The challenge of unintelligible speech following traumatic brain injury.

Management of unintelligible speech following traumatic brain injury is complex. In addition to multiple physiological system deficits, individuals typically present with complicating non-speech factors that impede their progress. The present case study illustrates the influence on outcome of impaired speech physiology, reduced cognitive abilities, pre-morbid personality characteristics, and psychosocial variables such as post-injury psychosis. Highlighted intervention strategies include optimizing the physiological system with a palatal lift prosthesis, reducing speaking rate by pacing, phonetically transcribing words to minimize apraxia of speech, adapting stimuli to optimize auditory comprehension, and providing therapy within functional contexts.