Return to Index | Contact SEPS
Anxiety disorders are categorized as:
[Source: Anxiety Disorder Association of America]
Return to Index | Contact SEPS
The terms more advanced autism, high functioning autism, Asperger's Syndrome and pervasive developmental disorder (PDD) refer to individuals within the autism spectrum who do not experience severe intellectual impairments. Although more advanced individuals with autism may score below average on standardized intelligence tests, they often learn at or above normal rates in certain areas. Areas of ability will differ across individuals. For example, an individual may learn academic content easily but have difficulty performing activities of daily living. Or a student who is very good at memorizing may not be able to answer essay-type questions.
[Source: MAAP Services for the Autism and Asperger Syndrome]
Return to Index | Contact SEPS
Attention Deficit Disorder is a variation of the more broadly defined Attention Deficit/Hyperactivity Disorder (ADHD) without the hyperactivity component. See Attention Deficit/Hyperactivity Disorder (ADHD) for more information.
Return to Index | Contact SEPS
Occasionally, we may all have difficulty sitting still, paying attention or controlling impulsive behavior. For some people, the problem is so pervasive and persistent that it interferes with their daily life, including home, academic, social, and work settings.
Attention-Deficit/Hyperactivity Disorder (AD/HD) is characterized by developmentally inappropriate impulsivity, attention, and in some cases, hyperactivity. AD/HD is a neurobiological disorder that affects three-to-five percent of school-age children. Until recent years, it was believed that children outgrew AD/HD in adolescence. Perhaps, this was because hyperactivity often diminishes during the teen years. However, it is now known that many symptoms continue into adulthood. In fact, current research reflects rates of roughly two to four percent among adults.
Although individuals with this disorder can be very successful in life, without identification and proper treatment, AD/HD may have serious consequences, including school failure, depression, problems with relationships, conduct disorder, substance abuse, and job failure. Early identification and treatment are extremely important.
Medical science first documented children exhibiting inattentiveness, impulsivity and hyperactivity in 1902. Since that time, the disorder has been given numerous names, including Minimal Brain Dysfunction, Hyperkinetic Reaction of Childhood, and Attention-Deficit Disorder With or Without Hyperactivity. With the Diagnostic and Statistical Manual, 4th Edition (DSM-IV) classification system, the disorder has been renamed Attention-Deficit/Hyperactivity Disorder. The current name reflects the importance of the inattention characteristics of the disorder as well as hyperactivity and impulsivity.
Typically, AD/HD symptoms arise in early childhood, unless associated with some type of brain injury later in life. Some symptoms persist into adulthood and may pose life-long challenges. Although the official diagnostic criteria state that the onset of symptoms must occur before age seven, leading researchers in the field of AD/HD argue that criterion should be broadened to include onset anytime during childhood. Criteria for the three primary subtypes are summarized as follows:
AD/HD predominately inattentive type: (AD/HD-I)
AD/HD predominately hyperactive-impulsive type: (AD/HD-HI)
AD/HD combined type: (AD/HD-C)
Return to Index | Contact SEPS
Autism is a complex developmental disability that typically appears during the first three years of life. The result of a neurological disorder that affects the functioning of the brain, autism impacts the normal development of the brain in the areas of social interaction and communication skills. Children and adults with autism typically have difficulties in verbal and non-verbal communication, social interactions, and leisure or play activities. Autism is one of five disorders coming under the umbrella of Pervasive Developmental Disorders (PDD), a category of neurological disorders characterized by "severe and pervasive impairment in several areas of development," including social interaction and communications skills (DSM-IV-TR). The five disorders under PDD are Autistic Disorder, Asperger's Disorder, Childhood Disintegrative Disorder (CDD), Rett's Disorder, and PDD-Not Otherwise Specified (PDD-NOS). Each of these disorders has specific diagnostic criteria as outlined by the American Psychiatric Association (APA) in its Diagnostic & Statistical Manual of Mental Disorders (DSM-IV-TR).
