Sorry for the post that many of you have probably gotten about a secure message from the Rehabilitation Institute of Chicago.  You can ignore it, the message is below.  My apologies, Ed

 

 

Sorry to be so late to the party on this one all.  I have been more concerned lately about facilitating speech and motor development on my first 5 week old daughter as of late.  (Probably should consult with an SLP before I expect much speech should I not! J )

 

In any case, I do have experience with the Audeo.  Cannot speak against any of the concerns about it already cited.  It does require some innervation of the larynx.  The intention/theory behind it is simply that even if the larynx (and breath support and all other factors associated with speech) cannot produce voice, then the Audeo can still pick up EMG (I am 90% sure it is EMG) activity from the larynx.  This is in principle the same idea behind using an EMG switch with an ALS client.  We know that eventually we may lose it, but certainly should use it in the meantime.

 

But the Audeo would not function as just a switch, what they are working on is an algorithm to translate laryngeal muscle activity into what the intended words are, then obviously use that for TTS.  They are also doing things like controlling wheelchairs, and have been progressively working on getting more and more varied output.  (They originally could only say “yes”, now I think they have around 40 different phrases.)

 

All of that being said, the obvious downside is that I have yet to see it working with an actual client (ALS or otherwise).  We provided them with access to some of our patients, and I know they worked for a while with these clients.  But I do not know of anyone being functional with it.  The obvious theory is that muscular degeneration in the larynx is changing the signal.  I do not know where they were at with surmounting that, and that info is now a couple of years old.

 

I have shared some of my concerns about the way it was/is being marketed as well.  Ultimately, they are still hoping to sell their product.  But I do not know of it being near any kind of functional availability or usage for ALS.  And that is how I explain it to any of my ALS clients who ask about it.  We do not bring it up as an option or even potential option in our evals. 

 

Hope that helps, Ed

 

Ed Hitchcock OTR/L

Technology Center

Rehabilitation Institute of Chicago

 

 

 

I guess the proof is in the pudding- the main thing is I just want to see it in action… It might benefit some folks, but it’s hard to say until we actually see it in action.

 

I imagine there might be people who are slowly progressive, who, theoretically might benefit. 

 

My concern is that if it’s funded as a “speech generating device”,  a person might use their only funding option on something which won’t serve them over the long haul…  (My other concern is those clients who don’t want to start the process of getting an SGD, because they want to hold out for something more magical that they think is coming down the road…)

 

Margaret Cotts

 

 

So maybe this is not the best option for ALS – sound like square peg in a round hole?  There are probably other diagnosis that would be better suited, ones where innervation of a muscle would be consistent.

 

 

 

This is the email I rec’d from Audeo a few months ago:

 

Margaret:

 

What is being transmitted: the signal that the brain sends to the vocal cords to move (make sound). So, there does need to be some activity in the muscles (that is the signal) that control the vocal cords. In other words, a patient cannot simply think of what they want to say but actually attempt to say it. You can try and put your fingers just to the patient's left of their voice box (Adam's Apple). Have the patient attempt to say something. No sound (residual speech) needs to be produced . If you can feel some movement on your fingers, it is likely the device will work.

 

Beta Testers: We are still preparing for testing. We are very limited to testing patients who are close to us. We are located in east central Illinois. Our first phase of development was just successfully tested on Augie Nieto in California. However, we still have some work to do. Each patient will need to go through a testing/trial and referral process with their health care professional/therapist before buying a device independently.

 

I hope this helps! Thanks!

Kimberly Beals

 

Hi Kimberly-

Thanks for your response- I appreciate it.

 

Would it be possible to ask some questions about the Audeo? There were some things I wasn't clear about.

 

1. I wasn't clear about exactly what was being transmitted. 

 

If a person has advanced stage ALS, and most of the nerves and muscles for speech are atrophied (and essentially dead) would the Audeo still work?

 

2. Are you currently using any beta testers?

 

3.  Does the person still have to have some residual speech in order for the device to work?

 

Thanks for your help with this-

 

Margaret Cotts, MA, ATP

 

 

Margaret Cotts

 

 

Hey Alisa –

 

I have heard similar comments from several of our ALS patients.  The technology sounds exciting but I am concerned that their claims may be misleading.  To that end, I have emailed the folks at The Audeo requesting additional information.   Thus far, I have received one email back – it is attached. 

Supposedly, it will be available to a limited number of ALS patients in the US in December of this year.  I am not sure how those patients will be chosen.  Here’s an ALSTDI forum link with some info: http://www.als.net/forum/topic.asp?TOPIC_ID=3310

 

Keep me in the loop and I’ll be sure to do the same!

 

Amy

 

 

The reason that I am asking the question about the Audeo is that information is flying through the internet and chat rooms that this technology is about to become available to the ALS market.   The intrepretation that PALS and families have is that they will think a thought and the Audeo will project that thought through the larynex and the sound will clearly come out.    Here is a quote from the company's web site:   The Audeo is being developed to create a human-computer interface for communication without the need of physical motor control or speech production. Using signal processing, unpronounced speech representing the thought of the mind can be translated from intercepted neurological signals.   By interfacing near the source of vocal production, the Audeo has the potential to restore communication to people who are unable to speak. The proposed solution is a featherweight wireless device resting over the vocal cords capable of transmitting neurological information from the brain. Using data analysis, this information can be processed into synthesized speech or a menu selection capable of conveying the basic necessities of human life. Current Applications of the Audeo: Speech – After a recent breakthrough, we have developed a method to exceed individual words and have shown the ability to produce continuous speech with high accuracy from the neurological signals.   I appreciate any help from the SLP's that are on this list!   Thanks, Alisa   Alisa Brownlee, ATP Clinical Manager, Assistive Technology Services ALS (Lou Gehrig's Disease) Association, Greater Philadelphia Chapter   Assistive Technology Consultant, ALS Association, National Office Direct Phone Number: 215-631-1877

 

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