March is Brain Injury Awareness Month. According to the Brain Injury Association of America, at least 5.3 million Americans live with a TBI-related disability, which is one in every 60 people. Individuals with acquired brain injury (ABI) can benefit from both low-tech and high-tech AAC for communication impairments (Oslund, 2017).
Every 9 seconds someone in the United States sustains a brain injury (Brain Injury Association of America, n.d.). An acquired brain injury (ABI) is an injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma while a traumatic brain injury (TBI) is a type of ABI in which there is trauma to the brain from an external force (Brain Injury Association of America, n.d.). Individuals with an ABI are candidates for AAC, however their AAC needs are unique as their communication changes over the course of their recovery (Wallace, 2010) and their AAC needs depend on the severity of their brain injury.
There are various modes of AAC that can be utilized by individuals with TBI. Topic supplementation has been found to increase word intelligibility by an average of 28% and sentence intelligibility by 10.7% in those with dysarthria (Hanson et al., 2004, 2013) while alphabet supplementation increased single-word intelligibility by 10% and sentence intelligibility by 25.5% (Hanson et al., 2004). Topic and alphabet supplementation can be completed using low-tech communication boards. Low-tech communication boards can be utilized across environments, such as in acute care or in-patient rehabilitation, for communicating simple wants and needs. Check out our Member Resource content Member Area | Forbes AAC | Augmentative Communication for access to several low-tech core boards and a low-tech medical keyboard.
Those with a moderate to severe TBI may present with significant and long-term impairment with their functional communication due to cognitive, linguistic, and motor deficits (Thiessen et al., 2019). There is limited empirical research characterizing communication changes in those with TBI who rely on AAC even though many present with acquired aphasia (Sarno et al., 1986), dysarthria (Yorkston et al., 1989), and cognitive-linguistic impairment (Beukelman & Light, 2020). Long-term impairment may require more robust system that a high-tech speech-generating device (SGD) can offer. For those who are ambulatory, our ProSlate 4 may be a good fit for them as it is our most portable device and is perfect for on the go communication.
Beukelman, D. R., & Light, J. (2020). Augmentative and alternative communication: Supporting children and adults with complex communication needs (5th ed.). Brookes.
Brain Injury Association of America (n.d.). Brain Injury Facts & Statistics. Retrieved March 11, 2022, from https://www.biausa.org/wp-content/uploads/MTMBI-Fact-Sheet-2021-Revised.pdf
Hanson, E. K., Beukelman, D. R., & Yorkston, K. M. (2013). Communication support through multimodal supplementation: A scoping review. Augmentative and Alternative Communication, 29(4), 310-321. https://doi.org/10.3109/07434618.2013.848934
Hanson, E. K., Yorkston, K. M., & Beukelman, D. R. (2004). Speech supplementation techniques for dysarthria: A systematic review. Journal of Medical Speech-Language Pathology, 12(2), 9-29.
Osmund, M. (2017). Tips on AAC Systems for Clients with Acquired Brain Injury. ASHA Leader Live.
Sarno, M. T., Buonaguro, A., & Levita, E. (1986). Characteristics of verbal impairment in closed head injured patients. Archives of Physical Medicine and Rehabilitation, 67, 400–405.
Thiessen, A., Brown, J., Freeland, T., & Brewer, C. H. (2019). Identification and expression of themes depicted in visual scene and grid displays by adults with traumatic brain injury. American Journal of Speech-Language Pathology, 28(2), 664–675. https://doi.org/10.1044/2018_AJSLP-18-0086
Wallace, S. E. (2010). AAC use by people with TBI: Affects of cognitive impairments. SIG 12 Perspectives on Augmentative and Alternative Communication, 19, 79–86.
Yorkston, K. M., Honsinger, M. J., Mitsuda, P. M., & Hammen, V. (1989). The relationship between speech and swallowing disorders in head-injured patients. The Journal of Head Trauma Rehabilitation, 4(4), 1–16. https://doi.org/10.1097/00001199-198912000-00005
Katie Threlkeld, M.S., CCC-SLP is a Doctoral Candidate at the University of Missouri and the Educational Program Developer at Forbes AAC. She has over 8 years of experience in AT and AAC assessment and treatment across the lifespan. Her goal is to provide all AAC users and those around them with evidence-based information for best practice in AAC.