MND and Communication
MND can affect the muscles used for speech, causing them to become weak or tight. Some people find that their speech sounds become less clearly pronounced or their voice becomes strained or maybe very quiet. This problem can become worse over time but if speech becomes very difficult to understand, alternative ways to communicate can be used alongside or instead of speech. Speech and Language Therapists (SLTs) give advice on communication tools. Alternative ways to get a message across include writing or pointing to letters on a printed alphabet chart.
Many people also use an electronic communication aid such as a touch screen tablet or a computer that can be controlled by a mouse, joystick or eye-gaze reader if hand movement is difficult. These devices have software with built-in computer-generated voices that speak out words or sentences as they are typed on a keypad; this is referred to as a ‘text-to-speech’ function. It is also possible to save some frequently used phrases referred to as ‘pre-stored phrases’ which can make communication faster for these messages because they do not need to be re-typed each time.
Banking speech can be considered as a ‘vocal insurance’. It is a way of planning ahead to preserve a part of personality that is captured by a person’s unique speaking voice. Banking speech involves making recordings for potential use in the future on an electronic communication aid should speech become difficult to understand. There are two ways to record speech for such a use: message banking (which can be used to read out ‘pre-stored phrases’ when selected on a device) or voice banking (which can be used to read out anything typed using a ‘text-to-speech’ function).
These are explained below. If a person completes one or both of these, it might never be necessary for them to consider using an electronic communication aid, but if they do, they will have created the option of incorporating their recorded phrases into their communication system.
For anyone with MND who chooses to bank their speech, an SLT can help and a technician from an assistive technology service can set up a communication system for you incorporating your recordings.
Message banking involves thinking of personally meaningful phrases and making voice recordings of those phrases, usually on a dictaphone-style recorder. The type of phrases that people tend to record are terms of endearment, sarcastic comments, phrases used mostly with close family or friends or catchphrases that others would associate with them. When played on an electronic communication device, they would sound exactly the same as the person’s voice when the recording was made.
Voice banking involves using a commercial service to create a personal computerised voice that is representative of the person’s own voice. It usually involves recording a large inventory of speech by reading aloud set lines of text that capture different speech sounds in different parts of words. Speech clarity therefore needs to be very strong for a successful outcome. The quality and likeness can vary between people. This type of computerised voice will sound more robotic with less intonation than natural speech because it is electronic.
This animation was developed as part of the ‘Irish Message Banking Project’ which aimed to develop resources for use in the Irish context by professional Speech and Language Therapists and people who may experience speech changes. The project group involved the SLT services in Beaumont Hospital and the Assistive Technology and Specialised Seating department of the Central Remedial Clinic – both of these organisations work regularly with people with a diagnosis of MND. It also involved research expertise from the Clinical Speech and Language Studies centre in Trinity College Dublin and was funded by Research Motor Neurone.