Information presented at USSAAC, August 2, 1997, by Dorothy Lennox, Luminaud, Inc.
PERSONAL VOICE AMPLIFICATION
ADVANTAGES TO USERS AND LISTENERS, PATIENT ASSESSMENTS
MICROPHONE POSITIONING, CONSIDERATIONS IN USE AND CARE
KEY WORDS: Voice amplifier, amplification, microphone, weak voice, whisper,
communication, Voicette, Rand Amp, Mini-Vox.
Voice amplification is helpful to those who can shape words understandably but have a voice volume too soft to be heard easily. If speech is fatiguing, requires frequent repetition and/or excessive listener proximity, a voice amplifier is likely to be very beneficial. Voice amplifiers are also valuable to people with no voice problems who speak to large groups or in noisy or wide-spread areas. They eliminate shouting, protect the throat and allow the speaker to reach a larger audience more effectively.
Voice amplifiers are useful to esophageal & TEP speakers and anyone with a weak voice or throat problem such as: vocal nodules, Parkinson's, ALS, MS, Guillan Barre, damaged or partially paralyzed vocal cords, impairment of throat or chest muscles, diminished lung capacity. They also can be used to amplify artificial larynx speech in large or noisy areas.
They are useful in almost any setting - home, office, factory, hospital, school, nursing home, church, retreat, park, camp, meeting, restaurant, party, ballgame, on the street, any place or event - for one to one conversation or for group activity. They are ideal for people who have difficulty being heard above engine or road noises in a car, bus, plane or train.
People with no voice problems will also benefit from using an amplifier when talking to groups or in a large or noisy area. Amplification will eliminate shouting and voice strain and provide better listener understanding. Amplifiers are a major asset to tour guides, teachers, coaches, clergy, lawyers, morticians, business and organization leaders, entertainers, public officials, public safety officers, politicians, and public speakers of all kinds.
VOICE AMPLIFICATION OFFERS EASIER, LESS FRUSTRATING COMMUNICATIONAND HAS MANY RELATED ADVANTAGES FOR BOTH USERS AND LISTENERS:
> Rests the throat to allow healing or to avoid damage or further damage.
> Minimizes overall strain and fatigue when physical condition makes talking a tiring effort.
> Less need for repetition, fewer misunderstandings.
> Makes life generally more pleasant and less frustrating both for people who want to be heard and for the family, friends, caregivers and teachers who want to be able to hear them easily.
> Promotes independence and self-assurance in those who previously could not "speak up" and take charge of their own lives and care.
> Improves communication when talking with people with hearing problems - a relief to both speaker and listener.
> Lets those with hearing impairment hear themselves better during speech practice - while improving tone and articulation, learning, esophageal speech, reacquiring speech after stroke or injury, etc.
> Allows longer phrasing for esophageal & TEP speakers.
> Helps develop poise and self-confidence in those not accustomed to public speaking.
> Enhances enjoyment for both participants and audience at special events.
> Increases effectiveness of classes, lectures, meetings, sales presentations.
> Provide easier, non-aggressive "crowd control" in institutions and a variety of public settings.
"HOW CAN WE TELL WHETHER VOICE AMPLIFICATION IS LIKELY TO BE SUCCESSFUL?"
Choose a quiet room and a listener with average hearing. Position the listener so that the speaker's mouth is about 12" to 18" behind the listener's ears. (This position precludes lip reading.) If the listener can understand most of what the speaker says - 70% or more, then there is a probably enough voice to make good use of a number of amplifiers. If only about 10% to 30% can be understood, then it is still possible that a Mini-Vox or other larger amplifier might bring the voice up to a usable level.
A successful amplifier user must be able to shape words fairly well - amplifiers improve only volume, not articulation. However, speech therapists often report that once a patient is freed of worry about volume, better articulation is easier. Also, people with dysphonia and others whose volume is variable and unpredictable sometimes find that the use of an amplifier allows them to produce more consistent voicing. And, amplifying the voice, even though not technically clarifying it, may bring words and speech nuances up to a level that the listener's brain can process them more easily, thus improving apparent intelligibility. These advantages cannot be promised to all amplifier users, but have been reported frequently enough to indicate that they definitely will happen with some individuals.
