Technology: A Friend or Foe of Someone who Stutters?

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Long-Term Effects of Anti-Stuttering Devices

From: Thomas David Kehoe
Date: 02 Oct 2006
Time: 13:42:41 -0500
Remote Name: 67.176.41.167

Comments

<p>Alan Badmington writes that he used an Edinburgh Masker anti-stuttering device ten to fourteen hours a day, for twenty years. His experience was, apparently, that his speech with the device on was more fluent but not perfect; that this improved fluency didn't increase or decrease over the twenty years; that his speech when speaking without the device didn't improve or deteriorate over the twenty years; and he experienced improved psychological effects, such as participating in professional and social activities and reduced speech-related fears and anxieties, such as fear of public speaking. He also had some increased fears when using the device, specifically a fear that the device might break.</p> <p>While there have been dozens of studies of the immediate effects of anti-stuttering devices, typically finding 60-80% reductions in stuttering, only a handful of long-term studies have been published.</p> <p>No long-term studies of the Edinburgh Masker were published. However, Herb Goldberg, founder of the non-profit foundation that distributed the devices in the United States, said:</p> <p>"I am in contact with over 500 people who use or have used the Masker [out of 2500 devices sold]. In most cases the end result is the person uses the device less and less as time passes due to less need for it...[a person who does not experience carryover fluency] is exceptional."</p> <p>It would be interesting to know whether these Edinburgh Maskers needed their devices less and less over time due to improved physical speech, or, as Alan described, due to improved psychological effects.</p> <p>Two long-term studies have been published about Casa Futura Technologies' School DAF anti-stuttering device. In the first study, nine adults who stuttered (eight severely) used the devices thirty minutes a day for three months. They didn't receive speech therapy. The thirty minutes usually consisted of reading aloud, a conversation with a family, and sometimes a telephone call to another subject in the study. No statistically significant "wearing off" of effectiveness was seen when wearing the devices after three months. When the subjects weren't wearing the devices, at the end of the study, they stuttered on average 55% less ("carryover fluency") than at the start of the study. In other words, the subjects needed the devices "less and less as time passes" due to improved physical speech. (Van Borsel, 2003)</p> <p>A second study found similar results after one year, combining the device with speech therapy. (Radford, 2005)</p> <p>One long-term study has been published about the SpeechEasy DAF/FAF anti-stuttering device. Nine subjects used the devices about seven hours per day, for twelve months. The delay was set at 60 milliseconds and the frequency compression FAF at 500 Hz up. At the end of the study there was no statistically significant change in fluency when wearing the device (i.e., no "wearing off" of effectiveness) or when not wearing the device (i.e., no "carryover fluency"). This study suggests that SpeechEasy users don't experience needing their devices "less and less as time passes." (Stuart, 2004)</p> <p>In an unpublished study of the SpeechEasy anti-stuttering device tested six subjects after on average eighteen months use of the device. Two subjects were stuttering about as much as before they purchased the device. The other four subjects were worse. On average, the subjects’ stuttering had increased about 50%. (Runyan, 2005)</p> <p>These studies suggest a need for more long-term research about anti-stuttering devices. Why do some devices improve users' speech over time, leading to the users needing the devices "less and less as time passes," but other devices don't, or possibly make users' speech worse? Are the effects due to physical changes in users' speech, or due to psychological changes? How could anti-stuttering devices be improved, or how should consumers use the devices, to maximize positive long-term effects?</p> <p>Casa Futura Technologies has developed several innovations to improve long-term effectiveness. First, one-half octave or one octave FAF downshifting is used to induce relaxed breathing and relaxed vocal folds. Studies of non-stutterers found that this induced changes in vocal pitch, due to changes in speech motor (muscle) activity. (Elman, 1981)</p> <p>Second, the Pocket Speech Lab monitors the user's vocal fold tension. When the user speaks with tense vocal folds, the device switches on DAF and FAF to induce speech motor changes. When the user speaks with relaxed vocal folds, the device switches off the sound. The user is thus trained to speak with relaxed vocal folds, without relying on DAF and FAF.</p> <p>Third, improved training materials (including a video) encourage consumers to use the devices to help them slow their speaking rate by stretching vowels (continuous phonation), to speak with relaxed breathing and vocal folds, and to make psychological changes such as talking more or identifying and reducing speech-related fears and anxieties.</p> <p>Thomas David Kehoe<br> <a href="http://www.casafuturatech.com/">Casa Futura Technologies</a></p> <p>References</p> <p>Van Borsel, J., Reunes, G., and Van den Bergh, N. (2003). "Delayed auditory feedback in the treatment of stuttering: clients as consumers," International Journal of Language and Communication Disorders, 2003, Vol. 38, No. 2, 119-129. </p> <p>Radford, N., Tanguma, J., Gonzalez, M., Nericcio, M.A., Newman, D. "A Case Study of Mediated Learning, Delayed Auditory Feedback, and Motor Repatterning to Reduce Stuttering," Perceptual and Motor Skills, 2005, 101, 63-71. </p> <p>Stuart, A., Kalinowski, J., Rastatter, M., Saltuklaroglu, T., Dayalu, V. "Investigations of the impact of altered auditory feedback in-the-ear devices on the speech of people who stutter: initial fitting and 4-month follow-up," International Journal of Language and Communication Disorders, 2004, 39:1, 93-113. Stuart, A., Kalinowski, J., Saltuklaroglu, T., Guntupalli, V. "Investigations of the impact of altered auditory feedback in-the-ear devices on the speech of people who stutter: One-year follow-up," Disability and Rehabilitation, 2006. 1-9. </p> <p>Runyan, C., Runyan, Sara. "The Speech Easy: A Two Year Study," presentation to American Speech-Language Hearing Association convention, November 2005. </p> <p>Elman, J. (1981). “Effects of frequency-shifted feedback on the pitch of vocal productions,” Journal of the Acoustical Society of America, 70 (1). Burnett, T.A., Senner, J.E., and Larson, C.R. (1997). “Voice F0 responses to pitch-shifted auditory feedback: A preliminary study,” J. Voice, 11, 202-211. Burnett, T.A., Freedland, M.B., Larson, C.R., Hain, T.C. (1998). “Voice F0 responses to manipulations in pitch feedback,” Journal Acoustical Society of America, 103 (6) June 1998. </p>


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