The Establishment, Transfer, and Maintenance of Fluent Speech in 50 Stutterers Using Delayed Auditory Feedback and Operant Procedures

1974 ◽  
Vol 39 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Bruce P. Ryan ◽  
Barbara Van Kirk
Keyword(s):  
Detailed Analysis ◽  
Auditory Feedback ◽  
Rehabilitation Center ◽  
Delayed Auditory Feedback ◽  
Fluent Speech ◽  
Speech Fluency ◽  
The Past ◽  
Clinical Program

Operant speech fluency techniques are being used in a clinical program in a rehabilitation center to treat people who stutter. Establishment, transfer, and maintenance programs are used. Delayed auditory feedback is commonly employed to produce the initial fluent speech. From more than 200 clients seen over the past four years, 50 recent clients were selected for a detailed analysis. The results indicate that the programs are effective in helping people of varying ages and stuttering severity to speak fluently. This was accomplished in relatively short periods (approximately 20 hours of therapy). The fluent speech of the clients has transferred to their environment and checks indicate that it has been maintained.

scholarly journals Investigation of the effect of Delayed Auditory Feedback and transcranial Direct Current Stimulation (DAF-tDCS) treatment for the enhancement of speech fluency in adults who stutter: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Narges Moein ◽  
Reyhane Mohamadi ◽  
Reza Rostami ◽  
Michael Nitsche ◽  
Reza Zomorrodi ◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Feedback ◽  
Intervention Group ◽  
Control Group ◽  
Anodal Tdcs ◽  
Delayed Auditory Feedback ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adults Who Stutter

Abstract Background: With a population prevalence of one percent, stuttering is among the main speech pathology-related topics of research. Adults who stutter may benefit from transcranial direct current stimulation (tDCS) as an adjunctive intervention for enhancing speech fluency. In this study, Delayed Auditory Feedback (DAF) was combined with tDCS applied over the superior temporal gyrus. It was anticipated that intervention caused improvements of speech fluency become more stable.Methods: A randomized, double-blind, sham-controlled clinical trial was conducted to investigate the effectiveness of intervention in enhancing speech fluency. Fifty participants were randomly allocated the intervention or control group. In the intervention group, participants received DAF combined with anodal tDCS, while the control group was exposed to sham tDCS simultaneously with DAF. Each subject participated in six intervention sessions. Speech fluency was assessed before intervention as baseline, as well as immediately, one week and six weeks after intervention.Results: In the intervention group, the percentage of stuttered syllables was significantly reduced immediately, one week and six weeks after the intervention, as compared with the control group. The scores of the Stuttering Severity Instrument, also showed a significant reduction in the intervention group compared with the control group. No significant difference was found in the Overall Assessment of the Speaker’s Experience of Stuttering questionnaire scores between the two patient two groups after intervention.Conclusion: The results of this study propose anodal tDCS as an adjunctive method to increase speech fluency in stuttering for a prolonged time course after intervention, when combined with fluency therapy.Trial registration: This trial was registered in ClinicalTrial.gov before recruiting the subjects. The registration number is NCT03990168 and the date of registration is June 18, 2019. https://clinicaltrials.gov/ct2/show/NCT03990168

Fluent Speech, Fast Articulatory Rate, and Delayed Auditory Feedback: Creating a Crisis for a Scientific Revolution?

1996 ◽  
Vol 82 (1) ◽  
pp. 211-218 ◽  
Author(s):  
Andrew Stuart ◽  
Joseph Kalinowski
Keyword(s):  
Auditory Feedback ◽  
Scientific Revolution ◽  
Speech Rate ◽  
Paradigm Change ◽  
Normal Science ◽  
Delayed Auditory Feedback ◽  
Fluent Speech ◽  
Puzzle Solving

In 1970 Kuhn argued that science does not progress through a process of accretion. It is typified, rather, by the successive emergence of different paradigms which during their reign dictate the direction of normal science's puzzle-solving activity. Normal science inevitably exposes an anomaly which violates expectations predicted by the reigning paradigm. The “crisis” evoking anomaly may induce a destructive/constructive paradigm change. Transformations from one paradigm to another constitute a scientific revolution and dictate the growth and maturation of a field. This paper suggests the recent finding, that stutterers experience enhancement of fluency while speaking under delayed auditory feedback at a fast articulatory rate, be viewed as an anomaly. By challenging the notion that a slowed speech rate is necessary for amelioration of stuttering, the anomalous finding may be perceived as a crisis in the study of stuttering.

