Long-term effectiveness of the SpeechEasy fluency-enhancement device.

UNLABELLED: The SpeechEasy has been found to be an effective device for reduction of stuttering frequency for many people who stutter (PWS); published studies typically have compared stuttering reduction at initial fitting of the device to results achieved up to one year later. This study examines long-term effectiveness by examining whether effects of the SpeechEasy were maintained for longer periods, from 13 to 59 months. Results indicated no significant change for seven device users from post-fitting to the time of the study (t=-.074, p=.943); however, findings varied greatly on a case-by-case basis. Most notably, when stuttering frequency for eleven users and former users, prior to device fitting, was compared to current stuttering frequency while not wearing the device, the change over time was found to be statistically significant (t=2.851, p=.017), suggesting a carry-over effect of the device. There was no significant difference in stuttering frequency when users were wearing versus not wearing the device currently (t=1.949, p=0.92). Examinations of these results, as well as direction for future research, are described herein. EDUCATIONAL OBJECTIVES: The reader will be able to: (a) identify and briefly describe two types of altered auditory feedback which the SpeechEasy incorporates in order to help reduce stuttering; (b) describe the carry-over effect found in this study, suggest effectiveness associated with the device over a longer period of time than previously reported, as well as its implications, and (c) list factors that might be assessed in future research involving this device in order to more narrowly determine which prospective users are most likely to benefit from employing the SpeechEasy.

Speech motor correlates of treatment-related changes in stuttering severity and speech naturalness.

Participants of stuttering treatment programs provide an opportunity to evaluate persons who stutter as they demonstrate varying levels of fluency. Identifying physiologic correlates of altered fluency levels may lead to insights about mechanisms of speech disfluency. This study examined respiratory, orofacial kinematic and acoustic measures in 35 persons who stutter prior to and as they were completing a 1-month intensive stuttering treatment program. Participants showed a marked reduction in stuttering severity as they completed the treatment program. Coincident with reduced stuttering severity, participants increased the amplitude and duration of speech breaths, reduced the rate of lung volume change during inspiration, reduced the amplitude and speed of lip movements early in the test utterance, increased lip and jaw movement durations, and reduced syllable rate. A multiple regression model that included two respiratory measures and one orofacial kinematic measure accounted for 62% of the variance in changes in stuttering severity. Finally, there was a weak but significant tendency for speech of participants with the largest reductions in stuttering severity to be rated as more unnatural as they completed the treatment program.

Orofacial movements associated with fluent speech in persons who stutter.

This study was intended to replicate and extend previous findings that (a) during fluent speech persons who stutter (PS) and those who do not (NS) differ in their vocal tract closing movements (L. Max, A. J. Caruso, and V. L. Gracco, 2003) and (b) ratios relating lip and tongue speed to jaw speed increase with stuttering severity (M. D. McClean and C. R. Runyan, 2000). An electromagnetic system was used to record movements of the upper lip, lower lip, tongue, and jaw of 43 NS and 37 PS during productions of a nonsense phrase and a sentence. Measurement and analysis of movement speeds, durations, and ratios of lip and tongue speed to jaw speed were performed on fluent productions of a nonsense phrase and sentence. Statistical comparisons were made between PS with low and high stuttering severity levels (LPS and HPS) and NS. Significant variations across groups in movement speed and duration were observed, but the pattern of these effects was complex and did not replicate the results of the two earlier studies. In the nonsense phrase, significant reductions in lower lip closing duration, jaw closing duration, and jaw closing speed were seen in PS. In the sentence task, HPS showed elevated tongue opening and closing durations. For tongue opening in the sentence, LPS showed elevated speeds and HPS showed reduced speeds. The elevated speeds for LPS are interpreted as a contributing factor to speech disfluency, whereas the reduced speeds and increased durations in HPS are attributed to adaptive behavior intended to facilitate fluent speech. Significant group effects were not seen for the speed ratio measures. Results are discussed in relation to multivariate analyses intended to identify subgroups of PS.