Many of my clients have trouble speaking clearly on the phone due to a speech or voice impairment. Their speech may be slurred, too slow, or too fast. Maybe their voice is weak or hoarse. Or maybe they stutter or have other unusual characteristics.
Free DIRECT download: 6 ways to use the phone if you have trouble speaking clearly (patient handout). (Email subscribers get free access to all the resources in the Free Subscription Library.)
The problem may range from mild to severe. For example, someone with mild trouble speaking clearly may be misunderstood only a few times during a conversation. On the other hand, someone with severe trouble may not be able to talk at all.
Free services are available to help people who have hearing or speech problems to communicate over the phone. This guide is easy-to-read and gives an overview of some of the different services. Find more information on the services your state offers.
This post will provide an overview of solutions for people who have trouble speaking clearly. In the next post, I dive more deeply into Speech-to-Speech relay and offer a free guide.
Below are tips and tools that can help you to be successful using a phone
- Improve your speech clarity
- Speech-to-Speech (STS) relay service
- Hearing Carry Over (HCO) relay service
- Sprint IP relay service
- Speech-generating device (SGD)
- Speech-generating device with eye-gaze control
Improve your speech clarity
If you have a mild speech problem, there are several things you can do to improve how easily you are understood over the phone.
- Talk in a quiet room. Ask your listener to do the same.
- Speak a little louder.
- Make bigger mouth movements than normal.
- Clearly state your topic.
- Use the names of people and places instead of “he/him” or “there”.
- Pay attention to your listener: listeners often make noises or say quick phrases that show they are understanding or not understanding.
- Check to be sure your listener understands: listeners often pretend to understand out of politeness. Ask questions or repeat important information.
If your listener doesn’t understand:
- Repeat what you said a little louder with even bigger mouth movements.
- Use different words.
- Ask your listener to repeat what they understood and you fill in the blanks.
If your listener still doesn’t understand:
- Is it important? Try spelling it out.
- If it’s not important, move on in your conversation.
You can add video or text to your conversations if you make your phone calls using a free app such as Facebook Messenger, WhatsApp, or Skype.
If you follow these tips and you are still having trouble speaking clearly over the phone, then read on to learn about other options.
Speech-to-Speech (STS) relay service
If you have a mild to moderate speech problem, the STS relay service may work well for you. No special equipment is needed. There is no charge for the service. Depending on your phone plan, you may be charged for long-distance calls.
Simply dial 711 from any phone in the United States and ask for STS relay. You speak as if you are speaking to the person you called. A trained operator, called a communication assistant or relay operator, repeats the message to the person you called. You can decide whether the person you called can hear your voice.
People with normal speech can dial 711 to talk to you. Each state differs in the languages it offers, and whether translation (interpretation) between languages is offered. You can call just about anywhere in the world, 24 hours a day, 7 days a week. Calls are confidential and records are not kept.
Sprint offers a direct connection with an STS operator from any phone on the Sprint wireless network by dialing *787 (*STS). The direct connection service is only available to Sprint customers at this time.
According to Wikipedia, STS service is available in Australia, New Zealand, and Sweden as well. Canada offers a video relay service and a message relay service.
Hearing Carry Over (HCO) relay service
If you have trouble speaking clearly enough for a relay operator to understand, you may find HCO helpful. With this service, you type what you want to say on a special keyboard called a teletypewriter (TTY). The relay operator will read those words to the other person on the phone. The other person speaks normally, and you hear what they say.
The TTY device is provided at no charge to you through your state program. You can use it with either a landline telephone or with a TTY-compatible cell phone. Simply connect the phone with the TTY device, dial 711, and request HCO relay.
People with normal speech can dial 711 to talk to you via HCO relay. Each state differs in the languages it offers, and whether translation (interpretation) between languages is offered. Calls are confidential and records are not kept. Again, depending on your phone plan, you may be charged for long-distance calls.
Sprint IP relay service
Sprint IP Relay is a free service is available to anyone in the United States who has an internet connection. Access the service via an app on your smartphone or tablet, or via Sprint’s website on your computer. You can enable HCO if you have two lines (such as your house phone plus the Sprint IP app on your smartphone).
You must register with Sprint to get a telephone number to use for IP relay. The service is offered in English and Spanish but translation services are not available. There is no charge for the service, but depending on your phone plan, you may be charged for long-distance calls. International calls are not allowed per FCC regulations.
You must be logged into the website or the free mobile app in order to make or receive calls. If someone calls you via your IP phone number and you are not logged in, your caller can leave you a text mail message.
