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Case Studies from Our SLP Community
Our special thanks to Vivian Topp, CCC-SLP, Maria Grogan, M.Ed., CCC-Sp, Sally McKee, MA, CCC, and Connie Dugan, CCC-SLP for contributing.
"SpeechEasy is another tool in the SLP toolbox, one more option for our clients. The device will not replace traditional therapy. Many people who stutter find that SpeechEasy enables them to use the techniques learned in speech therapy with less effort. As a SLP dispensing SpeechEasy, I am very interested in working closely with the original SLP to ensure that therapy, if needed, is continuous and I fully support that SLP in any way that I can."
Case Study #1
My client, a 30-year-old male, suffers from a severe stutter. He works as a radiology technician at a large hospital in Florida. The client's uncle (paternal) was also a suffered from severe stuttering. The client has received speech therapy "off and on" during elementary school, high school and as a young adult (approximately 12 years ago).
Prior to obtaining the SpeechEasy device, the client had difficulty speaking on the phone, speaking with his administrators and speaking to hospital patients. Specifically, he demonstrated tonic blocks that lasted 4-5 sec., repetitions, prolongations and facial contortions as well as movement of the lower extremities during stuttering events.
Results
The client experienced significant results with SpeechEasy. In stuttered syllables, conversation, he experienced stuttering 35% without SpeechEasy, and 5% with Speecheasy. In reading, he experienced stuttering 28% without SpeechEasy, and 3% with Speecheasy.
Case Study #2
My client, a 14-year-old male in the 9th grade at a private school, lives with his mother and brother in Florida. His father lives overseas but visits frequently. The client speaks two languages, English and Papiamiento. He suffers from severe stuttering.
Prior to obtaining a SpeechEasy device, the client reported difficulty when speaking with his peers, during oral reading in school and when asked to present reports or answer questions orally in school. He exhibited silent blocks (2-3 seconds) at the outset of phrases, voiced blocks, phonemic and part-word repetitions, and secondary characteristics such as closing his eyes, lip pressing, glottal fry and movement of the extremities.
According to the client's mother, he received speech therapy since elementary school with "one to two year breaks in between when we saw he was tired." His last round of therapy was approximately one year ago. He recently started receiving therapy in school and it was the school speech pathologist that brought SpeechEasy to the parents' attention.
Results
The client experienced significant results with SpeechEasy. In stuttered syllables, conversation, he experienced stuttering 36% without SpeechEasy, and 8% with SpeechEasy. In reading, he experienced stuttering 21% without SpeechEasy, and 3% with SpeechEasy.
The client continued to experience difficulty initiating phrases. The use of vocalizations, such as "uh" and "mmm," were demonstrated as "starter" techniques. He was able to return demonstration easily with good results in conversation.
Case Study #3
The client J. is 12 years old. His development was normal in every way except for his speech, which was somewhat delayed. At the age of 2 _, his speech "caught up," except that he exhibited beginning stuttering and articulation difficulty with /k/ and /g/. By the age of four his stuttering became less typical and he demonstrated pitch changes, hard blocks, and word avoidance. J. has received therapy since the age of four and has been treated by a highly experienced and well regarded fluency specialists for most of this time. The young man, his parents, and his speech-language pathologist agree that has made significant progress, but he still cannot manage his speech as well as he would like.
J. is an excellent student. He is proactive about taking part in special school activities such as science fairs. He presents as a mature for his age, articulate, and quietly engaging. He voices positive attitudes about his speech and appears highly motivated to continue to improve his fluency. He has very good eye contact, even when he blocks. His family unit appears to be exceptionally strong and supportive.
During the fitting we settled on a setting prescription of 60 ms delay and an upward frequency shift of 500 Hz. J.'s speech was rated using a modification of the Stuttering Severity Instrument. See the chart below for a comparison of his fluency without and with the SpeechEasy:
| Condition |
Reading |
Monologue |
Longest Block Avg. |
Base line |
16% syllables stuttered |
38% syllables stuttered |
2 seconds |
| Wearing SpeechEasy |
5% syllables stuttered |
19% syllables stuttered |
2 seconds |
Stuttering events were mostly single component, though in the baseline condition he demonstrated several more complicated blocks including 3 repetitions of an initial sound + prolongation. J. had no physical concomitants other than facial tension in either condition.
