The role of auditory temporal cues in the fluency of stuttering adults

ABSTRACT Purpose: to compare the frequency of disfluencies and speech rate in spontaneous speech and reading in adults with and without stuttering in non-altered and delayed auditory feedback (NAF, DAF). Methods: participants were 30 adults: 15 with Stuttering (Research Group - RG), and 15 without stuttering (Control Group - CG). The procedures were: audiological assessment and speech fluency evaluation in two listening conditions, normal and delayed auditory feedback (100 milliseconds delayed by Fono Tools software). Results: the DAF caused a significant improvement in the fluency of spontaneous speech in RG when compared to speech under NAF. The effect of DAF was different in CG, because it increased the common disfluencies and the total of disfluencies in spontaneous speech and reading, besides showing an increase in the frequency of stuttering-like disfluencies in reading. The intergroup analysis showed significant differences in the two speech tasks for the two listening conditions in the frequency of stuttering-like disfluencies and in the total of disfluencies, and in the flows of syllable and word-per-minute in the NAF. Conclusion: the results demonstrated that delayed auditory feedback promoted fluency in spontaneous speech of adults who stutter, without interfering in the speech rate. In non-stuttering adults an increase occurred in the number of common disfluencies and total of disfluencies as well as reduction of speech rate in spontaneous speech and reading.

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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

10.21203/rs.3.rs-29391/v1 ◽

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

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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

10.21203/rs.3.rs-29391/v2 ◽

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

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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

JMIR Research Protocols ◽

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

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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 (Preprint)

10.2196/preprints.16646 ◽

2019 ◽

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. CLINICALTRIAL ClinicalTrial.gov NCT03990168; https://clinicaltrials.gov/ct2/show/NCT03990168 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/16646

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

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.3901.03 ◽

1974 ◽

Vol 39 (1) ◽

pp. 3-10 ◽

Cited By ~ 60

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.

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Occurrence of urogenital mycoplasmas in men with the common genitourinary diseases

Brazilian Journal of Microbiology ◽

10.1007/s42770-021-00620-1 ◽

2021 ◽

Author(s):

Dominika Smolec ◽

Alicja Ekiel ◽

Piotr Kłuciński ◽

Jan Kawecki

Keyword(s):

Infectious Complications ◽

Prostatic Hyperplasia ◽

Control Group ◽

Study Group ◽

Immunocompromised Patients ◽

Healthy Men ◽

The Common ◽

Estimate Prevalence ◽

Positive Results

Abstract Many serious and fatal infections with urogenital mycoplasmas in immunocompromised patients have been reported. M. genitalium is recognized as a cause of male urethritis and other common genitourinary diseases. The aim of the study was to estimate prevalence of urogenital mycoplasmas which can cause complications in men with common genitourinary diseases. Study included 85 men with genitourinary tract carcinoma (n = 35), urolithiasis (n = 36), and BPH (benign prostatic hyperplasia) (n = 14). The control group consisted of 50 healthy men. FVU (first void urine) samples were examined by PCR for the presence of urogenital mycoplasmas DNA. Occurrence of urogenital mycoplasmas was significantly more common in study group compared with control 24/85 (28.2%) and 7/50 (14%), respectively (p = 0.05). In men with urolithiasis, positive results for mycoplasmas DNA were significantly more frequent than in control: 33.3% vs. 14% (p < 0.05). In patients with urolithiasis DNA of U. urealyticum was most often found, while in the genitourinary carcinoma and BPH groups, U. parvum was more frequent. Incidence of M. fermentans was also significantly higher in the urolithiasis group vs. control (p = 0.03). A higher percentage of positive results for urogenital mycoplasma DNA in study group has been found. Further studies are required to confirm the role of urogenital mycoplasmas in the development of infectious complications among patients with urolithiasis, genitourinary carcinoma, and BPH.

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Stutter and phenomena: The phenomenology and deconstruction of delayed auditory feedback

Journal of Interdisciplinary Voice Studies ◽

10.1386/jivs_00025_1 ◽

2020 ◽

Vol 5 (2) ◽

pp. 197-213

Author(s):

Roshaya Rodness

Keyword(s):

Auditory Feedback ◽

The Self ◽

Husserlian Phenomenology ◽

Human Consciousness ◽

Delayed Auditory Feedback ◽

The Voice ◽

Internal Division

Jacques Derrida’s early critique of Husserlian phenomenology discusses the production of the ‘phenomenological voice’ as the consummate model of human consciousness. Challenging Husserl’s conviction that consciousness is produced from the self-enclosed act of ‘hearing-oneself-speak’, Derrida points to vocality as the complex site of the self’s relationship to presence and exteriority. The internal division between hearing and speaking, he argues, introduces difference into the generation of conscious life. The use of delayed auditory feedback (DAF) as a prosthetic for stuttering provides an opportunity to engage Derrida’s insights on the connection between consciousness and voice with an ear to the speech of people who stutter. DAF, which may reduce or increase dysfluency depending on the speech of the user, introduces a series of delays, alterations and supplements to speech that underwrite the heterogeneous experience of conscious life. What can the philosophy of deconstruction add to conversations about the function of DAF, and what can theory about and experiences with DAF teach us about the self’s presence to itself and the role of alterity in shaping speech? What does stuttering teach us about the necessity of dysfluency for all speech? This article examines the relation between the voice and the phenomenological voice, and between stuttering and prosthetics. Concluding with an analysis of Richard Serra’s experimental recording, Boomerang (1974), it argues that voice is always already prostheticized with alterity, and that in hearing-oneself-speak we exist with voice in an expansive and unfinished conversation with our own mystery.

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