- Recommended Reading
- Esophageal Speech
- Hands-Free Devices
- Text to Speech Apps
- Alternative Communications
- Speech Difficulties
If you need help getting a device
Answer to people writing in to ask for freebies.....
Your state may have a program but only a few states do. You should check for that info here: http://www.tedpa.org/StateProgram.aspx
We at WW have a program for a loaner that a member can borrow for up to 90 days and sometimes extended arrangements can be made and ELs left to us for that purpose. The smart thing to do is have the patient join WW which will give him time to find out the rest.
He will need an email address to join us (or someone in the family can join for him using something like a gmail.com address. Most libraries have computers for public use so you don’t even have to own one.. Please read:
Please check their insurance. Most will have some help.
He also would learn from our members as we are a full fledged active volunteer support group with communication between our members who wish it.
Also, look here for other methods: (Leading them to this page)
If he has a smart phone, he can likely get a free app…text to speech.
Electrolarynx Speech Samples
ElectroLarynx - (abbreviated EL or AL for Artificial Larynx) There are several such devices on the market - of basically two types. They are all battery powered, but with one type of unit, you place it against your throat, push a button, and the machine transmits a vibration noise to your throat which you then form into words and sounds with your lips, teeth, and tongue. With the second type, the vibration sound is transmitted directly into your mouth via a small tube - words and sounds are made in a similar manner. Regardless of the type, the "sound" produced sounds something like THIS ("Hello! How are you?" on an electro-larynx).
(Permission to re-print provided by InHealth Technologies, Carpinteria, CA.)
Assorted Electro-Larynx Devices
You may think that you can get along with pencil and paper, but this is really a time consuming ordeal. One of the things that you will quickly discover is that when there are two or more people besides yourself trying to carry on a conversation, they are off on a different topic while you are still writing a comment on something mentioned earlier. An electrolarynx is the first "voice" most of us have after laryngectomy, sometimes the only voice we have and is a spare or back-up voice even if you learn another method of speech.
atos videos to help your speech
When Atos sent the address of a video relating to the use of an electrolarynx, I went to the site and watched a well done video explaining using an oral adapter on the electrolarynx. Then I noticed there were 60 of these videos. You can put them on autoplay or just have them in numerical order and chose the one you wish to see. They are varying lengths from 1 minute to double digits. Some are made for clinicians, instructional videos with professionals demonstrating how they solve problems. Many others, titled "Life as a Laryngectomy" simply tell who they are and a bit of their story. All are interesting and informative.
These links take you to information relating to te Electrolarynx:
#7 is Placement of an oral adaptor with SolaTone Electrolarynx - Video
#12 is Speaking with an Electrolarynx - Michael O'Brien
#13 is Speaking with an Electrolarynx - Albert Brooks
#21 is Life as a Laryngectomee – John Aguilar - Video
You will come through this being knowledgeable about all types of voices.
Griffin labs videos
Instructions: how to use an electrolarynx
This video details how to make adjustments to the trutone and solatone
Differences in the TruTone
Lauder Enterprises - SERVOX GURU
"How to adjust the Digital Servox"
Many of you may find the video clip beneficial and educational. For those of you who might use a digital Servox and have difficulty in understanding how to make adjustments to the pitch and volume settings for this device, this video clip would be of great benefit to you.
(Editor's note: The instruction provided by the "Servox Guru" in the video clip is clearly illustrated and very simple to understand)
"How to Waterproof Your SERVOX Digital Speech Aid"
Do you use your SERVOX device in a wet or dirty environment? You can protect the device by using a commonly found party balloon. Another helpful tip from the Servox Guru.
(Editor's note: When I would be working in the kitchen doing something like cutting up a chicken...I always had my Servox nearby in a thin plastic sandwich sized plastic bag and the telephone nearby so I could punch the speaker button with my knuckle!)
"Oral Adapter Moisture Barrier"
You can add a moisture barrier to protect your SERVOX device when using the oral adapter. Water can damage the internal electronics and this tip will prevent that.