The quality of stuttering moments in the monologue condition is summarized below.
| Baseline: |
| Interjection - 30% |
tense pause - 25% |
phoneme repetition - 20% |
| phrase repetition - 5% |
prolongation - 20% |
| Wearing SpeechEasy: |
| tense pause - 75% |
prolongation - 20% |
The client was coached in using active techniques to enhance the benefit of the SpeechEasy; specifically, he was shown how to focus on stretching the first vowel to consonant or consonant to vowel transition in a phrase. This was emphasized because of his success and experience with Easy Relaxed Approach, Smooth Movement (ERASM) which was a tool practiced in his therapy program.
J. was interviewed by telephone approximately 22 months after receiving his device. He wears the SpeechEasy device at home and "some of the time" at school. He does not like to wear it in the cafeteria, for example, because of noise. He stated he particularly likes to use the device for presentations. J. says the major benefit of the device is that it reminds him to use techniques learned in therapy and makes it easier for him to do so. He has won several science fair competitions. He shared he did not have his device for one of the science fairs as it was in the lab for repair. His mother stated he took care to remember he was capable of doing well for his presentation with or without his SpeechEasy device.
Case Study #4
The client, a 35-year-old-male who experiences severe stuttering, works in marketing. He reports having a cousin that also stutters. He has had traditional therapy beginning at the age of three, and received direct therapy services three times weekly during the school year from the age of five through twelve. He used an Edinburgh Masker for approximately one year, when he was twelve. He received psychological therapy when he was 15 to treat anxiety resulting from his dysfluencies.
The client participated in the "Stutter No More" program with Dr. Martin Schwartz at the age of 28. He attended the Hollins Intensive Program at the age of 30. He reports having used various anti-anxiety drugs in the past and was presently taking one at the time of the evaluation.
Prior to obtaining the SpeechEasy device, the client had difficulty communicating with customers, participating in business meetings and using the telephone. He expressed concern that his dysfluencies were hindering his job performance.
Upon evaluation for the SpeechEasy device, it was determined this client was an excellent candidate given his prior therapy experiences and motivation.
Results
The client experienced significant results with SpeechEasy. In stuttered syllables, conversation, he experienced stuttering 32% without SpeechEasy, and 18.3% with SpeechEasy. In reading, he experienced stuttering 16% without SpeechEasy, and 2.6% with SpeechEasy.
Also noted was a decrease in the physical struggle that was visibly evident during dysfluencies and the shortened length of his dysfluencies. Long-term results have been excellent. The client telephoned me several months after using the device to state that he now refers to it as "SpeechMiracle" versus SpeechEasy.
Case Study #5
The client is a nine-year-old male experiencing moderate stuttering, with no family history of dysfluencies. He has attended biweekly speech therapy sessions with a school clinician for the past several years.
Prior to obtaining the SpeechEasy device, his dysfluencies consisted of part-word repetitions, prolongations and silent blocks without secondary characteristics. The client's mother reported that the client participates in class. However, he is very dysfluent when speaking in front of peers.
His Mom stated his dysfluencies increased when he missed several therapy sessions due to holidays, summer break, etc.
Upon evaluation, it was determined the client would be a good candidate for the SpeechEasy device given his understanding of traditional therapy techniques.
Results
The client experienced significant results with SpeechEasy. In stuttered syllables, conversation, he experienced stuttering 17% without SpeechEasy, and 6% with SpeechEasy. In reading, he experienced stuttering 10% without SpeechEasy, and 2% with SpeechEasy.
Long-term results have been excellent. The client continued to receive speech therapy services from the school clinician on a consultative basis for the first three months after receiving the SpeechEasy device. He has since been exited from the SLI program and continues to exhibit consistent fluency within the normal limits.
