Use of Augmentative and Alternative Communication Technology to Retrain Attention and Enhance Functional Communication Following Severe Traumatic Brain Injury: A Clinical Case Report

Purpose: This case report outlines the use of high-tech assistive technology in the form of an augmentative and alternative communication device to assess and treat a veteran with severe speech, language, and cognitive impairments status post severe blast injury. Method: The patient is a right-handed male Veteran of the United States Marine Corps who sustained catastrophic injury after stepping on a dismounted improvised explosive device. He presented to the outpatient clinic 4 years status post injury for continued speech, language, and cognitive interventions. Based on assessments and observations, the patient was diagnosed with spastic anarthria, probable apraxia of speech, aphasia, and attentional impairments. His functional communication was restricted to limited facial expression and eye movements interpreted by those who knew him well. This case reviews the detailed informal and novel assessment techniques and training methods used to implement high-tech assistive technologies as part of the rehabilitation plan designed to enhance functional communication. Results: Through systematic instruction and retraining visual and sustained attention, the patient was able to engage meaningfully with a high-tech device to increase functional personal choice when supported by a partner. Conclusion: This case demonstrates the role high-tech assistive technologies can play in the rehabilitation and functional communication efforts for persons with severe traumatic brain injury and cerebrovascular accidents.