"SERVOX Battery Cap Bumper"
The battery cap bumper is used to protect the back of your SERVOX speech aid device.
hints for use - oral adapters
My husband, Bill, has to use the oral adapter with his Servox. He is lucky to have a daughter that cleans teeth and uses the adapters in her business, so she keeps him supplied with them. Thought maybe there are others that could ask friends and relatives in the business to help them out or maybe your dentist will give you a couple for spares. Just something else we don't have to buy. (Grace and Bill Wegman)
ORAL SPEECH "TUBE", NOT "STRAW"!
In response to those who have been wondering what, "Talking with a straw" is, it is a method of speech where the sound is put into the mouth through a
plastic tube connected to the EL rather than by pressing the EL to the neck.
This is useful to people who cannot get enough sound through the neck tissues or who find it painful to press an EL to the neck. These problems are most often because of hardened neck tissue from radiation, irregular tissue contours, scar tissue or a lot of fat tissue any of which may prevent good contact or good transmission of sound. Also, a very short neck so that the EL bumps the jaw bone or causes a pain or cough reaction from the pressure on the neck may cause the need for an oral speech tube.
To get the sound into the mouth with the tube, there are two possibilities. There is the Cooper-Rand Intra-Oral artificial larynx which is solely an oral
device. The tube attaches to a small silver cylinder called a Tone Generator
that has a button on the side and connects with a cord to the
battery/circuitry box. The user holds the Tone Generator up to the side of the face and inserts the tube into the side of the mouth and pushes the TG button to stop and start the sound.
The other method uses one of the neck-held ELs. A silicone or plastic tube is inserted into a small hole on the mostly closed end of a round rubber,
silicone or plastic device that looks like a crutch tip. The large open end
then is put and pressed over the end of the EL. The user holds the EL up and inserts the tube into the side of the mouth and pushes the EL button to start and stop the sound.
Either way, oral use can be very helpful to people who just cannot use an EL on the neck. The problem is that the tube interferes somewhat with the proper pronunciation of some sounds such as g's, k's, t's and d's that are made by putting the tongue to the back the teeth or the roof of the mouth just behind the teeth. That is probably the main reason that people using intra-oral devices have more trouble being understood, especially when talking on the phone so that people don't have visual clues to their speech.
Many people, with some practice, can learn to pronounce almost all of the
sounds quite well. Some people just can't quite get past those 4 difficult
sounds, but still can achieve quite understandable speech by substituting
words. For instance, "Mow the lawn" is much easier to say than "Cut the
Including, and beyond those 4 sounds, A LOT of the problem with pronunciation of many sounds using a mouth tube is the positioning of the tube. It should be put in from the side back of the mouth, about an inch or inch and a half beyond the teeth, with the open part of the tube aimed at the clear area in the roof of the mouth above the tongue, leaving the tip of tongue as free as possible to do its best with proper pronunciation.
BUT, HERE IS WHERE EVERYONE NEEDS TO HELP!!! HOW??? PLEASE DON'T REFER TO THE TUBE AS A "STRAW!!!." WHY?? BECAUSE WHEN ANYONE THINKS OF A STRAW, THE IMMEDIATE
INSTINCT IS TO PUT IT RIGHT IN THE FRONT MIDDLE OF THE TONGUE (where it is placed to sip), BUT THAT IS THE WORST PLACEMENT FOR AN ORAL SPEECH TUBE!!!
Everyone helping with the use of an oral adapter needs to make it clear right from the beginning that the tube is different from a straw!! You don't just stick it in, you learn to place it carefully in the best position in your
mouth, just as people using a neck placement experiment to find their best
position on the neck.
PLEASE HELP TO GET THE RIGHT IDEA OF ORAL TUBE PLACEMENT ACROSS TO ANYONE INVOLVED.
