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The SpeechEasy Device: Augmentative Communication for Stuttering

The SpeechEasy Device: Augmentative Communication for Stuttering. Presentation by Tim Saltuklaroglu, M.S. East Carolina University March 27, 2003. Our view of stuttering. Stuttering is central neurophysiological disorder that manifests during speech.

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The SpeechEasy Device: Augmentative Communication for Stuttering

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  1. The SpeechEasyDevice: Augmentative Communication for Stuttering Presentation by Tim Saltuklaroglu, M.S. East Carolina University March 27, 2003

  2. Our view of stuttering • Stuttering is central neurophysiological disorder that manifests during speech. • The overt manifestations of stuttering (repetitions, prolongations, silent speech blocks) are symptoms of this central pathology. • Stuttering is a extremely debilitating disorder that can impede every aspect of life.

  3. How is stuttering usually treated? • By attempting to retrain the speech producing subsystems: • Laryngeal. • Respiratory. • Articulatory.

  4. How Is stuttering usually treated? • ‘Speech Retraining’ involves the imposition of novel speech patterns that are supposedly incompatible with stuttering.

  5. Some results of therapy (Blood et al., 1994)

  6. There’s room for improvement… • Therapy can help many people but may still not produce the highest level of fluency possible. • Relapse rates need to be decreased for therapy to be considered efficient and effective.

  7. Efficiency and effectiveness in the treatment of stuttering • Efficiency: • Does the treatment act in a timely manner with as little effort as possible expended? • Effectiveness: • Does the treatment provide the relief that it promises?

  8. Our mission To ‘centrally’ inhibit stuttering and induce immediate and natural sounding fluent speech in those stutter.

  9. Choral speech • Considered to be the best known stuttering inhibitor. • Often inducing 90-100% fluency in almost everyone who stutters.

  10. What does choral speech do? • Inhibits stuttering at a more central level – closer to the source of the pathology. • Under choral conditions, brain imaging studies have shown ‘normalization’ of abnormal brain activations seen in PWS.

  11. Delayed Auditory Feedback (DAF) • Perceiving your own speech with a temporal delay (similar to an echo). • Delays as low as 25 ms have been found to induce fluent speech.

  12. Frequency Altered Feedback (FAF) • Altering the perceived pitch of a persons own speech, but the person is not required to change his/her speech patterns.

  13. Frequency Altered Feedback (FAF) • Pitch can be raised or lowered relative to the fundamental frequency: • Mickey Mouse (chipmunk) or Darth Vader. • Is also a powerful emulator of choral speech.

  14. How well do DAF and FAF work? • Immediate reduction in stuttering by 70-85% across a variety of situations. • Reading. • Monologue. • Scripted telephone calls. • Speaking in front of audience.

  15. The problem • Large bulky devices. • Lack of portability. • Conspicuous in nature. • Not functional.

  16. The solution • SpeechEasy introduced in April 2001. • DAF: up to 250 ms in 10 ms increments. • FAF: up to 2000 Hz up or down in 500 Hz increments. • Frequency shaping and noise attenuation. • In-the-canal model. • Completely-in-the-canal model.

  17. ITE/ITC • This model fits in the ear canal with only a small portion visible. • Very inconspicuous • A great combination of small size and robust effects. • External volume control.

  18. CIC • The smallest model. • The whole device sits in the ear canal with nothing showing. • Provides all the effects of the other models. • Volume is internally controlled.

  19. How is the SpeechEasy™ programmed? • PC compatible software. • Allows all parameters to be programmed. • Control Box: • Interfaces with computer via serial / USB cable. • SpeechEasy™ cables • ITC / BTE cable • Left CIC cable • Right CIC cable

  20. An adjunct or alternative to therapy… • Prosthetic devices are incorporated into the treatments of many disabilities. • The use of a fluency enhancing device may help people who stutter produce fluent speech that is more: • Stable • Natural sounding • Automatic

  21. What about the long-term? • Client satisfaction levels will tell. • Questionnaire data can be very useful. • Efficacy studies cannot tell the whole story as they only consider the countable aspects of stuttering in environments that are usually controlled. • However, they are necessary for documentation and accountability.

  22. Long Term Efficacy Study:4 month data - reading.

  23. Long Term Efficacy Study:4 month data - conversation.

  24. Fluency enhancing effects of the SpeechEasy protocol Average decrease in Stuttering Frequency • Reading (immediate) - 88% • Conversation (immediate) - 85% • Reading (after 4 months) - 86% • Conversation (after 4 months) - 69%

  25. Long Term Efficacy Study:4 month data - naturalness.

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