Current Environment:

The Inpatient Augmentative Communication Program is a one-of-its-kind bedside service aimed at supporting communication enhancement of patients in the acute care setting and optimizing patient-provider communication throughout the recovery continuum. Our full-time speech-language pathologists work collaboratively with our outpatient clinicians to optimize continuity of care during an inpatient admission. The Inpatient Augmentative Communication Program also works closely with multidisciplinary teams across intensive care units, acute care units, and hospitalwide departments and programs to ensure appropriate augmentative and alternative communication (AAC) and AT needs for patients and to support communication enhancement and recovery.

Our commitment to our patients

The reduced ability to communicate during a hospital admission can be scary and stressful, especially for children. Our speech-language pathologists aim to support every child’s unique communication needs to enhance their interactions with staff and loved ones as well as support communication recovery. Through careful bedside assessments and close follow-up, our clinicians provide compassionate, supportive, and evidence-based solutions to enhance communication access and skills for any patient experiencing communication vulnerabilities. Our clinicians also provide preoperative consultation for patients who have baseline or anticipated communication challenges. By meeting with medical professionals before their inpatient admission, children and families have time to participate in communication strategy planning and contribute to the patient’s care in a meaningful and developmentally appropriate way.

Our expertise

Our team of speech-language pathologists have special training in AAC and experience tailored to the ICU and acute care settings. Our program has a wide variety of tools and strategies, including mounting equipment, available for loan to patients in need during a hospital stay. Given the unique subspecialties of our inpatient speech-language pathology teams, our speech-language pathologists’ sole focus is on the communication enhancement and access needs of our patients.

Program history

In 1991, a nurse from the tracheostomy team and the Multidisciplinary Intensive Care Unit reached out to the ACP after meeting a child using a speech-generating communication device during an outpatient visit. She immediately recognized that augmentative communication strategies would allow many ICU patients who are unable to speak for a variety of reasons (see conditions we treat) to participate in care and express themselves. The request was simple: “Would you be willing to come up to the unit to see if there is anything you do in ACP that can help our patients?” This launched a partnership between nursing, the Augmentative Communication Program, and the Child Life Program, focused on helping our patients throughout the entirety of Boston Children’s Hospital to effectively communicate their medical, personal, and psychosocial messages and needs with family and staff.

In 1994, we introduced the concept of Message Banking for children who would experience a temporary inability to speak during their hospital stay. Little did we know that this model of preoperative intervention would have such a positive impact for our patients, their families and friends, and our medical staff. Since introducing this innovation at Boston Children’s Hospital and sharing information through national and international lectures as well as publications, it is now a model that hospitals throughout the world strive to duplicate. The utility of Message Banking is also applied well beyond the hospital setting to people who are at risk of permanently losing the ability to speak.

In 2002 the Boston Children's Hospital Medical Symbol Set was created to better support the communication needs of patients by representing unique vocabulary related to hospitalization. Because the dedicated augmentative communication service Boston Children's offers is extremely unique, in 2008 the creator of the Vidatak EZ Board teamed with Boston Children's to create the Vidatak Picture Communication Board. That is now used in medical centers around the globe.

As the benefit of meeting the needs of all patients who are communication vulnerable continued to be evident, Boston Children’s Hospital created the first-of-its-kind dedicated pediatric inpatient acute care/intensive care Augmentative Communication Speech-Language Pathology position in 2005. The demand for this program has been growing and expanding, and we now have two full-time speech language pathologists (see our staff) who focus exclusively on the augmentative communication needs of our inpatients throughout the hospital.