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Disability, dysphagia, and complex communication needs: Making room for communication in ethical decisions about dysphagia

Effective functional communication is important for successful management of dysphagia with individuals who have lifelong disability and complex communication needs (CCN).CCN is a broad term used to describe functional outcome in communication according to skills and needs: “Some people have complex communication needs associated with a wide rangeof physical, sensory and environmental causes which restrict/limit their ability to participate independently in society. They and their communication partners may benefit from using Alternative or Augmentative Communication (AAC) methods either temporarily or permanently” (Balandin, 2002, p. 2). Many people with dysphagia have associated communication difficulties that may affect their ability to participate in their dysphagia management plan. Speech pathologists are well placed to ensure, wherever possible, that individuals with dysphagia not only have an appropriate dysphagia management plan but also have a functional communication system that will support their involvement in the planning and ongoing management process. In this article, the importance of a functional communication system for individuals with dysphagia is highlighted in relation to ethical decision making in dysphagia management.