Using AAC apps in the ICU
While most clinicians would consider recommending AAC apps or software for children whose speech or language needed support; or for adults with an acquired neurological condition, there are often more transient needs for AAC; where a person’s communication is temporarily impaired due to their medical condition. Intubation is just one example where AAC may provide temporary support for a person in an acute medical situation. The intubation may be secondary to major surgery or needed due to a compromised airway. Either way, intubation will likely inhibit vocalisation such that a person cannot talk. A simple letter board, whiteboard or boogie board can be quick ways to help the person communicate. A more comprehensive and audible option would be an AAC app, such as Predictable. This would allow the person to prepare messages for quick access as well as quickly type out messages to be spoken aloud. As fatigue or other difficulties may be present, the word prediction options would help speed up message generation and reduce effort. The key difference between high and low tech is that an AAC app would provide an audible synthetic voice for ICU staff and family to hear. This is important for alerting or getting attention; but also for participating more holistically in a conversation. There are cases for iPads which enable satisfactorily disinfecting the app for use in this medical setting. The app can also quickly be reset to factory settings once a person no longer needs the app so that the next patient can use it without set-up. Predictable now has head tracking on later versions of the iPad Pro - which opens up alternative access for patients with restricted limb movement. This access method is in addition to the use of switch access; where a whole range of switches can be used to control the app with minimal set-up.