AAC and traumatic brain injury

Traumatic brain injury (TBI) is a term used to describe permanent or temporary brain damage caused by trauma to the head.  For example, people who have a TBI may have hit their head in a car accident, injured their head in a fall, or experienced brain damage from a firearm.  Some people who experience a TBI may have little or no speech. These difficulties may be long-term or can improve with time and rehabilitation.  AAC can be used to help them communicate.  AAC may also help people who have experienced TBI to understand their communication partners.

People who have a TBI can use a range of communication strategies.  For example they may use facial expression, body language, gesture, vocalisation, speech-attempts, communication displays, and/or voice output communication aids.

AAC and traumatic brain injury in the hospital

Following a TBI a person usually spends some time in a hospital.  AAC may be available in this setting so that the person can communicate his or her needs.  Basic communication aids covering needs such as food, drink, pain, comfort and medication are used. If the person has reading and spelling skills, simple strategies such as the use of a pen and paper, a white board and texta or a magna-doodle© board are often available.  AAC may also be used in a hospital to allow a person who has experienced a TBI to express his or her thoughts and emotions, as this can be a very difficult time for him or her.

AAC and traumatic brain injury in supported accomodation and day services

Some adults who have a TBI live independently or in the family home.  Others live in supported accommodation, such as community care facilities, nursing homes and hostels. These facilities provide long-term accommodation, and/or respite care.  People who have a TBI often use a range of communication strategies.  For example they may use facial expression, body language, gesture, voice, speech-attempts, communication boards, and/or voice output communication aids. 

When selecting or designing communication displays (eg. communication board, wallet, folder) and voice output communication aids, it is important to consider the person’s literacy skills.  Some adults who have a TBI have good literacy skills and may have communication aids and devices that use words and/or letters of the alphabet.  Others are not literate and may use photographs and/or line drawings on their communication aids.  

AAC and traumatic brain injury at home

In general, AAC use for people who have a TBI is likely to be less formal within the home.  Members of a person’s family are often the most familiar with his or her unique communication behaviours.  Communication at home often depends on the intimate knowledge of who the person was prior to the TBI. The person’s spouse or living companion may become the person’s primary communication partner.

The National Relay Service (NRS) provides telephone support to individuals who have complex communication needs and their communication partners. There are two different ways that the NRS provides help. Firstly, people with speech that is difficult to understand can speak to the operator at NRS who will interpret what is said and repeat the message to the listener. Secondly, a person with complex communication needs may use a telephone typewriter (TTY). This is a keyboard attached to a telephone, which is used by the person to type their message. The message is received by the relay officer who reads it aloud to the listener. In both situations the listener uses speech to respond.

Personal response systems are small personal alarms, which may be worn around the neck, on the wrist, or on a key-ring.  They allow people who have complex communication needs to access help in an emergency situation.

AAC and traumatic brain injury in the workplace

Many adults who have a TBI are able to return to the workforce.  Some of these people may use AAC strategies within the workplace.  AAC strategies may be unaided (eg. facial expression, gesture) or aided (eg. communication display or voice output communication aid).  When someone uses AAC as their main form of communication in a workplace, the other staff at the workplace need to become familiar with the AAC strategies used.  When selecting and designing an AAC aid or device for use in the workplace it is important to include the specific vocabulary that is related to the job, as well as vocabulary for social interaction and daily needs. The AAC aid or device chosen should be easy to use and match the person’s physical skills.