Speech, Language & Cognitive-Communication Assessment
The goal is not to collect a score. It is to understand what changed, what still works, and where communication breaks down in real life.
After an acquired brain injury, difficulties can be subtle. A person may speak clearly and still struggle with memory for spoken information, organization, discourse, executive function, reading, writing, social communication or the pace of everyday conversation.
Three questions matter more than one test score.
Work • school • household responsibilities • conversations • reading • writing • community participation
Listening • remembering • organizing • word finding • reading • writing • conversation • self-monitoring
Return to work • academic participation • appointments • family communication • independence • community activity
It should describe strengths and challenges, activity limitations, participation impact and relevant contextual factors.
What looks like one problem may sit across several communication systems.
Clarity • rate • intelligibility • speech movement when relevant
Understanding • word finding • sentence formulation • reading • writing
Attention • memory • processing • executive function • organization
Story / explanation • topic • inference • perspective • repair • conversational effectiveness
Work • school • healthcare • family • community • independence
The output can look similar while the cost becomes much higher.
Plan → write → send
Plan → lose idea → restart → check details → edit → reread → recover
Time, effort, strategy use, consistency and functional impact can be clinically important.
A strong assessment is built like a case file, not a quiz.
HISTORY & INTERVIEW
Injury history • communication before injury • client concerns • family / partner observations • education / work demands
STRUCTURED MEASURES
Standardized and non-standardized tasks selected for the person’s profile.
DISCOURSE SAMPLES
Stories • explanations • conversation • connected language.
FUNCTIONAL TASKS
Reading • writing • planning • communication activities related to daily life.
CONTEXT & PARTICIPATION
Home • healthcare • community • academic • return-to-work demands.
TEAM INFORMATION
Relevant information from other professionals and caregivers when available and appropriate.
A person can name objects correctly and still have difficulty organizing a real message.
“So I called them because I had to change it, and then they told me Tuesday — actually I think it was Thursday — and I was trying to ask about the paper from the other doctor, but then we were talking about the appointment again…”
Discourse analysis looks for patterns across appropriate tasks and contexts, interpreted alongside the rest of the assessment.
A score is evidence. It is not the whole conclusion.
The report should turn evidence into a usable next-step plan.
Individualized to the referral question and communication profile.
What remains effective?
Important abilities and supports that can be used in rehabilitation.
What is impaired, inconsistent or unusually effortful?
Speech, language, cognitive-communication and functional findings.
How does this affect everyday participation?
Work, school, family, community, healthcare and independence.
What support is appropriate next?
Therapy, strategies, accommodations, referrals and partner/team recommendations when indicated.
Different referral goals reveal different communication demands.
Meetings, email, multitasking, deadlines
Can the person process information quickly enough, organize responses, remember action items and communicate reliably under workload?
Lectures, reading, writing, assignments
Can the student learn from complex language, take notes, retain instructions, organize written work and advocate for support?
Appointments, instructions, decisions
Can the person explain symptoms, understand recommendations, remember next steps and ask needed questions?
Schedules, family, errands, social life
Can communication and memory supports help the person participate with greater consistency and independence?
The assessment should identify the specific communication demands of the roles the person is trying to resume.
Assessment should create direction — not another document that sits in a file.
EDUCATE — understand strengths, challenges and how communication changed.
RESTORE — work directly on impaired communication or cognitive-communication skills when appropriate.
COMPENSATE — use strategies, external supports and environmental modifications.
PRACTISE — apply skills in meaningful, increasingly real-life communication tasks.
COLLABORATE — coordinate with family and relevant rehabilitation, healthcare or academic professionals.
Questions clients, families and referral sources often ask.
What is a cognitive-communication assessment?
It is a speech-language pathology assessment of how cognitive processes such as attention, memory, processing and executive function affect communication activities including listening, speaking, reading, writing and conversation.
Who performs a cognitive-communication assessment?
Cognitive-communication assessment is within the scope of appropriately trained speech-language pathologists, who may work collaboratively with the person, family and other members of the rehabilitation or healthcare team.
Why can communication problems be missed after a brain injury?
Some difficulties are subtle and may become most apparent in complex real-life situations involving memory, attention, organization, social communication or several demands at the same time.
Is cognitive testing alone enough to assess communication?
Cognitive test results can provide useful information, but an SLP assessment specifically examines how cognitive and linguistic processes affect communication activities and participation.
What areas can the assessment examine?
Depending on the referral question, assessment may examine speech, language, verbal memory, executive function, discourse, social communication, reading, writing and functional communication.
Can the assessment relate to return to work or school?
Yes. When work or academic participation is part of the referral question, the assessment can consider the communication demands of those environments and make relevant recommendations.
What happens after the assessment?
Findings may lead to recommendations for therapy, strategies, accommodations, partner education, further referral or collaboration with other professionals, depending on the person’s needs.
Do you provide cognitive-communication assessments in Toronto and the GTA?
Speech Therapy Centres of Canada provides speech, language and cognitive-communication assessment services across Toronto and surrounding GTA communities. Contact the clinic to confirm the appropriate service and location.
Cognitive-Communication Assessment in Toronto & Across the GTA
Speech Therapy Centres of Canada provides cognitive-communication assessments in Toronto and the GTA for individuals experiencing communication changes after acquired brain injury, traumatic brain injury, concussion, stroke or other neurological injury.
An ABI speech-language assessment in Toronto may examine speech, language, verbal memory, executive function, discourse, social communication, reading, writing and the functional impact of communication changes.
Assessment findings can support treatment planning and recommendations related to home, rehabilitation, work, school, family interaction and community participation.
Toronto • North York • Scarborough • Markham • Richmond Hill • Vaughan • Aurora • Newmarket • Thornhill
Mississauga • Brampton • Burlington • Ajax • Pickering • Whitby • Oshawa • Ottawa • Sudbury
Build a communication profile that explains what daily life is actually asking of the person.
Tell us what changed after the injury and where the difficulty is showing up now. We can help determine the appropriate speech, language and cognitive-communication assessment pathway.