Telephone use to elicit voice or speech in brain injured subjects.

The initiation of speech is often delayed in the early stages of recovery from a serious brain injury. We have found a high percentage of patients with both speech and swallowing problems. This makes bedside assessment of swallowing safety difficult because one cannot listen for the sound of aspirated material on the vocal cords when a patient is at high risk for silent aspiration and is often unable to cooperate with a videofluoroscopic study. The use of the telephone has been described several times for aphasia treatment, but not to elicit speech or assess swallowing safety early after brain injury. This study, therefore, recruited subjects who had brain injuries and (1) were referred early for swallowing and other evaluations, (2) were out of coma and able to follow some commands, and (3) did not initiate voice or speak when asked to. Subjects were asked three questions under two different conditions: face to face and after ringing the telephone from another room. The results were recorded on videotape and analyzed by another investigator for quantifiable differences. Six of the seven subjects responded better with the telephone stimulus than without. This technique may elicit voice or speech early after brain injury in some patients and may be useful in bedside assessment of swallowing safety. It may also serve as an example of appropriate stimulation of brain injured subjects coming out of coma.

Canon communicator use by adults: a retrospective study.

The purpose of this study was to document aspects of successful Canon Communicator use by 13 subjects. Questionnaires were completed by the speech-language pathologists serving these individuals. Subjects ranged in age from 17 to 64 years. They had used the Canon as a communication augmentation device from 2 to 24 months. All were either anarthric or severely dysarthric as a result of a neurological disorder (cerebral palsy, bilateral CVA, closed head injury, ALS) but none were diagnosed as aphasic. The decision to recommend the Canon was made mre rapidly for older adults. Although a majority of the subjects used more than one communication system, all subjects for whom the Canon remained appropriate (11 of 13) continued to use this device more frequently than other systems. No malfunction other than power supply system was reported.