Use of Augmentative and Alternative Communication (AAC) in the Intensive Care Unit: a Scoping Review

Rurin Masruroh, Yanny Trisyani, Etika Emaliyawati

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ABSTRACT

 

Patients in the Intensive Care Unit (ICU) often experience limitations in verbal communication due to ventilator use, sedation, or other medical conditions. These communication barriers can interfere with the delivery of medical information and affect the quality of patient care. Augmentative and Alternative Communication (AAC) is a potential solution to improve interactions between patients, healthcare providers, and families in the ICU environment. This review aimed to explore the implementation of AAC in the ICU, including its effectiveness, challenges, and impact on the quality of communication and patient care. This study used a scoping review approach following the PRISMA-ScR guidelines. A literature search was conducted through the EBSCOhost Medline, PubMed, and Google Scholar databases, using relevant keywords related to AAC and ICU. Studies that met the inclusion criteria were analyzed thematically to identify key findings. Of the 386 articles identified, 11 articles met the criteria for further analysis. The results showed that implementing AAC in the ICU can improve communication between patients and healthcare providers, reduce patient anxiety, and strengthen the therapeutic relationship. However, there are obstacles to its implementation, such as a lack of training for healthcare providers, time constraints, and a lack of institutional policies that support the systematic use of AAC. Despite the challenges in implementing AAC in the ICU, this technology has great potential to improve patient communication and quality of care. Therefore, a more comprehensive strategy is needed, including training health workers, developing institutional policies, and procuring communication devices that are appropriate to patient needs to support optimal implementation of AAC in the ICU.

 

Keywords: Augmentative and Alternative Communication, ICU, Communication, Critical Care, Scoping Review.


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Al-Yahyai, A. N. S., Arulappan, J., Matua, G. A., Al-Ghafri, S. M., Al-Sarakhi, S. H., Al-Rahbi, K. K. S., & Jayapal, S. K. (2021). Communicating to Non-Speaking Critically Ill Patients: Augmentative and Alternative Communication Technique as an Essential Strategy. SAGE Open Nursing, 7. https://doi.org/10.1177/23779608211015234

Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020). Implications of Language Barriers for Healthcare: A Systematic Review. Oman Medical Journal, 35(2), e122. https://doi.org/10.5001/omj.2020.40

Alzrayer, N. M., Banda, D. R., & Koul, R. (2017). Teaching children with autism spectrum disorder and other developmental disabilities to perform multistep requesting using an iPad. Augmentative and Alternative Communication, 33. https://doi.org/10.1080/07434618.2017.1306881

Astuti, N. L. S., Setiyarini, S., & Rahmat, I. (2023). The Effect of Augmentative Alternative Communication on Anxiety in Patients under Mechanical Ventilators in the Intensive Care Unit: Pilot Study. Journal of Health Science and Medical Research, 41(6), 1–11. https://doi.org/10.31584/jhsmr.2023967

Aydin, O., & Diken, I. H. (2020). Studies comparing augmentative and alternative communication systems (AAC) applications for individuals with autism spectrum disorder: A systematic review and meta-analysis. Education and Training in Autism and Developmental Disabilities, 55.

Broyles, L., Tate, J., & Happ, M. B. (2012). Use of Augmentative and Assistive Communication Strategies by Family Members in the ICU. America Journal Critical Care, 21(2), 21–32. https://doi.org/10.4037/ajcc2012752.Use

Freeman-Sanderson, A., Istanboulian, L., & Rose, L. (2025). Communication with the critically ill patient: A nexus between patient needs, communication partner skills and the ICU environment. Intensive and Critical Care Nursing, 88, 103962. https://doi.org/https://doi.org/10.1016/j.iccn.2025.103962

Hagens, P., Pieterse, M., van der Valk, P., & van der Palen, J. (2017). Effectiveness of intensive smoking reduction counselling plus combination nicotine replacement therapy in promoting long-term abstinence in patients with chronic obstructive pulmonary disease not ready to quit smoking: Protocol of the REDUQ trial. Contemporary Clinical Trials Communications, 8, 248–257. https://doi.org/https://doi.org/10.1016/j.conctc.2017.08.014