scholarly journals Investigation of the effect of Delayed Auditory Feedback and transcranial Direct Current Stimulation (DAF-tDCS) treatment for the enhancement of speech fluency in adults who stutter: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Narges Moein ◽  
Reyhane Mohamadi ◽  
Reza Rostami ◽  
Michael Nitsche ◽  
Reza Zomorrodi ◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Feedback ◽  
Intervention Group ◽  
Control Group ◽  
Anodal Tdcs ◽  
Delayed Auditory Feedback ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adults Who Stutter

Abstract Background: With a population prevalence of one percent, stuttering is among the main speech pathology-related topics of research. Adults who stutter may benefit from transcranial direct current stimulation (tDCS) as an adjunctive intervention for enhancing speech fluency. In this study, Delayed Auditory Feedback (DAF) was combined with tDCS applied over the superior temporal gyrus. It was anticipated that the combined intervention cause improvements in speech fluency.Methods: A randomized, double-blind, sham-controlled clinical trial was conducted to investigate the effectiveness of intervention in enhancing speech fluency. Fifty participants were randomly allocated to the intervention or control group. In the intervention group, participants received DAF combined with anodal tDCS, while the control group was exposed to sham tDCS simultaneously with DAF. Each subject participated in six intervention sessions. Speech fluency was assessed as the baseline, before intervention as well as immediately, one week and six weeks after intervention. Results: In the intervention group, the percentage of stuttered syllables was significantly reduced immediately, one week and six weeks after the intervention, as compared with the control group. The scores of the Stuttering Severity Instrument, also showed a significant reduction in the intervention group compared with the control group. No significant difference was found in the Overall Assessment of the Speaker’s Experience of Stuttering questionnaire scores between the two groups after intervention. Conclusion: The results of this study propose anodal tDCS as an adjunctive method to increase speech fluency in stuttering for a prolonged time course after intervention, when combined with fluency therapy.Trial registration: This trial was registered in ClinicalTrial.gov before recruiting the subjects. The registration number is NCT03990168 and the date of registration is June 18, 2019. https://clinicaltrials.gov/ct2/show/NCT03990168

Active Inhibition of Stuttering Results in Pseudofluency: A Reply to Craig

2002 ◽  
Vol 94 (3) ◽  
pp. 1050-1052
Author(s):  
Vikram N. Dayalu ◽  
Joseph Kalinowski ◽  
Tim Saltuklaroglu
Keyword(s):  
Auditory Feedback ◽  
Delayed Auditory Feedback ◽  
Fluent Speech ◽  
Active Inhibition

Craig discussed fluency outcomes following stuttering therapy that involved retraining the speech system, on the assumption that the speech end product is truly fluent. As previously outlined by Dayalu and Kalinowski, we strongly disagree with the notion that behavioral paradigms can ever result in automatic, long lasting natural sounding fluent speech. Fluent speech is within the grasp of one who stutters as seen in the effects of choral speech and derivatives such as delayed auditory feedback.

Operant Procedures Applied to Stuttering Therapy for Children

1971 ◽  
Vol 36 (2) ◽  
pp. 264-280 ◽  
Author(s):  
Bruce P. Ryan
Keyword(s):  
Auditory Feedback ◽  
Operant Behavior ◽  
Gradual Increase ◽  
Social Reward ◽  
Delayed Auditory Feedback ◽  
Fluent Speech

This report concerns operant stuttering therapy programs for five children ranging in age from six to nine years. The programs included programmed desensitization, delayed auditory feedback, and gradual increase in the length and complexity of the speech utterance. Reinforcing events ranged from social reward to points which could be exchanged for toys. The programs varied in length from 15 to 73.3 hours. They were all successful in helping the children to establish fluent speech. Special transfer and maintenance programs were necessary for some of the children. Follow-up measures indicated that the children had maintained their fluency. The value of viewing stuttering as operant behavior was demonstrated.

scholarly journals Deficit or Difference? Effects of Altered Auditory Feedback on Speech Fluency and Kinematic Variability in Adults Who Stutter

