Speech Therapists: Take 30% off your first order using promo code "FirstOrder" at checkout! View all worksheets here

6 Traumatic Brain Injury (TBI) Speech Therapy Activities

Traumatic Brain Injury (TBI) can significantly impact an individual’s ability to communicate effectively. Traumatic Brain Injury speech therapy activities play a crucial role in rehabilitation for those affected by TBI, helping restore and improve speech, cognitive communication, and even swallowing functions.

This resource will explore a variety of speech therapy activities specifically designed to aid recovery and enhance communication skills in individuals who have suffered a TBI. From articulation exercises to cognitive communication tasks, we will delve into how these targeted interventions can make a profound difference in the lives of TBI patients, supporting their journey toward regaining confidence and independence in communication.

What is Traumatic Brain Injury (TBI)?

Traumatic brain injury (TBI) occurs when an external force causes sudden damage to the brain. It’s a leading cause of disability and death among adults. TBI covers a wide range of brain injuries, from focal injuries affecting a specific area to diffuse injuries impacting multiple brain areas. The severity of these injuries can vary significantly, from mild concussions that may result in brief changes in mental status to severe cases that can cause prolonged comas or even result in death.

Traumatic brain injuries (TBI) encompass a broad spectrum of injuries that impact the brain’s functioning, resulting from external mechanical forces. These injuries vary greatly in terms of mechanism, severity, and affected brain areas. Understanding the different types of TBI is crucial for diagnosis, treatment, and rehabilitation strategies.

Types of Traumatic Brain Injuries

Here’s an expanded look at each type:

Closed Brain Injury

Closed brain injuries occur when there is no penetration of the skull. They are typically caused by blows to the head, falls, or accidents where the head is struck or shakes violently. The damage can range from minor, such as in mild concussions, to severe, as in cases where there is extensive bruising or swelling of the brain.

These injuries can lead to complications like intracranial pressure, which can be life-threatening if not properly managed.

Open or Penetrating Brain Injury

In open or penetrating brain injuries, an object breaks through the skull and enters the brain. This can cause severe localized damage along the object’s trajectory, destroying brain tissue and blood vessels and causing bleeding.

The precise path of the object can often determine the extent and type of brain damage, which can range from loss of specific brain functions to more generalized impairment depending on which brain areas are affected.


Concussions, the most common type of traumatic brain injury, are caused by impacts or sudden momentum or movement changes that cause the brain to shake inside the skull. Symptoms can include temporary loss of consciousness, confusion, dizziness, and headaches. While concussions are generally classified as mild TBIs, their effects can be serious and prolonged, especially after multiple concussions, leading to chronic traumatic encephalopathy (CTE) in some cases.


A contusion is a direct bruise of the brain tissue often associated with bleeding on the surface of the brain. These are typically caused by a direct impact to the head. Large contusions may require surgical removal if they lead to swelling or increased intracranial pressure.

Coup-Contrecoup Injury

Coup-contrecoup injuries occur when the force impacting the head is not only strong enough to cause a contusion at the site of impact but also on the opposite side of the brain. This happens when the force is enough to cause the brain to move and hit the opposite side of the skull, resulting in injuries at both the initial impact site and the rebound site.

Diffuse Axonal Injury (DAI)

Diffuse axonal injury involves widespread brain damage resulting from the brain rapidly shifting inside the skull, which shears and damages the brain’s long connecting nerve fibers. DAI can disrupt regular neural communication, leading to significant impairments, coma, or death, and is one of the major causes of unconsciousness and persistent vegetative state after head trauma.

Anoxic Brain Injury

An anoxic brain injury happens when the brain receives no oxygen. This can occur as a secondary effect of any serious TBI that impacts blood flow to the brain or due to respiratory injuries associated with the traumatic event. The extent of damage in anoxic brain injury depends on the duration of oxygen deprivation; longer periods can lead to more severe and irreversible brain damage.

Treatment for TBI must be prompt and tailored to the type and severity of the injury. Rehabilitation may involve a team of health professionals, including neurologists, surgeons, physical therapists, occupational therapists, speech therapists, and psychologists, to address the wide array of consequences stemming from TBI. Each patient’s recovery path is unique and can range from complete recovery to long-term impairment, requiring ongoing support and therapy.

Symptoms of Traumatic Brain Injury

Traumatic Brain Injury (TBI) can present a wide range of physical, cognitive, emotional, and sensory symptoms. These symptoms can vary greatly depending on the severity of the injury, the area of the brain affected, and the individual’s health before the injury. Here are common symptoms categorized by their nature:

Physical Symptoms:

Traumatic Brain Injury Speech Therapy Activities

Cognitive or Mental Symptoms:

Sensory Symptoms:

Emotional Symptoms:

6 Traumatic Brain Injury Speech Therapy Activities

The impact of a traumatic brain injury (TBI) on communication skills can vary greatly depending on the specific area of the brain that is damaged. Identifying which speech skills have been affected is crucial for targeting therapy effectively.

