How Speech Language Therapists Understand Communication: The Evidence-Based Models that Guide Our Work
As SLT’s we draw on several well‑established models to understand how communication works after brain injury. These frameworks highlight that communication is never just about words, it is shaped by cognitive skills, social understanding, emotional and sensory regulation, physical factors, the social context, and the environment around a person.
Cognitive Communication Competence (MacDonald, 2017)
Shows how communication relies on the integration of comprehension, expression, cognition, language, emotion, physical abilities and self‑regulation. It emphasises that successful communication varies across contexts such as home, community, education, work and problem‑solving.
- The Cup of Competence (Snow & Douglas, 2017)
Uses a simple analogy to explain pragmatic (social) communication. It illustrates how social‑environmental factors and individual psychological characteristics influence a person’s ability to use communication effectively in real‑world interactions. - The Social Communication (SoCom) Model (Wiseman‑Hakes et al., 2020)
Designed for paediatric brain injury, this model shows how language, cognition and social cognition interact like building blocks. It also highlights how internal factors (such as sex and gender) and external factors (such as culture and environment) shape social communication development. - The SoCIAL Framework (Keegan et al., 2025)
Focuses on the many personal, cognitive, emotional, physical and environmental influences that affect social communication competence. It provides a practical lens for understanding everyday communication challenges.
These models help SLTs look beyond surface‑level speech or language difficulties. They allow us to understand the whole person, their thinking skills, emotions, relationships, environment and daily demands so we can design rehabilitation that truly supports meaningful communication in real life.