Autism is the most common of the Pervasive Developmental Disorders, affecting an estimated 1 in 250 births (Centers for Disease Control and Prevention, 2003). This means that as many as 1.5 million Americans today are believed to have some form of autism. And that number is on the rise. Based on statistics from the U.S. Department of Education and other governmental agencies, autism is growing at a rate of 10-17 percent per year. At these rates, the ASA estimates that the prevalence of autism could reach 4 million Americans in the next decade. The overall incidence of autism is consistent around the globe, but is four times more prevalent in boys than girls. Autism knows no racial, ethnic, or social boundaries, and family income, lifestyle, and educational levels do not affect the chance of autism's occurrence.
While understanding of autism has grown tremendously since it was first described by Dr. Leo Kanner in 1943, most of the public, including many professionals in the medical, educational, and vocational fields, are still unaware of how autism affects people and how they can effectively work with individuals with autism. Contrary to popular understanding, many children and adults with autism may make eye contact, show affection, smile and laugh, and demonstrate a variety of other emotions, although in varying degrees. Like other children, they respond to their environment in both positive and negative ways.
Autism is a spectrum disorder. The symptoms and characteristics of autism can present themselves in a wide variety of combinations, from mild to severe. Although autism is defined by a certain set of behaviors, children and adults can exhibit any combination of the behaviors in any degree of severity. Two children, both with the same diagnosis, can act very differently from one another and have varying skills.
Parents may hear different terms used to describe children within this spectrum, such as autistic-like, autistic tendencies, autism spectrum, high-functioning or low-functioning autism, more-abled or less-abled. More important than the term used is to understand that, whatever the diagnosis, children with autism can learn and function productively and show gains with appropriate education and treatment.
Every person with autism is an individual, and like all individuals, has a unique personality and combination of characteristics. Some individuals mildly affected may exhibit only slight delays in language and greater challenges with social interactions. The person may have difficulty initiating and/or maintaining a conversation. Communication is often described as talking at others (for example, monologue on a favorite subject that continues despite attempts by others to interject comments).
People with autism process and respond to information in unique ways. In some cases, aggressive and/or self-injurious behavior may be present. Persons with autism may also exhibit some of the following traits.
For most of us, the integration of our senses helps us to understand what we are experiencing. For example, our senses of touch, smell and taste work together in the experience of eating a ripe peach: the feel of the peach fuzz as we pick it up, its sweet smell as we bring it to our mouth, and the juices running down our face as we take a bite. For children with autism, sensory integration problems are common. Their senses may be over-or under-active. The fuzz on the peach may actually be experienced as painful; the smell may make the child gag. Some children with autism are particularly sensitive to sound, finding even the most ordinary daily noises painful. Many professionals feel that some of the typical autism behaviors are actually a result of sensory integration difficulties.
There are many myths and misconceptions about autism. Contrary to popular belief, many autistic children do make eye contact; it just may be less or different from a non-autistic child. Many children with autism can develop good functional language and others can develop some type of communication skills, such as sign language or use of pictures. Children do not "outgrow" autism but symptoms may lessen as the child develops and receives treatment.
One of the most devastating myths about autistic children is that they cannot show affection. While sensory stimulation is processed differently in some children with autism, they can and do give affection. But it may require patience on a parent's part to accept and give love in the child's terms.
While understanding of autism has grown tremendously since it was first described by Dr. Leo Kanner in 1943, most of the public, including many professionals in the medical, educational, and vocational fields, are still unaware of how autism affects people and how they can effectively work with individuals with autism. Contrary to popular understanding, many children and adults with autism may make eye contact, show affection, smile and laugh, and demonstrate a variety of other emotions, although in varying degrees. Like other children, they respond to their environment in both positive and negative ways.
Autism is a spectrum disorder. The symptoms and characteristics of autism can present themselves in a wide variety of combinations, from mild to severe. Although autism is defined by a certain set of behaviors, children and adults can exhibit any combination of the behaviors in any degree of severity. Two children, both with the same diagnosis, can act very differently from one another and have varying skills.
Parents may hear different terms used to describe children within this spectrum, such as autistic-like, autistic tendencies, autism spectrum, high-functioning or low-functioning autism, more-abled or less-abled. More important than the term used is to understand that, whatever the diagnosis, children with autism can learn and function productively and show gains with appropriate education and treatment.