2021 ◽  
pp. 1-18
Author(s):  
HeeCheong Chon ◽  
Eric S. Jackson ◽  
Shelly Jo Kraft ◽  
Nicoline G. Ambrose ◽  
Torrey M. Loucks
Keyword(s):  
Auditory Feedback ◽  
The Other ◽  
Speech Errors ◽  
Speech Motor Control ◽  
Articulation Rate ◽  
Delayed Auditory Feedback ◽  
Speech Fluency ◽  
Long Latency ◽  
Adults Who Stutter ◽  
Speech Motor

Purpose The purpose of this study was to test whether adults who stutter (AWS) display a different range of sensitivity to delayed auditory feedback (DAF). Two experiments were conducted to assess the fluency of AWS under long-latency DAF and to test the effect of short-latency DAF on speech kinematic variability in AWS. Method In Experiment 1, 15 AWS performed a conversational speaking task under nonaltered auditory feedback and 250-ms DAF. The rates of stuttering-like disfluencies, other disfluencies, and speech errors and articulation rate were compared. In Experiment 2, 13 AWS and 15 adults who do not stutter (AWNS) read three utterances under four auditory feedback conditions: nonaltered auditory feedback, amplified auditory feedback, 25-ms DAF, and 50-ms DAF. Across-utterance kinematic variability (spatiotemporal index) and within-utterance variability (percent determinism and stability) were compared between groups. Results In Experiment 1, under 250-ms DAF, the rate of stuttering-like disfluencies and speech errors increased significantly, while articulation rate decreased significantly in AWS. In Experiment 2, AWS exhibited higher kinematic variability than AWNS across the feedback conditions. Under 25-ms DAF, the spatiotemporal index of AWS decreased significantly compared to the other feedback conditions. AWS showed lower overall percent determinism than AWNS, but their percent determinism increased under 50-ms DAF to approximate that of AWNS. Conclusions Auditory feedback manipulations can alter speech fluency and kinematic variability in AWS. Longer latency auditory feedback delays induce speech disruptions, while subtle auditory feedback manipulations potentially benefit speech motor control. Both AWS and AWNS are susceptible to auditory feedback during speech production, but AWS appear to exhibit a distinct continuum of sensitivity.

scholarly journals Delayed Auditory Feedback and Transcranial Direct Current Stimulation Treatment for the Enhancement of Speech Fluency in Adults Who Stutter: Protocol for a Randomized Controlled Trial

10.2196/16646 ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. e16646
Author(s):  
Narges Moein ◽  
Reyhane Mohamadi ◽  
Reza Rostami ◽  
Michael Nitsche ◽  
Reza Zomorrodi ◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Feedback ◽  
Intervention Group ◽  
Control Group ◽  
Delayed Auditory Feedback ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adults Who Stutter

Background Stuttering is a complex speech disorder that affects speech fluency. Recently, it has been shown that noninvasive brain stimulation may be useful to enhance the results of fluency interventions in adults who stutter. Delayed auditory feedback (DAF) is a method to enhance speech fluency in individuals who stutter. Adjunctive interventions are warranted to enhance the efficacy of this intervention. Objective Individuals who stutter have pathological activation patterns in the primary and secondary auditory areas. Consequently, in this study, we hypothesize that stimulation of these areas might be promising as an adjunctive method to fluency training via DAF to enhance speech therapy success in individuals with a stutter. We will systematically test this hypothesis in this study. Methods This study is designed as a randomized, double-blind, sham-controlled clinical trial. All participants will receive DAF. The intervention group will additionally receive real transcranial direct current stimulation, while the control group will be exposed to sham stimulation. The assignment of the participants to one of these groups will be randomized. Before starting the treatment program, 2 preintervention assessments will be conducted to determine the severity of stuttering. Once these assessments are completed, each subject will participate in 6 intervention sessions. Postintervention assessments will be carried out immediately and 1 week after the last intervention session. Subsequently, to explore the long-term stability of the treatment results, the outcome parameters will be obtained in follow-up assessments 6 weeks after the treatment. The primary outcome measurement—the percentage of stuttered syllables—will be calculated in pre-, post-, and follow-up assessments; the secondary outcomes will be the scores of the following questionnaires: the Stuttering Severity Instrument–Fourth Edition and the Overall Assessment of the Speaker’s Experience of Stuttering. Results This protocol was funded in 2019 and approved by the Research Ethics Committee of the Iran University of Medical Sciences in June 2019. Data collection started in October 2019. As of February 2020, we have enrolled 30 participants. We expect data analysis to be completed in April 2020, and results will be published in summer 2020. Conclusions We anticipate that this study will show an adjunctive effect of transcranial direct current stimulation, when combined with DAF, on stuttering. This should include not only a reduction in the percentage of stuttered syllables but also improved physical behavior and quality of life in adults who stutter. Trial Registration ClinicalTrial.gov NCT03990168; https://clinicaltrials.gov/ct2/show/NCT03990168 International Registered Report Identifier (IRRID) DERR1-10.2196/16646