Handberg, C., & Voss, A. K. (2018). Implementing augmentative and alternative communication in critical care settings: Perspectives of healthcare professionals. Journal of Clinical Nursing, 27(1–2), 102–114. https://doi.org/10.1111/jocn.13851

Holm, A., Karlsson, V., & Dreyer, P. (2021). Nurses’ experiences of serving as a communication guide and supporting the implementation of a communication intervention in the intensive care unit. International Journal of Qualitative Studies on Health and Well-Being, 16(1). https://doi.org/10.1080/17482631.2021.1971598

Huang, L., Chen, S.-H. K., Xu, S., Wang, Y., Jin, X., Wan, P., Sun, J., Tao, J., Zhang, S., Zhang, G., & Shan, C. (2021). Augmentative and alternative communication intervention for in-patient individuals with post-stroke aphasia: study protocol of a parallel-group, pragmatic randomized controlled trial. Trials, 22(1), 837. https://doi.org/10.1186/s13063-021-05799-0

Karlsen, M.-M. W., Holm, A., Kvande, M. E., Dreyer, P., Tate, J. A., Heyn, L. G., & Happ, M. B. (2023). Communication with mechanically ventilated patients in intensive care units: A concept analysis. Journal of Advanced Nursing, 79(2), 563–580. https://doi.org/10.1111/jan.15501

Karmakar, M. (2024). Communication Methods Used with Conscious Intubated Patients : Scoping Review. 1–11. https://doi.org/10.2174/0118744346349706241112070527

Kent-Walsh, J., & Binger, C. (2018). Methodological advances, opportunities, and challenges in AAC research. Augmentative and Alternative Communication, 34. https://doi.org/10.1080/07434618.2018.1456560

Kent-Walsh, J., Murza, K. A., Malani, M. D., & Binger, C. (2015). Effects of communication partner instruction on the communication of individuals using AAC: A meta-analysis. AAC: Augmentative & Alternative Communication, 31. https://doi.org/10.3109/07434618.2015.1052153

Khan, U., Menezes, C. N., & Govind, N. (2021). Patterns and outcomes of admissions to the medical acute care unit of a tertiary teaching hospital in South Africa. African Journal of Emergency Medicine, 11(1), 26–30. https://doi.org/https://doi.org/10.1016/j.afjem.2020.11.006

Kulkarni, S. S., & Parmar, J. (2017). Culturally and linguistically diverse student and family perspectives of AAC. Augmentative and Alternative Communication, 33. https://doi.org/10.1080/07434618.2017.1346706

Kuruppu, N. R., Tobiano, G., Ranse, K., Abayadeera, A., & Chaboyer, W. (2024). Facilitators, barriers and acceptability of implementing a communication board in Sri Lankan intensive care units: A qualitative descriptive study. Intensive and Critical Care Nursing, 83, 103708. https://doi.org/https://doi.org/10.1016/j.iccn.2024.103708

Kyranou, M., Cheta, C., & Pampoulou, E. (2022). Communicating with mechanically ventilated patients who are awake. A qualitative study on the experience of critical care nurses in Cyprus during the COVID-19 pandemic. PLoS ONE, 17(12 December), 1–20. https://doi.org/10.1371/journal.pone.0278195

Light, J., & McNaughton, D. (2012). The changing face of augmentative and alternative communication: past, present, and future challenges. Augment. Altern. Commun., 28. https://doi.org/10.3109/07434618.2012.737024

McNaughton, D., Light, J., Beukelman, D. R., Klein, C., Nieder, D., & Nazareth, G. (2019). Building capacity in AAC: A person-centered approach to supporting participation by people with complex communication needs. Augmentative and Alternative Communication, 35. https://doi.org/10.1080/07434618.2018.1556731