ORAL ADAPTERS ON TELEPHONE
For those who have trouble with an EL/oral adapter on the phone, here are several things to try. We hope one or more may help:
1. If your pitch is set fairly high, try setting it a little lower. Phones often
pick-up and distort higher pitches.
2. Keep the mouth piece a couple of inches away from the mouth - not right up almost touching your lips. Phones will often amplify and distort speech and other sounds more than you realize when they are very close.
3. Keep the EL itself and the phone mouthpiece as far separated as possible to prevent the phone from picking up the extraneous electronic sound that most ELs have. That buzzing could compete with or drown out your voice. Sometimes that may be a major part of the problem when the listener isn't sure if there is actually a person on the line.
4. Talk more slowly and carefully when you are on the phone. People you speak to in person have visual clues from watching your lips, facial expressions and body language.. On the phone to a new person, consider say slowly something like, "Hello. I am using an artificial voice. I will talk very slowly so you can understand me."
In any case, don't give your name right away. The people listening have no
clues as to what you are saying. Instead, start with a couple of sentences
with words that are very easy for you to pronounce and for most people to
understand so they can "sync into" your speech before you say anything vital.
5. Consider what it sounds like to you when you listen to someone with a heavy accent on the TV. At first you can understand very little, but after a few sentences it becomes much easier. It often works the same way listening to someone using an EL.
6. Phone two or three friends or relatives and ask them to honestly let you know what problems they hear when speaking to you on the phone. Maybe they'll have some good ideas that they just didn't think about mentioning before because they knew your speech well enough not to be bothered much by those problems when talking to you on the phone.
7. Make arrangements with a friend or relative who has an answering machine for you to phone and have the answering machine pick up. Say several of the kinds of sentences that you might normally use when calling to place an order or for any other common call. Then visit the friend and listen to how you sound on the answering machine. That should give you some good clues. Since answering machines differ considerably, it might help to try it with more than one phone/answering machine system.
8. Don't be insulted by this one - but when you are talking on the phone be sure that you don't have a radio or TV playing loudly in the background and don't stand next to a dishwasher, microwave, washing machine or a barking dog. It may seem obvious, but a lot of people do make phone calls without having any idea how much the phone is picking up other noise around them.
If you would like, you can e-mail us at email@example.com and arrange a time to phone us. Since we have been working primarily with intra-oral (mouth tube) artificial larynges for over 35 years, we have had a lot of experience with this sort of thing and if we listen to you, we might have a good idea what the problem is. We would need to prearrange a time so that Tom or I would be here since we would be the most logical ones here to be able to help you.
Good luck and best wishes,
Vendor Member, Luminaud, Inc.
USING THE NECK TYPE ELECTROLARYNX
Most artificial or electrolarynges (called either AL or EL) are made to be used by holding them against the outside of the neck, but some have oral adapters, particularly useful when the throat is swollen or sensitive. Some of these brand names are Servox, TruTone, Romet, Optivox, Nu-Vois, Denrick and Solatone . Important tips on using them include:
Find the "sweet spot". There will be one, two, or even more places on the neck which produce a louder, clearer, sound. A simple way to find the sweet spot is to open your mouth and keep it in one position as you place the electrolarynx in different locations on your neck and push the button on the device. Try and maintain a uniform pressure of the EL head against your neck at each location. The laryngectomy operation produces lots of scar tissue and swelling which will initially muffle the sound (that’s when you use the oral adapter). Neck tissue which has been treated with radiation can be difficult. Also, the sweet spot can change over time as healing progresses, so you should periodically try other locations. In addition to trying different locations, experiment with different amounts of pressure to get a good compromise between too tight, which can be very uncomfortable, and too loose, which will produce an unpleasant clatter and unintelligible speech.
