In my last blog post, I talked about the difficulty some individuals who have had a stroke or TBI have accepting AAC.  This time, I’d like to look at the issue of acceptance from the perspective of family members.  For many individuals who have had a stroke or TBI, support from the communication partner is essential:  help is needed to  turn the device on, position it on the wheelchair or near the bed, update the content in the device, and support the individual as he/she learns to communicate.  Other individuals who have had a stroke or TBI might be more independent in operating their device but still might benefit from help to use it functionally.  This can be difficult if close family members or caregivers are not accepting of AAC.  Let’s look at why this might happen and steps we can take to facilitate acceptance:

1.  Lack of acceptance due to the grieving process:  It is natural for family members to grieve following a life changing injury or medical condition.  This grief process has multiple different stages and takes different amounts of time for different people.  Grief can make it difficult to make decisions—especially decisions that mean things won’t “go back to the way they used to be.”  We need to respect that grief is playing a role and provide extra time and support for family members.
2. Fear of technology:  Like individuals who have had a stroke or TBI themselves, spouses, parents, and other family members may also have a fear of technology.  If this is the case, it can be helpful to enlist the assistance of a younger family member who is very comfortable with technology.  The following can also be helpful:
   • Present the device using simple words rather than technical lingo.
   • Focus on simple (yet meaningful) content on the device rather than every feature.  Just because a device has lots of capabilities does not mean that all of them need to be introduced at one time.  A colleague of mine uses the example that most people have features on our personal computers, cell phones, or even alarm clocks that we don’t use.  Someone does not need to use ALL of the features of an AAC device to benefit from access to it. 
3. Lack of understanding of the purpose of AAC.  As we have talked about in the past on this blog, some family members might say “He can meet his basic needs already, why do I need AAC? Or “I understand what she wants… She doesn’t need AAC, right?”  It is likely that the individuals saying these things don’t yet understand the full benefit of using AAC.  Showing them videos of people who have had a stroke or TBI talking about what AAC does for them can help.  The videos at http://www.dynavoxtech.com/start/stroke/ and http://www.dynavoxtech.com/success/default.aspx can be helpful.
4. Lack of training:  In number 2 above I talked about presenting devices in a simple, easy manner.  Even so, there can still be a lack of comfort with something so new and different.  Providing training resources to family members can certainly help.   Local SLPs can certainly provide some of this training.  In addition, DynaVox provides live product trainings, web classes, and many online resources.  To get started with online resources, visit Communication Solutions for Stroke Survivors and the Aphasia and AAC  section of the Implementation Toolkit found on DynaVox Mayer-Johnson’s website.   If technology is truly a barrier, accessing online resources might be a challenge.  Involving that tech-savvy family member or SLP to print or show some resources can help! 

Taking the time to explore acceptance with family members can be a crucial step in the successful use of AAC by individuals who have had a stroke or TBI.  Hopefully these ideas will help!