Twilio does not offer a way to handle audio as an IVR input, as far as I know. They suggest using number entry, but it’s not as smart as what you are going to do: https://www.twilio.com/docs/api/twiml/gather .
You can, however, listen to a call that is currently in process, with a trick. It should be configured as a conference. A conference can do anything a regular disk can do. You can disable some additional features, and then you can use the twilio js library to seamlessly join the conference and listen to the call. I suppose if you were very ambitious, you could use some kind of speech in text-based software to do all kinds of things through the Twilio client.
Watch annyang! for some interactive speech with text: https://www.talater.com/annyang/
Chris jenkins
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