If possible, learn to hold and operate the EL in your non-dominant hand since it frees up your other hand so that you can write. Press the button on and off to coordinate with your phrases and sentences. It will make it easier for people to understand you, as well as make it a more pleasant and natural sound for the listener. Pauses are important. A variety in your speech rate (how fast you talk), and pauses can help substitute for the pitch variations in your pre-laryngectomy voice. Over-articulate, or slightly exaggerate your pronunciation of words. Open your mouth wider and give more emphasis to the final consonant sounds in words, such as the "d" sound in the word "cold", the "t" sound in "pleasant", the "ch" sound in "speech", and the "p" sound in "tape". Try and speak more slowly than you did with your pre-laryngectomy voice. If your EL has a pitch and/or volume control, practice using them to vary the pitch to provide variety, and adjust your volume to different situations.
WHAT DO THE VARIOUS EL DEVICES SOUND LIKE?
While it is difficult to reproduce the EXACT sounds via the Internet, the following are various "example" recordings (.wav and .aiff files) made of individuals using the indicated device. (Note: Your personal "sound" could vary greatly from one device to another. Everyone is different and success is dependent upon the right combination of equipment, training, and practice.) Some of the larger files take a minute or two to upload completely, but they are worth the wait. Make sure the file is fully loaded before you play it.
1. TruTone - "Hello, how are you?" (.wav - 28 KB)
2. SolaTone - "I'm doing great!" (.wav - 16 KB)
3. Nu-Vois - "I'm doing great!" (.wav - 49 KB)
4. OptiVox - "I'm doing great!" (.wav - 19 KB)
5. Servox - "I'm doing great!" (.wav - 18 KB) *
6.UltraVoice Plus - (Provided by UltraVoice) (.wav - 376 KB)
7. Cooper-Rand - "The rainbow is a division of white light into many beautiful colors." (.aiff - 260 KB) *
(*Samples provided courtesy of Dr. Philip C. Doyle, Voice Production and Perception Laboratory, University of Western Ontario)
Also, "BBC Tyne" in the UK has made two "videos" showing a gentleman using an electrolarynx. You will need "RealPlayer" or the AOL Media Player to view them. Links to these are as follows:
1] Look at the person to whom you are speaking, and have them look at you. A lot of our communication is visual. Understanding is enhanced from seeing your head nod in agreement or the expression on your face as something pleases or displeases you. Don't try to talk from one room to another and lose the benefits of face to face conversation.
2] As a Realtor/general contractor I spend 30-40% of my day on the phone.After a bad phone experience with a customer I found a solution that works great for me. When I answer or call someone for the first time, I start my call by say... "First let me explain my voice, I speak with an electronic speech device due to the loss of my voice to cancer, so it may take a moment for your ears to tune in."
Seems to work everytime... amazing how everyone answers back that they can understand me just fine.You also become an excellent judge on who is or is not a good listener, plus I no longer have to introduce myself to anyone on the phone after first call since as soon as they hear my Servox voice they know who it is!
Randy Wienke, WI
Repairs and maintenance
BATTERIES FOR ELECTROLARYNX
1. If your batteries are not charging well, the charging port may not be making a good contact. Try cleaning off the surface of the Servox with alcohol, and rub the little contact point in the charging port with a clean pencil eraser. Also make sure the contact point on the bottom of the Servox battery cap is clean. You can use the pencil eraser on this as well. Jack Nolin
2. After having problems with batteries not charging, I found the culprit. The batteries are good, it was the charger malfunctioning and shutting off long before battery was charged. Be sure your charger is working. (Jerry Lowe)
3. About 9.6v Nuvois II or III batteries - I am a little frugal and, consequently, hate to throw away batteries when they start to weaken. I charge them to the max and use them in garage door openers and they do very well.
John AR - 0208
(Comment: Most clocks and other household items use little power but our fireman warns us, smoke protectors are important to our lives.)
4. Jim Lauder advised to NOT refrigerate your batteries. On the other hand, don't leave them in a hot car. They shouldn't be exposed to extremes in temperature.
5. Jim Lauder advised keeping our extra batteries in those little film canisters as loose batteries can make contact with change or keys in your pocket and can short circuit and either get very hot or in some cases explode.
