A member of my family, I’ll call him Jonas, recently had a stroke.  While he is still able to communicate verbally, he does experience difficulty with vision, memory, word finding, use of his right hand, and mobility.  As a result, Jonas has not been able to take care of all of the everyday things that have been his responsibility for many years.  While I think I would love never having to deal with cleaning and cooking againJ, Jonas really did miss his roles.  Mainly, he missed his ability to manage the finances.  Over time, his frustration grew and began to impact his interaction with other family members.  Jonas began to exhibit resentment and even distrust of those who were managing the finances.  

Think for a minute about your everyday roles.  Which ones would you miss if you weren’t able to do them?  Be honest; even if I wouldn’t miss cleaning I would certainly want to be able to tell someone else EXACTLY how I wanted the cleaning done! 

Now think about the individuals you know who have had a stroke or a TBI and are no longer able to either maintain their everyday roles or tell someone else what they would like to have done.  Can you imagine how frustrating that would be?

As you program communication devices or create communication boards it will be important to provide vocabulary related to everyday roles and responsibilities like finances, home repairs, keeping the social calendar, maintaining the car, setting up appointments for the doctor or hairdresser, decorating for holidays, and many other things.  In fact, understanding that a communication device can serve these purposes may even help it to be accepted more readily. 

Consider the following types of vocabulary:

•  Messages to express feelings about not being able to activity maintain their everyday roles, like “I’m frustrated” and “This is hard” and “I wish I could….”  Sometimes being able to talk about feelings, rather than keeping them inside, is helpful.
• Messages to ask questions about important activities or events like, “Did you make my hair appointment?” or “What is our balance today?”
• Messages to give directions to others, like “Move that over there” or “Please take the car in for an oil change.”
• Message to provide feedback to whoever is performing the activity.  Being able to say “I would like you do wash the floor differently” is just as important as saying “I really appreciate how you mow the lawn for me.”
• Vocabulary related to the key words or ideas related to an activity, like “bills,” “account,” and “investment” for finances or “color,” “cut,” or “curl,” for talking about the hair salon.  Even if their participation is limited, having access to a few key words can help.
• Vocabulary that expresses opinions, like “I like it” or “It looks good” or even just “good” and “not good.”  These messages will allow for participation in discussions even if the individual isn’t able to access more specific words. 

One resource I like to provide guidance related to vocabulary for adults who are using AAC is a book called “See What We Say:  Situational Vocabulary for Adults who use Augmentative and Alternative Communication by Barbara Collier (http://www.accpc.ca/Product-See_What_We_Say.htm).  It provides lists of possible vocabulary items that would allow individuals to maintain many everyday roles.  If you are using a DynaVox V, Vmax, or Xpress, you also have vocabulary (or places to put vocabulary) in many of the categories above.  Take the time to explore your device before you add any new messages!