MTBI can cause a wide range of communication problems. The following provides a summary of communication problems related to expression and comprehension that MTBI patients commonly face, and what physicians can do to help address these issues to improve physician-patient communication.

Problem Area	Problem Description	What Physicians Can Do
Expression	May have trouble thinking of specific words (word-finding problems)	Allow patients time to express themselves
Comprehension	Spoken: May become confused if too much information is presented at once or too quickly Need extra time to understand what others are saying Have trouble following complex multi-step directions. May take longer than expected to respond to a question	Speak slowly and clearly Use short sentences Allow time for patients to comprehend Provide both spoken and written instructions and directions
	Written: Read slowly Have trouble reading material in complex formats or with small print Have trouble filling out forms	Allow patients extra time to read and complete forms Provide written material in simple formats and large print when possible For patients who have trouble filling out forms themselves, have someone read the items and fill out the forms for them

In addition to the communications problems listed above, it is also important note that patients may be sensitive to environmental stimuli. In particular, patients may become disoriented or confused when exposed to:

• bright lights;
• complex visual stimuli such as busy carpet patterns; and/or
• noise, including from radio or TV.

To address this, physicians should consider offering patients access to a quiet, low-stimulation waiting area if needed.