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Inbal Eshel: Speech-Language Pathologists Tell People with TBI to

Speech-Language Pathologists Tell People with TBI to "Think Smart, Not Hard"

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One thing that we encourage our patients with mild traumatic brain injuries to do, and we do it with them, is to think smart not hard. So we have to think of tricks and ways to help the patient really maximize and be savvy about tackling some of those challenges that they're having. It doesn't have to be tricky. It just has to be savvy and smart. I think that's something that we really help and guide the patients do, and we've gotten some great results. One specific strategy that we use often in our clinic is goal, plan, predict, do, review. It really is a strategy that we all use subconsciously all the time, but we're not quite aware of it. With our patients it can be really helpful to bring that strategy to a conscious level and apply it first in the therapy room and then more broadly outside of the therapy room and in a number of different functional contexts. Then the hope is, and what we've seen with our patients, is that eventually the patients become so used to using that strategy that they apply it in their own day-to-day lives successfully. Another example of something that we do frequently with our patients is engage them in holistic projects. So not something that work on just during one session, but something that they're going to work on across a number of sessions. That could be for a patient who is used to giving a lot of briefings, we might work with them. They choose a topic of a briefing of their choice, and we work on that over a long period of multiple sessions. Finally they would end up giving that as a presentation. It's really remarkable how powerful that can be. Getting somebody back into a type of activity that they used to do and that they haven't done in a while.

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SLPs use effective strategies for their patients with TBI based on the model of "goal, plan, predict, do, and review." With practice, this thought process can become subconscious again making, day-to-day tasks easier.


Produced by Victoria Tilney McDonough, Brian King, and Jared Schaubert, BrainLine.

Inbal Eshel, MA, CCC-SLP Inbal Eshel, MA, CCC-SLP is the lead traumatic brain injury speech-language pathologist at Walter Reed National Military Medical Center. She provides diagnostic and therapeutic interventions aimed at minimizing cognitive and language deficits and maximizing quality of life.

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