Recent Advances in Stuttering Therapy
Recent Advances in Stuttering Therapy
Recent Advances in Stuttering Therapy
Integrated Approaches:
Affective (feelings),
Guitars (1998) approach focus on creating speech changes along with a reduction in
or elimination of negative feelings, emotions and avoidance behaviors.
First phase increasing awareness and desensitizing stuttering.
Second phase teaching to stutter easily and speak more fluently through the use
of progressively longer and more complex linguistic units (i.e., single words,
sentences, phrases, paragraph reading and conversation).
Following this training - reducing negative emotions and attitudes as well as
reducing avoidance behaviors.
Scaffolds are cues, prompts, or any type of physical, visual, auditory support which
assists the client in becoming an active participant in an interaction.
Scaffolds may be,
Real objects.
Replicas.
Pictures.
Reading materials.
The clinician may paraphrase or summarize information that is about to be read by the
client so the linguistic processing demands are minimized.
Scaffolding should be minimized as the patient improves.
The clinician might also expect the client to increase the number of speaking turns,
produce more complex discourse and speak to other listeners.
DAF/FAF Assistant:
This is a software application that implements Delayed Auditory Feedback (DAF) and
Frequency Altered Feedback (FAF) techniques on Windows computers.
40 220 milliseconds (10 ms step).
FAF shifts the pitch of the patients voice.
Provides pitch shift in the range from one-half octave down to one-half octave up.
Small Talk
Casa Futura Technologies
Speech Easy:
This device uses Altered Auditory Feedback (AAF) and produces choral effect.
The speech is fed in to the patients ear with a slight delay along with frequency
modification.
This induces perception of speaking in unison which creates the choral effect.
13 adult stutterers were tested using the Speech Easy anti-stuttering device for reading,
monologue, and conversation.
On average stuttering was reduced 36%, however, the effectiveness "varied greatly
across participants."
The subjects were then given speech therapy (training vowel prolongation) and the
combination of therapy and the device reduced stuttering 53%.
[Armson, J., Keifte, M., Mason, J., De Croos, D. "The effect of SpeechEasy on stuttering
frequency in laboratory condition," Journal of Fluency Disorders 31 (2006) 137-152].
9 stutterers used a DAF/FAF device about seven hours per day. Their fluency was
measured after 4 months and after 12 months.
The subjects received brief speech therapy, specifically to prolong vowels and use
"starter sounds" such as "um" and "ah."
[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].
Edinburgh Masker - provides a low buzzing to both ears that masks his own voice when
speaking.
Valsalva Stuttering:
The stutterer instinctively activates the body's Valsalva mechanism in an attempt to force
out words, particularly during anticipation.
Symptoms:
Delays in phonation.
The ordinary Valsalva maneuver involves effort closure of VF for the purpose of sealing
off the respiratory tract, accompanied by contraction of muscles of the abdomen and
chest.
The Valsalva Hypothesis postulates that the symptoms may involve a neurological
confusion between speech and the human body's Valsalva mechanism.
Stutter may have learned to activate the Valsalva mechanism in an effort to produce
words.
Diaphragmatic breathing.
Continuous airflow
Pre-voice exhalation.
Continuous phonation.
Cafet-for-Kids:
Hardware consists of a plug-in circuit board, respiratory sensor, and tie-clip microphone.
Video game graphics for teaching a new phonatory and respiratory skill, including
Diaphragmatic breathing
Continuous airflow
Pre-voice exhalation
Syllable stretch
Continuous phonation.
The targets are manipulable by the clinician to meet individual client needs.
References:
www.valsalva.org
http://www.mnsu.edu/comids/kuster/TherapyWWW.html.
http://www.mnsu.edu/comdis/kuster/TherapyWWW/intensive/cafet.html
http://www.mnsu.edu/comdis/kuster/TherapyWWW/intensive/cafetkids.html