Inpatient Augmentative Communication Program

The Augmentative Communication Program (ACP) at Boston Children’s Hospital, formerly known as the Communication Enhancement Center, was established by Dr. Howard Shane in 1979. This outpatient program has provided patient and family centered care for children and young adults who experience congenital or acquired conditions leading to severe speech difficulty. Through innovations including hardware and software development, use of commercially available tools and technologies, as well as collaboration with engineers, programmers and designers, the ACP has been a leader in the care of persons with complex communication difficulties.   

The culture of care at Boston Children’s Hospital is one that embraces the whole child and family. 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 all of our patients throughout the entire 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 (link to message bank site here).

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 Children's offers is extremely unique, in 2008 the creator of the Vidatak EZ Board teamed with Children's to create the Vidatak Picture Communication Board which is now used in medical centers throughout 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 ever since 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.

In 2009, Boston Children's Augmentative Communication Program was invited to join The Joint Commission in developing nationwide standards of care for patients who are communication vulnerable. In partnership with The Joint Commission, John M. Costello, MA, director of Children's Augmentative Communication Program participated in this 2009 webinar, "Call to Action: Improving Care to Communication Vulnerable Patients".  View the webinar Powerpoint presentation.  We are pleased to have been part of the large multidisciplinary national committee who helped launch the 2010 Joint Commission Standard for Advancing Effective Communication, Cultural Competence and Family Center Care.