Communication Alternatives

Common Communication Disorders

Aphasia

Aphasia is a language disorder caused by brain damage that affects the ability to understand or produce spoken or written language.

Dysarthria

Dysarthria is a motor speech disorder resulting from weakness or poor control of the muscles used for speech. It often leads to slurred, slow, or unclear speech.

Apraxia of Speech

Apraxia of speech is a motor planning disorder in which the brain has difficulty coordinating the movements needed for speech, even though the speech muscles themselves work normally.

The good news is that many effective communication options exist. The best approach depends on a person’s abilities, including their understanding, movement, vision, and cognitive skills.

Communication Options

1. Low-Tech, Pointing-Based Communication

Often the best and easiest place to start, these methods are quick to set up, reliable, and require little to no training.

• Yes/No systems: blinking, nodding, or thumbs up/down
• Word boards: common phrases such as “I’m tired” or “I’m cold”
• Writing or drawing: if a hand or adaptive grip can be used
• Pointing: to objects, photos, or printed choices

Start with a small set of 10 to 20 essential items and expand as needed.

Example of a Simple Yes/No System

• One tap = yes
• Two taps = no
• Pointing to body parts = location of pain

This approach is especially helpful when communication tools are not nearby.

2. Mid-Tech Tools

These options provide more flexibility while remaining relatively simple.

• Alphabet boards: pointing to letters to spell words
• Picture boards: selecting images for basic needs such as food, water, pain, bathroom, and emotions
• Dry-erase boards or notebooks: reusable for frequent communication

Generic picture boards can work, but personalized boards are far more effective. Consider including:

• Names of family members
• Favorite foods and drinks
• Daily routines
• Medical needs, including pain scale and symptoms

Printed photos can be used instead of symbols if they are easier to understand.

3. High-Tech Options: AAC

High-tech AAC, or augmentative and alternative communication, tools include tablets or smartphones with apps that produce spoken output when tapped.

• Proloquo2Go
• Lingraphica TalkPath
• TD Snap

These systems range from simple “tap-to-speak” buttons to advanced sentence-building tools.

Supportive Communication Techniques

Effective communication is not only about tools. It also depends on interaction style.

• Ask yes/no or choice-based questions, such as “Do you want tea or coffee?”
• Speak slowly and clearly, without sounding childish.
• Allow extra time to respond. Avoid rushing or finishing sentences.
• Use visual cues, such as pointing or showing objects.
• Confirm understanding, such as “You mean you’re tired, right?”

Professional Support

A speech-language pathologist, or SLP, can:

• Assess which skills are impaired
• Customize communication systems
• Train family members and caregivers

A speech therapist can determine whether the primary challenge is aphasia, apraxia of speech, or dysarthria. This distinction matters because it affects how complex and structured a communication system should be.

Design Tips for Communication Boards

• Use large targets, at least 1.75 to 2 inches.
• Place “HELP” in the top row.
• Limit choices to avoid overload.
• Put high-priority items in the top-left corner for quick access.
• Keep the layout consistent to support muscle memory.

What to Avoid

• Relying only on guessing needs, which quickly becomes frustrating.
• Rushing responses or assuming lack of understanding.

A Simple Setup You Can Use Immediately

Start with a single printed sheet that includes:

• YES / NO
• A pain scale using numbers or faces
• Icons for food, water, and bathroom

Add an alphabet board once the person is comfortable.

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