School of Health Professions

Concussion can affect communication and cognition long after injury, study finds

Assistant Professor Rocio Norman, Department of Communication Sciences and Disorders


Concussions can cause long-term deficits in communication, according to findings from a study conducted by Assistant Professor Rocío Norman, PhD, CCC-SLP.

Norman and her research team wrote an article on their study findings, “Self-Perception of Cognitive-Communication Functions After Mild Traumatic Brain Injury,” that was published in the American Journal of Speech-Language Pathology in January. The article describes a qualitative study led by Norman that focuses on the lived experience of 30 participants who reported a history of mild traumatic brain injury, or concussion.

In the study, participants shared their lived experience and reported  perceptions of their own deficits by answering questions via virtual survey. Sixteen of the 30 participants reported a history of two or more concussions, and the time post-injury ranged from 11 months to 11 years. Participants were asked about speaking and writing, comprehension skills, thinking skills, social skills, and whether they felt that fatigue after brain injury had affected their communication and thinking skills. Six of the 30 participants reported no concerns with communication or thinking or other areas of their life after concussion.

“What really stood out to me in these results was the emotional aspect,” Norman said. “We had participants saying that because they had communication problems, they didn’t want to socialize. For example, they couldn’t play sports because they couldn’t communicate effectively with other players on the field, or they couldn’t play board games which were an important part of their life.”

Norman believes better clinical screening methods are needed to identify when people who have had a concussion are experiencing deficits in communication and cognition. These deficits can linger for years, she said.

“For me, what this illustrates is that people fell between the cracks,” Norman said. “They had a concussion and perhaps there was a lot of emphasis on physical recovery but not that much on their cognitive or communicative recovery, so from my point of view, those deficits were missed in the initial assessment and recovery period.”

“I think it’s because the assessments we use for cognition and communication are not sensitive. We know that life is much more complex than a standardized test  and that injuries change. The whole goal of my program of research is to create assessments that are more sensitive to deficits in daily life.”

Clinicians treating patients for mild traumatic brain injury also should educate patients and hospital staff about speech-language therapy and make referrals to speech-language pathologists as needed, the study authors concluded.

Persistent communication problems resulting from concussion can lead to other serious conditions, said Tara Flaugher, a doctoral student at the University of Texas at San Antonio and one of Norman’s study co-authors.

“People are experiencing these problems and it’s impacting them socially and that can lead into the other comorbidities we see with mTBI, such as depression, anxiety and stress,” Flaugher said.

The study was funded under Norman’s KL2 career development grant from the National Institutes of Health, National Center for the Advancement of Clinical and Translational Science. To learn more about Norman’s research, visit her lab’s website.

The study provides a strong foundation for Flaugher’s dissertation, which is funded through the Brain Health Consortium Collaborative Seed Grant program, sponsored by the Office of the Vice President for Research, Economic Development, and Knowledge Enterprise at UTSA. Norman is part of the collaborative team led by Nicole Wicha, PhD, at the UTSA Wicha Lab: Brain, Language and Cognition, that is working to develop an electroencephalography/event-related potential paradigm to measure subtle language comprehension differences after mTBI in the visual and auditory domains.

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