122:(DAF) in reducing stuttering has been noted since the 1950s. A DAF user hears his or her voice in headphones, delayed a fraction of a second. Typical delays are in the 50 millisecond to 200 millisecond range. In stutterers, DAF may produce slow, prolonged but fluent speech. In the 1960s to 1980s, DAF was mainly used to train prolongation and fluency. As the stutterer masters fluent speech skills at a slow speaking rate, the delay is reduced in stages, gradually increasing speaking rate, until the person can speak fluently at a normal speaking rate. It was not until the 1990s that research began to focus on DAF in isolation. Recent studies have moved from longer delays to shorter delays in the 50 millisecond to 75 millisecond range, and have found that speakers can maintain fast rates and achieve increased fluency at these delays. Delayed auditory feedback presented binaurally (i.e. in both ears) is more effective than that presented in monaurally, or in one ear only.
152:
stutterers using the SpeechEasy show greater reductions in reading than for monologue and conversation. Using AAF was effective in reducing stuttering in scripted telephone calls and giving presentations according to two studies. Another study examining the effects of the SpeechEasy in more naturalistic situations (conversation and asking questions of strangers outside the clinic) found that the SpeechEasy failed to show a significant effect following six months of use, though individual subjects varied in their response. A further study examining the use of the device during phone and face to face conversation also found wide variations in stuttering reduction, with just under half exhibiting stable improvement over the course of the four months of the study.
156:
reports suggest that over time users receive continued but lessened effects from their device. While one group study has reported continued overall reductions in stuttering after a year of daily use of the SpeechEasy on reading and a monologue task, others have found that some participants showed adaptation effects, gaining less benefit from the device after exposure for several months, including stuttering more with the device than without it. Some studies of various altered auditory feedback devices have noted carryover fluency, i.e. a reduction in stuttering after the stutterer removes an electronic fluency device, while others have not.
178:
caused by the changes in speech production, including slower speech rates, higher pitches and increased loudness, rather than the AAF per se. However, subsequent studies have noted that increased fluency occurred in some stutterers at normal and fast rates using DAF. Some suggest that stuttering is caused by defective auditory processing, and that AAF helps to correct the misperceived rhythmic structure of speech. It has been shown that some stutterers have noted that have atypical auditory anatomy and that DAF improved fluency in these stutterers but not in those with typical anatomy. However,
131:
pitch shift required to maximally reduce stuttering. In studies that gave longer exposure to FAF and used more meaningful daily life tasks such as generating a monologue, only some participants experienced a reduction in stuttering. Initial claims that AAF was more powerful than FAF in reducing stuttering have not been supported by subsequent research. FAF is, like DAF, more effective when presented binaurally. In the last years a number of smart phone apps have been developed that implement DAF/FAF as software and are much cheaper than the special hardware devices.
160:
being particularly useful on the telephone. They reported that the device was difficult to use in noisy situations as the device amplifies all voices and sounds, and some acclimatization to the use of the device over time. Qualitative reports of satisfaction may be disassociated from more objective measures of fluency: some stutterers who gain little or no benefit from a device based on objective measures rate the device highly, while others who were obtaining benefit on measures of fluency reported negatives opinions about the device.
86:
quality, breathing patterns, and voicing strategies. These programs are designed to train features related to prolonged speech, a treatment technique which is frequently used in stuttering therapy. No peer-reviewed studies have been published showing the effectiveness of commercial systems in a clinical context. A study of electromyographic (EMG) feedback in children and adolescents found it to be as effective as other treatments (home-based and clinic-based smooth speech training) in the short and longterm.
57:
140:
in stuttering with an electronic fluency device can occur without a reduced speech rate, and that speech naturalness is often enhanced with AAF. However, the effects of altered feedback are highly individualistic, with some obtaining considerable increases in fluency, while others receive little or no benefit.
