Feedback on AAC intervention from adults who are temporarily unable to speak

Electronic voice-output communication aids for temporarily nonspeaking patients in a medical intensive care unit: a feasibility study

“…13,14,16 In fact, multimodal or combination solutions and customized AAC techniques have become the standard of care in AAC practice. 30 Dowden et al 13,14 found natural speaking approaches (writing, mouthing words, gesture) had best success rates of all types of AAC methods recommended for ICU patients.…”

“…15 Alphabet and picture boards were preferred over electronic devices by 4 of the 5 ICU survivors interviewed about their experiences with AAC in ICU. 16 VOCAs are a subset of AAC devices that produce prerecorded, digitized voice messages (recorded speech) or synthesized speech (computer-generated voice) when the communicator accesses specific locations on a dynamic display screen or membrane keyboard. Most electronic VOCAs can be pre-programmed with situationally-relevant whole messages, such as "I'm having pain," that are accessed via one location on the device display.…”

AAC intervention in the intensive care unit: The children's hospital Boston model

“…These interventions include alphabet and picture boards, Magic Slates © or felt-tip pens for written output, eye gaze displays, electrolarynges, small typing systems, and digitized recording systems (Dowden, Honsinger, & Beukelman, 1986;Fried-Oken et al, 1991;Mitsuda, Baarslag-Benson, Hazel, & Therriault, 1992). The success of such interventions may be compromised by patients' (a) inability to process information effectively because of their medical conditions and/or medications; (b) reduced motor and/or sensory status secondary to traction, edema, or the insertion of intravenous lines/tubes; (c) temporary lack of access to glasses or hearing aids; and/or (d) restricted mobility due to the temporary use of restraints that may be necessary during periods of sedation-induced confusion in order to guard against self-extubation or selfremoval of other supports.…”

“…The inability to communicate, no matter how temporary, has been identified as one of the most frustrating and stressful aspects of an intensive care unit (ICU) admission for patients who are temporarily unable to speak (Dowden, Honsinger, & Beukelman 1986;Fitch, 1987;Fried-Oken, Howard, & Stewart, 1991;Gries & Fernsler, 1988;Hafsteindóttir, 1996;Hudelson, 1977;Jablonski, 1995;Menzel, 1994;Stovsky, Rudy, & Dragonette, 1988;Villaire, 1995;Williams, 1992). This is no less the case when an ICU admission is planned because of a condition such as a disorder of the upper airway or ventilator dependency or because of the need for a surgical intervention such as maxillofacial/orofacial reconstruction, organ transplantation, or an oncology-related procedure.…”

Use of the quasi-experimental sequential cohort design in the Study of Patient–Nurse Effectiveness with Assisted Communication Strategies (SPEACS)

“…Patients report anxiety, panic, frustration and distress with the inability to communicate during mechanical ventilation in the ICU [5][6][7]. The literature suggests that provision of assistive and alternative communication (AAC) strategies as well as trained communication partners might improve patients' daily interactions and, by extension, clinical outcomes [7][8][9][10][11][12][13][14][15][16]. Critical care nurses, however, typically receive little or no training in the interpretation of nonvocal communication or in the assessment and application of AAC techniques [17,18].…”