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Training Effects on Speech Production Using a Hands-Free Electromyographically Controlled Electrolarynx

James T. Heaton
Massachusetts General Hospital, Boston, and Harvard Medical School, Cambridge, MA

Cara E. Stepp
Harvard–MIT Division of Health Sciences and Technology

Robert E. Hillman
Massachusetts General Hospital, Boston, and Harvard Medical School

Contact author: James T. Heaton, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, One Bowdoin Square, 11th Floor, Boston, MA 02114. E-mail: jheaton{at}partners.org.

Purpose: The electrolarynx (EL) is a widely used device for alaryngeal speech, but it requires manual operation and produces voice that typically has a constant fundamental frequency. An electromyographically controlled EL (EMG-EL) was designed and implemented to provide hands-free control with dynamic pitch modulation.

Method: Three participants who underwent total laryngectomy surgery and 4 participants with normal voice were trained to produce EMG-EL speech through a multiple-baseline, successive-stage protocol. Baseline performance was established through 3 testing probes, followed by multiple hour-long training sessions.

Results: At the end of the training, all participants learned to initiate, sustain, and terminate EMG-EL activation in correspondence with articulation, and most were able to modulate the pitch to produce intonational contrasts. After completing the testing/training protocol, 1 of the 3 participants who underwent total laryngectomy was encouraged to independently use the EMG-EL at his residence. This participant sustained his performance for an additional 6 weeks and also used the EMG-EL successfully to communicate over the phone.

Conclusions: Our findings suggest that some participants with laryngectomies and vocally normal individuals can learn to produce hands-free speech using the EMG-EL device within a few hours and that significant additional gains in device control (particularly pitch modulation) are attainable through subsequent training sessions.

KEY WORDS: alaryngeal speech treatment, artificial larynx, electromyography, laryngectomy, speech