Every person with autism is an individual, and like all individuals, has a unique personality and combination of characteristics. Some individuals mildly affected may exhibit only slight delays in language and greater challenges with social interactions. The person may have difficulty initiating and/or maintaining a conversation. Communication is often described as talking at others (for example, monologue on a favorite subject that continues despite attempts by others to interject comments).
People with autism process and respond to information in unique ways. In some cases, aggressive and/or self-injurious behavior may be present. Persons with autism may also exhibit some of the following traits.
For most of us, the integration of our senses helps us to understand what we are experiencing. For example, our senses of touch, smell and taste work together in the experience of eating a ripe peach: the feel of the peach fuzz as we pick it up, its sweet smell as we bring it to our mouth, and the juices running down our face as we take a bite. For children with autism, sensory integration problems are common. Their senses may be over-or under-active. The fuzz on the peach may actually be experienced as painful; the smell may make the child gag. Some children with autism are particularly sensitive to sound, finding even the most ordinary daily noises painful. Many professionals feel that some of the typical autism behaviors are actually a result of sensory integration difficulties.
There are many myths and misconceptions about autism. Contrary to popular belief, many autistic children do make eye contact; it just may be less or different from a non-autistic child. Many children with autism can develop good functional language and others can develop some type of communication skills, such as sign language or use of pictures. Children do not "outgrow" autism but symptoms may lessen as the child develops and receives treatment.
One of the most devastating myths about autistic children is that they cannot show affection. While sensory stimulation is processed differently in some children with autism, they can and do give affection. But it may require patience on a parent's part to accept and give love in the child's terms.
[Source: Autism Society of America]
Return to Index | Contact SEPS
Carson Smith Special Needs Scholorship
Communication Disorders involve a wide variety of problems in speech, language, and hearing. For example, speech and language disorders include stuttering, aphasia, dysfluency, voice disorders (hoarseness, breathiness, or sudden breaks in loudness or pitch), cleft lip and/or palate, articulation problems, delays in speech and language, autism, and phonological disorders. Speech and language impairments and disorders can be attributed to environmental factors, of which the most commonly known are High Risk Register problems, which include drugs taken during pregnancy, common STD's such as syphilis, and birthing trauma to name a few. Communication disorders can also stem from other conditions such as learning disabilities, dyslexia, cerebral palsy, and mental retardation.
[Source: West Virginia University]
Return to Index | Contact SEPS
A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.
Depressive disorders come in different forms, just as is the case with other illnesses such as heart disease. This pamphlet briefly describes three of the most common types of depressive disorders. However, within these types there are variations in the number of symptoms, their severity, and persistence.
Major depression is manifested by a combination of symptoms (see symptom list) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.
A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.
Another type of depression is bipolar disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees. Mania, left untreated, may worsen to a psychotic state.
Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.
Depression
[Source: National Institute of Mental Health]
Return to Index | Contact SEPS
Dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and / or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.
[Source: The International Dyslexia Association]
Reading and related language-based learning disabilities
Signs and Symptoms[Source: Learning Disabilities Association of America]
Return to Index | Contact SEPS
Howard's teachers say he just isn't working up to his ability. He doesn't finish his assignments, or just puts down answers without showing his work; his handwriting and spelling are poor. He sits and fidgets in class, talks to others, and often disrupts class by interrupting others. He used to shout out the answers to the teachers' questions (they were usually right), but now he day-dreams a lot and seems distracted. Does Howard have Attention Deficit Hyperactivity Disorder (ADHD), is he gifted, or both? Frequently, bright children have been referred to psychologists or pediatricians because they exhibited certain behaviors (e.g., restlessness, inattention, impulsivity, high activity level, day-dreaming) commonly associated with a diagnosis of ADHD. Formally, the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) (American Psychiatric Association) lists 14 characteristics that may be found in children diagnosed as having ADHD. At least 8 of these characteristics must be present, the onset must be before age 7, and they must be present for at least six months.
DSM-III-R Diagnostic Criteria For Attention-Deficit Hyperactivity Disorder
Almost all of these behaviors, however, might be found in bright, talented, creative, gifted children. Until now, little attention has been given to the similarities and differences between the two groups, thus raising the potential for misidentification in both areas-giftedness and ADHD.
