Table 2.

Communication strategy descriptions

Communication Strategy	Description/Purpose
Establishing a clear yes/no signal (46)	Ensuring there is an established yes/no signal that can be consistently performed by the patient (e.g., nod/shake head; tap finger/foot; eye blinks; eye gaze (up or down). Ensure all providers use the same method for yes/no responses. Post a sign or communication plan with the patient’s yes/no method.
Tagged yes/no (46)	The communication partner ends (tags) questions with the phrase “Yes… or no?” and an appropriate signal/gesture (head nod or shake), alerting the patient to the possible response choices.
Writing (whiteboard or pen/paper)	Writing utensil should be large enough for the patient to hold comfortably. Consult OT for an orthotic pen holder if needed. Use clipboards and spiral notebooks so patients can refer to previous messages.
Written choice (63)	The CP asks questions and provides the patient with keywords for possible answers in large print on paper; CP asks the questions, followed by reading answers out loud while pointing to choices, then instructs the patient to point to their selection/response.
Gesture/signal dictionary (63)	Posting of signals/gestures commonly used by the patient and their meanings so patient and CP can refer to them (e.g., gestures for particular symptoms, encourage pointing to body part).
First-letter spelling with mouthed speech (46)	Patients point to the first letter on the alphabet board and then mouth the word.
Alphabet boards (46)	The spelling of messages by pointing to letters printed on the board.
Picture board	Provision of a board with pictures depicting common patient needs, symptoms, questions, or responses.
iPad or tablet applications	Allow text or picture-to-voice communication. The patient may need to use a stylus.

Definition of abbreviations: CP = communication partner; OT = occupational therapy.