Title: Digital Speech Recovery from Articulator Movement (DiSArM)
Funder: Department of Health (England)

Abstract: Background Patients who have a laryngectomy inevitably lose the ability to speak. Loss of speech is known to cause social isolation, feelings of loss of identity and can lead to clinical depression. All methods available to restore speech have limitations in terms of quality of speech, ease of use and, in the case of implanted speech valves, the requirement for frequent replacement. A new approach is proposed based on electronic sensing of the motion of the mouth and tongue during mouthed but silent ‘speech’, to determine what has been articulated and hence produce the desired speech. Laboratory trials have demonstrated that such a system can recognise isolated words with an accuracy of over 98% for a 57 word vocabulary, appropriate for basic communication and for command and control applications. Aims The aim of this proposal is to prove the effectiveness and improve the capability of the demonstrator system so that it can be used to restore speech in patients after laryngectomy. We want to deploy our technology outside the laboratory and ensure it is appropriate and acceptable to both patients, in terms of their priorities of speech quality, ease of use, flexibility and appearance, and to clinicians, in terms of their objective of an integrated approach to speech rehabilitation. We aim to understand the most appropriate arrangement for sensing movement, for processing signals and deployment of speech technology to generate high quality speech while making the system suitable for users and cost effective to produce. Plan of Investigation The research will involve consultation with stakeholders, primarily patients and clinicians, to understand their priorities, followed by a programme of technical development, testing and refinement aimed at achieving those priorities. A preliminary prototype system will be developed for laboratory based patient trials and, using feedback from this and further technical development, a second prototype system will be developed that is appropriate for everyday use, i.e. discrete in appearance and mobile. Further patient trials, carried out in their everyday environments, will then be used as the basis for final evaluation of the system. Potential Impact For laryngectomees, progress beyond oesophageal, electrolarynx and valved speech, with their psychosocial and surgical complications, would improve the patients’ quality of life greatly. Our technology would reduce the need for a tracheo-oesophageal fistula and the continuous cycle of valve replacement which currently costs the NHS about £10M per annum. Patients would be able to communicate in their original voice without drawing attention to their laryngectomy, as happens now by the use of an electrolarynx or by finger closure of their tracheostome. The proposed system would also be particularly attractive to those patients currently unable to use a speech valve, and the system might benefit those affected by other speech conditions such as dysarthria associated with cerebral palsy.


Research activity codes: 6.3 MEDICAL DEVICES;5.3 MEDICAL DEVICES
Health categories: CANCER AND NEOPLASMS