Impaired verbal Communication

Definition: Decreased, delayed, or absent ability to receive, process, transmit, and use a system of symbols


  • Decrease in circulation to brain, brain tumor
  • Anatomic deficit (e.g., cleft palate, alteration of the neurovascular visual system, auditory system, or phonatory apparatus)
  • Difference related to developmental age
  • Physical barrier (tracheostomy, intubation)
  • Environmental barriers
  • Cultural differences
  • other on the book...



  • [Reports of difficulty expressing self]


  • Unable to speak dominant language
  • Speaks or verbalizes with difficulty
  • Does not or cannot speak
  • Disorientation in the three spheres of time, space, person
  • Stuttering; slurring
  • Dyspnea
  • other on the book....

SAMPLE CLINICAL APPLICATIONS: brain injury/stroke, facial trauma, head/neck cancer,radical neck surgery/laryngectomy, cleft lip/palate, dementia, Tourette’s syndrome, autism, schizophrenia.


Sample NOC linkages:

  • Communication Ability: Ability to receive, interpret, and express spoken, written, and nonverbal messages.
  • Communication: Expressive Ability: Ability to express and interpret verbal and/or nonverbal messages

Client Will (Include Specific Time Frame)

  • Verbalize or indicate an understanding of the communication difficulty and plans for ways of handling.
  • Establish method of communication in which needs can be expressed.
  • other on the book....


Sample NIC linkages:

  • Communication Enhancement: Speech Deficit: Assistance in accepting and learning alternative methods for living with impaired speech
  • Communication Enhancement: Hearing Deficit: Assistance in accepting and learning alternative methods for living with diminished hearing
  • Active Listening: Attending closely to and attaching significance to a patient’s verbal and nonverbal messages

NURSING PRIORITY NO. 1. To assess causative/contributing factors:

  • Review results of diagnostic studies (e.g., speech/language and hearing evaluations, brain function studies, psychological evaluations) as needed to assess/delineate underlying conditionsaffecting verbal communication.
  • Note new onset or diagnosis of deficits that will progress/permanently affect speech.