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Our selection of medical literature on Augmentative and Alternative Communication, the field in which the DICo® device has been implemented.
High-Tech Augmentative and Alternative Communication in a Burn Patient With Voicelessness: A Case Study
Nursing in Critical Care, 2026; 31:e70496
This case study describes the use of a high-tech AAC system based on a motion sensor in an adolescent with second- and third-degree burns covering 60% of the total body surface area, requiring both invasive and non-invasive mechanical ventilation. Due to injuries to their hands and neuromuscular weakness, the patient was unable to use conventional low- or high-tech AAC devices.
The use of the motion-sensor-based AAC system enabled the patient to communicate specific needs and formulate complex sentences, facilitating individualised nursing care. The patient and family reported high satisfaction with the quality of care, while nurses noted a positive impact on the care relationship without increasing their workload.
https://doi.org/10.1111/nicc.70496
Communicating to Non-Speaking Critically ill Patients: Augmentative and Alternative Communication Technique as an Essential Strategy
SAGE Open Nursing Volume 7: 1–9
The study reported that the nurses used variety of communication strategies while communicating to nonspeaking critically ill patients. However very few nurses used Augmentative and alternative communication strategies to communicate to non-speaking critically ill patients. The study recommends the importance of establishing Augmentative and Alternative Communication strategies in the hospitals.
https://journals.sagepub.com/doi/10.1177/23779608211015234
Strategies for communicating with conscious mechanically ventilated critically ill patients
Baylor University Medical Center Proceedings, 2019; 32(4): 534–537
Critically ill patients admitted to the intensive care unit (ICU) frequently require ventilatory support. To provide this life-saving therapy, oral intubation or tracheostomy placements are needed. Consequently, verbal ability to communicate is lost. Furthermore, depending on the severity of the clinical condition and other comorbidities, patients commonly develop ICU-acquired weakness, which may preclude gestural communication and motor abilities. Under this circumstance, the patient’s inability to interact with health care providers and/or family members results in psychological alterations, as well as isolation and reduction of self esteem.
A variety of tools have been developed to improve patient-clinician communication. This article reviews patient complications due to lack of communication, available tools to enhance interactions, and current published evidence to support communication tools.
https://doi.org/10.1080/08998280.2019.1635413
A systematic review on voiceless patients’ willingness to adopt high-technology augmentative and alternative communication in intensive care units
Intensive & Critical Care Nursing 63 (2021) 102948
Although the existing evidence is limited, voiceless patients regard high-tech AAC devices as a useful, reliable, and acceptable alternative communication choice in the ICU. Multicenter, large-sample, and high-quality studies are highly recommended in the future.
https://doi.org/10.1016/j.iccn.2020.102948
Outcome measurement tools for communication, voice and speech intelligibility in the ICU and their clinimetric properties: A systematic review
Journal of the Intensive Care Society
There is a relatively small number of studies which have established clinimetric properties for outcome measurement tools that evaluate communication, voice and/or speech intelligibility, and a fewer number which have done so in the mechanically ventilated ICU population.
https://journals.sagepub.com/doi/10.1177/1751143720963757
Patients’ statements and experiences concerning receiving mechanical ventilation: a prospective video-recorded study
Nursing Inquiry 2012; 19(3): 247–258
The patients experienced almost constant difficulties in breathing and lost their voice. The most common types of communication techniques patients used were nodding or shaking the head. Their expressions were interpreted as stiffened facial expression, tense body position and feelings of sadness and sorrow. Nursing care for patients’ conscious during MVT is challenging as it creates new demands regarding the content of the care provided. In caring for patients undergoing MVT while conscious, establishing a caring relationship, making patients feel safe and helping them to communicate seem to be most important for alleviating discomfort and instilling hope.
https://onlinelibrary.wiley.com/doi/10.1111/j.1440-1800.2011.00576.x
The Effect of Using Communication Boards on Ease of Communication and Anxiety in Mechanically Ventilated Conscious Patients Admitted to Intensive Care Units
J Nursing Midwifery Res 2018;23:358-62.
The results showed that the use of the communication board is possible in mechanically ventilated conscious patients and may contribute to ease of communication and decrease patients’ anxiety during mechanical ventilation.
https://doi.org/10.4103/ijnmr.ijnmr_68_17
A systematic review of the effectiveness of nurse communication with patients with complex communication needs with a focus on the use of augmentative and alternative communication
Journal of Clinical Nursing 17, 2102– 2115
Communication between nurses and patients is critical to providing and receiving quality care. Nurses and patients have reported concern and frustration when communication is not adequate. Using AAC strategies will help nurses and patients better communicate with each other when speech is not an option.