đź“Ś Personal Note:
This article is based on my personal experience and research. It’s not medical advice.  Want to add your story? Email me — contact info is at the bottom.
Introduction
After a traumatic brain injury (TBI), and as we age,  many people experience lasting changes in how they speak, behave, or interact socially.  These changes look different from person to person.  They aren’t always obvious at first—but over time, patterns tend to show up.
 👉 Side Note: I’m a TBI survivor who’s had the chance to spend many years with other survivors and the aging population.  I’ve made friends with people in the aging population, stroke survivors, and many different health conditions.  Having said that, I’ve seen a wide variety of speech and communication differences.
Feel free to join the conversation by emailing me, my contact is at the bottom of the page 👇👇👇
Speech Can Look (and Sound) Different for Everyone
Some of my friends speak slowly and seem to use a lot of energy just to get words out.  Their mouths move a lot, almost like they’re trying to force every sound to come out right.  You can tell they’re thinking fast, but their speech takes longer.
Others mumble too, but with less visible effort.  They speak faster, but the words are hard to understand.  It doesn’t take as much energy, but it’s still hard to follow what they’re saying.  Everyone processes and expresses differently.
Aphasia and Other Communication Complications
I know people with aphasia—where the brain struggles to find and say the right words.  One of my friends can say some words clearly, but often needs help finishing thoughts.  He gives clues, uses tone, and gestures like a thumbs up when someone guesses what he means.  In other circumstances, and when interacting with other friends, communicative technology is often needed as seen in the picture-  It’s actually pretty amazing how much they can communicate that way!
When Speech Is Minimal or Nonexistent
Some friends of mine can barely speak at all.  One person I know can only respond with a thumbs up or thumbs down.  Someone else can’t move his eyes or head much—but he understands everything and still finds ways to say “yes” when he agrees. His brain is sharp. He was actually a doctor before his injury.
For people like this, even the smallest gestures—like a nod or a blink—become their voice.  Respect and patience are everything.
Understanding Communication Patterns: A Key to Inclusive Conversations
Communication patterns are described as the ways people express themselves beyond spoken words.
These patterns include tone of voice, speaking speed, rhythm, pauses, and sentence structure.
It has been estimated that tone of voice makes up about 38% of how communication is understood.
Patterns are also noticed in the subjects that people often talk about.
When someone frequently discusses certain topics, clues are provided about what they might be trying to say, even if their words are not clearly pronounced.
For example, a person with a traumatic brain injury may produce speech that is difficult to follow, yet shifts in tone are used to show whether frustration, humor, or questioning is intended.
Additionally, if a person often talks about sports or family, those familiar topics can help guesses be made about unclear speech.
When these patterns are recognized, conversations are made clearer, and misunderstandings are reduced.
Nonverbal communication is said to make up as much as 80% of how people interpret messages.
Because of this, attention should always be given to how things are said, not just the words spoken.
Through awareness of communication patterns, respect is shown, and individuals are made to feel valued and included.
Inclusive communication is built one thoughtful observation at a time.
Talking That Seems Fast but Off Track
I’ve met people who speak at a regular pace but say things that don’t make much sense.  They talk like the conversation is flowing normally, but the words are jumbled or don’t fit the moment.
For example, I’ve been in a fitness class where someone suddenly said something like, “It’s my boyfriend’s birthday! We’re gonna get drunk, and he uses my walker to carry our laundry.”  It was totally unrelated to what was going on. The instructor handled it kindly—talked with her after class—but didn’t shame her in front of everyone.
Saying Everything They See or Think
Some survivors I know have what seems like no filter. They say exactly what they see or think out loud. If someone’s wearing bright clothes or holding hands, they’ll call it out: “You’re wearing Hawaiian clothes!” or “You’re holding hands!”
It’s not rude—it’s just that the part of their brain that used to filter those thoughts has been affected. It’s called disinhibition, and it’s a common result of frontal lobe injury.
Understanding Emotional Fluctuations and Boundaries
One thing I’ve learned is that past comfort doesn’t always mean current consent.  Emotions and reactions can shift without warning.
I once had a friend with a traumatic brain injury who loved taking selfies and videos. Â She even asked me to take photos with her to send to a mutual friend. Â Another time, she excitedly asked to take a selfie-style video with me at the gym. Â I thought it was a shared activity we both enjoyed.
Later, I saw her at a different gym. She was proud of standing and dribbling a basketball—something that takes great balance.  Wanting to celebrate her milestone, I pulled out my phone to record it and cheer her on.  Suddenly, she had a PTSD blowout and started yelling at me.
I was confused. She had always wanted to take pictures and videos before, and even after that, she later asked an instructor if videos could be taken in class.  But that one moment was different for her. And I had to learn not to take it personally.
Lesson learned: Even if someone has been fine with certain things before, things can change.  It might be their mood, memory, stress level, or a trauma trigger.  The safest thing is to always ask first—even if they asked you last time.  And if something goes wrong, step back with empathy and give them space.
Tips for Communicating With People Who Speak Differently
These tips are based on what I’ve learned by just being around people every day. You don’t need to be a therapist to practice kindness.
🕊️ Be Patient
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Don’t rush or finish sentences for people unless they want help.
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Silence doesn’t mean someone has nothing to say.
đź‘€ Look for Nonverbal Communication
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A smile, a gesture, or a tone change can speak volumes.
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Watch for thumbs up, eye movement, or facial expression.
đź“Ł Acknowledge All Efforts
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Even one word, a gesture, or trying again deserves encouragement.
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Celebrate progress, not perfection.
🧠Don’t Take Comments Personally
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If someone says something “off,” understand that it’s not always in their control.
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Gently redirect the conversation when needed.
🙋 Include Everyone in Conversation
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Speak to them directly, not just their caregiver.
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Invite them to share, even if it’s just a yes or no.
Real-Life Scenarios to Practice
âś… Scenario 1: The One-Word Talker
Your friend says: “Arm… before… couldn’t… move.”
Try this: Nod and say, “Your arm couldn’t move before?” Wait for a gesture. Then say, “That’s amazing progress!”
âś… Scenario 2: The Fast Talker Who Goes Off Topic
In class, someone says something unrelated.
Try this: Smile and respond kindly. Later, say: “Let’s catch up after class—I want to hear more.”
âś… Scenario 3: The Unfiltered Commenter
At an outing, someone says, “You have red shoes!”
Try this: Say, “Yep, I do!” Or gently redirect: “What do you think of today’s activity?”
âś… Scenario 4: The Person Who Can Only Give a Thumbs Up
You ask a yes/no question, and they give a small thumbs up.
Try this: Smile and say, “Got it, thanks!” Speak to them like you would anyone else.
Final Thoughts
Speech and social behavior can change after a brain injury. But at the end of the day, everyone still wants to connect, be heard, and feel included. These communication challenges aren’t personality flaws—they’re part of healing and recovery.
The more we learn to meet people where they are, the stronger our communities become.
I’d Love to Hear From You
I’m not a speech therapist or a medical professional.  I’m a TBI survivor who’s just sharing stories and observations from my real-life experiences.  This article isn’t expert advice—it’s just one perspective.
If you have your own tips, stories, or insights about communicating with people who have speech or neurological challenges, I’d love to hear from you.
Please leave a comment below or email me directly. If you’d like to share your voice on this website, you’re welcome to become a contributor too.
Together, we can learn how to support each other better—one conversation at a time.
Â
Nolan@CoachNolan.com
