Communication fatigue

Also called AAC fatigue, Communication effort, Speaking fatigue

AAC is physical and mental work, every sentence. Why it tires people out, and how to build rest into the day instead of blaming them.

What it is

Communication fatigue is the exhaustion that comes from communicating when it costs effort. Every word on a device is a search, a decision and a movement, and a conversation that a speaking person finds effortless can take an AAC user the energy of a workout. People who stammer, people with dysarthria, people who lip-read and Deaf people working through an interpreter all describe the same thing.

The tiredness is real, it is cumulative, and it is why a person who was chatty at ten in the morning has nothing to say at four.

Who it can help

Anyone who communicates with effort, and the people who plan their day. It matters most for people using slow access methods, eye gaze and switch scanning particularly, for people with a progressive condition whose effort is rising, and for children, who are timetabled to communicate all day and then asked why they are "not engaging" after lunch.

It is not laziness, refusal or a sign that the person does not want the device. Those are the labels it gets, and they are wrong.

How it works

Cost adds up on three fronts. Physical: holding a posture for eye gaze, pressing a switch hundreds of times, keeping the head still for a head pointer. Cognitive: finding the word, planning the sentence, remembering where things are on the page set. Social: watching the partner's face for whether they have understood, holding the turn while they wait, repairing when they have not; see repair strategies.

The partner sets much of the cost. A partner who asks open questions demands long answers; one who offers choices asks for one move. A partner who waits reduces the need to repeat; one who guesses wrong doubles it. A day with rest built in, where the person is not expected to communicate through every meal and every transition, leaves energy for the conversations that matter.

Efficiency on the device is the other lever: quick phrases, word prediction, a well-organised core board and access settings tuned so that each selection costs less. See scanning speed and timing.

Getting started

This week, look at the person's day and mark where communication is demanded. Take one demand out. A meal where nobody asks questions is a rest.

Give the person a one-move way to say "I'm tired of talking" and treat it as a full sentence. Then plan the conversation that matters, the review meeting or the phone call with a friend, for the time of day when the person has the most energy.

Add five quick phrases for the things the person says most often, and ask the speech and language therapist to check the access settings; a slightly longer dwell or a better switch site can halve the effort.

Where to get help

Communication Matters publishes AAC users' own accounts of fatigue, which are the best evidence there is. A specialised AAC service can review access settings; see specialised AAC services. STAMMA covers the fatigue of stammering. RNID describes concentration fatigue in deaf people. MND Association covers rising effort in a progressive condition.