Communication in Children After TBI: Does Use of Symbols and Signs Affect Emotional Processing?

Active and athletic children are particularly prone to sustaining traumatic brain injury (TBI), which can result in a number of cognitive and behavioral deficits, and language impairment. Previous research has suggested that the development of language and emotional competence are related in children who use speech. However, there are few such studies involving children with cognitive disabilities who rely on alternative methods of communication, such as symbols, gestures, pictures, signing, or body language. These methods collectively are called augmentative and alternative communication (AAC). To determine if this language-emotion relationship still exists for children who don’t use verbal speech, a group of researchers compiled a review of AAC-related research.

After reviewing multiple studies related to children’s communication and emotional processing, the researchers’ key findings were that:

  • Private speech, or speech that is not directed toward speaking partner, helps children self-regulate their emotions and improve their social skills. AAC limits opportunities to externalize the internal monologue, which may in turn limit the emotional and social development of children who rely on AAC.
  • Speech comprehension is crucial in conversations about emotion, and AAC systems may need to provide more expressive options, especially for children who are pre-verbal and rely on AAC symbols to communicate.
  • Beyond offering more emotion-related symbols to children who rely on AAC, these systems should also aid in open discussion about these emotions and their situationally appropriate responses.

Children who rely on AAC may be negatively impacted by AAC’s limited capacity for emotional expression. Because language development and emotional competence are correlated, limitations of AAC systems can impair disabled children’s ability to engage in social situations and interpersonal relationships. Improvements to AAC-related interventions are necessary to better support non-verbal children and to promote their quality of life.

Source: Na JY, Wilkinson K, Karny M, et al. A synthesis of relevant literature on the development of emotional competence: Implications for design of augmentative and alternative communication systems. American Journal of Speech-Language Pathology. (August 2016.)

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