Date of Award

January 2014

Degree Type

Open Access Thesis

Degree Name

Master of Arts (MA)


Special Education

First Advisor

Tamara B. Cranfill

Department Affiliation

Special Education


Current research is lacking on the frequency of augmentative and alternative communication (AAC) system use in intensive care units (ICU) and clinical decision making patterns. AAC is use of any alternative method of communication when oral communication cannot be achieved (ASHA, 2013). Patients in the ICU may become nonverbal for many reasons including tracheostomy, mechanical ventilation (McKinley, Pooke, & White, 2010) and intubation (Radtke, Bauman, Garrett, & Happ, 2011). Being nonverbal in the ICU may lead to poorer health outcomes (Patak, Wilson-Stronks, & Costello, 2009). AAC systems may improve outcomes by allowing patients to communicate more clearly with family, friends, and hospital staff. ICU patients communicate with nurses more than any other healthcare professional (Happ, Tuite, Dobbin, DiVirgilio-Thomas, & Kitutu, 2004). AAC systems are crucial for patient-nurse communication. Speech-language pathologists (SLPs) evaluate for and provide AAC systems to individuals across the lifespan and setting, including those in ICU.

Forty SLPs who worked in a hospital with an ICU and 8 RNs who worked in the ICU responded to an electronic survey. Half of the SLPs indicated some form of AAC was being used in the ICU. The majority of RNs (n=5) responded that AAC was seldom used in the ICU. Lack of equipment/resources, time constrains, and feasibility were among the most selected reasons why AAC was not being provided per SLPs. Overall, results from the research suggested that AAC is not standard practice within the ICU.