Affiliations: Department of Otolaryngology and Center for
Communication Enhancement, Augmentative Communication Program, Children's
Hospital Boston, Boston, MA, USA | Department of Anesthesiology, University of Michigan
Health Systems, USA
Note: [] Corresponding author: John M. Costello, M.A., CCC-SLP,
Department of Otolaryngology and Center for Communication Enhancement,
Augmentative Communication Program, Children's Hospital Boston, 300 Longwood
Avenue, Boston, MA 02115, USA. Tel.: +1 781 216 2220; Fax: +1 781 216 2252;
E-mail: [email protected]
Abstract: Children in pediatric intensive care units (PICUs) may experience a
broad range of motor, sensory, cognitive, and linguistic difficulties that make
it difficult for them to communicate effectively. Being unable to communicate
is emotionally frightening for children and can lead to an increase in sentinel
events, medical errors and extended lengths of stay. Implementation of
augmentative and alternative communication (AAC) tools and strategies can
address the communication needs of children in the PICU by enabling them to
communicate their wants, needs and feelings to healthcare providers and family
members and participate in their own care more productively. Hospitals around the world are increasingly recognizing and
addressing patients' needs for communication access and have begun to implement
communication screenings and assessments and interventions at admission and
throughout the hospital stay. New standards for all American hospitals, in
fact, mandate efforts to improve patient communication. When patient-provider
communication improves, treatment success goes up, hospital-caused errors
decrease and patient and family satisfaction improve. This article describes
three phases of intervention for communication vulnerable children in the PICU
and provides examples of treatment approaches that ensure communication access
as their medical condition changes.
Keywords: Children, augmentative and alternative communication, AAC, communication, assistive technology, pediatric intensive care unit, pediatric, hospital, communication vulnerable, sentinel events
