Damage to the frontal lobes of the brain can cause executive functioning impairment, sometimes called ‘Dysexecutive Syndrome’. People who have impaired executive functioning can present as having changes in personality and impaired thinking skills; this can significantly affect their communication skills and rehabilitation.
Communication characteristics of the person with executive functioning impairment may include:
- Changes to the person’s ability to build and maintain social relationships. They may be perceived as ‘difficult’ and hard to get on with.
- ‘Blunt’ and insensitive speech content.
- Difficulties demonstrating empathy and impaired ability to see things from other people’s perspective. This may affect what the person says and how they say it.
- Impaired ability to make judgements about appropriate topics and content of communication and about the appropriate manner of communication (e.g. using a calm manner versus a threatening and aggressive style of communication).
- Reduced ability to change and adapt communication style to the needs of the situation. Generally people change how they speak and what they say in different situations: they do not speak in the same way to friends, family, bank clerk and GP, they adapt their communication to suit the setting.
- Impulsive speech content; the person may say things that are rude, inappropriate and distressing to others. They can struggle to ‘edit’ what they say before they say it.
- Disinhibited speech content and communication style. The person may make inappropriate comments and/or appear over familiar. Non-verbal communication may be inappropriate to the situation and relationship.
- Difficulties planning and organising language content and the way the person communicates. This affects the person’s ability to get their message across effectively.
- Difficulties initiating communication.
- Talking too much and saying things that are ‘over personal’, which may make other people feel uncomfortable.
- Drifting off the topic.
- Significant difficulties thinking of conversation topics.
- Misinterpretation of social situations, impaired social judgement. For example, the person may mistakenly perceive people as being friendly or even being attracted to them. They may also mistakenly believe someone is being cheeky, rude, sarcastic, angry towards them, that they are under threat etc. This will influence the style and content of the person’s communicative response.
- Reduced ability to judge and understand other people’s communicative intent and motivation.
- Reduced insight into communication difficulties. The person may be unaware of any language, memory problems etc.
- Reduced motivation to engage in interaction.
- Communication may become challenging.
For further information about executive functioning please refer the relevant section of this website.