Memory & Cognition

Many illnesses, traumas, and disorders can cause difficulties with memory and cognition including Alzheimer's disease, multiple small strokes (multi-infarct dementia), Parkinson's disease, Huntington's disease, drug use or interactions, depression, brain tumors, other cerebrovascular disease, head trauma, and alcoholism.

Cognitive-communication problems that can occur include difficulty with attention, memory, organization, reasoning, problem-solving, orientation, social judgment / pragmatics.

Attention problems include difficulty concentrating on a task amid distractions and paying attention for more than a few minutes at a time. Also, performing more than one task at once may be difficult or impossible. When a person's memory is affected, they may have difficulty recalling already learned information, such as street names or important dates, and may not be able to learn new information easily. Organization problems include being able to correctly sequence events when telling a story or giving directions or maintaining a topic while conversing with others.

Reasoning may also be impaired and the person may not be able to interpret abstract language, such as metaphors, or respond to humor appropriately. The individual may not react appropriately when presented with a common occurrence, such as a car breakdown or overflowing sink. This is due to impaired problem-solving abilities. Leaving the individual unsupervised may be dangerous in such cases, as they could cause injury to themselves or others.

A person who has difficulty recalling the date, time, or place is said to have orientation problems. The individual may also be disoriented to self, meaning that they cannot correctly recall personal information, such as birthdate, age, or family names. When human beings converse, they rely not only on words to convey messages, but also on body language, facial expressions, and intonation (how the voice rises and falls while speaking).

Cognitive impairments can cause problems with pragmatics, leading the individual to ignore or misinterpret such nonverbal cues and lose the meaning of the message. They may also lack facial expression when speaking ("flat affect") or speak in monotone or too rapidly. Social judgment may also be impaired and the person may laugh at inappropriate times or say inappropriate things without realizing that they have done so.

Speech-language pathologists certified by the American Speech, Language & Hearing Association (ASHA) with training in the area of memory and cognitive-communication skills can plan and implement treatment to improve and supplement a client's compromised skills in memory and cognition.

• Provide a consistent routine every day.
• Use calendars, clocks, and notepads to remind the person of important information.
• Decrease distractions when communicating.
• Break down instructions to small steps and repeat directions as needed.
• Ask questions and use reminders to keep the individual on topic.
• Avoid sarcasm, metaphors, etc. when speaking to the individual.
• Provide appropriate supervision to ensure the person's safety.