Getting Started with Communication

by Ben Lieman

The eyes may be the window to the soul, but it sure helps to clarify with a voice, what we say with our eyes. There are options available when the voice is too soft or simply unable to be understood. This article will help explain the simple, low-tech options that are currently out there. There are also high-tech solutions that may be covered by insurance and Medicaid, and can be operated with minimal movement of hands, fingers, head, or even just eye-movement. An evaluation for this equipment is necessary, and we are happy to share information about this equipment, and where to obtain an evaluation.These High Tech options provide very good computerized voice output in English, Spanish, and other languages. They also enable computer and internet access, again with minimal body movement or even just eye movement.

But there are also simple solutions that can be set up with no or little technology. It won’t get you on the internet, but it will enable communication immediately. An involved listener is essential as these low-tech methods do not store messages for later use. Communication with this method is done in real time.

1) Communication Boards can be a sheet of paper, cardboard, lightweight plastic that has communication options on the page. Letters, or pre-printed words and phrases can be identified by pointing with a finger (or pointing object like a pen or wrist cuff). With letters, you can spell out anything. With words or statements, you can easily communicate a simple request (How are you?, Raise my leg, I’m thirsty, Who called?, etc.).

Communication boards can be obtained on-line (there are numerous options available) OR created with any word processing program. The key component is that the letters or messages on the communication board are easy to read, and differentiated by enough space so pointing does not need to be precise.

2) Laser Pointers (i.e. key chain or presentation) utilize a pinpoint light generated to point to the letters or messages on a pre-written communication board (see above). They can be velcro’ed to a head band or baseball cap, and highlight choices with small head movements. (Be sure to avoid pointing at someone's eyes.) Some small LED flashlights accomplish a similar effect with a narrow beam of light. The beam of light generated must be narrow (1 inch diameter or less) at a distance of 1-2 feet (where a communication board is held).

3) ETran Boards are transparent plastic boards with the same communications placed on both sides (communications can be letters or words/phrases). The board is placed between the communicator and the listener. While the communicator looks at a specific communication, the listener looks at the communicator’s eyes, to determine which communication they are looking at. A wide hole in the middle of the board allows both parties to easily see each other.

4) Eye-Link – Large block letters listed on a transparent sheet of plastic. Like the ETran board, the Eye-link is held between the communicator and the listener. As the communicator looks at a letter, the listener speaks which letter they think is being looked at. If correct, the communicator looks on to the next letter in the word they are spelling. If the listener is incorrect, the communicator continues to look at the letter for the listener to try again. Generally, the listener learns where the communicator is looking and spelling can occur at a good pace. CINI (Communication Independence for the Neurologically Impaired) sells these online – www.cini.org.

With a little patience, these methods can provide a good means of communication right away, while you consider or apply for higher tech solutions. If you have questions about any of these or other low- and high-tech forms of communication, please contact the Chapter office at (212) 619-1400 and ask for Ben Lieman, Assistive Technology Specialist.