95:
permitted increasingly portable devices such as
Derazne Correctophone, the Edinburgh Masker, the Vocaltech Clinical Vocal Feedback Device, the Fluency Master and the SpeechEasy. Current devices may be similar in size and appearance to a hearing aid, including in-the-ear and completely-in-the-canal models.
182:
studies on choral reading in stutterers suggest that AAF also made changes in motor and speech production areas of the brain, as well as the auditory processing areas. Choral reading reduced the overactivity in motor areas that is found with stuttered reading, and largely reversed the left-hemisphere
139:
Studies have shown that altered auditory feedback (including delayed auditory feedback, frequency altered feedback) as provided by devices such as the Casa Futura School DAF machine or SpeechEasy can immediately reduce stuttering by 40–80% in reading tasks. Laboratory studies suggest that reductions
177:
The precise reasons for the fluency-inducing effects of AAF in stutterers are unknown. Early investigators suggested that those who stutter had an abnormal speech–auditory feedback loop that was corrected or bypassed while speaking under DAF. Later researchers proposed increased fluency was actually
155:
While there is evidence of the immediate, short-term effectiveness of AAF devices in reducing stuttering, the longterm effects of altered feedback are unclear. There is some limited experimental data that in some speakers the effect of AAF may fade after a few minutes of exposure, and some anecdotal
168:
There is little experimental evaluation of the therapeutic effect of AAF on children who stutter: one study noted that effects of FAF were less in children than adults. Given the lack of evidence of its effectiveness, as well as concerns about the impact of altered feedback on developing speech and
159:
The effective of electronic fluency devices as measured by qualitative measures and ratings by stutterers have also been made. Studies show that some stutterers report improved fluency and confidence about speaking, and less severe stuttering and some carryover effects; the device is perceived as
109:
has been well documented to reduce stuttering. Clinic-based and portable devices, such as the
Edinburgh Masker (since discontinued) have been developed to deliver masking, and found that masking was effective in reducing stuttering, though many found that reduction in stuttering faded with time.
130:
Pitch-shifting frequency-altered auditory feedback (FAF) changes the pitch at which the user hears his or her voice. Varying pitch from quarter, half or full octave shift typically results in 55–74% decreases stuttering in short reading tasks. Individuals differ as to direction and extent of the
151:
There are few published studies on the effect of the AAF in the daily activities of life; studies have mainly examined the effect of AAF on short oral reading tasks, with some studying the giving of a monologue that is usually short in duration. Several studies have produced group results that
94:
Altered auditory feedback (AAF) such as singing, choral speaking, masking, delayed or frequency altered feedback have long been known to reduce stuttering. Early altered auditory feedback devices were large and thus confined to the laboratory or therapy room, but advances in electronics have
85:
Computerized feedback devices (such as CAFET or Dr. Fluency) use computer technology to increase control over breathing and phonation. A microphone gathers information about the stutterer’s speech and feedback is delivered on a computer screen. Measurements include intensity (loudness), voice
148:; in particular that AAF effects continue over the long term and in everyday speaking situations. The high-profile promotion in the media of devices such as the "SpeechEasy" has been criticized as inappropriate given the lack of scientific evidence for their effectiveness.
183:
based auditory-system and speech production system underactivation. Noting that the effects of altered feedback vary from person to person and can wear off over time, distraction has also been proposed as a possible cause of stuttering reduction with AAF.
499:
Stuart A, Kalinowski J, Rastatter M, Saltuklaroglu T, Dayalu V (2004). "Investigations of the impact of altered auditory feedback in-the-ear devices on the speech of people who stutter: initial fitting and 4-month follow-up".
143:
A 2006 review of stuttering treatments noted that three treatment studies of the SpeechEasy device did not meet the criteria for experimental quality. In addition, studies have been critiqued for failing to demonstrate
1136:
Bothe AK, Davidow JH, Bramlett RE, Ingham RJ (2006). "Stuttering
Treatment Research 1970–2005: I. Systematic Review Incorporating Trial Quality Assessment of Behavioral, Cognitive, and Related Approaches".
