Aphasia is common after a stroke. Across studies, about a third of people who have a stroke have aphasia in the early weeks,1 and about 2 million people in the United States are living with it.2 Slurred speech, called dysarthria, is even more common after some strokes.3
AAC (augmentative and alternative communication) means any way of communicating that adds to or stands in for speech. For someone after a stroke, it can be as simple as pointing to "yes" or a picture of a cup, or as full as typing a sentence that's spoken aloud.
Aphasia and slurred speech need different help
- AphasiaA person with aphasia may know what they mean but can't find the word, says a different word, or can't follow long sentences. Reading and writing are often affected too, so typing may be hard. Pictures, short saved phrases and yes/no choices are options when typing is hard.
- Dysarthria (slurred speech)Weak or uncoordinated muscles make speech slurred or quiet. If reading and spelling are unaffected, typing with word prediction can be quick.
Studies of tablet-based AAC for people with aphasia are small and varied, but together they suggest these devices can help people communicate.4 AAC can be used during speech therapy as well as after it.5
How Dawn can help
- Fixed word positionsCommon words like I, want, help, no and more stay in the same cells as more words are added. You can start with fewer words shown.
- Saved phrases"I know what I want to say, give me a moment." "Please ask me yes or no questions." "I'm in pain." One tap each.
- Personal photos as buttonsIf symbols are hard to recognize, use photos of familiar people and places, like a grandchild.
- Write it by handSome people can write a word they can't say. The whiteboard reads handwriting aloud.
- Typing with word predictionA large keyboard with word prediction, for people with dysarthria or as spelling returns.
For partners and carers
Things that help: slow down, keep sentences short, ask one question at a time, and give plenty of time for an answer. Offering choices ("tea or coffee?") is easier than an open question. Our guide on talking with someone who uses AAC has more.
When you set up the app, choose words and phrases from their real life: family names, favourite foods, the things they'd want to tell a nurse. If you point to a word on the board as you say it, they see where words are and how the board is used.
A speech and language therapist can assess the person's language and help decide which words and phrases to put on the board. If you don't have one yet, ask the stroke team for a referral.