Acquired brain injury (ABI) can suddenly alter the way a person thinks, communicates and behaves in everyday life. Simple tasks can be difficult, and feelings of anxiety, panic and depression can ensue.

Speech-Language Pathologists have a key role in helping individuals with ABI to understand their cognitive-communication changes and how to cope with them. Most speech pathology rehabilitation programs focus on education, daily routines and improving cognitive-communication skills. These and general coping strategies for families are described below:

• Education - Accident survivors and families adjust better to ABI when they understand its impact on day-to-day life. This helps them make adjustments in the way they approach tasks, and in using compensatory strategies more effectively. With treatment, difficulties with thinking, communication and/or behaviour become more clear, and survivors and families can set more realistic long and short-term rehabilitation goals as a result.
• Establish Daily Routines - Many individuals with ABI function best when their lives are structured (i.e. scheduling, steps in task completion and physical organization of space). Families can help to establish routines for daily or weekly events (e.g. personal care, chores, social time, appointments). They can encourage the use of routines for completing multi-step tasks like day planning and laundry. They can help assign, label and use designated locations for household items (e.g. car keys). To reduce anxiety, which can occur with changes in routine, families can:
  Plan ahead for change and allow plenty of time for discussion
  Ensure that changes are marked down, e.g. in day planner
  Gradually introduce change if possible (e.g. one teacher/ class at a time for a student entering high school) Routines are important because they can decrease cognitive overload, memory failure and associated anxiety.
• Enhance Communication - Communication impairments, although subtle, are one of the most common consequences of ABI. They can range from a reduced capacity to listen and remember conversations, to difficulties naming words or structuring verbal descriptions. Consider the following during interactions:
  Avoid overloading them with too much information
  Allow extra time to process information, by pausing or checking back frequently
  Slow speech rate and break information down into points or steps
  Repeat instructions or important points v Use concrete, familiar language
  Back up information in writing, preferably using point form notes
  Restrict discussions to one topic or issue at a time.
• Listen and Support - Here are some other ways to provide general support to an individual with ABI:
  Listen: welcome discussion about problems and frustrations
  Guide: during stressful times or times of change help guide them through the decision making process
  Give feedback: give honest feedback on behaviour and choice making (e.g. "When you did….I felt…In future please…")
  Prompt: help them follow routines and complete tasks by reminding them to use memory/ organizational aids, e.g. day planner.
• Seek Professional Input - Speech-Language Pathologists can identify specific areas of cognitive-communication strength and weakness in testing, and help you to develop appropriate and effective plans for home, school and/ or work reintegration. Services include:
  Comprehensive cognitive-communication assessment and therapy
  Individual, family, teacher and employer education and support
  Group treatment
  Job and rehabilitation coaching
• Remember…
  Individuals with ABI need routine and consistency in their lives
  Be aware of how you communicate and simplify listening demands
  Be available to listen, guide and support
  Allow extra time for information processing and task completion
  Request speech-language pathology testing and treatment services

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