1323:
Stuart A, Kalinowski J, Saltuklaroglu T, Guntupalli VK (2006). "Investigations of the impact of altered auditory feedback in-the-ear devices on the speech of people who stutter: one-year follow-up".
1411:
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974:
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110:
Interest in masking reduced during the 1980s as a result of studies finding delayed auditory feedback and frequency altered feedback were more effective in reducing stuttering.
1220:"Help for stutterers? Devices such as the SpeechEasy are growing popular due to exposure on shows like "Oprah," but experts say they may not be the miracle cures people expect"
1376:
Radford NT, Tanguma J, Gonzalez M, Nericcio MA, Newman DG (2005). "A case study of mediated learning, delayed auditory feedback, and motor repatterning to reduce stuttering".
73:
Computerized feedback devices provide feedback on the physiological control of respiration and phonation, including loudness, vocal intensity and breathing patterns.
542:
Kalinowski J, Armson J, Roland-Mieszkowski M, Stuart A, Gracco VL (1993). "Effects of alterations in auditory feedback and speech rate on stuttering frequency".
934:
Hargrave S, Kalinowski J, Stuart A, Armson J, Jones K (1994). "Effect of frequency-altered feedback on stuttering frequency at normal and fast speech rates".
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Zimmerman S, Kalinowski J, Stuart A, Rastatter M (1997). "Effect of altered auditory feedback on people who stutter during scripted telephone conversations".
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1797:
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899:
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1606:
Foundas AL, Bollich AM, Feldman J, et al. (2004). "Aberrant auditory processing and atypical planum temporale in developmental stuttering".
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1812:
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Stager SV, Denman DW, Ludlow CL (1997). "Modifications in aerodynamic variables by persons who stutter under fluency-evoking conditions".
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Armson J, Stuart A (1998). "Effect of extended exposure to frequency-altered feedback on stuttering during reading and monologue".
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818:
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Finn P, Bothe AK, Bramlett RE (2005). "Science and pseudoscience in communication disorders: criteria and applications".
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language systems, some authors have expressed the view that the use of an AAF with children would be unethical.
1754:
1536:
Kalinowski J, Stuart A (1996). "Stuttering amelioration at various auditory feedback delays and speech rates".
740:
Kalinowski J, Stuart A (1996). "Stuttering amelioration at various auditory feedback delays and speech rates".
76:
Altered auditory feedback (AAF) devices alter the speech signal so that speakers hear their voices differently.
1254:
O'Donnell JJ, Armson J, Kiefte M (2008). "The effectiveness of SpeechEasy during situations of daily living".
272:
Lincoln M, Packman A, Onslow M (2006). "Altered auditory feedback and the treatment of stuttering: a review".
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Fox PT, Ingham RJ, Ingham JC, et al. (1996). "A PET study of the neural systems of stuttering".
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53:. Most electronic fluency devices change the sound of the user's voice in his or her ear.
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309:"Evaluation of a stuttering treatment based on reduction of short phonation intervals"
2003:
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Harrington J (1988). "Stuttering, delayed auditory feedback, and linguistic rhythm".
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49:) are electronic devices intended to improve the fluency of persons who
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Electronic fluency devices can be divided into two basic categories:
1345:
307:
Ingham RJ, Kilgo M, Ingham JC, Moglia R, Belknap H, Sanchez T (2001).
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195:
Stuttering and
Cluttering: Frameworks for understanding treatment
1743:
1052:
International
Journal of Language & Communication Disorders
502:
International
Journal of Language & Communication Disorders
27:
Devices intended to improve the fluency of persons who stutter
453:
Pollard R, Ellis JB, Finan D, Ramig PR (April 2009).
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622:British Journal of Disorders of Communication
424:Saltuklaroglu and Kalinowski (2006) p. 173-4
212:Tim Saltuklaroglu; Joseph Kalinowski (2006).
8:
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820:Journal of the Acoustical Society of America
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689:Saltuklaroglu and Kalinowski (2006), p. 239
173:Causes of altered auditory feedback effects
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197:. Hove and New York: Psychology Press.