Spectrographic Study of Vowels in Stutterers' Fluent Speech

1982 ◽  
Vol 25 (3) ◽  
pp. 364-370 ◽  
Author(s):  
Richard J. Klich ◽  
Gaylene M. May
Keyword(s):  
Normal Condition ◽  
Auditory Feedback ◽  
Vowel Duration ◽  
Vowel Production ◽  
Experimental Conditions ◽  
Delayed Auditory Feedback ◽  
Fluent Speech ◽  
Formant Frequencies ◽  
Masking Noise

Measurements were made of the formant frequencies and formant transitions associated with the vowels/i/,/æ/ and /u/ produced by seven moderate-to-severe stutterers when they read fluently in a control (normal) condition and under four experimental conditions: masking noise, delayed auditory feedback, rhythmic pacing, and whispering. The first and second formantfrequencies in an isolated/hVd/context were more centralized than those reported for nonstutterers. The formant frequencies were centralized even more in reading, but varied little across conditions despite changes in fluency, speaking rates, and vowel duration. Duration and rate of formant transitions also were essentially the same across conditions. These findings and those reported in other studies indicate that stutterers' vowel production is more restricted, spatially and temporally, than nonstutterers'.

Using audiovisual feedback during speaking

2012 ◽  
Vol 25 (0) ◽  
pp. 49
Author(s):  
Jennifer Chesters ◽  
Riikka Möttönen
Keyword(s):  
Visual Feedback ◽  
Auditory Feedback ◽  
Native English Speakers ◽  
English Speakers ◽  
Disruptive Effect ◽  
Delayed Auditory Feedback ◽  
Speech Fluency ◽  
Articulatory Movements ◽  
History Of ◽  
Delayed Visual Feedback

The sensory systems have an important role in speech production. Monitoring sensory consequences of articulatory movements supports fluent speaking. It is well known that delayed auditory feedback disrupts fluency of speech. Also, there is some evidence that immediate visual feedback, i.e., seeing one’s own articulatory movements in a mirror, decreases the disruptive effect of delayed auditory feedback (Jones and Striemer, 2007). It is unknown whether delayed visual feedback affects fluency of speech. Here, we aimed to investigate the effects of delayed auditory, visual and audiovisual feedback on speech fluency. 20 native English speakers (with no history of speech and language problems) participated in the experiment. Participants received delayed (200 ms) or immediate auditory feedback, whilst repeating sentences. Moreover, they received either no visual feedback, immediate visual feedback or delayed visual feedback (200, 400, 600 ms). Under delayed auditory feedback, the duration of sentences was longer and number of speech errors was greater than under immediate auditory feedback, confirming that delayed auditory feedback disrupts speech. Immediate visual feedback had no effect on speech fluency. Importantly, fluency of speech was most disrupted when both auditory and visual feedback was delayed, suggesting that delayed visual feedback strengthened the disruptive effect of delayed auditory feedback. However, delayed visual feedback combined with immediate auditory feedback had no effect on speech fluency. Our findings demonstrate that although visual feedback is not available during speaking in every-day life, it can be integrated with auditory feedback and influence fluency of speech.

Speaking Speed Effects on Delayed Auditory Feedback Disruption of Speech Fluency

1999 ◽  
Vol 89 (3_suppl) ◽  
pp. 1095-1109 ◽  
Author(s):  
Sergio Zanini ◽  
Andrea Clarici ◽  
Franco Fabbro ◽  
Antonio Bava
Keyword(s):  
Auditory Feedback ◽  
Delayed Auditory Feedback ◽  
Speech Fluency
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