Communications Assistance for Stroke Victims

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To download these tools for free, scroll down to the bottom of this page.

The Nodding Page

A close relative of ours recently suffered several strokes and seizures.  She could barely move or talk, but was mentally completely alert.  She could nod and shake her head, but was not capable for speaking clearly.  To see her struggle to try to communicate was painful, so we got on our computer and developed a couple of simple tools that seemed to make it much easier for her to communicate.  And now we've put them on this website, to make them available for free to the families of other stroke victims.
If the stroke victim can nod, you can point to each item on the Nodding Page and ask if that's what she wants.  The stroke victim can nod when you've pointed to what she wants.  It's an easy way for her to make common requests.  We made and printed icons, on one page, for the following common requests:
  • Move my arms
  • Move my legs
  • Move the head on my bed up
  • Move the head on my bed down
  • Adjust my pillow
  • Turn me on my other side
  • Wipe my chin
  • Adjust face mask
  • Sponge my lips
  • Move the hose (on the face mask)
  • Change the channel or volume (on the TV)
  • (I'm) too hot
  • (I'm) too cold
  • Suction (if the stroke victim can't swallow)
  • Other (for anything else)
When the stroke victim indicates that she wants something, start by using the Nodding Page, and ask her if what she wants is on the page.  If yes, work through the items on the page until she finds what she wants.  If no, go to the Spelling Workbook.

The Spelling Workbook

If there was something she wanted that wasn't on the Nodding Tool, we used the Spelling Workbook.  We asked her to spell out what she wanted, letter by letter, by shaking her head or nodding to a series of questions. 
We wrote down what she spelled, then made a book out of the requests and phrases that she spelled.  That way, she could refer to some of the requests she had spelled out in the past, without having to re-spell them. 

A two-page file is provided for you to download on this website.  The first page is the Nodding Page, and the second is one page of the Spelling Workbook.
  • To make the Nodding Page, just print out the page and use it.  You might want to take it to an office services store like Kinko's and laminate the page, so you won't have any trouble finding it.
  • To make the Spelling Workbook, make about 20 copies of the second page and bind or staple them together.
A Kinko's-like store should be able to help you.  In fact, in many such stores, you can simply walk in with the address of this website (, and they can help print out, make copies, laminate and bind.
If you do have Microsoft PowerPoint® software on your computer, you can download the PowerPoint® version of the file.  Then you can modify it as you see fit.
If you don't have Microsoft PowerPoint® software, download the .PDF version of the file.  Then you can print it out using the Adobe Reader® .  If you don't have Adobe Reader® on your computer, you can download it with the link at the bottom of this page.

The Nodding Page and the Spelling Workbook


To download these tools for free:

Click here to download the PowerPoint® Version (if you have PowerPoint® already installed on your computer)

Click here to download the .PDF version (if you have the Adobe Reader® already installed on your computer)

If you don't already have the Adobe Reader® installed on your computer, click here to download and install it for free

This website and the associated files are copyright © 2004 by James K. Hickel.  The files may be downloaded and reprinted for private or nonprofit use only.  Reproduction for commercial use without express written permission is prohibited.  These tools should only be used in consultation with, and with the approval of, your qualified health care provider.