1882:International Stuttering Awareness Day
1788:American Institute for Stuttering (US)
936:Journal of Speech and Hearing Research
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216:. Plural Publishing. pp. 173–4.
7:
1828:National Stuttering Association (US)
1813:International Stuttering Association
1887:National Stuttering Awareness Week
1620:10.1212/01.wnl.0000142993.33158.2a
1425:10.1097/01.mrr.0000128063.76934.df
25:
1925:The Case of the Stuttering Bishop
90:Altered auditory feedback devices
43:altered auditory feedback devices
1663:10.1097/00001756-199502000-00024
1958:Scatman (Ski-Ba-Bop-Ba-Dop-Bop)
1509:(3): 187–200, quiz 200–1, III.
471:10.1044/1092-4388(2008/07-0204)
1:
1818:Israel Stuttering Association
1808:Indian Stammering Association
1515:10.1016/S0094-730X(02)00128-6
1468:10.1016/S0094-730X(98)00021-7
1325:Disability and Rehabilitation
1294:"Those who stutter find hope"
1268:10.1016/j.jfludis.2008.02.001
1218:Hidalgo, Jason (2004-01-26).
1115:10.1016/j.jfludis.2006.04.004
286:10.1016/j.jfludis.2006.04.001
81:Computerized feedback devices
1456:Journal of Fluency Disorders
1292:Davis, Robert (2004-10-18).
648:"Stuttering: A Brief Review"
514:10.1080/13682820310001616976
180:positron emission tomography
1979:Su.. Su... Sudhi Vathmeekam
1378:Perceptual and Motor Skills
1197:10.1044/1058-0360(2005/018)
1151:10.1044/1058-0360(2006/031)
1064:10.1080/1368282021000042902
727:10.1044/1058-0360(2007/010)
325:10.1044/1092-4388(2001/096)
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1833:Stuttering Foundation (US)
556:10.1177/002383099303600101
126:Frequency-altered feedback
31:Electronic fluency devices
1988:
1861:Electronic fluency device
1856:Delayed Auditory Feedback
1823:Michael Palin Centre (UK)
1550:10.3109/13682829609033157
1337:10.1080/09638280500386635
1014:J. Speech Lang. Hear. Res
976:J. Speech Lang. Hear. Res
901:J. Speech Lang. Hear. Res
878:10.3109/13682829709017901
782:J. Speech Lang. Hear. Res
754:10.3109/13682829609033157
634:10.3109/13682827909011361
587:J. Speech Lang. Hear. Res
459:J. Speech Lang. Hear. Res
383:J. Speech Lang. Hear. Res
313:J. Speech Lang. Hear. Res
120:delayed auditory feedback
114:Delayed auditory feedback
60:Electronic fluency device
1310:Ward (2006), p. 296, 298
47:altered feedback devices
2010:Anti-stuttering devices
1390:10.2466/PMS.101.5.63-71
1185:Am J Speech Lang Pathol
913:10.1044/jslhr.4206.1347
794:10.1044/jslhr.4005.1130
395:10.1044/jslhr.4106.1242
18:Anti-stuttering devices
1026:10.1044/jslhr.4103.479
988:10.1044/jslhr.4002.361
948:10.1044/jshr.3706.1313
599:10.1044/jslhr.4004.832
61:
360:10.1044/jshr.3904.808
59:
1585:10.1044/jshr.3101.36
1224:Reno Gazette-Journal
193:Ward, David (2006).
1911:A Fish Called Wanda
1698:1996Natur.382..158F
1538:Eur J Disord Commun
1084:Ward (2006), p. 299
832:1997ASAJ..101.3806S
544:Language and Speech
241:Ward (2006) p. 300
146:ecological validity
1991:List of stutterers
1918:Attention bandits!
