Voice banking is a way for a person with motor neurone disease (MND) to create a digital version of their own natural voice before their speech becomes significantly affected by the disease.
MND can damage the motor neurons that control the muscles involved in speech. As these muscles become weaker, a person may develop dysarthria, meaning their speech becomes slower, quieter, slurred or increasingly difficult to understand.
Voice banking allows a person to record their voice while they can still speak relatively clearly. The recordings are then used to create a synthetic voice that can be used later through a communication device.
How Does Voice Banking Work?
The process generally involves:
Assessment
A speech and language therapist (SLT) may assess the person’s speech and discuss whether voice banking would be appropriate.
It is usually easier to create a good-quality voice while speech is still relatively clear.
Recording
The person records a large number of sentences or phrases.
These sentences contain different sounds, words and combinations of speech sounds.
Depending on the system, recording may take several hours and can sometimes be completed over multiple sessions.
Creating the Synthetic Voice
The recordings are processed using specialised voice technology.
The system learns characteristics of the person’s voice, such as pronunciation, pitch and rhythm.
This produces a synthetic voice intended to sound similar to the person’s original voice.
Using the Voice Later
If the person’s natural speech becomes difficult to understand, they can use an AAC (augmentative and alternative communication) system.
The person types a message or selects words on a communication device.
The device then speaks the message using their banked voice.
Why Is Voice Banking Particularly Relevant to MND?
Speech deterioration is relatively common in MND, particularly when the muscles involved in speech are affected. Someone may initially notice that their speech is becoming:
• Slower
• Quieter
• Less precise
• More effortful
• Slurred
• Difficult for unfamiliar people to understand
Eventually, some people may lose functional speech altogether. This is sometimes referred to as anarthria.
Voice banking provides a way of preparing for this possibility before communication becomes severely affected.
Voice Banking and Quality of Life
Communication is much more than simply exchanging information. A person’s voice contributes to their:
• Identity
• Personality
• Relationships
• Sense of independence
• Ability to express emotions
• Ability to participate in social activities
For someone with MND, losing their natural speech can therefore feel like losing an important part of themselves.
Having a synthetic version of their own voice can help maintain some continuity.
For example, instead of a communication device producing a generic computer-generated voice, the person may be able to communicate using a voice that resembles their own voice.
Psychological Benefits
Voice banking can potentially support mental wellbeing by giving the person a greater sense of control and preparedness.
Maintaining Identity
A person’s voice is strongly associated with who they are. Retaining a version of it may help someone feel that MND has not completely taken away an important aspect of their identity.
Maintaining Independence
Being able to communicate independently can reduce reliance on family members or carers to interpret what the person wants to say.
Reducing Uncertainty
Knowing that there is a communication plan available if speech deteriorates can reduce anxiety about the future.
Maintaining Relationships
Being able to communicate with family and friends using a familiar-sounding voice may make conversations feel more personal.
Preserving Personality
A person’s voice can convey humour, warmth, enthusiasm and other aspects of their personality. A familiar synthetic voice can help preserve some of this.
But Voice Banking Can Also Be Emotionally Challenging
It is important not to assume that voice banking is always a positive experience.
Recording a voice can make the person think about the possibility that they may eventually lose their ability to speak. This can bring up feelings of:
• Fear
• Sadness
• Anger
• Grief
• Anxiety
• Loss of control
Some people may find the recording process frustrating because it can be tiring, particularly if they already have speech or muscle weakness.
There can also be a psychological difference between planning for a possible future loss and actually experiencing that loss. A person may initially feel reassured by having their voice banked but later experience grief when they have to start using the synthetic voice.
Voice Banking vs Message Banking
These are related but not the same thing.
Voice banking aims to create a synthetic version of the person’s voice that can generate new sentences.
Message banking involves recording specific, personally meaningful phrases in the person’s own natural voice.
For example, someone might record phrases such as:
• “I love you.”
• “Give me a minute.”
• “That’s hilarious.”
• “I’m proud of you.”
These recordings can then potentially be played back when the person is no longer able to say them naturally.
Message banking can therefore preserve not just the sound of the person’s voice, but particular expressions that have emotional or personal significance.
When Should Someone Consider Voice Banking?
Ideally, voice banking is considered early, while the person’s speech is still sufficiently clear and they have enough energy to complete the recordings.
Waiting until speech has deteriorated significantly can make creating a high-quality personalised voice more difficult.
However, the timing should be individualised. Introducing it too early or without sensitivity can make someone feel as though professionals are already assuming that they will lose their speech.
A speech and language therapist can help the person decide when it is appropriate.
Overall
Voice banking is not a treatment for MND and it does not prevent speech deterioration. Instead, it is a communication-planning strategy that can help a person retain a personalised means of communication if their natural speech becomes severely impaired.
Its importance extends beyond communication: it can support identity, independence, relationships, emotional expression and psychological wellbeing, while also potentially helping the person feel more prepared for changes associated with MND.