Building an ICU communication kit after a spinal cord injury

Immediately after a spinal cord injury (SCI) there can be uncertainty along with rapid changes. Medical priorities take center stage and factors like positioning, fatigue and a person’s sense of control can be compromised. In these moments, communication is essential.

Starting with a light-tech AAC kit that includes a simple communication board can be a game-changer. While high-tech options are being considered or set up, light-tech tools offer a reliable, low-friction way for individuals to be understood.

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Why start with light-tech AAC?



Always on

No batteries, logins, or calibration required. These tools work during transport, procedures, or when someone is too fatigued to use high-tech devices. 


Hygiene & safety

Easy to clean and cover, and simple to share across care areas with proper sanitation protocols


Low cognitive load

Clear choices, large targets, and calm layouts reduce visual and motor demands - especially helpful when everything else feels chaotic. 


Easy to integrate

Laminated communication boards are simple enough for staff, caregivers and family to use consistently, even when medical priorities are pressing. 



Trauma-aware

Offering immediate control, like the ability to express pain levels or basic needs, can be empowering for someone navigating a traumatic event. 


How to build a simple ICU communication kit 

Make it high-contrast, wipeable and within reach. Keep a second copy at the nurse’s station. Pre-made resources can be a great starting point. Not every item will be necessary for every individual, but thoughtful inclusion ensures the communication system is tailored and effective. 
  1. Yes / No / Maybe 
    These should be large and obvious. While some individuals may communicate these responses nonverbally, establishing a clear method is vital, especially in urgent medical situations. 
  1. Pain scale (0–10) + quick needs 
    Pain scales aren’t perfect, but they’re useful. Include options for suction, repositioning, mouth care, temperature and other immediate needs. Keep it simple and adaptable.
  2. Comfort requests 
    Options like lights, music, quiet, blanket, or position changes offer a sense of control and can help reduce anxiety.  
  1. People identification 
    Include visuals or words for family, nurse, doctor, chaplain, interpreter, and others who may be part of the care team. 
  1. Repair & pacing phrases 
    Phrases like “I missed that,” “Slower please,” or “Repeat” help individuals advocate for clearer communication, especially when fatigue or medication affects cognition. 
  1. Alphabet board & basic word list 
    These tools can dramatically expand communication. Offer them when appropriate to support more robust expression. 
  1. Bilingual boards 
    Provide language options that reflect the individual’s needs to ensure inclusive and effective communication. 

In the ICU, communication is more than a convenience; it’s a lifeline. By offering simple, accessible tools from the start, we can help individuals regain a sense of control, dignity and connection during one of the most vulnerable times in their lives. 


Written by:
Amanda Grabiner, MS, CCC-SLP, ATP
Clinical Training Specialist & Product Specialist

Amanda Grabiner headshot.

Light-tech aacSpinal cord injury

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