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Journal of the Australasian Society for the Study of Brain Impairment
RESEARCH ARTICLE

Impact of communication modalities on autonomy and social participation of persons with locked-in syndrome

Marie-Christine Rousseau https://orcid.org/0000-0002-8065-8667 A B * , Margaux Hautin C , Véronique Blandin D , Frédéric Pellas E , Pascal Auquier B , Karine Baumstarck B and Sébastien Lazzarotto B
+ Author Affiliations
- Author Affiliations

A Fédération des Hôpitaux de Polyhandicap et Multihandicap Hôpital San Salvadour, Assistance Publique Hôpitaux de Paris, BP 30 080, Hyères cedex, 83 407, France.

B EA 3279, CERESS, Self-perceived Health Assessment Research Unit, School of Medicine, Aix Marseille Université, 27 bd Jean Moulin, Marseille 13385, France.

C Université de Franche-Comté, UFR Sciences de la Santé – Centre Universitaire de Formation en Orthophonie, France.

D French Association of Locked-in syndrome (ALIS), Paris, France.

E Service MPR Centre Hospitalo Universitaire de Nîmes Carremeau, France.


Handling Editor: Melissa Brunner

Brain Impairment 26, IB24030 https://doi.org/10.1071/IB24030
Submitted: 15 April 2024  Accepted: 10 March 2025  Published: 28 March 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Australasian Society for the Study of Brain Impairment.

Abstract

Introduction

Locked-in syndrome (LIS) is a complex neurological condition characterised by paralysis of all four limbs and anarthria. Persons with LIS may communicate via eye blinks/low technology Augmentative and Alternative Communication devices (low tech AAC devices) or may use high technology Augmentative and Alternative Communication devices (high tech AAC devices). Our three objectives were: (1) to describe the distribution of communication modalities used by persons with LIS, (2) to describe the satisfaction of persons with LIS with their communication modality and social participation, and (3) to compare the characteristics and social participation among high tech AAC devices users versus low tech AAC devices or eye blinking users.

Methods

The questionnaires were sent by e-mail to persons with LIS. Data collected were communication modality, examination of communication ability, satisfaction with the communication modality and contribution of the communication modality to social participation.

Results

Of the 53 participants, their mean age was 52 years, 43% used low tech AAC devices, 43% used high tech AAC devices and 13% communicated via eye blinking. Communication ability was examined in only half the participants. Participants’ satisfaction with their communication modality in terms of ergonomics, rapidity, adaptability and functionality were 80, 67, 36 and 47% respectively. Participants who used high tech AAC devices had significantly better e-mail and social network access, could more often initiate conversations and had longer communication durations.

Conclusion

The communication abilities of persons with LIS should be examined as quickly as possible and repeated regularly. High tech AAC devices should be rapidly and systematically proposed.

Keywords: autonomy augmentative and alternative communication devices, communication, communication evaluation, communication partners, internet access, locked-in syndrome, proxies, social participation.

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