Concussion Awareness 101

Article by Moody Neuro

Concussions have become a hot topic in recent years but there are many misconceptions regarding them. Let’s take a moment to talk about what they are, what are the symptoms and what steps may be taken after a concussion. A concussion is a form of traumatic brain injury. More specifically, it comes under the category of “mild” traumatic brain injury. By definition, a mild traumatic brain injury may involve no loss of consciousness to a loss of consciousness of up to 30 minutes. It involves an alteration in consciousness or mental state from a quick moment to up to 24 hours. It also may also involve Post-Traumatic Amnesia, in which an individual cannot make memories and/or may act in an odd behavioral manner, for up to 24 hours. For the purpose of this blog post, we will use the term concussion instead of mild traumatic brain injury.

Generally speaking, a concussion occurs when the head is impacted by another item (e.g. fist or ground), which causes the brain to hit the inside of the skull. This impact then changes the normal functioning of the brain. An example of this is a baseball hitting a batter in the head. The batter may be dizzy or confused after the impact. In some cases, a concussion can be due to a rapid acceleration-deceleration of the head, which causes damage to the brain. An example of this would be a hard shoulder to shoulder football tackle. Although the offensive player’s head was not directly impacted, the quick snapping back of the head due to the tackle can lead to a concussion.

According to the Centers for Disease Control, the highest rate of concussions occurs in older adults and very young children. Both groups tend to have the greatest difficulties with balance and mobility, which contributes to falls. In fact, falls are the top cause of concussions. Although most people think of concussions in children as due to sports such as football, the most common activities leading to children’s concussions are when playing on playground equipment and bicycle accidents. Children spend far more time playing in a playground or riding bicycles than they do playing football so the likelihood of an accident is higher. Other accidents, such as motor vehicle accidents, also commonly lead to concussions.

The most common concussion symptoms are headaches, confusion, dizziness, nausea, difficulty with concentration, difficulty with memory and changes in vision. Individuals can have ringing in the ears, light sensitivity or difficulty sleeping. Further, they may experience irritability, low mood, fatigue or difficulty managing stress. Usually, individuals with concussions do not experience all of these symptoms but only a selection of them. Approximately 80% of individuals with a concussion will see their symptoms resolve in a few weeks to a month, oftentimes sooner. For other individuals, their symptoms will last for longer periods of time, from months to years. These individuals with longer post-concussion symptoms may be referred to rehabilitation.

Following a concussion, the most important action is to contact your doctor. Your doctor may have a variety of recommendations, depending on the severity of symptoms and previous health history. Typically, doctors will recommend a period of limiting mental and physical activities to allow the brain to rest, followed by a period of gradual return to previous activities. For instance, this may involve recommendations to significantly reduce or temporarily stop exercise workouts or screen time in front of a computer. This may also involve a temporary reduction of work or school hours. Many schools develop return to learn and return to play plans for students with concussions, allowing schools and physicians to collaborate for the best plan for the student. It is important to give time for the brain to heal from the concussion. Following the initial concussion, individuals are at a higher risk of another concussion and a more serious injury, if they should receive another concussion prior to allowing the brain to fully recover. If symptoms worsen, such as an increase in nausea or seizures, then you should immediately contact your doctor or go to the nearest emergency room, as this may be a sign of a more serious evolving brain condition such as bleeding or swelling of the brain.

There are a number of ways to reduce the likelihood of receiving a concussion; here are a few recommendations:

  1. Always wear a seatbelt in motor vehicles.
  2. Make sure to have small children in age-appropriate and correctly installed child seats.
  3. Make sure that children are properly supervised when engaging in physical activities.
  4. Always use safety equipment, such as bicycle and motorcycle helmets.
  5. Do not overuse alcohol or use illicit substances. Alcohol/substance induced accidents and falls are common ways to receive a concussion.
  6. Clean up spills quickly and keep halls/walkways clear of trip hazards such as toys or loose carpeting. Be aware of slip/spill signs when in stores and other community locations.
  7. Especially for older adults, make sure that you receive a yearly physical and eye exam. Consider installing anti-slip mats and shower bars in the bathroom.

For those looking to learn more on concussions, the Centers for Disease Control offers a course for parents, teachers and coaches to improve in their concussion awareness.

Strokes are medical conditions that affect millions globally. In the United States, more than 795,000 people have a stroke each year, with about 610,000 cases being first or new strokes. 

