generating devices are used for communication by
individuals that do not have the ability to speak. These individuals
have a diagnosis of severe apraxia, aphasia, aphonia, and/or
may be secondary to motor dysfunction, spasticity, tremor, rigidity, or
Their disability may result from a disease or congenital disorder, such
cerebral palsy, stroke, progressive amyotrophic lateral sclerosis,
multiple sclerosis, muscular dystrophy, traumatic or
quadriplegia, or traumatic brain injury.
or augementative communication devices enable an individul to
more effectively with others. A device assists an individual in
through printed words, speech or voice output, pictures, or any
these. Devices range from having basic components and performing
language functions to having the ability to perform computer-like
control household appliances. SGDs are designed to be used as a
mode of communication to augment existing communication strategies and
configured or customized to address most communication needs.
are a variety of communication devices available. Devices can have a
or multiple messages. Devices are categorizes based on the following
- Speech Output-
Digitized (recorded human speech) or Synthesized
of text into speech).
Type- Prerecorded (messages that are stored) or Message
spontaneously create novel messages).
- Access Method- Direct Physical Contact with Device or
switch, mouse, joystick, etc.).
- Message Formulation Technique- Spelling only or Spelling
devices have different selection sets (dynamic, static or both).
are similar to a computer monitor. The selection set or level changes automatically
on a dynamic screen as the user makes
choices. Static sets
have fixed symbol choices or levels
that can be manually changed. Most static sets Static sets usually have
of letters, pictures and/or words on an overlay that is inserted or
Specialized switches are used with the scanning feature on some
devices. Specialized switches can be activated by almost any body part
or body action. Some examples of specialized switches include sip and
puff, myoelectrical, mercury, eye blink, and vibration.
About half the
laryngectomy population uses hand-held electrolarynges (EL) as their
primary means of communication. An
electrolarynx is an electronic
vibrating device that is placed against the neck and creates vibration
mouth that the speaker then articulates into speech. It is a
medical device used to produce clearer speech by those who have lost
their original voicebox, usually due to cancer of the
are several such battery powered devices on
the market. With one
type of unit, you place it against your throat, push a button, and the
transmits a vibration noise to your throat which you then form into
sounds with your lips, teeth, and tongue. With the second type, the
sound is transmitted directly into your mouth via a small tube.
artificial or electrolarynges are
made to be
used by holding them against the outside of the neck, but some have
adapters, particularly useful when the throat is swollen or sensitive.
these brand names are Servox, TruTone, Romet, Optivox, Nu-Vois, Denrick
EL devices produce speech that sounds non-human (mechanical, robotic,
monotone), has reduced intelligibility and loudness, and draws
undesirable attention to the user. The poor quality of EL speech has
been traced to limitations in performance of current EL sound
generating transducers, and to the loss of the fine control of pitch,
amplitude, and voice onset and offset timing that is normally provided
by the laryngeal mechanism.
The advantages of the electrolarynx are it's short learning
time, ability to use immediately postop,
and relative availability and low cost.
prosthesis allows the production of the much preferred
"tracheo/esophageal" (TE) voice after total
laryngectomy. In this method, a channel (called
“voice-fistula”) is made
through the wall between the windpipe and the gullet (the TE-wall).
Voice functions are generally replaced with a voice
prothesis placed in the tracheo-esophageal puncture created by the
surgeon. The voice
prosthesis vibrates the esophageal tissue in lieu of the larynx.
exhale while covering the stoma at the same time, the air from the
be pushed through this channel into the gullet where an esophageal
produced. To prevent food and liquids from passing into the lungs via
fistula, a voice prosthesis is inserted. A voice prosthesis is a
that allows exhaled air to pass freely. The valve closes during
prevent food and liquids from entering the lungs.The main benefit of
technique is that you can get your new voice fairly soon after surgery.
secondary benefit is your ability to control the volume, intonation and
voice prosthesis is made of soft silicon and it can stay in
place for a
long time. The Provox voice prosthesis has a unique, strong
construction with a
low-resistance valve molded in one piece with the prosthesis. The valve
against a stabilizing, non-deformable blue ring made of hard plastic.
prosthesis has stable flanges to keep it in place. The
Provox voice prosthesis can be inserted at the time of surgery, some
after surgery or whenever convenient.
with a voice prosthesis is easy and requires little training. Just like
speech, you use the air you breath out. Simply cover the stoma with
and gently exhale. The air is led through the voice prosthesis into the
where the wall vibrates and creates an esophageal voice. You can vary
TE voice, both in loudness and pitch, in the same manner as a normal
changing the flow of air as you exhale.
How Electrolarynx works
Assorted Electrolarynx devices
Voice prosthesis inserted in the trachea-esophagus