Case Study #6
The client is a 17-year-old male high school junior. Initial telephone screening questions with his father revealed the client has had a history of cerebral palsy since birth and "has stuttered for as long as I can remember." He walks with the aid of crutches and a walker. He reported having been enrolled in fluency therapy for his stuttering for more than one year at a regional rehabilitation center, focusing on "taking deep breaths" before he talks. His parents heard about the SpeechEasy® Fluency Device from a family friend who had used the device successfully for two years.
The client requested a SpeechEasy® evaluation "so I can talk better to others and won't be embarrassed." His parents observed the evaluation process, and were visibly moved by the positive difference they heard in his speech. His father stated, "If he can experience even 50% improvement, it will be worth the cost."
Due to the client's learned habit of "taking a deep breath" and holding it before speaking, the majority of the evaluation process involved focusing on exhalation rather than inhalation. The Initial Vowel Words and Phrases list was used to introduce and practice silent breathing and "tired talking."
Results
Results of his evaluation process, as suggested by behavioral observations and measured by the Riley Stuttering Severity Instrument, indicated very severe stuttering without the SpeechEasy® and mild stuttering with the device. In stuttered syllables, conversation, he experienced stuttering 28% without SpeechEasy, and 5% with SpeechEasy. In reading, he experienced stuttering 35% without SpeechEasy, and 9% with SpeechEasy. His duration of blocks without SpeechEasy: 9 seconds; with SpeechEasy: 1 second.
A copy of the Initial Vowel Words and Phrases list was provided to the client to continue practicing at home until he received his device. Three weeks later, when he returned for his final fitting, his stuttering frequency and blocks were less than his pre-SpeechEasy® results, more than his post-results. His father reported during the long drive home following the evaluation, the client demonstrated more fluent speech by using the strategies learned in the evaluation session. His fluency decreased, however, after a few weeks. During his final fitting, with the use of the exhalation strategy and the SpeechEasy device, his dysfluency frequencies decreased to 2% in conversation and fleeting hesitations rather than blocks. I referred him to his Speech Pathologist for continued therapy, and spoke with her to discuss continuing the strategy that enhances his fluency.
The client has maintained his post-fitting fluency for two months, and credits the device, his weekly speech therapy and his daily practice with the Initial Vowel Words and Phrases.
Case Study #7
The client is a 19-year-old male with severe dysfluencies. He was referred to an SLP for a SpeechEasy® evaluation one year ago by his public school SLP, who described the client as an outstanding student whose stuttering prevents him from speaking in class. She further reported that his stuttering severely interfered with his school achievement, and was "preventing him from applying for a college scholarship."
Prior to obtaining the SpeechEasy device, the client exhibited voiced blocks, part-word repetitions, and secondary characteristics of hand movements, eye blinks, and jaw movement contortions. The client reported choosing to take lower grades rather than verbally participate in class.
Results
Results of his evaluation process, as suggested by behavioral observations and measured by the Riley Stuttering Severity Instrument, indicated very severe stuttering without the SpeechEasy® and mild stuttering with the device. In stuttered syllables, conversation, he experienced stuttering 30% without SpeechEasy, and 2% with SpeechEasy. In reading, he experienced stuttering 30% without SpeechEasy, and 2% with SpeechEasy. His duration of blocks without SpeechEasy, 5 seconds; with SpeechEasy: fleeting hesitations.
A copy of the Initial Vowel Words and Phrases list was provided to the client to continue practicing at home until he received his device. I talked with this client when he attended our recent SpeechEasy Fluency Group Meeting. He reported to the group that his speech had become so fluent after six months of wearing the SpeechEasy device, that he decided he would leave it home while he was out of the country for two months. He admitted his speech "began to fall apart after the first month." When he returned home, he forgot about his daily practice and had difficulty speaking even when wearing the device. After the group meeting, we had a brief therapy session with the device, and he was back on track with his fluency. In our phone conversation this week, he continued to demonstrate 99% fluency after one year of wearing the SpeechEasy. I recommended speech therapy to him on a monthly basis.
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