These can lead to a wide range of physical and cognitive impairments. Speech and language disorders are among the most common and most challenging consequences of strokes, occurring in about a third of stroke survivors. 

Understanding Stroke-Induced Speech & Language Disorders

Stroke-induced speech and language disorders significantly impact communication abilities. Among these, aphasia, dysarthria, and apraxia of speech are prevalent. Understanding how they are diagnosed and their specific symptoms can aid in prompt and effective management.


Aphasia is a common outcome of stroke, manifesting as difficulty in speaking, understanding, reading, and writing. There are many different types of aphasia, depending on the affected brain area, and are categorized based on the symptoms present:

  • Expressive Aphasia (Broca’s Aphasia): Characterized by broken speech, limited vocabulary, and difficulty forming complete sentences. Patients often understand what is being said to them but struggle to verbalize responses.
  • Receptive Aphasia (Wernicke’s Aphasia): Patients can produce fluent speech but may lack meaning or include nonsensical words. They often have significant difficulty understanding spoken language.
  • Global Aphasia: A severe form of aphasia where individuals have extensive difficulties with both speech production and comprehension.
  • Anomic Aphasia: Individuals have difficulty finding words, particularly nouns and verbs, making their speech sound vague.


Dysarthria is a speech disorder that affects 20-30% of stroke survivors. It occurs when stroke impacts the muscles responsible for speech, leading to slurred or slow speech that can be hard to understand. It is typically diagnosed through a physical examination and a series of speech evaluations conducted by a speech-language pathologist (SLP). 

It is characterized by the following symptoms:

  • Slurred or slow speech that can be difficult to understand
  • Monotone or robotic-sounding speech
  • Difficulty controlling the volume of speech, which may be too loud or too soft
  • Challenges with the rhythm and flow of speech, including rapid speech that’s hard to interrupt or slow, drawn-out speech
  • Respiratory issues affecting the ability to speak loudly or for extended periods

Apraxia of Speech (AOS)

Apraxia of speech is a neurological disorder characterized by difficulty sequencing the movements needed for speech. This is caused by the impact of the stroke on the brain’s pathways involved in producing speech. 

Patients with AOS know what they want to say but struggle to coordinate the muscle movements to articulate words correctly. This results in distorted speech, difficulty initiating speech, or the inability to accurately produce speech sounds or sequences of sounds. 

How Long Is the Stroke Speech & Language Recovery Time?

According to one study on post-stroke speech and language therapy, approximately one-third of stroke patients experience speech problems after a stroke. Many of these individuals begin to recover within a few months, with significant progress typically observed within three to six months.

In another study, 62% of subjects had speech challenges after suffering from a stroke. By six months post-stroke, 74% were able to completely recover their communication abilities. 

However, the figures above provide a general timeline for post-stroke speech and language recovery. Stroke speech recovery time is highly individualized and can vary depending on several factors. These can include the following:

  • Severity of the Stroke: More severe strokes often lead to extensive brain damage, resulting in longer and more challenging recovery periods for speech.
  • Location of the Brain Injury: The brain’s specific regions control different speech and language functions; damage to these areas directly impacts recovery complexity and duration.
  • Age and Overall Health of the Patient: Generally, younger patients with better overall health before the stroke tend to experience faster and more complete recoveries.
  • Pre-existing Conditions and Comorbidities: Conditions such as diabetes or hypertension can slow down recovery by complicating the overall health scenario and rehabilitation process.
  • Individual Variability and Resilience: Personal resilience, the support system’s strength, and the individual’s motivation significantly influence the pace and success of speech recovery efforts.

The first three months after a stroke is a crucial period for recovery, as a majority of stroke patients see the most significant improvement during this period. However, it’s also important to note that, although at a slower pace, recovery can continue well past the 6-month mark with continued therapy and practice. 

This underpins the importance of early intervention and ongoing rehabilitation efforts, including speech therapy, to maximize each patient’s recovery potential. 

What Does the Stroke Speech & Language Recovery Process Look Like?

The journey to regain speech and language after a stroke is multifaceted and varies significantly from one individual to another. Understanding the structured phases of recovery can provide insight into what patients and their families can expect during this challenging time. 

Here’s a closer examination of each phase in the stroke speech recovery process.

