More than 2 million Americans are speech-impaired because of a severe communication disorder. Today, a growing number of these individuals have found their voice through speech generating devices (SGDs)—electronic devices that talk for them. Several recent advances in SGD technology have made the devices even more powerful and accessible. Here’s a quick look at some of the innovative new features that are available. Look Who’s Talking The simplest SGDs use digital speech—words or sentences that have been prerecorded by a human speaker. Specific messages can be retrieved and played back as needed. Such devices work well for many people. But for some, having to rely on a limited number of set messages is too confining. That’s where text-to-speech SGDs come in. Users type what they want to say, and the device figures out how to pronounce the message using a complex set of rules for that language. The device then “speaks” the words using synthesized speech—an artificial simulation of the real thing. It doesn’t quite sound human, but it’s close. Think of how a GPS sounds, and you’ve got the idea. “Text-to-speech SGDs continue to get better and better as the years go by,” says David Beukelman, Ph.D., professor of communication disorders at the University of Nebraska-Lincoln. Today they’re available in a host of languages. Some devices are even bilingual. One Look Can Say It All With SGDs, the machine may be doing the talking. But it’s the user who chooses what is said. Typically, this is done by typing on a keyboard, touching a screen, rolling a trackball, or tilting a joystick. But for users with very limited mobility, there are other options as well. Eye tracking uses a sophisticated camera system to track the glint in a user’s eye. This allows the system to see where the person is looking on a screen. Then it directs a cursor to that location. After the user’s gaze has stayed on the same location for a set time—typically, somewhere between one-quarter-second and one second—the cursor clicks on that spot. In some systems, a blink can also activate a click. In this way, the user can select letters, words, or symbols to create a message. Head tracking is similar. But rather than following the gaze of the eyes, a specialized camera tracks the movement of a small, disposable reflective dot that sticks to the user’s forehead or glasses. The user is then able to point and click a cursor with head movements. In essence, the “head dot” works like a wireless mouse. The newest twist, which is called brain-computer interface (BCI), is still experimental and sounds like something straight out of a sci-fi novel. The user wears a cap with electrodes on it. These electrodes are attached to an EEG machine, which tracks electrical activity inside the brain. “The person looks at a screen that’s flashing letters very quickly. When the desired letter flashes, the person’s EEG changes,” says Melanie Fried-Oken, Ph.D., professor and director of the Assistive Technology Program at Oregon Health and Science University. This triggers the SGD to select that letter. Dr. Fried-Oken is one of the researchers studying this new technology. She says it shows great promise for helping those who can’t voluntarily move any part of the body, sometimes even the eyes. The Need for Speed For people who would otherwise find it difficult or impossible to express themselves through speech, SGDs can be life-changing. Yet the devices are still slower than ordinary conversation. To address this problem, many SGD features are aimed at reducing the number of keystrokes needed to create a message. Word-prediction software predicts what someone is going to type from the first few keystrokes. Then it offers the rest of the word or phrase so the user doesn’t have to type the whole thing. You may have seen this at work in mobile phones, many of which use word prediction to speed up texting. Another way to speed things up is by using icons instead of letters. “Let’s say you use an apple icon to mean food,” Dr. Fried-Oken says. “You might press the apple icon and then an Italian flag icon to mean pizza.” Some people with limited hand mobility control their SGD with a switch that’s turned on with another part of the body. Scanning can speed up the process. In a switch-based system, an array of words or icons is displayed on the screen, and each is highlighted in turn. When the highlight reaches the desired choice, the user hits the switch. In scanning, whole rows or columns are highlighted at first. Once the number of choices has been narrowed, the user can quickly select the right word or icon. Gadgets and Gizmos “The newest wave in the area of SGDs is iPad apps,” says Dr. Beukelman. With speech generating applications for the popular tablet computer, the user touches letters, words, or symbols on the screen to select what to say. Such apps don’t offer all the whiz-bang features found on the most advanced traditional SGDs. But they may be an option for people with simpler communication needs and good finger dexterity. A handy variation on the SGD theme is the ability to synch with other devices, such as a phone or intercom. Some SGDs can be outfitted with a wireless adapter that allows them to control a computer from several feet away. In short, there are a growing number of innovative options to fit the varied needs of SGD users. Dr. Beukelman says, “For people who can’t meet their communication needs with their own speech, SGDs can open up a whole new world.” Certain speech-language pathologists (SLPs) are trained to evaluate and recommend SGDs within the field of augmentative and alternative communication. If you think an SGD might be right for you, an SLP can help you sift through the options and find the best match for your needs.