At Children's Hospital Boston, children have digitally recorded messages, songs, and even signature expressions and sounds that are meaningful only to the most familiar communication partners.
One example of voice banking comes from Andrea, the mother of a 12-year-old with juvenile Huntington's disease:
The way my son and I connect with each other is through these silly phrases, noises, and songs that we've shared since he began to speak. Now that he has lost his speech and he is nearing the end of his life, these recordings are all we have left. They allow us to connect. When he pushes the button with his voice recorded singing "You are my Sunshine," he knows I am going to sing with him and hold him.
Beth, the mother of a 12-year-old with cystic fibrosis, also reflected on the importance of voice banking: "I know I am going to lose him and he is now so sick that he doesn't even look like the son I know, but then I hear his voice, and I know he is here with me."
Voice banking also benefits the care providers, as one nurse described in an interaction with a young patient: "I didn't know her before she was too weak to speak, but today when I swabbed her mouth, she pushed a button that said 'thank you' in her recorded voice! I suddenly knew her so much better when I heard the sound of her voice."
Voice and message banking may be achieved through a variety of strategies, including AAC devices that support digital recording or creating audio WAV files on a computer-based system and then linking those files to text or symbols in an augmentative communication application. Another option is to use a system that will match written text to recorded words and phrases in memory, supporting a broader use of the recorded voice in many messages; a newly released software update from a manufacturer of eye-tracking technology performs this function. One product under development uses representative segments of speech to create a unique synthetic voice that approximates a person's natural speech.
At Children's Hospital Boston, voice and message banking typically is introduced to children as a support they can use if they are too tired to speak. Often children have already experienced periods of fatigue or changes in status during which it was more effortful to speak, so the value of this strategy is immediately recognized.
In addition, many children find the application of technology to be intriguing and are motivated to participate. For many of these children, the course of the disease and treatment may make it impossible to know at the time of banking if, indeed, the messages will be needed or used as a primary communication support. For others, the medical course and impact on speech is clear and the need for AAC is assured.
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