From Surviving to Thriving: Supporting Young Adults with TBI as They Return to College
- jacquelynnardelli
- Feb 13
- 2 min read
In November 2025, I had the honor of presenting at the ASHA (American Speech-Hearing Association) Convention in Washington, DC on a topic that is both clinically complex and deeply personal to my work: How speech-language therapy supports cognitive-communication in young adults returning to college after a traumatic brain injury (TBI).
As a speech-language pathologist and owner of The Rose Speech Therapy Group, I have worked with many young adults navigating the long road from medical recovery to academic reintegration. Returning to college after a traumatic brain injury goes well beyond healing. It’s about rebuilding identity, independence, and confidence.
This population deserves targeted, functional, and empowering therapy. Here’s why.
The Hidden Challenges of Returning to College After TBI
Young adults experience challenges in the classroom as the demands quickly reveal cognitive-communication breakdowns.
Common challenges include:
Difficulty with attention and sustained focus in lectures
Reduced processing speed
Executive function (planning, organizing, time management)
Memory impairments (remembering details in lectures, remembering to complete assignments)
Word retrieval difficulties
Cognitive fatigue
Trouble synthesizing and integrating information
Social-pragmatic changes affecting peer relationships
College is cognitively demanding. Students are expected to independently manage complex schedules, multi-step assignments, note-taking, group projects, and exams. On top of these, students are also expected to regulate sleep, stress, and social interactions. For a brain still healing, this can feel overwhelming.
The Role of Speech-Language Therapy
Speech-language pathologists are uniquely trained to address cognitive-communication which is simply known as the intersection of thinking and communication skills.
Therapy for young adults returning to college must be:
Functional
Executive Function–Focused
Fatigue-Aware
Self-Advocacy Centered
Why This Matters
Young adulthood is a critical developmental stage. College represents more than academics. Further it can symbolizes independence, future career goals, social belonging, and personal growth.
When cognitive-communication challenges are left untreated, students may:
Withdraw from classes
Lose scholarships
Experience anxiety or depression
Question their intelligence or identity
With skilled, individualized therapy, students can:
Return to coursework (gradually)
Strengthen executive functioning
Improve academic performance
Restore confidence
Thrive, not just survive!
A Personal Reflection from ASHA 2025
Presenting at ASHA in Washington, DC was a meaningful milestone in my professional journey. Sharing this work with colleagues from across the country reinforced something I deeply believe:
Cognitive-communication therapy for young adults is essential.
As clinicians, we must move beyond non dynamic tasks and fully embrace functional, academic reintegration. We should consider the lived experience of our clients, which might include the exhaustion, the fear of falling behind, the comparison to peers, and the quiet grief of “before.” Through all the vulnerabilities, working with this population I am confident that I also witness resilience.
Every time a client independently manages a semester, advocates for accommodations, or earns a passing grade after thinking they couldn’t; we see the power of targeted intervention.
Moving Forward
At The Rose Speech Therapy Group, I remain committed to serving adolescents and young adults with cognitive-communication challenges through highly functional, individualized care. Whether returning to high school, college, or graduate programs, these students deserve therapy that meets them where they are. Most importantly, I strive to help them move forward with confidence.
—
Jacquelyn Nardelli, M.S., CCC-SLP
Owner, The Rose Speech Therapy Group
ASHA Convention Presenter – Washington, DC (November 2025)
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