I said that I put my charged batteries in the canister so I can see the "+" on the top of the battery. If I change my battery during the day, then I put the dying or dead battery back in the canister with the "+" side on the BOTTOM. That way, for my short term memory, when I get home, I will know for sure that this battery needs charging. Vicki Metz
PROTECTING THE SERVOX?
1. In the kitchen while doing chores such as peeling onions or cutting up chicken, you can protect your electrolarynx by sticking it in a sandwich size thin plastic bag (the cheapest kind). (Pat Sanders)
2. At the garage, I found that greasy hands were messing up my Servox. A baggie was the answer to keep the Servox clean and you can talk just as well through the plastic.
3. My laryngectomee husband, Jay, works at construction sites. He uses a Servox EL. He was having a lot of problems with it because of dust and grime and was having to send it off on a regular basis to Siemens for costly repairs. They recommended he try to protect it from dust. We pondered this for quite some time and he was trying a baggie wrapped around the end. He was explaining to one of the construction workers why he does this and the guy whipped a condom out of his wallet and said to Jay, "Here, try this." It was the perfect solution! The last repair was almost a year ago and since he's gone to this type of "protection", the Servox has worked fine. (Sara Rothenberger)
4. Another tip from Jim Lauder, instead of the condom, one could use a party balloon (cheaper than a condom) to cover the head of the EL to protect it from rain or dust. Remove it when not needed to prevent condensation from forming.
5. If using the oral adaptor, to prevent moisture, cover the head of the EL with saran wrap, then put on the oral adaptor. Remove it occasionally to prevent condensation.
OTHER MAINTENANCE OF EL'S
Ideas from Jim Lauder's maintenance demonstration
1. If EL ever gets really wet and/or dirty, take apart as much as possible, remove battery, clean as well as possible, and let it all air dry before inserting battery and using again.
2. If you tend to screw head of EL on too tight, you can get a thicker or new O-ring from the hardware store--this is just used as a spacer.
3. Use an old toothbrush to clean threads on EL where parts screw together.
4. If you need to clean parts, use isopropyl alcohol--NOT rubbing alcohol. The rubbing alcohol leaves a residue.
5. Jim gave us "bumpers" to put on the lower end of our EL's--to help protect them if dropped. These are the things he applies to BOTH ends when shipping them back to us after repairs.
USING AN ELECTROLARYNX AS A "BACK-UP"
FOR YOUR TEP OR ESOPHAGEAL SPEECH
UltraVoice is a different type of artificial larynx. There are three basic components which need to be located in the mouth and are specially mounted into an upper denture or an orthodontic retainer. A Loud Speaker, Radio Circuit and rechargeable batteries. You can see the process and listen to a voice at:
There is a Control unit to go in your pocket or on your belt, a Charging unit for overnight re-charging
Comments from some of our members:
1. To any one interested in ultra voice II: this little gizmo is the greatest
thing since the wheel invention. I have had mine since april 2008. It is so
wonderful to be able to make a noise, words just can't describe.
If it gives you a problem, call the company and if it can't be fixed over the phone or internet then they have you ship it back at their expense. I have had to return my unit 3 or 4 times, in a year and three months. It took 3-5 days round trip. ( It has all been covered by Ultra voice) Problems with my unit:
#1 volume I have had to purchase a Spokeman Amplifier so I can be heard by certain individuals.
#2 If you put too much air in it there is no sound or if there is not enough air in it, again no sound.
#3 I guess I talked to much sometimes, causing the batteries to go dead? In the very beginning of use, it seemed like they lasted 12 hours. As time went by it only last 6 to 8 hours; here again I may have talked too much? Joyce
2. They tried to get me one, but when my insurance ( blue cross and blue shield of fl.) wouldn't pay, they told me to call back in 2 years when I go on medicare. BG
SOME STATES FURNISH FREE ELECTROLARYNX
NEWEST INFORMATION - CHART OF STATES PROGRAMS
We have left the following information because in some cases, it offers some personal experiences
There are a few states that furnish an electrolarynx to a new laryngectomee, free.
