The most important thing is to be able to arrive at a proper diagnosis.  I'm actually pretty big on that - I always play the investigative role in reading a medical chart really thoroughly and understanding what life looked like before, during, and after the incident.  Our role as a speech-language pathologist is to achieve the maximum potential and gain independence for our patients.  It's really important that we gather evidence-based practice literature and apply it to our assessment and treatment.  We must understand the behavioral, the emotional, and the social aspect of what this could entail.

After a thorough assessment, we arrive at long-term and short-term goals, we educate the family, we agree on the treatment plan, and then we apply what we've gathered so far to deliver the most appropriate treatment for each individual.  And of course, given the nature that everyone is very different in the damage that they sustain and the behaviors they exhibit, that's something that a speech-language pathologist should be very mindful about and again apply that to treatment.

For example, we may have patients that exhibit a similar lesion a similar type of accident - not to say that they will present exactly the same during treatment.  So if a person may sustain trauma to their frontal lobe - the front of their head - two of the patients may manifest very differently.  So pending the result of the assessment is what should be driving your treatments - that's very, very important.

We have to consider the aspect of neuroplasticity - this is basically how our brain is malleable, flexible, and always has the ability to rewire and regain connections.

Aphasia is what we call a deficit of speech and language, which could happen as a result of trauma.  It's very different from cognition, although of course they're intertwined.  We need speech and language to communicate and to be able to perform cognitive tasks but they are very different domains.  Pragmatics, or social interaction, attention, orientation, this is all higher order cognition and that's very different. So going back to the diagnosis, we must match imaging of the damaged site and create our treatment plan accordingly.  We need to make sure the person does not present with aphasia before addressing cognition and pragmatics.