A Brief Historical Review of Assistive Devices for Treating Stuttering by Larry Molt, written for the ISAD online conference 2005.
The Stuttering Foundation of America has a single page listing several of the Electronic Devices Used In Conjunction With Stuttering Treatment. They suggest that "before you spend a considerable sum of money on an electronic aid for stuttering is to log on to a discussion group of individuals who stutter and parents of children who stutter where you can ask for advice about using such an aid." In their Winter, 2004 newsletter, they published Results of Survey on Electronic Devices: Most don't buy; fewer than half of owners happy six months later - SFA newsletter, Winter 2004, p 3. (The article is available online in PDF format from the SFA). Also check Results of Survey on Electronic Devices and Letters: Readers Response to Survey on Electronic Devices from the Stuttering Foundation of America.
An SLP, Tim Mackesay, has written a brief Straight Talk on Portable DAF that has some helpful information and points to consider.
Another SLP, Rick Merson, has shared Strengths and Weaknesses of two different devices (Fluency Master and SpeechEasy), from his perspective of use of these devices by clients in his practice.
Auditory Sidetone and the Management of Stuttering: From Wollensak to SpeechEasy, a paper by Dr. Rick Merson on electronic devices from the 2003 ISAD online conference.
Help For Stutterers?, a fairly well-balanced article about various devices from the Reno Gazette-Journal, January 26, 2004.
Lee Reeves, DVM, Chairman, NSA, reported (February 14, 2003, SID#4 listserv) that in 2002, the National Stuttering Association "conducted a survey of it's membership in order to gather information on a variety of topics. One of the questions asked about experiences with treatments other than speech therapy including assistive devices.
125 of the 710 respondents reported using a feedback or speech pacer device such as DAF, masker, Fluency Master, Pacemaster, etc. Of those:
If you have a PC, there is a place online where you can get software that will sort of do what several of these products do to maybe check out what they are like:
I have saved some information about personal experiences with various devices from past discussion about use of electronic devices such as the Edinburgh Masker, DAF, and the Fluency Master. from various Internet mailing lists. Reading through this information may provide helpful information.
I would also suggest signing on to some of the discussion groups and searching the archives yourself, since there is already a LOT of discussion that has gone on about the various devices.
Many people ask me specifically about the Janus SpeechEasy device especially since it has been featured often in the media where programs like Oprah Winfrey and Montel Williams, show the SpeechEasy as a "miracle cure" for stuttering. One of these media presentations, Montel Williams "Miracle Cures" has been placed on a website in China - Speecheasy in China. It plays on RealPlayer after you download it. It took me about 1 1/2 hours to download (and I have a fast connection, but the site in China may have been sending the file slowly). It shows how quickly SpeechEasy can help an individual become fluent. It does not talk about long-term effects or follow-up or that it may work (at least temporarily) for some and not for others. It is interesting to watch if you missed the program, but such programs need to be viewed keeping in mind there are currently no long-term studies about the effectiveness of SpeechEasy.
From my understanding, the Janus SpeechEasy costs about $4000. There is a limited money-back guarantee regarding the client's satisfaction with the device--Janus Development Group, Inc. will refund 90% of the purchase price if it is returned undamaged within 30 days of purchase. (10% is retained to offset unrecoverable costs incurred in custom producing a device). The Speecheasy's website (http://www.janusdevelopment.com/speecheasyhome.htm ) says that it is between 70-80 percent effective, but also claims that the fluency boost can be anywhere between 50-95 percent. It does not claim to cure stuttering"in spite of what the media sometimes tries to portray. You can read all about this device from their website. There is also a discussion board where users and interested people have posted questions and comments.
There is a paper written by Greg Snyder that talks about the Janus product. I think Greg wrote a very balanced article about these kinds of speech aids, The Use of Altered Speech Feedback in Stuttering Management. You might want to read it
I searched the archives of a couple groups specifically about the SpeechEasy device since it is quite new. I found a lot of discussion, and some individuals who have tried the SpeechEasy device. Just because it didn't meet expectations for one individual, doesn't mean it won't serve others, but you still might be interested in the comments and follow-up. Relevant information is quoted below, with permission of the authors. What is included is merely a sampling of what one can find in the archives.
Some like it, and may be excited about it.
