Communication by Telephone

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Part 1: Introduction

People with speech disabilities (PSDs) in all states and in several other countries use an accessible telephone service. Speech to Speech (STS) started as an idea in my head about 1990 and grew out of my own attempts to be understood over the telephone despite my cerebral palsied speech. I successfully lobbied first at the California Public Utilities Commission, then at the Federal Communications Commission (FCC) to require STS be added as a service of the TTY relay and I was privileged to help write the FCC regulations for STS.

Part 2: What is Speech to Speech?

STS is a telephone access service for PSDs that is free to users. STS provides human revoicers for PSDs who have difficulty being understood with telecommunications, and allows many PSDs to use the telephone independently. Users access STS through their state's TTY relay provider. Current STS use shows that PSDs find it readily usable.

The FCC now requires that STS be provided nationwide. STS is available nationwide and in parts of Sweden. Australia has a permanent service, which I helped design and initiate when visiting Australia. New Zealand's STS trial is taking place this year.

Part 3: Who Uses STS?

Most STS users have cerebral palsy or similar developmental disabilities. Individuals with speech impairments are understood by patient listeners with acute hearing who have had experience and education to serve as Communication Assistants (CA) listening to PSDs. Users may also access STS with a speech synthesizer or an artificial larynx.

The general public can not understand most STS users' speech. Users may also have dyslexia or limited hand use (which precludes keyboarding adequate to use a TTY relay service).

Most successful STS user consumers: A) Speak well enough for a CA to understand them most of the time and, B) Have the social skills and motivation to carry on a telephone conversation with translation through a CA to the second party.

Part 4: How Does STS Work?

To use STS: PSDs call toll free to reach a communications assistant (CA) by calling 711 and requesting STS or calling their own state's STS 800 number listed on the Internet.

Editor Note: The Nationwide 711 number will connect a caller to the state in which a person is located who is making the call.

After requesting STS, (or Speech to Speech Assistance), a CA places the call for the individual and repeats his/her words to the listener. Users tolerate frustrations related to having a CA make calls for them because they like the increased speed of communications compared with TTY relay calls which are cumbersome when initiated by very slow PSD typists.

STS is very much like the TTY relay for people who are deaf and hard of hearing, except that while TTY relay users type to a communications assistant who verbalizes their words and types their callers words back to them.

Editor Note: Persons who are hard of hearing may also use the STS services if they are unable to relay messaging through TTY, but have sufficient hearing with an amplified telephone. In this case, the person who is hard of hearing must self report his/her disability to the CA and request the CA remain on the line to assist with relaying messages between the two communicators.

We learned from initial STS trials that good communication requires that the CA and both callers hear each other throughout the call. That is why STS utilizes "cross-hearing" (My word) which maximizes communication by allowing everybody to hear each other throughout the call.

Part 5: What do Communication Assistants (CA) Do?

The STS CA revoices what the PSD says after every three to four words, a procedure that I adapted from face-to-face revoicing. CAs make callers as comfortable as possible even when the caller is not understood. After two repetitions the CA may ask the caller to "say that another way" or "spell the word".

The STS CA: 1) Expects to hear someone with distorted speech or a speech synthesizer and is therefore not shocked or confused by them, 2) Uses earphones to eliminate all background noise, 3) Has acute hearing and excellent receptive language skills, 4) Can concentrate on understanding the PSDs words as the CA has no interest in content and no emotional involvement with the speaker to distract her/him, and 5) Can solicit the speech-able user's patience.

STS Training: CAs who worked on the TTY relay need a few days of additional training about PSDs to work as STS CAs. Audio tapes of PSDs are useful to train CAs; the tapes teach CAs the "feel" for listening to PSDs. We taught CAs how to respect PSDs and training by a PSD helps CAs understand their job.

Part 6: Outreach

The greatest challenge for STS outreach is that there is no central source for locating potential STS users. Potential STS users have been identified one-by-one in order to build an STS user base. It is like looking for needles in a haystack. To supplement this approach, outreach workers telephone and mail flyers to medical professionals who work with PSDs.

Some potential users so fear using STS that they must be telephoned and/or visited repeatedly before they will make an STS call themselves. Family members and caretakers may require counseling if they feel a loss of role and power when PSDs start using STS.

About a half million Americans could use STS if they knew that it existed. Because of intensive outreach, California has more STS users than any other state.

Editor Note: Through the work of Dr. Segalman, STS is recognized in all 50 states across the United States of America. The service is available to users with both speech and hearing difficulties. The CA must be informed if a caller has a hearing loss to assure the CA has his/her microphone adjusted properly. STS is not intended for persons with profound hearing loss, and by reporting this disability, the CA can provide communication between a person with speech difficulties and using a TTY system, relay the message to the person who is profoundly deaf. This dual network of communication is one of the most profound advantages for persons with sensory disabilities.

Part 7: What Users Say

I asked one STS user if she would attempt the same calls on her own without STS, She replied: "Never in a million years!" Several employers of users say that STS improved on the job communication. One recent college graduate applied to law school because STS would enable her to telephone clients.

Dr. Judy Montgomery, Past National President of the American, Speech-Language-Hearing Association, told me that STS relieved the able-bodied caller of responsibility for deciphering garbled speech and allowed her to concentrate on the content of the call. An aide in the California Governor's Office told me that he was impressed with the potential of STS to increase the employment opportunities of PSDs.

Julia Hollenbeck, President and Chief Executive Officer of Wheel Me On, an organization for persons with and without disabilities, reports that she is able to converse with several members on a National level who she would not be able to communicate with if it were not for STS.

Part 8: Footnote

STS broadens the role of relay. Direct and speedy telephone access helps mainstream PSDs into jobs and many other activities. Such service expansion reflects the spirit of the Americans with Disabilities Act (ADA). The ADA advocates using new technology to benefit people with disabilities.

The ability to make one's own phone calls dramatically increases one's independence. Think back on all the phone calls that you have made in the last week and consider how much independence you would lose if you had to ask a friend to make each of those calls for you!

Next to getting married and earning a Ph.D., developing STS is the most exciting thing I ever did. Imagine my joy helping others overcome what had been my own greatest personal frustration!

Bob Segalman, Ph.D.
Founder of Speech to Speech
3330 Tropicana Court
Sacramento CA 95826

This article is based on an article that Dr. Segalman and Katherine Keller wrote (publisher: http://www.stsnews.com).

Editors Note: It is against the law for persons without disabilities to use the STS or TTY system to contact individuals who do not have a speech or hearing disability or if they are not calling an individual who requires a Communication Assistant.