Debunking Myths of Augmentative and Alternative Communication After Stroke
After a stroke, it's common for individuals to experience problems with speech and language. In these circumstances, Augmentative and Alternative Communication (AAC) can be a lifeline. However, many myths and misconceptions about AAC can get in the way of getting started. This article seeks to debunk these myths and shed light on how AAC can significantly improve the quality of life for stroke survivors.
Understanding Stroke and Its Impact on Communication
A stroke, also known as a cerebrovascular accident (CVA), is a sudden interruption of blood flow to the brain caused by a blood clot or a ruptured blood vessel. Depending on its severity and location, a stroke can lead to various physical and cognitive impairments, including speech and language difficulties. The ability to comprehend and formulate language may be significantly affected, leading to a condition known as aphasia.
Aphasia: A Common Outcome of Stroke
Aphasia is an acquired disorder that affects a person's ability to understand and produce language. It occurs as a result of brain damage, commonly due to a stroke. Aphasia can be different for everyone. People with fluent aphasia can produce words but struggle to make sense of them, while those with non-fluent aphasia can understand language but struggle to express themselves. Most people with aphasia experience difficulty in both understanding and producing language.
Augmentative and Alternative Communication (AAC): A Lifeline for Post-Stroke Communication
AAC is a range of communication methods that supplement or replace speech and writing. It goes beyond "talking boxes" and picture boards and encompasses a range of strategies that provide external support for people unable to understand or generate messages independently.
AAC strategies can be beneficial for individuals with severe aphasia, enabling them to communicate more effectively in different settings, including acute-care hospitals, rehabilitation centers, and at home. However, misconceptions about AAC can deter its adoption, leading to missed opportunities for improved communication and quality of life.
Myths Surrounding AAC
One common myth is that AAC is a last resort used only when all other communication strategies have failed. This notion can delay the introduction of AAC, denying individuals the opportunity to communicate effectively at the earliest possible time.
Another widespread myth is that using AAC will hinder or stop further speech recovery. This is not true! Research shows that AAC use can stimulate natural speech recovery rather than impeding it. AAC should not be viewed as giving up on speech recovery, but rather as a tool to practice functional communication while providing communication support.
AAC Strategies for Different Levels of Aphasia Severity
The application of AAC strategies can vary depending on the severity of aphasia:
For those with severe aphasia, partner-dependent conversation strategies can be used. Such strategies include Augmented Input, where communication partners supplement their spoken language with gestures, written key words, or drawings, and Written-Choice Conversation, where the person with aphasia communicates by pointing to written key-word choices related to a conversational topic.
For individuals with moderate aphasia, transitional communication strategies can be applied. These include stored message retrieval, where individuals learn to access a small selection of pre-stored messages, and the use of remnants or topic-setters to initiate a conversation.
For independent communicators with mild aphasia, more complex AAC strategies can be employed. These may include the use of sophisticated speech-generating devices (SGDs) or strategies that enable them to combine symbols, letters, stored messages, and other unaided communication modalities to convey their ideas effectively in various situations.