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Light Technology Augmentative Communication for Acute Care and Rehab Settings (summary)

Low
technology
AAC
after
stroke

Background

Therapists working in hospital settings with patients who have recently had a stroke try both to improve the patient's ability to communicate functionally and to give strategies to help compensate for communication difficulties that might remain.

Families often prefer to work on techniques to improve function rather than to compensate for a lack of it, but this can have a negative effect on the patient's participation in their own rehabilitation. There is some evidence that people who used a voice output device in hospital had more positive views of their care.

What did the authors do?

The author focusses on the use of light-tech communication systems for people with aphasia who were in the early stages of recovery. That is paper-based and battery operated systems which are generally able to be provided more quickly and easily than more complex devices.

The paper reports on several systems and considers there benefits and disadvantages for people who have aphasia.

The need for individualisation of resources is stressed throughout, in terms of the layout of systems, the use of symbols versus pictures/photographs and the choice of vocabulary. The benefits of a multidisciplinary approach closely involving the patient and their family is emphasised.

The author considers communication boards, which might have pictures or symbols, and suggests that using these with eye-gaze can be successful if the patient has difficulty using their arms or hands to make selections, provided any visual problems are also considered.

She mentions simple voice output devices, to attract attention to the use of a communication board or for use alongside it, and briefly discusses the use of auditory scanning, either built in to a voice output system or used with a communication partner. There is also some discussion of the use of written choices.

Throughout the article the importance of training family members in the use of appropriate compensatory strategies is emphasised, particularly with regard to discharge from hospital, to ensure that the home environment is 'communication friendly'.

Cautions

This is not a piece of research, but a paper based largely on the author's own experience. It contains several practical ideas which others might find useful.

Conclusions

The use of compensatory communication strategies is very useful and important for many people with aphasia after a stroke. AAC should be part of the rehabilitation process from the beginning and needs to be individualised for each person.


Things you may want to look into:

Bill's experiences after a stroke

Communication difficulties 

The effect of remnant and pictographic books on the communicative interaction of individuals with global Aphasia

Weblinks - aphasia / stroke

Factsheet - What is Aphasia?

Added to site September 2014


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