Name of the Procedure:

• Common Name(s): Speech Generating Device (SGD)
• Technical Term: HCPCS Code E2510: Speech Generating Device, Synthesized Speech, Permitting Multiple Methods of Message Formulation and Multiple Methods of Device Access

Summary

A Speech Generating Device (SGD) is an assistive technology tool designed to aid individuals who have severe difficulties in speaking. These devices produce synthesized speech by converting text or symbols into voice output, providing users with alternative ways to communicate effectively and efficiently.

Purpose

SGDs are used to help individuals with significant communication impairments due to medical conditions like ALS, cerebral palsy, or stroke. The primary goal is to enable users to express their needs, thoughts, and emotions, thereby improving their quality of life and social interactions.

Indications

• Individuals who are non-verbal or have severely impaired speech.
• Patients with conditions such as amyotrophic lateral sclerosis (ALS), cerebral palsy, traumatic brain injury, or aphasia following a stroke.
• Patients who have a functional understanding and cognitive ability to use an SGD.

Preparation

• Comprehensive assessment by a speech-language pathologist.
• Possible trials of different types of SGDs to determine the most suitable one.
• Training for the patient and caregivers on how to use the device effectively.
• No specific fasting or medication adjustments required.

Procedure Description

1. Assessment and Prescription:
   • Evaluation by a speech-language pathologist to assess the patient’s communication needs and abilities.
   • Selection and prescription of the appropriate SGD model based on the assessment.
2. Customization:
   • Customizing the device settings to match the user’s preferences and needs.
   • Programming the device with commonly used phrases, words, and symbols.

3. Training:

   • Training sessions for the patient and caregivers on how to operate and maintain the device.
   • Instruction on various methods of message formulation and device access (e.g., touch screen, switches, eye-tracking).

   No anesthesia or sedation is involved in the provision of an SGD.

Duration

Initial assessments and training sessions typically span several hours spread over multiple days.

Setting

• Outpatient clinic or specialized AAC (Augmentative and Alternative Communication) center.
• Follow-up and training can also be conducted at the patient’s home or school.

Personnel

• Speech-language pathologist
• Occupational therapist (for access and positioning assessments)
• SGD vendor or representative (for device provision and tech support)

Risks and Complications

• Minimal risk as the procedure is non-invasive.
• Possible technical issues or device malfunctions that require technical support and maintenance.
• Initial frustration or learning curve in effectively using the device

Benefits

• Enhanced communication abilities, improving social interactions and quality of life.
• Greater independence in expressing needs and desires.
• Increased participation in educational, social, and professional activities.

Recovery

• Ongoing adaptation period where the user becomes proficient with the device.
• Regular follow-up appointments for calibration and updates.

Alternatives

• Manual communication boards or picture exchange systems.
• High-tech devices with different output formats (text-to-speech apps on smartphones/tablets).
• Traditional speech therapy aimed at improving natural speech production when possible.

Patient Experience

• The introduction phase may be challenging but becomes more intuitive with practice.
• Typically, patients do not experience pain or physical discomfort.
• Comfort and motivation from successfully communicating with others.