How Concussions Can Affect Cognitive Communication
After a concussion, it’s common to focus on headaches, dizziness, and fatigue—but many people overlook one of the most frustrating and long-lasting effects: cognitive communication difficulties. This term refers to how we use thinking skills to communicate clearly, efficiently, and appropriately. It includes things like organizing your thoughts, remembering what someone just said, staying on topic, and picking the right words for the situation. These skills are often impacted after even a mild traumatic brain injury (TBI), like a concussion, and can make everyday interactions more difficult than expected.
Someone recovering from a concussion might find it hard to follow conversations, especially in noisy or fast-paced environments. They may lose their train of thought mid-sentence, forget the question they were asked, or interrupt without realizing it. Others might talk in circles, take longer to find the right word, or repeat information they’ve already said. These changes can feel subtle—but for the person experiencing them, and for their loved ones, they can cause frustration, embarrassment, and social withdrawal.
Some communication changes are normal in the early days after a concussion. It’s expected to feel foggy, need more time to think, or struggle with multitasking. But if issues like memory lapses, disorganized speech, or trouble following conversation persist beyond a few weeks, that’s a sign it may be time to see a Speech-Language Pathologist (SLP). SLPs can assess cognitive communication skills and create a treatment plan to improve clarity, efficiency, and confidence in conversation.
One practical way to support cognitive communication after a concussion is to limit distractions during conversations. Turn off the TV, reduce background noise, and give the person your full attention. If you’re the one recovering, ask for these accommodations when you need them. For example, saying “Can we talk somewhere quieter?” helps advocate for your needs and gives your brain a better chance at success.
Slow down the pace of conversation. People with post-concussion difficulties often need more time to process what’s being said or to organize their response. Give extra time without rushing or finishing their thoughts. Pauses may feel awkward at first, but they are incredibly helpful for cognitive recovery. If you’re unsure whether your loved one is following, pause and check in by saying, “Should I go over that again?”
Write it down or visualize it. For someone dealing with memory or attention difficulties, having a visual reference can be a game changer. Keep a small notebook or phone note handy to jot down key points from a conversation, to-do lists, or plans. If you’re the support person, you can help by summarizing verbally and then writing it out—e.g., “So we’ll meet at 2 p.m. at the café. I’ll write that down in your planner too.”
Stick to one topic at a time. Jumping between ideas can be especially confusing for someone with a concussion. Try to keep conversations focused, and if the topic shifts, use clear language to transition. For example, “That was about groceries—now I want to ask you about the doctor’s appointment.” This structure supports attention and helps the person stay engaged without getting overwhelmed.
Reduce communication pressure. After a concussion, it’s not uncommon for people to avoid social interactions because they feel “off.” Create low-stakes opportunities for conversation—like short check-ins or talking during a walk, rather than expecting long, focused conversations. Allow the person space to say “I’m too tired right now” without guilt. Fatigue often worsens cognitive communication difficulties, so respecting mental energy limits is key to recovery.
If you or someone you love is still experiencing word-finding problems, trouble keeping up with conversation, or difficulties staying organized in speech weeks after a concussion, don’t wait. A speech-language pathologist can help retrain those skills and offer personalized strategies. Cognitive communication issues aren’t just frustrating—they can affect relationships, school, and work. But with support and the right tools, recovery is absolutely possible.
