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How can I help other team members understand how speech, language, and cognition contribute to communication difficulties in the inpatient setting?

Elizabeth K. Hanson, PhD, CCC-SLP, Joanne Lasker, PhD, CCC-SLP, Laura Ball, PhD, CCC-SLP

October 2, 2023

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Question

How can I help other team members understand how speech, language, and cognition contribute to communication difficulties in the inpatient setting?

Answer

Here are a couple of approaches.  One might work better than the other in your situation but don’t be afraid to use both or combine them to devise a third approach that works better for you!

  1. The first approach is the “in-service” method.  Offer to provide a short training session for staff (many organizations offer these in the form of “brown bags,” which occur during a lunch break).  Set the scene by describing a specific situation, such as a patient who comes in for an appointment and has trouble following directions.  Describe options for communication, such as writing down keywords or a couple of different options (Wood, Lasker, Siegel-Causey, Beukelman, & Ball, 1998) on a notepad or small whiteboard. Then, demonstrate a specific strategy, perhaps with someone in the audience.  You want to demonstrate how the strategy is worked into their typical communication exchange with the patient.

Cover in-service topics such as:

  • How to help patients communicate a variety of messages at crucial times.
  • Changes in status, context, topics, or partners 
  • Frustrations - need for persistence and patience.
  • Need to keep teaching new partners over time - as staff changes.
  • Something quick, efficient, and nonfatiguing, that won’t break down is needed.
  • There are challenges associated with patient access, awareness, and timing of interventions.
  1. The second approach involves building on what they’re already doing successfully.  For this you could start by asking the provider to give an example of when they get really frustrated with communication.  Then, ask them what they’ve tried and how well it worked.  Often, the best solutions are those that people develop in the moment.  You might need to encourage them to keep doing it.  You might also see a way to add to what they’re doing to make it more effective.

Also, if you can create communication opportunities that result in success for your co-workers and patients, there may be more buy-in regarding the resources and interventions you offer.  Successful communication is always the best reward, so if you can arrange for them to try out a strategy right away and be there when it happens to offer guidance, you can set them up for success, and that will engender more motivation to keep doing it.

If you want communication partners to use something, like a dry-erase board or notebook, try to have those tools available for them during the lesson and allow them to take it with them to use.  That will avoid the excuse that materials aren’t available when needed.

This Ask the Expert is an excerpt from the course, 20Q: Communication Strategies for Inpatients Who Can’t Talk, authored by Elizabeth K. Hanson, PhD, CCC-SLP, Joanne Lasker, PhD, CCC-SLP and Laura Ball, PhD, CCC-SLP.


elizabeth k hanson

Elizabeth K. Hanson, PhD, CCC-SLP

Elizabeth K. Hanson, Ph.D., CCC-SLP is an associate professor at the USD Department of Communication Disorders where she teaches graduate courses in AAC, Motor Speech Disorders, Research Methods, and Advanced Communication Science.  Her research interests include AAC and Motor Speech Disorders.  She earned her Ph.D. from the University of Nebraska – Lincoln, and her M.S. from the University of Wisconsin – Madison.  Dr. Hanson practiced as an augmentative communication specialist at the TRACE Center, an AAC clinic in Madison, Wisconsin, and as a clinical educator in AAC at the Speech-Language & Hearing Clinic, University of Nebraska-Lincoln.  


joanne lasker

Joanne Lasker, PhD, CCC-SLP

Joanne Lasker, Ph.D., CCC-SLP, focuses her teaching and research on augmentative and alternative communication (AAC) for adults living with acquired neurogenic disorders. She has published numerous papers and chapters related to the assessment and treatment of adults with acquired communication disorders who may benefit from augmentative and alternative communication techniques. Her current research focuses on selecting and creating low-tech and high-tech communication strategies for people living with aphasia. Joanne’s scholarship has appeared in widely read textbook chapters and refereed journals, including Augmentative and Alternative Communication, Journal of Medical Speech-Language Pathology, Clinical Aphasiology, and Perspectives of SIG 12: Augmentative and Alternative Communication. Joanne and her coauthor received the ASHA Leader Outstanding Contribution Award for Speech-Language Pathology, for their article entitled, "Aphasia and AAC: Enhancing communication across health care settings." Joanne has served as Chair of the Department of Communication Sciences and Disorders, the Graduate Program Director for the On-Campus Master’s Program, and the founding Graduate Program Director for the Speech@Emerson Online Master’s program. She is the recipient of the college-wide Spirit of Emerson Award and the Emerson College Alumni Award for Teaching Innovation.


laura ball

Laura Ball, PhD, CCC-SLP

Laura J Ball, PhD, is a retired Professor of Speech-Language Pathology. She currently facilitates AAC coursework at Emerson College and is active in several research projects focused on degenerative neurological conditions. Dr. Ball completed PhD research at the University of Nebraska-Lincoln, with focused interests in AAC and neuromotor speech disorders. She has over 40 years’ experience as a speech-language pathologist, working with persons with complex communication impairments and dysphagia. She has particular research interests in motor-based assessment and treatment and has authored numerous publications on AAC, dysarthria and apraxia.


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