"IT SEEMS LIKELY THAT A VOICE AMPLIFIER WOULD HELP - SO WHAT'S THE BEST ONE???"
Really - there isn't any one best! The ideal voice amplifier, of course, would be the size of a common pin, worn on the lapel!! Unfortunately, that kind of StarTrek technology is not yet available. In order to get good amplification - with reasonable sound quality and minimal feedback problem - at a reasonable price - the speaker/circuitry must have size, weight and bulk and there must be a microphone close to the lips. So choices must be made from what is available.
"Trade-offs" are often necessary. Some people may want or need more amplification even if it means dealing with a heaver instrument. Others want a smaller amplifier even if it limits their easy-conversation area to just a few feet away. Some may want very good voice quality for singing. Others just want reasonable amplification at as small a size and/or as economical a price as possible. Some want or need a "hands-free" mic. We feel, certainly, that some brands are generally preferable, but overall, the best amplifier is the one that has the most optimal mix of features for the individual user.
THINK ABOUT THESE FACTORS WHEN CHOOSING AMPLIFICATION EQUIPMENT:
Amplification Potential - how loud the amp will go compared to how much amplification the user wants.Sound Quality - This includes clarity and fidelity. In general, the larger the speaker, the louder and clearer the sound. As long as the sound quality is reasonable, many people will prefer a smaller amplifier to a larger device with excellent sound quality. Note that high fidelity is not always desirable. Some good amplifiers for people with voice problems are tailored to emphasize better parts of the voice and dampen unwanted areas.
Weight, size, shape, arrangements for carrying - shoulder strap, carrying case, etc.
Price, Guarantee, Return policy
Durability - expected longevity and resistance to breakage
Power source, battery usage and/or recharge requirements. Battery powered amps have no cord to limit movement and no danger of electric shock in wet areas, but the batteries must be replaced or recharged. People who move around will definitely want battery power, but people who will be in one indoor place most of the time may want to consider an amplifier that plugs in to line power.
Handling requirements
Location of controls, knobs, switches
Whether the volume level can be left preset or is combined with the on/off switch.
User's hand and arm capabilities and cognitive ability to handle and position the device, change batteries, etc. or availability of family member or caregiver who can assist reliably.
Compatibility with preferred microphone
Availability of use with wireless mic if desired
CONSIDERATIONS IN CHOOSING A MICROPHONE: Handling and placement requirements of microphones must be compared to the head, hand and arm control capabilities of the user.
Hand-held mics
Are convenient to pick up and use as needed, quick and easy to position.
Do not require "wiring" of head.
Do not interfere with hair or clothing.
Are quick and easy to pass from person to person for group use (laryngectomee club, for instance)
Often are the least expensive choice.
Require that the user have reasonable control and movement of hands and arms.
Can easily be held for the user, when needed, by a therapist, family member, friend or caregiver.
Hands-free mics for those who cannot use hands and/or arms or need hands free for work or activities. Headset, headband and starset type mics
Stay with the mouth at all times unless deliberately moved - useful for those without good head control, those who must turn their heads constantly (for instance: special needs teachers), or who must bend over or jump around (doing craft demonstrations, bending over small children's desks, leading jazzercize classes) (starset is less stable - not as suitable for major activity)
Require a cord to the head and may interfere with hair style.
Require user's or someone else's "hands-on" to get away from the mic - to eat, drink, or, if desired, to avoid amplification when coughing, sneezing, clearing the throat, etc.
CollarMicUser can turn toward it for amplification, turn away when amplification is not wanted.
Does not usually give as much of a feeling of being "wired."
Does not interfere with hair style or put any pressure on the head.
Does not move with head - requires head control and the cognition to turn to it when speaking.
Unless deliberately pinned or tied down, will bounce around if user jumps around and will probably bump the user in the nose if he/she bends over.
Hand-held mics on goosenecksOften an ideal arrangement for people using wheel chairs or sitting or lying at the same place for long periods of time.
Does not require that any cords or wires be placed or draped on the head or body.
Allows complete freedom of head and mouth.
Often work well for people lying in bed since other mics may be knocked out of place when turning head or be uncomfortable to lie on.
Requires control of head movement, the cognition to turn to the mic when speaking.