Still researching this one
Some liked it at first and are not as enthusiastic about it as they were at first.
Still resesarching this one
Some are still experimenting"with it and haven't really decided yet.
december 4, 2002
So far it (SpeakEasy) has helped me significantly. I have a hard time on blocks and will be seeing a therapist to try and learn some techniques to help with that. The device only helps if you can actually speak--so when nothing comes out, it does nothing for you. They told me that once I see the therapist, I'll get excellent results. When I'm just talking in a relaxed conversation, it is like a miracle. But when a stressful situation (like calling to make a doctors appointment)occured, I had a tough time even with the device in. But I would have never even made the appointment without the speecheasy. So I guess it does help a little even in tough situations. I'm hoping to really practice and gain some confidence so that I can be more fluent and less stressed. Wish me luck!
I've had the speech easy device for 5 weeks now. At first, I was very fluent at least for 2 weeks straight. I'd say it was about a 90% improvement in my speech. Then, I decided to apply for a position at a company. A man from Human Resources called me and asked me a few questions, then asked if I have a speech impediment and said he needs somebody that can speak more fluently. Actually, this really upset me and ever since, my speech has declined since then (with the device).
Some days it amazed me how fluent that I can be and other days, I am so frustrated with this device. As for now, I'd say it is a 40% improvement in my speech.
On the other hand, I am supposed to do reading exercises at least 2 times/day and I haven't been doing this everyday. But I started reading out loud to myself recently and I started to become a little bit better with my stuttering.
This is all I can really say about it for now. I sometimes feel confused about my opinion on the device. Some days are good and other days are not so good.
For me the background noise issue and general "disconnection" has made it tough to use. Currently, I am only using it in circumstances in which I feel I absolutely need it (or think I need it). At those times it does help a great deal. While I don't think it has worked for me as I initially expected or was told to expect, I am happy that I have it and look forward to a future device that can address the "noise" issues.
Personal correspondence, March 21, 2004 - "I don't use Speech Easy that much because it is not helping me at all. I don't know if I have to get used to it? For the first two weeks it worked fine but after that I went back to stuttering again, plus I hate the distraction noises that I hear back."
Catherine Montgomery, M.S.,CCC-SLP (SID#4, mailing list, February 14, 2003) "I know of two teens who tried it (age 13 & 19) and had no positive effect whatsoever and were devastated by the experience because of extremely high hopes. One family reported to me that they are still "picking up the pieces" from this experience from last July . . . ."
Another 13 year old's family purchased the device on his report that it felt like it helped "a little bit". He continued in weekly sessions with me . . . . with the device and there has been no noticable change in fluency. The Mom, in her words, "has had it" and is "very angry" about its lack of effectiveness. While on vacation during the holidays for 2 weeks, he refused to wear it in order to "take a break" from it because of its bothersome noise.
An. . adult client . . . report(ed) was that it was "no great thing" and that he only used it when he didn't take the time to practice his skills and felt that it gave him a bit of a comfort zone on those days. Although he reported that his speech had been pretty much the same whether he had it in or not."
Walt Manning, Ph.D., CCC-SLP (SID#4 list, February 13, 2003) What follows is a summary of comments from an young adult (age 23) client of mine. "My experience in North Carolina with Speech Easy is hard to characterize; in ways it was very demoralizing because it was not the panacea for my stuttering that I was secretly hoping for on some level (even though I professed otherwise). Basically, I was fitted by a grad student and sent out in public to test out the device. When I did not get the results I was hoping for, I went into a panic, i.e. I must be in the 5% of people it is not effective for,"that kind of thing. What I was coming to realize is that the Speech Easy has no impact whatsoever on silent blocks, obviously it can't echo if no sound is coming out. So he was trying to show me techniques to get my voicing going by using starters like um"before speaking, which was confusing for me because that was something I used to do frequently and worked had at Hollins to get over. He also told me that for the majority of people it takes a few weeks for the fluency to really develop, which is contradictory to something I read on the website about the effects being immediate."
I also purchased the Speecheasy. I received it in the middle of December. It worked great for the first couple of weeks and it slowly declined. I noticed after the first couple of weeks if I change the battery every 3 days, it worked better. But now, over 2 months later, I pretty much sound the same whether I wear it or not. (posted to Stutteringchat - 1/28/2003)
Some are skeptical and urge a "cautious approach."
