survivor may be a different person in many ways
Techniques to address the changes in everyone’s life without blame
It’s important to know that speech therapists work on short-term goals with you. They want to see you make progress on small goals in a short amount of time. If you want to make progress, it’s important to do your homework. If you make very good progress, your speech therapist and your doctor can request more sessions from the insurance company. Then if you get discharged, know that you can go back again. Wait a few months, and ask your primary care provider for another referral for speech therapy.