AAC after a brain injury

After a head injury, communication can change from week to week. Dawn has picture buttons, saved phrases and a keyboard; you choose what the person can use now and change it with the rehab team.

Dawn's symbol board on iPad with picture buttons for common words such as I, want, help, yes and no

Dawn speaks typed messages or chosen words during rehabilitation; it doesn't speed up recovery. A traumatic brain injury can affect communication in several ways. Some people can't find words, some have slurred speech, some lose track of a conversation or of what they were saying, and many tire very quickly.

Needs often change during recovery, so a setup that suited someone last month may be too simple or too complicated now.

Choosing a setup

A few large buttons. Yes, no, pain, tired, toilet and family names. Dawn's smaller grids have bigger buttons, and "Words to show" can start with only a few words. Showing more later puts new words in empty cells and leaves the rest where they are.

Saved phrases for things the person says every day.

Typing with word suggestions, for someone who can read and spell.

Review the setup with the rehab team when the person's needs change.

Dawn's Layout settings on iPad showing Words to show, Grid size and Button spacing
Words to show, grid size and button spacing are in Layout settings.

Tiredness

Talking takes a lot of energy after a brain injury. Put the most-needed messages in the Phrases tab so they take one tap. Turn on Lock Settings so the layout doesn't change by accident. Keep practice short.

Dawn's Phrases tab with buttons such as 'I need help please', 'I'm finished' and 'I want to be alone please'
The Phrases tab.

The rehab team

The speech and language therapist and occupational therapist on a rehab team can work out what the person needs now and how to set up the app. Bring the iPad or iPhone to sessions so they can adjust it.

Questions people ask

Is it too early for AAC while they're still recovering?

No. There are no skills a person has to show before AAC can be tried.1 Early on, a few big buttons for yes, no, pain and family names may be enough, and more can be added later.

Will using AAC slow down speech recovery?

AAC is normally used alongside rehabilitation. Ask the speech and language therapist on the rehab team how they'd like it used.

They get tired quickly. What helps?

Saved phrases and a few large buttons take less effort than typing. Short sessions usually work better than long ones. Lock Settings helps prevent accidental changes to the layout.

Can it be set up for memory problems too?

Personal photos work well as buttons, and saved phrases can hold things the person wants to say often. Dawn isn't a memory aid; an occupational therapist can suggest tools for that.

Sources

  1. American Speech-Language-Hearing Association. Augmentative and Alternative Communication (Practice Portal). www.asha.org/practice-portal/professional-issues/augmentative-and-alternative-communication

Try Dawn on iPhone or iPad

Symbols, typing and saved phrases, spoken in a natural voice. Dawn can also build a voice from about eight seconds of your own speech.

Requires iOS 17 or later.