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From: Greg Snyder
Date: 06 Oct 2008
Time: 20:13:22 -0500
Remote Name: 207.68.248.51
Hi Jack. A real quick view of the background...Since we don't know the specific cause of stuttering, we can't really treat the core of the pathology. Instead, our treatments basically try and manage the overt symptoms of stuttering--and are thus limited. As a consequence, I'm really excited about some of the options that are just becoming available. Traditional behavioral therapy, alone, can significantly improve the quality of lives in people who stutter--but the results (relative to speech alone) can be limited in many clients. Similarly, the (sole) use of prosthetic DAF/FAF will likely have limited results. (As will the sole use of pharmaceutical stuttering managements.) But what excites me is the possibility of including traditional behavioral therapy, prosthetic and pharmaceutical stuttering managements. I'm excited to see if and how the synergy of the three will impact overall quality of life and relative ease towards effective communication. In any event--to answer your question, yes--prosthetic use of DAF/FAF can fit well with traditional behavioral speech techniques. (Caveat is that the client must have a realistic view of what prosthetics offer--not a "cure", but they can make life easier for many people.) Traditional fluency shaping techniques are often good matches for DAF/FAF, which would benefit from the gentle-onsets, as well as prolongation of the initial syllable in the phrase or breath group. Targets like amplitude contour (or continuous phonation) would likewise be a good match with what DAF/FAF can offer. Similarly, the 'stretch' (most commonly associated with stuttering modification) would be a very applicable speech tool as well. Anything to help speech initiation while giving the DAF/FAF a voiced sonorant speech signal to 'feedback' through the auditory pathway. And as an interesting side note, some of the benefits of DAF/FAF use (along w/ traditional speech therapy) include increased self-confidence (even though there may not be a big change in actual overt stuttering frequency). Further, many clients have anecdotally reported to me that the use of prosthetic stuttering management devices help them concentrate on their behavioral techniques (or they seem to be able to use their behavioral techniques to better effect).