Stuttering in China brings about enormous difficulty in the patient's education, employment, and daily life -- for instance: making a phone call, speaking in a meeting, conversing, shopping and so on. A relatively easy thing often becomes very difficult for a stutterer. Some young people lose the opportunity to go to the university or to get a job as a result of their stuttering. A lot of departments in colleges and universities in China, such as business trade, foreign language, politics and law, normal school, public security (police), and military all refuse to accept students with stuttering. In the interview for employment, a stutterer cannot compete against a person who does not stutter. Moreover, stutterers often fail to seek a relationship with the opposite sex or to married.

At the present time, the treatment of stuttering in China follows two forms: speech training and psychological adjustment. These methods may alleviate the patient's symptoms in a short-term, but the effect is usually not permanent. After a period of time, the overwhelming majority suffer a relapse. The stuttering returns and remains unchanged. Therefore, many experts believe that adult stutterers cannot be cured.

It is well known that speech is an extremely complex process. In order to produce air flow, the lungs, the trachea, the chest, the diaphragm and the anterior abdomen muscles all must have appropriate movements. In order to make the sound, the glottis and the vocal cord also must maintain a suitable position. In order to cause the sound to appear sonorous and pleasant, the nose, the mouth, the pharynx and larynx, and the lungs and the trachea must resonant adequately. In order to change the original throat sound into the uniquely human language, the tongue, the lips the teeth, the lower jaw and the soft palate must coordinate well. The whole speech process is completed through perfect coordination of these breathing and speaking organs. All these relationship and coordinations are controlled by the central nervous through two crisscrossing interweaving processes which excite (activate) and suppress. In this entire process, slight incoordination is not allowed.

Commonly, the two processes (excite and suppress) in the brain maintain balance and intercoordination. However, organs in the human body, including the brain, all have their certain physiological limit. In addition, excessive stimulus from the outside world can also surpass the psychological limit which the person can withstand. Breaking the balance between excite and suppress can also affect the central nervous system causing malfunction of its subordinated organs. This kind of imbalance in the function of speech is stuttering.

In my opinion stuttering is a speech-language disorder that is perpetuated by psychological barriers. A strong stimulus often makes such a deep memory in the brain of the stutterer that a conditioned reflex has been formed. This conditioned reflex is continuously reinforced. Consequently, it is extremely difficult for a stutterer to change the situation by his own will. In those specific situations, a stutterer's speech function inevitably emerges from conditioning and he stutters.

By avoiding the specific intense environmental stimulus, "Fluencer" can gradually decrease the stimulus-provoked conditioned reflex in the language center of the brain, thus realizing the balance and coordination, restoring fluent speech.

It is widely known that, regardless of the severity of stuttering, stutterers seldom stutter when singing or speaking to him(her)self. To most stutterers, stuttering appears only in specific environments. However, they often stutter at the very moment when fluent speech is needed. The overwhelming majority of those who stutter have the following clinical manifestations in common:

1. He doesn't stutter when he talks to himself (when he is alone), but he stutters immediately once he finds that someone else is listening to him.
2. He has less stuttering in a noisy environment, but more stuttering in a quiet environment with many people.
3. In the same environment with a lot of people, he has less stuttering when other people are speaking simultaneously, but more stuttering when he is asked to speak alone..
4. In a tense or frightening situation, he stutters when speaking with normal volume, but doesn't stutter when whispering or speaking softly.

How the Fluencer works

It would be a mistake to think that the "Fluencer" can get results quickly just by putting it on. On the contrary, one cannot succeed without following instruction and extensive practice. It is something like learning to drive -- one cannot drive a car without a lot of careful and continuous training and practice. Therefore, the stutterer first has 5 days of special training in pronunciation skills from a speech therapist before using the "Fluencer". After this training, the stutterer practices with the "Fluencer" for an hour a day for six months, especially at work and in daily life. We are confident that if the stutterer follows this guidance, his speech will be fluent when using the "Fluencer."

What is the difference between the "Fluencer" and other kinds of DAF? The difference lies in the length of the delay time. Regardless of the length of the sentences said by a stutterer, the "Fluencer" delays the sentences as long as 3 seconds. This delay is much longer than other DAF devices which typically cause a delay measured in milliseconds. From our experience, the longer the delay time, the better the technique. During the extended delay produced by the "Fluencer", the stutterer can calmly send what he wants to say into the phone by whispering fluently using pronunciation skills practiced in the clinic.

The whispered sound is delayed and sent into the stutterer's ear through digitized processing producing a more than 3 second gap between what the stutterer "hears" and what he "says". This makes the stutterer feel as if what he "hears" and what he "says" are separated entirely in time and space which in turn creates a feeling of isolation from the outside world. Our clinical practice demonstrates that this effect decreases or eliminates the stimulus which previously provoked the conditioned reflex and produced stuttering and seems to protect the stutterer's language center from intense stimulation from the specific environment he finds himself in. Thus the continuously reinforced negative conditioned reflex is weakened, eliminating the former impact on the stutterer's speech-related organs, and restoring fluent speech.

Other apparent advantages of the "Fluencer" are that the somewhat noisy artificial sound field made by the "Fluencer" seems to relax the tense state of the stutterer. Furthermore, the delay of the sound by the "Fluencer" causes the stutterer to feel that someone is guiding and accompanying him to speak, making the speech easier (the choral speaking effect). Finally, even if the stutterer is in an extremely frightening situation, the "Fluencer" may help him speak when whispering or speaking softly as he begins to speak.

After more than 10 years of clinical practice, we believe that the "Fluencer", a kind of delayed auditory feedback (DAF) system invented by the Chinese, may open a path to fluency for adult stutterers.