[What follows is my opinion:] I was as intrigued with the Speech Easy device as anyone, but as a life-long stutterer I am no stranger to delayed auditory feedback (DAF) and white-noise-in-the-ear concepts.
I'm dismayed that the cost of the Speech Easy device is $4000 or more. As an embedded microprocessor and software expert, I can tell you that the cost of goods sold is probably on the order of under $100. Sure, the research and development costs need to be recovered, and of course the company deserves to make a profit. But the R & D expenses come EXCLUSIVELY from the miniaturization effort, NOT the concept of DAF itself (that is a very old technique to improve stuttering). I can only conclude that Speech Easy somehow expects patients to have comprehensive health insurance that covers such "medical" devices. We'll see if my own carrier provides this benefit - doubtful, though.
Moreover, I have found in using white-noise devices over the long-term tends to stop working. The user has to crank up the volume over time, which can cause some hearing loss. Eventually, for some people, the effect stops working.
They all work in a similar way, that is: it sets up an interferance pattern in the brain, causing the brain to rely on its default speech patterns - see Scientific American December 2002 issue for details). It also has secondary effects as well - the cadence/beat setting, rhythmic intonations, soft initiations helps itself, and so on.
Speech Easy gives a 30 day money back refund (of 90% of the cost, which is reasonable). But beware: in my experience with DAF and white-noise systems, the effect wears off in a few MONTHS, and 30 days may not be long enough to TELL if its going to wear off - or not! In short, I'm skeptical - properly so, given the very high price.
In the end, if you can afford it, if NOTHING else you have tried works, if you have great health insurance coverage, .... go for it. But its NOT a magic cure for stuttering.
Alan R. Weiss
Chairman and CTO, ECL
EEMBC Certification Laboratories
Austin, Texas USA
Some are "curious" and others are simply taking a "wait and see" approach before investing in it.
Hi all, Last Tuesday night, our Royal Oak support group members were given a little presentation about the new SpeechEasy device. Dr. Rick Merson. . . told us was that the SpeechEasy was not for everyone.
At the presentation, there were 15 people from our group, and we all learned how it works. We all had a chance to try it out. First, and most importantly, let me say that Dr. Merson (Rick) did a great job, and does not try to push the device. His first preference is for people who stutter to learn to manage their speech, naturally. And he is a strong believer in working on attitudes and emotions for people who stutter.
For most of us, the SpeechEasy worked pretty well. But, you do have to let the device "work for you" and not fight it. It might take some getting used to hearing your own voice "delayed" back at you. One of our members said that she didn't like the sound of her voice, and kind of "fought" it. Myself, I still had blocks, but the SpeechEasy helped me work through them, once I caught on to the mechanics of it. It can be a good tool, but remember, it does not "cure stuttering."
One thing that I mentioned during the presentation, was that for me, the SpeechEasy might put a little extra pressure on myself. I wondered if my friends and co-workers would expect me to be "perfectly" fluent if I was wearing that thing. The attitudes and feelings of a PWS, for me, might still be there.
Purchasing the SpeechEasy is a tough question for a lot of people who stutter. There still are no long term results. Dr.Merson told us that he has had parents purchase the SpeechEasy for their teens, against his recommendations. They are looking for the cure.
For myself, I can't see me running out and buying the SpeechEasy, just yet. I'm gonna be one of those people that sits back and let the results speak for themselves.
Some people may buy this thing and get no use from it. Others, some of them severe, might use it and become mild in their stuttering. For some people it's not fear alone that keeps them silent; it's the difficulty of speaking, the tension they feel, the frustration, the inability to communicate.
The Edinburgh Masker transformed me from a very severe stutterer into an outspoken mild-moderate stutterer. Those who know me or who have read my book, know that I don't push the Masker at all; I've suggested that some severe stutterers I know use it or try out the Cassa Futura devices. But it's their choice. I do push support groups, the NSA, Friends, Speak Easy, CAPS, and do suggest therapy. But people ought to know about electronic devices. They ought to have the info that they are available. The Masker changed my life. The Speech Easy could and probably will change the life of many of the people who use it. There is a pain/gain equation that seems to work with all these devices. Wearing them is a pain. If the gain is worth it, people will wear them. If, a person is a mild stutterer, the pain won't exceed the gain, and they won't.