Sometimes, professionals have diagnosed ADHD by simply listening to parent or teacher descriptions of the child's behaviors along with a brief observation of the child. Other times, brief screening questionnaires are used, although these questionnaires only quantify the parents' or teachers' descriptions of the behaviors (Parker, 1992). Children who are fortunate enough to have a thorough physical evaluation (which includes screening for allergies and other metabolic disorders) and extensive psychological evaluations, which include assessment of intelligence, achievement, and emotional status, have a better chance of being accurately identified. A child may be gifted and have ADHD. Without a thorough professional evaluation, it is difficult to tell.
Seeing the difference between behaviors that are sometimes associated with giftedness but also characteristic of ADHD is not easy, as the following parallel lists show.
Behaviors associated with ADHD (Barkley, 1990)
Behaviors associated with Giftedness (Webb, 1993)
It is important to examine the situations in which a child's behaviors are problematic. Gifted children typically do not exhibit problems in all situations. For example, they may be seen as ADHD-like by one classroom teacher, but not by another; or they may be seen as ADHD at school, but not by the scout leader or music teacher. Close examination of the troublesome situation generally reveals other factors which are prompting the problem behaviors. By contrast, children with ADHD typically exhibit the problem behaviors in virtually all settings-including at home and at school-though the extent of their problem behaviors may fluctuate significantly from setting to setting (Barkley, 1990), depending largely on the structure of that situation. That is, the behaviors exist in all settings, but are more of a problem in some settings than in others.
In the classroom, a gifted child's perceived inability to stay on task is likely to be related to boredom, curriculum, mismatched learning style, or other environmental factors. Gifted children may spend from one-fourth to one-half of their regular classroom time waiting for others to catch up-even more if they are in a heterogeneously grouped class. Their specific level of academic achievement is often two to four grade levels above their actual grade placement. Such children often respond to non-challenging or slow-moving classroom situations by "off-task" behavior, disruptions, or other attempts at self-amusement. This use of extra time is often the cause of the referral for an ADHD evaluation.
Hyperactive is a word often used to describe gifted children as well as children with ADHD. As with attention span, children with ADHD have a high activity level, but this activity level is often found across situations (Barkley, 1990). A large proportion of gifted children are highly active too. As many as one-fourth may require less sleep; however, their activity is generally focused and directed (Clark, 1992; Webb, Meckstroth, & Tolan, 1982), in contrast to the behavior of children with ADHD. The intensity of gifted children's concentration often permits them to spend long periods of time and much energy focusing on whatever truly interests them. Their specific interests may not coincide, however, with the desires and expectations of teachers or parents.
While the child who is hyperactive has a very brief attention span in virtually every situation (usually except for television or computer games), children who are gifted can concentrate comfortably for long periods on tasks that interest them, and do not require immediate completion of those tasks or immediate consequences. The activities of children with ADHD tend to be both continual and random; the gifted child's activity usually is episodic and directed to specific goals.
While difficulties and adherence to rules and regulations has only begun to be accepted as a sign of ADHD (Barkley, 1990), gifted children may actively question rules, customs and traditions, sometimes creating complex rules which they expect others to respect or obey. Some engage in power struggles. These behaviors can cause discomfort for parents, teachers, and peers.
One characteristic of ADHD that does not have a counterpart in children who are gifted is variability of task performance. In almost every setting, children with ADHD tend to be highly inconsistent in the quality of their performance (i.e., grades, chores) and the amount of time used to accomplish tasks (Barkley, 1990). Children who are gifted routinely maintain consistent efforts and high grades in classes when they like the teacher and are intellectually challenged, although they may resist some aspects of the work, particularly repetition of tasks perceived as dull. Some gifted children may become intensely focused and determined (an aspect of their intensity) to produce a product that meets their self-imposed standards.