The rules are different in each state and we will add more comments here as we receive them.
The Deaf and Disabled Telecommunications Program (DDTP) is a California State mandated program, under governance of the California Public Utilities Commission (CPUC). Under the DDTP the California Telephone Access Program (CTAP) distributes telecommunications equipment and services for individuals certified as having functional limitations of hearing, vision, mobility, speech and/or interpretation of information.
This program provides equipment to people who have trouble hearing/talking on the phone. They provide the TruTone electrolarynx to laryngectomees. To qualify, a person has to be a resident of the state of Georgia, certified by a professional, and meet the income requirements. Applicants must show proof that their annual income does not exceed 200% of the federal poverty level.
Kansas has just recently added an electrolarynx (only the kind that is attached to a phone) to list of provided equipment. At present, they do NOT provide for an electrolarynx that is independent of the phone. For more information or to request an application, please contact: Kansas Telecommunications Access Program (TAP), 4848 SW 21st Street, Suite 201, Topeka, Kansas 66604-4415. You can also phone: (785) 234-0200
In Massachusetts, Verizon will provide you with a Servox 'free of charge' as part of their 'phone service for people with disabilities'. So long as you are one of their customers. My husband got one from them within a week of calling. There is (of course) paperwork to be filled out, which the Social Service person at the hospital then sent in for us. (Stephanie Buck)
Verizon offers laryngectomees who are Massachusetts residents an electronic larynx free of charge or with a small co-payment if they meet certain eligibility requirements. More information may be obtained by calling 1-800-974-6006. VERIZON offers a variety of equipment such as: TTY's, Braille TTY's, amplifiers, artificial larynx, light signalers, loud bell signalers, etc.
North Carolina had a program to assist folks with Telephone, TTY, ALD (TruTone) items with Income limitations . We were just informed (10/2013) that they no longer have the electro-larynx in the program. This could change in the future but for now, they can not help with this particular device. Information came from:
Merri Schermerhorn, N.C. Department of Health and Human Services
Community Accessibility Consultant, Division of Services Deaf and Hard of Hearing
Add SC to your list of states that provide a free AL. I had to fax off a lot of paperwork; copy of my drivers license, voters card, and a copy of my telephone bill plus a form signed by my SLP. They wanted to ensure I was a resident and, 5 days later, UPS was at my front door with a new one. If I pass on I must have a relative return it to them. Ron Gillette
Before purchasing your electrolarynx, apply for a voucher for a "free EL" from the State of Texas for a $35.00 processing fee. You can obtain the paperwork from: Texas Commission for the Deaf and Hard of Hearing, Box 12607, Austin, Texas 78711; Phone: 512-407-3250 or Fax: 512-451-9316. The paperwork is called Specialized Telecommunications Devices Assistance Program Voucher. You can also access this Texas office on the Internet and download an application to complete and send in.
We have the TEPP (Telecommuncations Equipment Purchase Program) for Wisconsin residents. It's a way to get equipment needed to use basic telephone equipment at a reasonable cost. For laryngectomees, this would include TTY's, electrolarynges, etc. You need to fill out an application on-line or print an application. It can take several weeks to receive your voucher in the mail. Then you give the voucher to the vendor with $100 and get your equipment. As of 2008, the speech impaired were allowed up to $1600 on the voucher for a purchase. This can be done every three years for the same disability. Oftentimes a vendor knows how to handle all the paperwork. All you have to do is pay them the $100. The TEPP program is paid for by the Wisconsin Universal Service Fund. Money collected from Wisconsin telephone service providers goes into the USF. For more information, go to: http://psc.wi.gov/consumerinfo/assistancePgms/tepp/tepp-ind.htm
(or just Google TEPP). Vicki Metz
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