Alphabet board

Also called Letter board, Spelling board, ABC board, E-tran alphabet frame

The simplest text-based aid there is: 26 letters on a card. Every AAC user who can spell should own one, and it should be in the bag right now.

What it is

An alphabet board is a card or sheet with the letters of the alphabet on it, usually with a space, "yes", "no", "end of word" and a few essentials like "start again". The person points to letters and the partner reads the word as it forms. Some boards add numbers, common words or phrases; some are arranged QWERTY, some alphabetically, some by frequency; some are clear plastic frames for eye pointing.

It costs nothing, never runs out of charge, goes through airport security, survives the bath, and for a person who can spell it is a complete voice.

Who it can help

Anyone who can spell, even slowly. Adults who lose speech suddenly, on a ward after a stroke, a laryngectomy or an intubation, can be given one within the hour and be talking by the afternoon. People with motor neurone disease, whose device may fail before they do. People with locked-in syndrome, for whom a partner-scanned alphabet is often the first and sometimes the only system. And every device user, as the backup that never fails.

Its limit is that it needs a spelling person and a reading partner, and it is slow: a few words a minute. So it supplements rather than replaces, unless it is all there is, in which case it is everything.

How it works

Direct pointing: the person touches or looks at each letter; the partner says each letter aloud, then the word, and guesses ahead when they can, checking "is it 'tomorrow'?" A good partner says the letters back so the person can catch an error.

Partner-assisted scanning: for a person who can't point, the board is laid out in rows and the partner reads the rows ("A to E? F to J?"), the person signals yes, then the partner reads the letters in that row. With a block or frequency layout and a fast partner, this reaches a respectable pace.

First-letter cueing: a person with unclear speech points to the first letter of each word as they say it, which gives the listener enough to catch the word. This is one of the most effective and least used strategies for dysarthria.

Getting started

Make one now. Type the alphabet in a large clear font on one side of A4, add "yes", "no", "space", "start again", print two, laminate them or put them in plastic wallets. Put one in the bag and one by the bed. The Talk board also has a big-key letter keyboard that speaks, for when there is a phone to hand.

Agree the method with the person before it is needed. Do they want letters read back, or words guessed? Guessing is faster and some people hate it.

If the person is in hospital, ask the ward for one; many keep them. If they don't, print one and leave it, with the person's name on, and a note on how they use it.

Where to get help

ACE Centre and CALL Scotland publish free printable alphabet boards in several layouts, including frames for eye pointing. The MND Association supplies them to people with MND and explains partner scanning. On a ward, the speech and language therapist is the person to ask; see intensive care and communication.