[Source: KidSource]
Return to Index | Contact SEPS
There are a range of medical diagnoses and subsequent health problems that can have a temporary or chronic impact on a student's academic performance. Common diagnoses include arthritis, cancer, Multiple Sclerosis, Asthma, AIDS, and heart disease. Unless the condition is neurological in nature, health impairments are not likely to directly affect learning. However, the secondary effects of illness and the side effects of medications can have a significant impact on memory, attention, strength, endurance, and energy levels.
Health impairments can result in a range of academic challenges for a student. Problems may include missing class for unpredictable and prolonged time periods and difficulties attending classes full-time or on a daily basis. Health problems may also interfere with the physical skills needed to complete laboratory, computer, or writing assignments. Individuals with arthritis, for example, may have difficulty writing due to pain or joint deformities, making it a challenge for them to meet the writing requirements for some classes. Students with Multiple Sclerosis may not be able to manipulate small laboratory equipment or complete tasks that require precise measuring, graphing, or drawing. Prolonged sitting may pose challenges for an individual with chronic pain or back problems. Illness or injury may result in limitations in mobility which require the need to use a wheelchair or scooter for mobility. Some students must avoid specific activities that trigger their conditions. For example, a student with asthma may need to avoid specific inhalants in a lab.
[Source: University of Washington]
Return to Index | Contact SEPS
Return to Index | Contact SEPS
Learning DisabilitiesA learning disability is a neurological disorder that affects one or more of the basic psychological processes involved in understanding or in using spoken or written language. The disability may manifest itself in an imperfect ability to listen, think, speak, read, write, spell or to do mathematical calculations.
Every individual with a learning disability is unique and shows a different combination and degree of difficulties. A common characteristic among people with learning disabilities is uneven areas of ability, “a weakness within a sea of strengths.” For instance, a child with dyslexia who struggles with reading, writing and spelling may be very capable in math and science.
Learning disabilities should not be confused with learning problems which are primarily the result of visual, hearing, or motor handicaps; of mental retardation; of emotional disturbance; or of environmental, cultural or economic disadvantages.
Generally speaking, people with learning disabilities are of average or above average intelligence. There often appears to be a gap between the individual’s potential and actual achievement. This is why learning disabilities are referred to as “hidden disabilities:” the person looks perfectly “normal” and seems to be a very bright and intelligent person, yet may be unable to demonstrate the skill level expected from someone of a similar age.
A learning disability cannot be cured or fixed; it is a lifelong challenge. However, with appropriate support and intervention, people with learning disabilities can achieve success in school, at work, in relationships, and in the community.
In Federal law, under the Individuals with Disabilities Education Act (IDEA), the term is “specific learning disability,” one of 13 categories of disability under that law.
“Learning Disabilities” is an “umbrella” term describing a number of other, more specific learning disabilities, such as:
Signs and Symptoms:
Signs and Symptoms:
Signs and Symptoms:
Signs and Symptoms:
Signs and Symptoms:
Signs and Symptoms:
Signs and Symptoms:
Signs and Symptoms:
[Source: Learning Disabilities Association of America]
Return to Index | Contact SEPS
Individuals with Obsessive-Compulsive Disorder (OCD) are plagued by persistent, recurring thoughts (obsessions) that reflect exaggerated anxiety or fears; typical obsessions include worry about being contaminated or fears of behaving improperly or acting violently. The obsessions may lead an individual to perform a ritual or routine (compulsions)-such as washing hands, repeating phrases or hoarding-to relieve the anxiety caused by the obsession. See Anxiety Disorder.
[Source: Anxiety Disorder Association of America]
Return to Index | Contact SEPS
Tourette Syndrome is an inherited, neurological disorder characterized by repeated and involuntary body movements (tics) and uncontrollable vocal sounds. In a minority of cases, the vocalizations can include socially inappropriate words and phrases -- called coprolalia. These outbursts are neither intentional nor purposeful. Involuntary symptoms can include eye blinking, repeated throat clearing or sniffing, arm thrusting, kicking movements, shoulder shrugging or jumping. These and other symptoms typically appear before the age of 18 and the condition occurs in all ethnic groups with males affected 3 to 4 times more often than females. Although the symptoms of TS vary from person to person and range from very mild to severe, the majority of cases fall into the mild category. Associated conditions can include attentional problems, impulsiveness and learning disabilities. Most people with TS lead productive lives and participate in all professions. Increased public understanding and tolerance of TS symptoms are of paramount importance to people with Tourette Syndrome. The disorder was named for a French neuropsychiatrist who successfully assessed the disorder in the late 1800s.
