title: Training effects on speech production using a hands-free electromyographically controlled electrolarynx.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Harvard University, Cambridge, MA, USA.
authors.forename: Ehab A
authors.initials: EA
authors.lastname: Goldstein
authors.forename: James T
authors.initials: JT
authors.lastname: Heaton
authors.forename: Cara E
authors.initials: CE
authors.lastname: Stepp
authors.forename: Robert E
authors.initials: RE
authors.lastname: Hillman
mesh_terms: D000328:Adult; D000368:Aged; D004558:Electric Stimulation / Q000295:instrumentation; D004576:Electromyography / Q000295:instrumentation; D005260:Female; D006801:Humans; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010898:Pitch Perception; D013018:Sound Spectrography; D013067:Speech Perception; D013068:Speech Production Measurement; D014831:Voice