You type what you want to say, and a relay operator reads it to the other person on the call. The other person speaks normally, and the relay operator types it for you to read. You may save and print your conversation.
Speech-generating device (SGD)
If you have a moderate to severe speech problem, you may be using an AAC (augmentative and alternative communication) device or mobile app to help you communicate in face-to-face conversations.
The computer, tablet, or smartphone generates your messages into verbal speech. Because the SGD produces verbal speech, you can use Speech to Speech Relay Service with your SGD.
An SGD offers many advantages to HCO because you can type your messages ahead of time so that they are ready to go before you make the call. You can select pre-program common messages, saving time when you are on the phone call. You can also use the keyboard to type out any message you wish during the phone call.
If you have trouble using your hands, you may still be able to use an SGD with various tools such as a stylus, a mouse, a head-pointer, or a button next to any part of your body that you can move.
If you have difficulty using these tools with the SGD, you may be able to use your eyes to select your messages. This is called eye-gaze control and I talk about it next.
Speech-generating device with eye-gaze control
If you cannot use your hands or other tools to interact with an SGD, you may be able to use your eyes. Infra-red cameras track where your eyes are looking on the computer screen. When you want to select a letter, word, or message, you stare at it or blink your eyes.
As with any SGD, you can pre-program the things you want to say during a conversation to have them handy. You can always create new messages on the fly during a conversation.
Have you had experience with any of these tools?
I’ll be honest and say that I just learned about the STS and HCO relay services about a week before writing this post. I was researching ways for a speech-impaired client to talk to his hearing impaired parent when I stumbled across these services. I’m frankly shocked I’m just now learning about these services.
If you or someone you know has trouble speaking clearly, I’d love to learn any tips you have for talking on the phone. Please leave a comment below or contact me privately.
Free DIRECT download: 6 ways to use the phone if you have trouble speaking clearly (patient handout). (Email subscribers get free access to all the resources in the Free Subscription Library.)
Lisa earned her M.A. in Speech-Language Pathology from the University of Maryland, College Park and her M.A. in Linguistics from the University of California, San Diego.
She participated in research studies with the National Institute on Deafness and other Communication Disorders (NIDCD) and the University of Maryland in the areas of aphasia, Parkinson’s Disease, epilepsy, and fluency disorders.
Lisa has been working as a medical speech-language pathologist since 2008. She has a strong passion for evidence-based assessment and therapy, having earned five ASHA Awards for Professional Participation in Continuing Education.
She launched EatSpeakThink.com in June 2018 to help other clinicians be more successful working in home health, as well as to provide strategies and resources to people living with problems eating, speaking, or thinking.
My brother’s throat is closed up due to radiation treatment from cancer. He can hardly speak and his wife needs to translate. I saw on TV an sportscaster that couldn’t speak for two months after a throat operation and he had a devise or apt which he could type on and then press something that verbalized what he had just typed and I was wondering if there was something that my brother could use,
Hi Beth,
I’m sorry to hear about your brother’s difficulty communicating. Yes, there are many apps for smart phones or tablets that could possibly help him communicate. He could search in the app store on his cell phone or other device for “AAC” and take a look at the choices. You can also search online and read descriptions. There are many apps, and I don’t know what devices your brother has, but two I like are ClaroCom and Verbally. (There are dozens at least!)
I’m crying as im writing this amd reading it to say thank you. For posting this. Im researching for myself. Im 30 and idk if its seizures or ptsd but something is not working and I’m beginning to have issues with my speech. Its making me sad. The worst times have been when I dont have paper and pen with me.
I’m sorry to hear that you’re having trouble with your speech. I encourage you to see your doctor and ask for a referral to a speech-language pathologist. I hope you find some helpful tips on my blog, but chances are that seeing an SLP would be even more helpful. Good luck, and take care!
I have a client who can speak, but can not interpret speech neurologically to understand. Visitors speak into his Android devise, which changes the words into Text. Now families are not allowed to visit.
We are looking for a method for family to speak by phone and turn the voice into text for him, allowing him to respond with voice directly back to family. Sprint IP-Relay tells me they can’t do that.
Any recommendations?
Thank you
TIm
Hi Tim,
I understand what you’re saying, and I think you should take a look at this other post: https://eatspeakthink.com/6-free-internet-based-telephone-relay-services-if-you-have-trouble-hearing/
There are free services that will do exactly what it sounds like you’re looking for. Your client’s communication partner would talk to your client, then your client could read what they say on a screen, and your client can respond verbally.
I hope that helps!