Initial Assessment and Diagnosis

Before recovery can begin, a thorough evaluation is conducted by a team of healthcare professionals led by an SLP. This assessment aims to identify the type and severity of the speech and language disorder, be it aphasia, dysarthria, or AOS. The evaluation may include cognitive-linguistic assessments, comprehension tests, speech production analysis, and functional communication measures. 

Based on this assessment, a personalized therapy plan is crafted to address the patient’s specific needs.

Acute Phase

The acute phase typically occurs within the first days to weeks following a stroke. During this period, medical stabilization is the primary focus, with healthcare teams working to manage the immediate effects of the stroke. 

Speech therapy may begin with simple exercises or assessments to gauge the patient’s abilities. However, intensive therapy usually does not start until the patient is medically stable. During the acute phase, the goal is to support overall recovery and prevent complications immediately after the stroke.

Subacute Phase

The subacute phase generally spans from two weeks to three months post-stroke and is characterized by more intensive speech therapy interventions. As the patient’s medical condition stabilizes, the focus shifts to active rehabilitation. Therapy during this phase is tailored to the individual’s specific speech and language deficits and may include:

  • Exercises to improve articulation, fluency, and voice control for those with dysarthria.
  • Language therapy to enhance understanding, speaking, reading, and writing skills in patients with aphasia.
  • Motor speech exercises and strategies to improve speech planning and production in apraxia of speech.

The subacute phase is crucial for taking advantage of the brain’s natural recovery processes and neuroplasticity, where the brain begins reorganizing and adapting to the loss of function.

Chronic Phase

The chronic phase of recovery extends from several months to years after the stroke. It focuses on long-term rehabilitation and adjustment to any residual speech deficits. During this time, patients may continue to see gradual improvements in their speech and language abilities, although the rate of recovery may slow. Therapy in the chronic phase often includes:

  • Advanced communication strategies to cope with ongoing challenges in daily life.
  • Maintenance exercises to preserve and enhance speech gains achieved in earlier phases.
  • Supportive technologies and aids, such as communication devices, to assist in effective communication.
  • Community reintegration activities to help patients return to as normal a life as possible, engaging in social, vocational, or recreational activities.

What Is the Role of Neuroplasticity in Speech & Language Recovery?

Neuroplasticity refers to the brain’s fundamental property to change and adapt its responses to new experiences, learning, and environmental changes. This adaptive capacity enables the brain to reorganize itself by forming new neural connections.

When the brain, or a part of the brain, is damaged after a stroke, neuroplasticity is what allows the other parts of the brain to take over the functions of the damaged area. Through targeted rehabilitation and therapy, such as speech therapy for stroke survivors, patients can retrain other brain areas to perform the lost functions and facilitate recovery.

Enhancing Stroke Speech & Language Recovery Time

Adopting a comprehensive approach involving several key strategies is vital to enhance the stroke speech and language recovery time. This multifaceted approach can maximize the chances of regaining speech and communication abilities.

This comprehensive approach must incorporate the following strategies:

  • Early intervention to leverage the brain’s highest potential for neuroplasticity in the initial period following a stroke, significantly improving the chances for recovery.
  • Alternative communication strategies, such as gestures, writing, and visual aids, to help maintain communication during the recovery process. 
  • Adopting technology, including speech-generating devices and software applications designed for speech rehabilitation, for personalized exercises and continuous practice, which is vital for progress.
  • Providing continuous support from psychologists, support groups, and therapy to help manage feelings of frustration, depression, and anxiety, fostering a positive mindset essential for rehabilitation.
  • A healthy diet and lifestyle to supply essential nutrients that support brain function, along with regular physical activity, adequate sleep, and management of medical conditions.

Begin Your Post-Stroke Recovery Journey With Moody Neurorehabilitation

Moody Neurorehabilitation understands the complexities and challenges that come with post-stroke rehabilitation. We are dedicated to supporting patients and their families through this critical time with specialized care and personalized treatment plans.

Since our inception in 1982, Moody Neurorehabilitation has been a leader in brain injury rehabilitation. Our approach centers on providing comprehensive care tailored to each patient’s needs and goals. We believe in treating the whole person, not just the symptoms, to improve overall quality of life.

We invite you to start your recovery journey with us. Contact Moody Neurorehabilitation today to schedule a consultation with our experts. Let us help you navigate the path to recovery with care, compassion, and expertise.