[Source: Tourette Syndrome Association, Inc.]
Return to Index | Contact SEPS
Traumatic brain injury is sudden physical damage to the brain. The damage may be caused by the head forcefully hitting an object such as the dashboard of a car (closed head injury) or by something passing through the skull and piercing the brain, as in a gunshot wound (penetrating head injury). The major causes of head trauma are motor vehicle accidents. Other causes include falls, sports injuries, violent crimes, and child abuse.
The physical, behavioral, or mental changes that may result from head trauma depend on the areas of the brain that are injured. Most injuries cause focal brain damage, damage confined to a small area of the brain. The focal damage is most often at the point where the head hits an object or where an object, such as a bullet, enters the brain.
In addition to focal damage, closed head injuries frequently cause diffuse brain injuries or damage to several other areas of the brain. The diffuse damage occurs when the impact of the injury causes the brain to move back and forth against the inside of the bony skull. The frontal and temporal lobes of the brain, the major speech and language areas, often receive the most damage in this way because they sit in pockets of the skull that allow more room for the brain to shift and sustain injury. Because these major speech and language areas often receive damage, communication difficulties frequently occur following closed head injuries. Other problems may include voice Cognitive and communication problems that result from traumatic brain injury vary from person to person. These problems depend on many factors which include an individual's personality, preinjury abilities, and the severity of the brain damage.
The effects of the brain damage are generally greatest immediately following the injury. However, some effects from traumatic brain injury may be misleading. The newly injured brain often suffers temporary damage from swelling and a form of "bruising" called contusions. These types of damage are usually not permanent and the functions of those areas of the brain return once the swelling or bruising goes away. Therefore, it is difficult to predict accurately the extent of long-term problems in the first weeks following traumatic brain injury.
Focal damage, however, may result in long-term, permanent difficulties. Improvements can occur as other areas of the brain learn to take over the function of the damaged areas. Children's brains are much more capable of this flexibility than are the brains of adults. For this reason, children who suffer brain trauma might progress better than adults with similar damage.
In moderate to severe injuries, the swelling may cause pressure on a lower part of the brain called the brainstem, which controls consciousness or wakefulness. Many individuals who suffer these types of injuries are in an unconscious state called a coma. A person in a coma may be completely unresponsive to any type of stimulation such as loud noises, pain, or smells. Others may move, make noise, or respond to pain but be unaware of their surroundings. These people are unable to communicate. Some people recover from a coma, becoming alert and able to communicate.
In conscious individuals, cognitive impairments often include having problems concentrating for varying periods of time, having trouble organizing thoughts, and becoming easily confused or forgetful. Some individuals will experience difficulty learning new information. Still others will be unable to interpret the actions of others and therefore have great problems in social situations. For these individuals, what they say or what they do is often inappropriate for the situation. Many will experience difficulty solving problems, making decisions, and planning. Judgment is often affected.
Language problems also vary. Problems often include word-finding difficulty, poor sentence formation, and lengthy and often faulty descriptions or explanations. These are to cover for a lack of understanding or inability to think of a word. For example, when asking for help finding a belt while dressing, an individual may ask for "the circular cow thing that I used yesterday and before." Many have difficulty understanding multiple meanings in jokes, sarcasm, and adages or figurative expressions such as, "A rolling stone gathers no moss" or "Take a flying leap." Individuals with traumatic brain injuries are often unaware of their errors and can become frustrated or angry and place the blame for communication difficulties on the person to whom they are speaking. Reading and writing abilities are often worse than those for speaking and understanding spoken words. Simple and complex mathematical abilities are often affected.
The speech produced by a person who has traumatic brain injury may be slow, slurred, and difficult or impossible to understand if the areas of the brain that control the muscles of the speech mechanism are damaged. This type of speech problem is called dysarthria [Source: National Institute on Deafness and Other Communication Disorders (NIDCD)]