You will want to devise a system between the patient and caregiver or "reader" to indicate "yes" and "no". This will help facilitate the speed of the communication process. Twitches, smiles, blinks, winks or any form of movement other then the eye itself can be used to set up the confirmation process. If only one such capability is evident, you should use this as an indication of "no" and no indication is "yes" and continue.

The reader says aloud which box the patient has indicated with his/her eye movement. The patient indicates "yes" or "no". The reader then says aloud the letter the patient indicates, again the patient gives a confirmation or rejection.

You will find that both patient and caregiver will pick up on this system very quickly, and within 3 or 4 letters, will be able to judge the patients anticipated word. For example, the patient begun spelling T-H-E-R, once the letter R is reached, the caregiver should say the word "There" and allow the patient to confirm or reject the word.

Although the board is marked patient-side and care-giver side, your personal situation should determine which side is appropriate. If the patient will be seeing a good number of irregular visitors or has a steady change of staff, it may be better for him/her to become familiar with the care-giver side instead, since the patient-side layout is in an order most similar to how we read, and therefore easier to memorize.

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