The Role of Speech Therapy in Concussion Management
Written by Mariya Kika, M.H.Sc., Reg. CASLPO, Speech-Language Pathologist
What is a concussion?
A concussion is a mild traumatic brain injury (mTBI) and it is the most common type of brain injury. It results from the brain moving rapidly within the skull. Concussions most often occur from falls, motor vehicle accidents, or sports injuries.
About 1 in 165 Canadians* suffer a concussion every year. Importantly, 90% of all concussions do not result in loss of consciousness*. With proper management, many people see symptoms resolving after a few weeks. Symptoms range from person to person and can involve physical, sensory, cognitive, and communicative difficulties.
Speech language pathologists (SLP) can play an important role in concussion management for those with cognitive communication difficulties or challenges with successfully returning to work and/or school.
Why Speech Therapy For a Concussion?
SLPs are trained in far more than speech sounds and can work with anyone, not just children. The SLP’s main role in concussion care is to assess and treat a patient’s cognitive communication skills.
Cognitive communication is the successful integration of cognitive skills and language skills. Cognitive skills can also be called thinking skills. These are the fundamentals that everyone uses daily: attention, memory, organizational skills, and a few more.
When these are disrupted, communication can break down. You may lose track of schedules, experience disorganized ideas or speech, or feel like your processing is slowed. All this can happen even when your speech itself sounds completely normal. Language skills include word finding, idea organization, listening and reading skills, and writing.
These skills do not exist in isolation. They interact with each other, with some executive functioning skills providing the foundation upon which more complex skills are built. This means that difficulties in one area can have a domino effect and lead to difficulties in other areas as well.
A concussion can affect exactly these systems, even when speech itself sounds completely unaffected. When you receive speech therapy for your concussion, SLPs look at all of these skills, the specific difficulties you have, and how these disruptions impact your current functioning. This includes the way you think, communicate, and get through your day.
What Does an SLP Evaluate After a Concussion?
Every concussion is different, and so is each recovery pathway. When evaluating someone after a concussion, SLPs look at the fuller picture of how the brain is managing daily demands, not just isolated symptoms. This typically includes:
Attention & Concentration: the ability to sustain concentration or shift between tasks without losing your place, drifting off, or feeling confused
Memory: The ability to remember the conversation you had yesterday, the question you were just asked, or where you left off in a task. Short-term memory and recall for details are common goals
Word-Finding: Speech is intact but that one word suddenly escapes you mid-sentence or you start a sentence and you’re not sure where you’re going
Processing Speed: following a conversation, a lecture, skimming an article or listening in a busy room takes more effort than it used to
Organization & Problem Solving: in both conversation and daily tasks like managing a schedule or managing an unexpected disruption
Many people may not immediately connect these difficulties with their concussion, especially if the injury happened weeks or months ago. What’s more, it’s a common belief that these difficulties will go away on their own and there is limited public knowledge on the role of SLP interventions.
How Is Concussion Treated in Speech Therapy?
Successful and functional speech therapy doesn’t treat symptoms in isolation. It holistically assesses and treats difficulties, symptoms, tolerances, and strengths to build a communication profile of where you are and where you need to be. It starts with the end goal in mind, be it return-to-work, return-to-school, or return-to-family.
Treatment is grounded in principles of concussion care, which build on neuroplasticity, the brain's ability to adapt and rebuild pathways with the right kind of practice. Functional speech therapy starts with structured cognitive exercises and strategies, which then progress to functional implementation in real-world settings, and practical tools that make daily tasks more manageable while your brain continues healing.
Speech Therapy for Ontario Student Athletes After a Concussion
Student athletes, in particular, face a unique set of challenges in the recovery process.
Under Rowan's Law, Ontario's concussion safety legislation, schools and sports organizations across the province follow mandated concussion protocols and return-to-school and return-to-sport guidelines. Ultimately, though, school is demanding and recovery time often overlaps with the expectations of keeping up in the classroom.
Homework, tests, and group projects don’t stop and such high and complex demands can lead to poor performance, with no clear indication of the specific skills affected. SLPs can work with student athletes to support a successful return-to-school with recommendations as well as ongoing skill and strategy training through treatment.
This can include:
Classroom Accommodations: Personalized accommodations lists, including extended time, sensory supports, and modified assignments
Managing Screen Time & Reading Fatigue: Practical strategies for rebuilding tolerances without worsening symptoms
School Coordination: Communicating with teachers, school staff, and coaches so return-to-learn and return-to-play decisions reflect your full recovery, not just physical symptoms
The goal is ensuring a young athlete isn't forced to choose between healing and keeping up.
Do You Need a Diagnosis to Be Seen?
You don't need a formal post-concussion syndrome diagnosis to be seen, and you don't need to have "tried everything else first." If your symptoms are affecting how you function day to day—even in small ways—then, that's reason enough to be evaluated. Early evaluation can also help catch patterns before they become more entrenched, which often makes treatment more effective.
Please note, you do not need a referral to get started. Speech therapy can be initiated by anyone at any time.
Recovery isn't linear, and it looks different for everyone. Whether your concussion happened last week or last year, it's not too late to seek support to get back to the parts of life that matter to you.
Additional Resources:
Get Support for Concussion Recovery in Ontario
About the author
Mariya Kika is a CASLPO-registered speech-language pathologist and the founder of Cognicare Speech Therapy, operating virtually across Ontario. She holds a Master of Health Science from the University of Toronto. She previously worked as the sole speech-language pathologist at Altum Health, part of Toronto's University Health Network, providing outpatient neurorehabilitation that centered return-to-work care. She is a member of the Canadian Concussion Network.
For more on specific conditions, see Brain Injury & Concussion.