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Effective workplace communication with employees with acquired brain injury


Talking about quality and quantity

The complex nature of the impact of ABI may mean that the employee needs assistance to meet the quality and productivity standards consistently.

Disability employment services must operate as businesses and compete with other businesses to make revenues so they can employ and pay their workers. To do this, they must set and achieve productivity targets and ensure the quality of their goods and services.

All employees need to know that they have a responsibility to:


Quality means that the product, service, process or outcome meets the standard set or expected by the user or consumer. When you are communicating with employees with an ABI about the abstract concept 'quality':


Similarly, we can assist employees understand productivity requirements by bringing the abstract 'quantity' down to the simpler and more concrete 'how much' or 'how many'.

Cognitive problems resulting from a brain injury may make it very difficult for the employee to process the information they need to understand and produce the required work outputs.

Some people with ABI also have difficulties with numeracy, or find it very hard to keep track of numbers going through. Again, your communication should:

The complex and individual nature of brain injury may mean that an employee can complete one task to the required standard and meet the productivity requirements, but cannot do so with another similar task.


Alex seems to be able to count and estimate numbers but has very limited attention and poor memory. He also behaves very impulsively, grabbing things from other people and getting angry and aggressive if he's thwarted in any way. Alex is constantly seeking attention, and very easily bored. He moves rapidly from one task to another, rarely completing anything.

Alex has no friends and although attempts have been made to engage him in activities with others, he becomes very anxious with other employees, often resorting to agitated pacing and muttered repetitions. He frequently misinterprets what supervisors say to him and any responses he makes are brief and often repeated over and over.

From Nathan's diary

We're having real trouble with the pastry shipments. Three pallets have gone out this week wrongly labelled and Falkners sent back two cartons they said were rejects. With so many employees off sick at the moment I'm having to get a lot more done by Carmen and Alex and I just can't rely on either of them. I had thought Alex had finally got it last week with the pallet stacking. He didn't make one mistake on Wednesday. This week there's been a complete mess. There's no excuse for it: he can count properly, he just won't pay attention. Too busy making mischief, if you ask me.

As for Carmen, she can't count but she should be able to tell if the pastry case is okay because she's got a sample right there beside her. She just has to match it and she's shown me that she can. I don't think she's really interested in her work at all.


  1. Observe and ask questions about the employee's task performance regularly. Focus on:

Alex, would you like to tell me how many boxes you are aiming to fill with pastry cases before lunch time?

Mal, which shelves will you need to put on the pallet first?

Carmen, do you remember how many boxes are supposed to be in each pile? … That's right, six. But there are only four boxes in this pile. What do you need to do to make this into a pile that has the right number of boxes?

  1. Check how the employee is interpreting the quality/quantity requirements by carefully observing their actions.
  2. At each stage of the task sequence, get feedback from the employee to determine how they are using the information.

How many have you cut now? How many do you need to cut to finish?

  1. Help the employee make comparisons.

Provide concrete cues that will allow the employee to see where they are in relation to the required standard. For example, devise some simple jigs that will enable, say, 20 documents to be counted out for collation and serve as a visual prompt for comparison.

  1. Assist memory function. Chunking is a good technique to assist the employee remember numbers.

Your line needs to do 266 of these – you were 26 on your last birthday and you have been at Merrinvale for 6 years.

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