The media overstates everything: "enemy" threats, the significance of sports, the importance of celebrities, AND fluency enhancing devices. That's too bad and it's an area that needs to be criticized. But the fault is mainly the media . Oprah would not spend a second on a device that, "well, may help some people".
Myself, I'm curious of how these devices work. How well they shut out background noise; how good they are in conversation. There's no doubt, from previous research, that DAF and FAF work, not as distractions, not as temporary crutches. They enhance fluency and if a wearer does other therapy and other work on his or her speech they are even more effective.
I made an appointment to try the SpeechEasy last week. . . . While it was a relatively positive experience overall, I am still on the fence as to whether to pull the trigger or not -- the $4000 cost is certainly giving me pause.
Another source of my hesitation is that I wasn't "blown away" by what happened -- but then I really didn't expect to be either. The 2 SLP's doing the evaluation/testing/fitting and my own SLP all told me that they could detect an improvement in my fluency whilst wearing the device -- but I was having a relatively "good day", and felt good about my overall (dys)fluency. I certainly "felt" like I was stuttering the same amount, because I could "feel" each and every impending stutter coming, whether I got through it OK or not.
It's obvious to me that the benefits of such a device can only be fully realized after a bit of practice, so maybe I need to get it and give it a chance. On the other hand, after resuming my speech and language rehab again in January (I had a ruptured brain aneurysm in July), I feel like I am slowly getting back the level of "control" I had previously -- so maybe I just need to stay the course with therapy.
My stuttering problem is relatively mild (perhaps borderline moderate on a really bad day), so I'm really torn as to whether to pursue getting the SpeechEasy (or a similar DAF device that isn't as expensive). I think I have answered the question whether or not I respond to DAF and the "choral speech effect" (I think that I do) -- so why am I having a tough time making my decision? It's not as much of a no-brainer as I hoped it would be...
A lot of the discussion fits with what I personally think about stuttering treatment -- one size does not fit all. What works for some, may not work for others. I also believe this kind of device should be used/learned in conjunction with speech therapy.
People will have to do the research, read the information themselves and decide if it "fits"for them personally.
The National Stuttering Association has come out with an official statement about the Janus SpeechEasy device:
Because people who stutter are such a diverse population, no remedy - be it a therapy program, an assistive device, or a medication - will work for everyone. Often, we hear of "new" treatments or miracle cures, but to date, no single treatment method has proven to be effective for all people who stutter. Also, although a treatment may appear to help at first, its effectiveness may diminish over time.
Researchers, clinicians, and members of the stuttering community are very divided as to the effectiveness of these and other treatment approaches. One thing we do know is that reducing the number of disruptions in a person's speech is only part of effective management of stuttering. Although many people who stutter can increase their fluency, through a variety of methods, many also benefit from assistance in dealing with the emotional consequences of a lifetime of speaking difficulties. The professionals who are best qualified to help people who stutter deal with these negative consequences are speech-language pathologists, preferably board-recognized specialists in fluency disorders, working in conjunction with stuttering support groups such as the National Stuttering Association.
Today, there is more help available for people who stutter than ever before, and the research currently in progress offers much hope for the future. People who stutter can benefit from educating themselves about stuttering and considering all available treatment options before making choices about what is best for their individual needs. For that reason, the NSA does not endorse any single approach to treating stuttering, and we tend to be very cautious about new claims of effective remedies, whether they be traditional speech therapy approaches, medications, or fluency enhancing devices.
Still, where possible, we do wish to help people find the treatments that are right for them. Further information about the device that you saw on television can be obtained through the Janus Development website.
We hope this information will be helpful to you, and we thank you for contacting the National Stuttering Association. The NSA serves adults and children who stutter through education, advocacy, and support. The nonprofit organization, founded in 1977, has more than 80 local chapters nationwide. We sponsor workshops and youth programs around the country and publish a growing list of publications and booklets about stuttering for people who stutter, their families, and the clinicians who serve them.
If we can be of any further assistance, please don't hesitate to contact us at firstname.lastname@example.org. You can also get information at our website, www.WeStutter.org or by calling 1 (800) We Stutter.