Momennasab, M., Mohammadi, F., DehghanRad, F., & Jaberi, A. (2023). Evaluation of the effectiveness of a training programme for nurses regarding augmentative and alternative communication with intubated patients using Kirkpatrick’s model: A pilot study. Nursing Open, 10(5), 2895–2903. https://doi.org/10.1002/nop2.1531

Muradov, O., Petrovskaya, O., & Papathanassoglou, E. (2021). Effectiveness of cognitive interventions on cognitive outcomes of adult intensive care unit survivors: a scoping review. Aust Crit Care, 34. https://doi.org/10.1016/j.aucc.2020.11.001

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. The BMJ, 372, 1–11. https://doi.org/10.1136/bmj.n71

Patak, L., Gawlinski, A., Fung, N. I., Doering, L., Berg, J., & Henneman, E. A. (2006). Communication boards in critical care: patients’ views. Applied Nursing Research, 19(4), 182–190. https://doi.org/10.1016/j.apnr.2005.09.006

Quinn, E., Kaiser, A., & Ledford, J. (2020). Teaching preschoolers with Down syndrome using augmentative and alternative communication modeling during small group dialogic reading. Am J Speech Lang Pathol, 29. https://doi.org/10.1044/2019_AJSLP-19-0017

Rahimi, S. A., Dery, J., Lamontagne, M.-E., Jamshidi, A., Lacroix, E., Ruiz, A., Ait-Kadi, D., & Routhier, F. (2022). Prioritization of patients access to outpatient augmentative and alternative communication services in Quebec: a decision tool . Disability and Rehabilitation: Assistive Technology, 17(1), 8–15. https://doi.org/10.1080/17483107.2020.1751314

Sayde, G. E., Stefanescu, A., Conrad, E., Nielsen, N., & Hammer, R. (2020). Implementing an intensive care unit (ICU) diary program at a large academic medical center: Results from a randomized control trial evaluating psychological morbidity associated with critical illness. General Hospital Psychiatry, 66, 96–102. https://doi.org/10.1016/j.genhosppsych.2020.06.017

Sigafoos, J., Roche, L., & Tait, K. (2021). Challenges in providing AAC intervention to people with profound intellectual and multiple disabilities BT - Augmentative and alternative 76. Communication: challenges and solutions (B. Ogletree (ed.)). Plural Publishing Inc.

Sii, S., & Swann, D. (2015). Communication With Ventilated Patients In ICU: Perceptions On Existing Communication Methods And Needs. Res Medica, 23(1), 2. https://doi.org/10.2218/resmedica.v23i1.1216

Singh, S. J., Diong, Z. Z., & Kamal, R. M. (2020). Malaysian teachers’ experience using augmentative and alternative communication with students. Augmentative & Alternative Communication, 36. https://doi.org/10.1080/07434618.2020.1785547

Syriopoulou-Delli, C. K., & Eleni, G. (2022). Effectiveness of Different Types of Augmentative and Alternative Communication (AAC) in Improving Communication Skills and in Enhancing the Vocabulary of Children with ASD: a Review. Review Journal of Autism and Developmental Disorders, 9(4), 493–506. https://doi.org/10.1007/s40489-021-00269-4

Tönsing, K. M., & Soto, G. (2020). Multilingualism and augmentative and alternative communication: examining language ideology and resulting practices. Augmentative and Alternative Communication, 36(3), 190–201. https://doi.org/10.1080/07434618.2020.1811761

Wang, M., Muthu, B., & Sivaparthipan, C. B. (2022). Smart assistance to dyslexia students using artificial intelligence based augmentative alternative communication. International Journal of Speech Technology, 25(2), 343–353. https://doi.org/10.1007/s10772-021-09921-0

Waydhas, C., Ull, C., Cruciger, O., Hamsen, U., Schildhauer, T. A., Gaschler, R., & Weckwerth, C. (2024). Behavioral pain scale may not be reliable in awake non-verbal intensive care patients: a case control study. BMC Anesthesiology, 24(1), 84. https://doi.org/10.1186/s12871-024-02472-2




DOI: https://doi.org/10.33024/mahesa.v5i12.19990

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