671:Ward (2006) p. 298
415:Ward (2006) p. 293
62:
1997:
1996:
1939:The King's Speech
1892:The Monster Study
1734:Ward, 2006, p. 57
1573:J Speech Hear Res
1488:Ward, 2006, p. 50
1413:Int J Rehabil Res
348:J Speech Hear Res
223:978-1-59756-011-5
204:978-1-84169-334-7
164:Use with children
35:assistive devices
16:(Redirected from
2017:
1877:Stuttering pride
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1692:(6587): 158–61.
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1528:
1490:
1481:
1462:(2): 127–136.
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1403:
1368:
1331:(12): 757–65.
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1303:
1281:
1235:
1210:
1172:
1145:(4): 321–341.
1128:
1086:
1077:
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1001:
961:
926:
907:(6): 1347–54.
891:
853:
807:
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682:
673:
664:
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628:(3): 219–229.
612:
577:
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389:(6): 1242–52.
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1582:
1578:
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1262:(2): 99–119.
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1257:
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1214:
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1191:(3): 172–86.
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1120:
1116:
1112:
1109:(2): 137–52.
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1104:
1097:
1095:
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1087:
1081:
1078:
1073:
1069:
1065:
1061:
1058:(2): 119–29.
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1053:
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1027:
1023:
1020:(3): 479–90.
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989:
985:
982:(2): 361–72.
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977:
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949:
945:
942:(6): 1313–9.
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872:(3): 359–66.
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837:
833:
829:
826:(6): 3806–9.
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791:
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748:(3): 259–69.
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654:on 2008-07-06
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508:(1): 93–113.
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465:(2): 516–33.
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19:
1977:
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1963:
1956:
1937:
1930:
1923:
1916:
1909:
1860:
1803:FRIENDS (US)
1730:
1689:
1685:
1679:
1657:(3): 501–5.
1654:
1650:
1644:
1611:
1607:
1601:
1579:(1): 36–47.
1576:
1572:
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1541:
1537:
1531:
1506:
1502:
1484:
1459:
1455:
1449:
1416:
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656:. Retrieved
652:the original
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1793:Stamma (UK)
1773:/stammering
1651:NeuroReport
698:Ward, p. 49
680:Ward, p. 48
550:(1): 1–16.
104:White noise
1932:K-K-K-Katy
1843:Management
1771:Stuttering
1346:10342/1095
1229:2007-12-02
658:2009-07-18
214:Stuttering
187:References
1972:Stutterer
1952:Porky Pig
1608:Neurology
1298:USA Today
721:: 77–83.
2004:Category
1851:Overview
1636:10622180
1628:15534249
1523:12371347
1476:18259595
1441:25350429
1433:15167118
1398:16350610
1363:19872380
1355:16754573
1276:18617051
1205:16229669
1167:24775349
1159:17102144
1123:16753207
1072:12745932
921:10599617
572:16949019
522:14660188
479:18695013
333:11776361
294:16750562
1722:4314976
1714:8700204
1694:Bibcode
1671:7766852
1593:3352254
1558:8944848
1034:9638914
996:9130204
956:7877290
886:9474287
848:9193064
828:Bibcode
802:9328884
762:8944848
607:9263947
564:8345771
403:9859881
368:8844560
107:masking
99:Masking
51:stutter
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1686:Nature
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1870:Other
1718:S2CID
1632:S2CID
1437:S2CID
1359:S2CID
1163:S2CID
568:S2CID
65:Types
1710:PMID
1667:PMID
1624:PMID
1589:PMID
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1519:PMID
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1429:PMID
1394:PMID
1351:PMID
1272:PMID
1201:PMID
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1119:PMID
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1030:PMID
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882:PMID
844:PMID
798:PMID
758:PMID
603:PMID
560:PMID
518:PMID
475:PMID
399:PMID
364:PMID
329:PMID
290:PMID
218:ISBN
199:ISBN
45:and
1702:doi
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1659:doi
1616:doi
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1511:doi
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1421:doi
1386:doi
1382:101
1341:hdl
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1193:doi
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1111:doi
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1022:doi
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909:doi
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510:doi
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282:doi
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