‘Would you like to use one of these or would you rather be able to talk?’ – facilitated and/or augmentative communication and the preference for speaking

This article examines the concepts of identity and personhood in relation to people with severe communicative disabilities. Data gathered at a Swedish day centre for people with acquired brain damage show that three main strategies in communication between able-speaking and impaired-speaking persons can be found: (1) perfunctory, (2) jigsaw puzzle, and (3) conjectural, all three strategies being based on the act of 'speaking'. This article shows why it seems important to talk with one's own physical voice instead of using augmentative and/or facilitated communication, even when one has a highly impaired speech pattern. I argue that an ideology of spoken language exists within western culture and that such an ideology has practical implications for the (re-)creation of meaning-making strategies in relation to people with severe communicative disorders. Implications for health-care personnel working with communicatively impaired people are also identified, as well as implications for researchers studying this field of interest.