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Students who Stutter.
A Case Study, Survey of Software and Devices, and Resource List
By Erin Fent, Dustin Freeman, Gordon Graber, Jackie Haller
Introduction
The language disability of stuttering can affect a person's confidence and therefore
their interactions with others. It is not generally held that stuttering is indicative of
an underlying cognitive problems, but generally purely a speech mechanics
problem. It may be affected by biofeedback mechanisms - possibly stress and
anxiety about lack of fluid speech performance exacerbate the stuttering condition.
A person who stutters may have difficulty at school socially, dependent on
interactions with peers and teachers. They may be placed at a social disadvantage,
and possibly disadvantaged in the classroom. But there is no basis for any claim that
stutterers are intrinsically less capable, or less intelligent:
"The only thing that differs between people who stutter and people who don't is that
the people who stutter stutter." - Wendell Johnson, speech pathology pioneer.
Case Study
A 15-year old male of above average intelligence is experiencing difficulty
participating in class discussions and interacting socially. The only diagnosed
learning disability is stuttering. His diagnosis was made at age 6 and the student
received school provided speech therapy through 8th grade. Therapy was
discontinued at the request of the parent and student based upon the student's
progress in controlling his stuttering. A re-evaluation was scheduled for the end of
the first semester 9th grade.
The following observations were made at the re-evaluation.
Impact on Learning: The condition of stuttering prevents the student from asking
necessary questions and providing verbal feedback due to frustration and
embarrassment.
Social Impact: The student has been observed avoiding interaction with peers. He
has difficulty working in groups.
Recommendation: The student has been recommended for renewal of speech
therapy based upon the regression observed after the therapy was terminated.
Available Hardware and Software for Therapy and Treatment
There are several manufactures of software and hardware devices that may be used in
the treatment of stuttering. All of these systems use a microphone and earphones, to
capture, alter, and feedback the altered audio to the stutterer. They use bio-feedback
principles in attempt to relive the auditory-speech neural pathways that are often involved
in the conditions that result in stuttering.
There are studies that show these systems benefit stutters.
(http://jslhr.asha.org/cgi/content/abstract/39/2/396)
These systems may also be used by licensed Speech Language Therapists as a
supplement to traditional treatments.
There are three primary approaches used by these systems:
Masking Auditory Feedback - MAF:
When speaking, some stutterers experience a condition in which they cannot
produce sound with their vocal chords. This effect is increased by their anxiety at
not being able to perform. In essence, air is trapped in the vocal chords, which
freeze up. The more they try to push the sounds out, the tighter the vocal chords
become.
With the use of a computer program, or hardware device, that implements MAF,
when the system detects a silent point in speech, white noise is produced in the
earphones. This white noise fools the brain into think the vocal chords are actually
making sound, and relaxes them, freeing the stutterer to speak again. These
systems have proven effective on changes in speech while the system is being
used. Their use may, over time, result in a lasting curative effect.
Delayed Auditory Feedback – DAF:
With the use of Delayed Auditory Feedback, the sound of the voice is delayed by a
few milliseconds and then supplied to the ear. This delay causes a slower
speaking rate and improves the fluency of those who stutter.
Frequency Altered Feedback – FAF:
FAF involves altering the pitch of the speaker’s voice, up or down, and feeding it
back though the speaker’s earphones. There is an immediate improvement in
stuttering after the pitch shift s accepted. After a few months, though, lowering
the pitch seems to produce consistent results. After about 18 months, some studies
have shown not only a ceiling to improvement but have shown a decline, and
sometimes to a degree worse than the original condition.
Resources for parents and teachers of children who stutter:
Information resources: stuttering, causes
http://www.casafuturatech.com/Books/NoMiracleCures/FAF.shtml
http://www.shrs.pitt.edu/Supercourse/langstut.htm
This site provides several PowerPoint lectures from universities around the world on
stuttering's relationship to language and other aspects of diagnosis and treatment.
http://www.asha.org/public/speech/disorders/stuttering.htm
Resources on treatments and support
http://kidshealth.org
"Stuttering." The Nemours Foundation, KidsHealth.org
http://www.mnsu.edu/comdis/kuster/
The Stuttering Home Page. Minnesota State University, Mankato.
http://www.wiu.edu/csd/
"What is Stuttering?" Robert W. Quesal, PhD, Professor and Program Director.
http://www.wiu.edu/csd/
Communications Sciences and Disorders. Western Illinois University.
Assistive Technology -Anti-Stuttering Devices
http://www.casafuturatech.com/Catalog/effective.shtml
Among the devices offered is the Casa Futura Telephone Fluency System.
This is an anti-stuttering telephone device with delayed auditory feedback (DAF) and
frequency-shifted auditory feedback (FAF).
http://www.speecheasy.com
This DAF/FAF device is worn like a hearing-aid.
www.stuttering.com The Fluency Master
Vocal tone amplification is transmitted through a hearing aid device.
http://shop.store.yahoo.com/azhearing/desfluensys.html Desktop Fluency System.
A complete system with a phone adaptor, headsets for conversation and therapy use. The
system utilizes DAF/FAF/MAF (masking auditory feedback)
http://wwwsoc.nii.ac.jp/jslp/e-471/16.html
A miniature metronome which is worn behind the ear is claimed to stabilize speech
fluency.
http://www.artefactsoft.com/pocketdaf.html
A source for software for PCs and handheld computers. The software utilizes DAF and
FAF therapies
http://www.intertapeww.com/eng/research.html
Info and Hardware
http://www.kayelemetrics.com/Product%20Info/3500/3500appsec10.htm
An auditory feedback device
Organizations
http://www.stutteringhelp.org
National Stuttering Foundation of America. 1-(800) 992-9392.