Here are some of the top speech therapy activities designed to aid in recovering communication skills following a TBI. Many of these exercises are aimed at enhancing coordination of the facial muscles.

Facial Strengthening

Traumatic Brain Injury (TBI) can affect the nerves that control facial muscles, leading to speech difficulties such as dysarthria, where speech becomes slurred. Retraining your muscles through specific facial exercises can help improve speech clarity. Here are several facial strengthening exercises that can be performed to aid in recovery:

1. Lip Puckering

    • Pucker your lips as if to kiss someone. Hold this position for 5 seconds, then relax. Repeat this 10 times.
    • Pucker again, and while holding the pucker, shift your lips from side to side. Ensure your tongue remains still during this exercise. Repeat this movement 10 times.
    • Finally, close your lips tightly and alternately say “mm..mm..mm,” “p…p…p,” and “b…b…b.”

2. Cheek Puff Exercise

    • Inhale deeply through your nose and puff out both cheeks. Hold the air in your cheeks for 5 seconds before slowly exhaling. Perform this 10 times.
    • For a variation, inhale deeply again, but this time hold the air in your left cheek only, then switch to your right cheek. Do this alternation 10 times.

3. Tongue Strengthening

    • You will need a flat wooden stick, such as a popsicle stick or tongue depressor, for these exercises.
    • Stick your tongue out and press the tip against the stick 2 or 3 times.
    • Press the stick against your tongue while simultaneously pushing your tongue against the stick as if trying to push it out of your mouth. Hold for 5 seconds. Repeat 10 times.
    • Place the stick on top of your tongue and push down as if a doctor is examining your throat. Push your tongue up against the stick while it presses down. Hold this tension for 5 seconds. Repeat 10 times.

These exercises are designed to strengthen the muscles in your face and improve your control over them, helping to alleviate symptoms of dysarthria and improve your speech clarity.

Apraxia after TBI

Apraxia of Speech is another speech disorder that may occur following a Traumatic Brain Injury (TBI). This condition makes it difficult for individuals to pronounce and sequence words correctly due to a disconnect between the brain and the muscles responsible for speech, affecting the coordination needed for speech movements.

Speech therapists often utilize articulation exercises to help treat apraxia, adjusting the difficulty level based on the severity of the condition. These exercises aim to retrain the brain better to coordinate muscle movements during speech.

Here are some examples of articulation exercises for individuals with apraxia:

4. Lip Articulation Exercises

  • Stand in front of a mirror to observe your lip movements. Begin by saying “ooo” while shaping your lips into an O. Then switch to saying “eee” while stretching your lips into a smile. Alternate between these sounds, repeating “ooo-eee” 10 times.
  • Practice the sound “puh” and aim to create a sharp, popping sound with your lips.
  • Drink water using a straw, which helps improve coordination among your lips, cheeks, and tongue—ideal for those with apraxia.

5. Tongue Articulation Exercises

  • Say “lalalala” using only the movement of your tongue’s tip, keeping your jaw still. Repeat this 10 times for practice.
  • Place the tip of your tongue just behind your upper front teeth and try to hold it there, gradually increasing the duration up to three minutes.
  • Practice consonant sounds by saying “t-d-n,” focusing on using just the tip of your tongue.
  • Open your mouth and form an O with your lips. Move your tongue to trace around the inside of your lips from one corner to the other and back, ensuring your jaw remains stationary.

6. Coordination Exercises

  • After mastering individual articulation exercises, combine these skills in coordination exercises:
    • Repeat the words “buttercup” and “rocket ship” five times each. These words help engage different parts of your tongue and lips.
    • Say the sequence “puh tuh kuh” slowly at first, then gradually speed up to improve fluidity and coordination.

These exercises are designed to strengthen the muscles involved in speech and improve the coordination necessary for clear articulation, helping individuals with apraxia regain their ability to communicate more effectively.

Conclusion on Traumatic Brain Injury Speech Therapy Activities for Speech Therapy

Traumatic Brain Injury (TBI) speech therapy activities are crucial in helping individuals regain their communication abilities post-injury. These activities extend beyond just enhancing the mechanics of speech to improve overall communicative competence.

By integrating a variety of dynamic and engaging exercises, therapists can significantly improve a patient’s capacity to process and express information effectively. This holistic approach not only aids in restoring language skills but also strengthens cognitive functions, enhances critical thinking, and fosters better social interactions. Participating in TBI speech therapy is vital for developing both verbal and non-verbal communication skills, ultimately facilitating a broader set of life skills essential for recovery and everyday functioning.

SpeechTherapyByPro is an online speech therapy directory that connects speech therapy pros with clients in need. If you’re a speech therapist, you can Join our community and add your practice listing here. We have assessments, practice forms, and worksheet templates speech therapy professionals can use to streamline their practice. View all of our speech therapy worksheets here.

SLP Team
Author: SLP Team

Our Speech-Language Pathology (SLP) team is a dedicated group of professionals committed to sharing industry expertise to help you grow your practice and improve how you treat your patients.

Scroll to Top