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What is a cognitive-communication disorder?

Communication is a highly complex skill which forms part of what we call cognition.

Cognitive-communicative disorders affect the ability to communicate by the social rules of language.

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Cognitive Processes


  • Orientation e.g. knowing the date, recognising your name, recognising where you are
  • Attention e.g. being able to concentrate and not get distracted
  • Perception e.g. recognising objects and what they are for
  • Memory e.g. remembering recent events
  • Problem solving e.g. how to deal with every-day and non-routine problems
  • Impulsivity e.g. Not being aware of danger and consequences
  • Planning & sequencing e.g. being able to change a tire
  • Social behaviour e.g. being able to react appropriately with other people
  • Emotional lability e.g. not being able to control laughing/crying
  • Reduced insight e.g. having limited insight into any or all of these problems. They believe they are acting 'normally'. It makes change difficult because it is hard to deal with a problem if they don't know there is one.


Communication Impairments

  • ALTERED TURN-TAKING SKILLS (either overly talkative or not realising that it is their turn to speak)
  • VERBOSITY (talking too much, interrupting)
  • TALKING IN AN EXPLICIT WAY or swearing at inappropriate times
  • ALTERED ABILITY TO TALK AROUND A SHARED TOPIC (changing topic frequently or having a reduced range of topics)
  • SPEAKING ONLY ABOUT THEMSELVES and fixating on certain subjects
  • GETTING STUCK ON A TOPIC (wishing to leave hospital)
  • ALTERED ABILITY TO GIVE INFORMATION IN AN ORGANISED WAY (assuming the other person shares knowledge about the topic when they don't)
  • NOT USING OR 'READING' NON-VERBAL CUES ACCURATELY, such as facial expressions and body language.


Cognitive communication difficulties can often co-occur with language difficulties such as aphasia.

Cognitive-communicative difficulties occur with the following conditions:

  • Traumatic brain injury
  • Stroke
  • Tumours
  • Hypoxic brain damage
  • Viral infection
  • Old age
  • Dementia


What can I do to help?

  • Minimising distractions. Remove background noise – a television or radio can be very distracting
  • Ensuring you talk directly to the person and not talk over them. Try to sit at the same level as the person, and make eye contact
  • Establishing a consistent routine and environment where possible
  • Gaining the person’s attention before speaking to them
  • Talking about familiar topics
  • Encouraging the person to communicate
  • Explaining what is happening e.g. “your brother has come to visit”
  • Only asking one question at a time
  • Don’t change the topic suddenly - it’s much easier to talk about one topic at a time
  • Taking a break if the conversation is “going round in circles”
  • Keeping written reminders of important information e.g. writing key names and dates in a diary
  • Use simple language, as this can be easier to understand
  • Repeat key words or phrases to help the person to understand more
  • Allow enough time for the person to respond
  • Give forced alternatives (e.g. would you like tea or coffee?)
  • Use visual references where possible – for example show a cup when asking whether the person requires a drink
  • Use gesture to help the person to understand
  • Give feedback and confirm that you have understood
  • Activities like looking at photos and magazines or playing simple games are often a nice idea.