Lapel or Lavaliere mics
Are not suitable for people with weak voices. (Those television announcers have strong voices, are not being amplified in the same room so the gain can be turned up with no feedback problems - and the station can spend big $$$$$ on their sound systems!)
Are useful for people with good voices using wireless amplifiers, with mic and amplifier speaker separated by at least 8 to 10 feet.
Bone conduction and throat mics
Are usually not suitable for people with weak voices - Have difficulty in picking up sound energy from a weak voice through the tissue or structure of the neck, so are likely to provide very limited amplification.
Sound quality is likely to be poor, with "static" sounds, due to pick-up of body noises and mic rubbing on skin, hair and beards.
Microphone must be compatible with chosen amplifier.
SEE ACCOMPANYING SHEET FOR INFORMATION ON MIC USE AND CARE"BUT MS. JOHNSON, A VOICE AMPLIFIER WOULD MAKE EVERYONE LOOK AT ME !!"There is sometimes objection to voice amplification on the grounds that it is too noticeable and makes the user feel too conspicuous. This is similar to the resistance people have traditionally had to wearing hearing aids and eyeglasses. People of any age may have this response, but it particularly frequent among teenagers. But consider, as well as the obvious advantages of voice amplification to both speaker and listeners, that a voice amplifier actually allows the user to be LESS conspicuous. Voice amplification is no longer an oddity - entertainers and many others use it all the time. After a very short initial adjustment, both the user and the listeners will forget about the amplifier and give no more attention to it than they would to glasses on someone's face. Then everyone is free to carry on natural conversations without any undue attention to the person with the voice problem.
Of course, as with any equipment, the use of a voice amplifier will often seem awkward and cumbersome at first, but with a little practice it will become routine. Often the amplifier is so helpful that the user will wonder how he/she ever got along without it.
FINANCIAL ASSISTANCE FOR AMPLIFIER PURCHASE
may sometimes be obtained include the Veterans Administration, state Bureau of Vocational Rehabilitation, Sertoma Club, Lions/Lionesses, Telephone Pioneers of America, Easter Seal Society, churches, and local chapters of health, fraternal and service organizations. If one agency cannot help, it may be able to direct you to another that can. INSURANCE FOR VOICE AMPLIFIERS: MEDICARE does not routinely provide coverage since they consider voice amplifiers to be aids, like eyeglasses and hearing aids, not prosthetic devices. However, they will consider any device on an individual basis. Some state MEDICAID programs cover amplifiers. PRIVATE INSURANCE COMPANIES may provide coverage, depending on the user's policy. In any case, there is a better chance of coverage if the claim is accompanied by a detailed medical professional's explanation of the need for the voice amplifier, emphasizing the medical aspects of the need, rather than the social or psychological benefits to the user.THE FOLLOWING INFORMATION APPLIES PARTICULARLY TO PURCHASES FROM US AT LUMINAUD, INC.
Due to the uncertainty of Medicare coverage, we cannot "accept assignment" (bill Medicare). Those who have Medicare Part B should mention it when they order. We'll send a form for the user and physician to fill out so we can file a claim in the hope that the user may be reimbursed. With a good write up emphasizing the MEDICAL basis of the need for the amplifier and with good luck in getting an examiner who allows wide interpretation of the guidelines, reimbursement is sometimes given.
We no longer participate in any Medicaid programs due to excessive paperwork and frequent non-payment, but we can sometimes work with a local Durable Medical Equipment provider - the kind of store that would provide walkers, commodes, wheelchairs, etc. - to provide a voice amplifier. An individual, therapist, social services worker or DME dealer may contact us for further information
We cannot bill Private Insurance or fill out insurance forms. When we sell an amplifier to an individual, the package will include the original and 2 copies of the paid invoice. One of these copies may be sent, along with the customer-completed insurance claim form and a physician's statement of need, to the insurance company to obtain whatever reimbursement they will allow.
There are only a few brands of personal voice amplifiers available. At Luminaud, we offer a versatile selection of high quality amplifiers and microphones and over 25 years experience in providing communication equipment. We are happy to discuss specific requirements, preferences and capabilities to assist therapists and their patients in choosing the most appropriate voice amplification system for any individual's needs.