I don’t know how long ago you posted this question, but as of this reply newer android accessibility functions have settings that provide closed captions for phone calls. It’s called LiveCaption and should be in the same settings area as LiveTranscribe.
Thanks so much for sharing this information! I’m sure it will be helpful to many people.
Lisa
I use an android program called speech assistant which is free on google play. the only problem hang up on me because they think its a automated call.
Ah, that is a good point. You may want to ask a friend or relative to help you create a more natural-sounding synthesized voice which apps could use instead of the standard voice. For instance, you could check out The Voice Keeper: https://eatspeakthink.com/easy-voice-banking-with-voicekeeper/
hello I am a hospital dispatcher new to have moderate speech issues take calls on landlines wondering what would be best for me to take calls from multiple phones multiple phone lines to answer and communicate back with them
Hi Lisa,
That sounds like a challenging situation to be in. I would recommend asking your doctor for a referral to a speech-language pathologist for personalized recommendations based on your strengths and weaknesses and job requirements. I would also suggest talking to HR to find out what accommodations could be made, or what supports they could offer.
Thanks for your question,
Lisa
My 62 y/o brother has had a laryngectomy surgery plus other major surgeries in the chest and esophageal area. They vibrating Speaking device does not work well for him as so much muscle and tissue has been compromised. He uses texting to contact family and friends. The difficulty he has is trying to get services such as calling an auto repair service. Family in his area are all well over 80 with their own health issues. and assistance has become too much for them. What service is available for him to live independently? Thanks for your help. Mary
I’m sorry to hear that your brother is having so much difficulty. If he lives in the US, he has four options.
First, if he has some ability to produce speech with the electrolarynx speaking device, he has free access to speech-to-speech relay. The operators are specially trained to understand impaired speech. He wouldn’t need special equipment.
The other option is to use the hearing carry-over service, which is also free but requires special equipment. He would type what he wants to say, and the operator would read it to the other person.
The third option is to use the Sprint IP relay service, which is also free but requires an internet connection. Your brother would type into the app and the relay operator would read it to the other person.
The fourth option is to use an AAC communication app or device, which would allow him to talk to people face-to-face as well.
You can find information about all four services in the post above.
Thanks for your question and good luck to your brother.
Hello. I like someones suggestion about speech assistant for my high level expressive aphasics. My one question is, is there any way to utilize the AAC part while on a phone call? My patient has o much difficulty with expression and if she needed help i’m trying to find a way (besides life alert) that she could call for help and have the know her name, where she is, etc… Any suggestions would be greatly appreciated.
Hi Kelly, great question! It sounds like you’re asking about how a specific app works during phone calls. I think the best thing to do would be to have your patient call you during a session, put their phone on speaker, then use the app to verbalize a message. I don’t see why it wouldn’t work, but we’d love to find out how it goes for you.
If your client lives in the US, I believe you can also have them registered with the local police department as someone who has trouble with verbal expression. That way, if they call 911 from the registered number, the operator should have that information.
Good afternoon!
My cousin has had a Laryngectomy recently. We just finished up with Radiation. Is there a device for him to be able to use with a cellular device. I would like for him the able to communicate through the phone. If he should need something make a phone call. I see the TTY devices, but how do you go about ordering one? Thank you In advance for your help.
Hi Tiffany, thank you for reaching out. If your cousin is able to produce speech that is understandable face-to-face (for instance, using an electrolarynx), then he could either make the call normally or use speech-to-speech relay. If he’s not able to produce speech well enough to use STS relay, then I think his best option may be Sprint IP relay, using his smart phone. You can learn more here, just scroll down to that section: https://www.sprint.com/en/shop/services/accessibility/services.html
Also, there is a nonprofit who provides free copies of a self-help book for people who’ve had laryngectomies in the past 48 months: https://laryngectomeeinfo.org/
I’m not sure how oils this posting is? My brother is 70 years old with very progressive Parkinson’s disease. His speech is very bad but he can type into a larger key board device. He does not have a smart phone or tablet yet. He fortunately doesn’t have a severe tremor but does suffer with rigidity. Is there any device that could help him to speak?
Hi Judith, I’m very sorry for my late reply. I am just seeing this comment now. Yes, I’m sure there is some type of AAC (alternative and augmentative communication) tool that your brother could use to help him communicate. My recommendation is to have him consult with a speech-language pathologist who can address 2 issues. The SLP can assess his speech capabilities to see if he is a candidate for a program such as SPEAK OUT! or LSVT LOUD. They can determine if a tool such as a voice amplifier will help. And they can do the AAC assessment and write the report to support insurance paying for the AAC device.