Joe is a 10th grade student from Pennsylvania, USA. In April of 2018, Joe had a total laryngectomy (surgery to remove voice box) due to having Squamous Cell Carcinoma. He is currently in remission and is doing well. Joe has a TEP (tracheo-esophageal puncture/prosthesis). Joe sees a speech pathologist in a medical setting once per month to check on his TEP, but did not wish to participate in voice therapy at these appointments. Joe was very unhappy with how his TEP felt and how much his voice quality had changed. Joe expressed a strong desire to find an alternative means of communication to use with his peers and unfamiliar conversational partners, with whom he felt most self-conscious about his voice.
When we first met Joe, he was pleasant and cooperative, but he did not attempt any voiced speech productions through his TEP. Joe showed us that he used a free version of a text-to-speech app on his phone. Since this app was free, it had very limited features and was lacking crucial software components that would increase Joe’s speed and ease of use. The app on his phone spoke with a female voice, the only voice available on the free version of the app. We educated that there are apps with male voices that could make Joe more comfortable speaking with others.
Joe reports that he is able to effectively communicate with others through the use of his phone to type answers and via the written modality, but that it takes him a long time to generate his message and it is very difficult for him to gain others’ attention. Also, when presented with various scenarios (e.g. ordering a pizza, making appointments, etc.), Joe was unable to determine how he would communicate effectively. These problematic scenarios are what lead us to Predictable®. Since Joe is already quite comfortable with texting and navigating his personal devices, Predictable®’s advanced word prediction was exactly the type of feature we were looking for to increase Joe’s speed with communicating. The prestored message feature also made Predictable® a perfect fit for Joe’s communication needs, as most of his communication occurs in large group settings (e.g. school, work, etc.) where he requires a means of gaining and keeping others’ attention until he generates his message. Lastly, one of the most important features for Joe was having the opportunity to select a male voice for his speech output. This may seem like a small detail, but it was so important for him to have this part of his identity back. We have seen a huge increase in Joe’s confidence and willingness to communicate at school since he began using Predictable®. We are so grateful for the creators at Therapy Box and all they have done for people like Joe!
Author of case study: Hannah Skerbetz, B.S. SLP Intern Jennifer Laughlin, M.S. CCC-SLP Pennsylvania, USA
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