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An SLP's Insights Into SpeechEasy's Value As A Treatment Option
This article was written by Constance L. Dugan, CCC-SLP, Speech-Language Pathologist & Communication Coach and Certified SpeechEasy® Provider in Chicago, Illinois. Connie first wrote the article for Passing Twice, a newsletter for a network of gay, lesbian, bisexual, and transgender people who stutter, and their friends and allies. The article first appeared in Issue #46, Spring 2005. For more information go to www.passingtwice.com.
Several of the Passing Twice family have asked my opinion about the SpeechEasy anti-stuttering device. I have been working with the SpeechEasy as part of my private practice for the past two years. I have evaluated about 140 clients and have about 60 wearers. I am a Board Recognized Specialist in Stuttering and Fluency Disorders. I have been working as a speech-language pathologist for more than 30 years and for the last 15 years almost all of my clinical work has been with stuttering.
To put my thoughts about the SpeechEasy in perspective, I should say a little about my treatment approach. I don't care about perfect fluency. I care a lot about people speaking freely and as easily as possible and being comfortable with themselves and with their speech. I favor attitudes and techniques that connect the person who stutters with other people ("bridges"). I generally disapprove anything that separates a stutterer from others ("barriers"). I'm against all avoidance maneuvers because avoidance (such as substituting words, looking away, or not showing up) is addictive and progressive and shaming and inevitably backfires. Other than that, I am pretty much a "whatever works" kind of therapist.
In a nutshell, the SpeechEasy looks like a hearing aid (but is not one) and allows the wearer to hear his or her own voice altered slightly. This has been described as the "choral effect." Speech is heard at a slight delay and at a higher or lower pitch. We don't know exactly why this helps people be more fluent but we have long known that it does so. It doesn't work just by slowing down speech. Wearers usually speak at their habitual rate. If you are interested in the facts, check out the FAQ's at www.speecheasy.com. The information there is accurate and well written.
What I hope to do here is to share my experience and some opinions. The SpeechEasy is a wonderful product for those who respond to altered auditory feedback (AAF). It doesn't help at all for a small percentage of people. It is almost perfect for another small group. Most clients are helped a lot or somewhat. A few people put it in and have a wonderful result without doing much of anything but keeping a fresh battery. Most people, however, have to use some active techniques such as prolonging sounds to get the AAF signal started and keeping it going. This is complementary to a number of tried-and-true therapy tools. Many clients have told me wearing the SpeechEasy it makes it easier to use therapy techniques that were previously unusable outside the clinic. I find the SpeechEasy comfortable. (I wear it a couple of hours a week so I can appreciate what my clients are experiencing.) Some people are bothered by background noise and others find it harder to understand what other people are saying, especially in groups. My belief is that some individuals are just extremely sensitive. Others who might be able to adjust may not give it a chance or may not seek or receive adequate help to make the adjustment. Some people are disappointed because it is not invisible. It isn't invisible, just tiny (http://www.speecheasy.info). The device isn't good in noisy environments. You wouldn't want to have it turned on at a basketball game, for example. It does change what you hear, so you would turn it down or off if you went to a concert. You must not get it wet or expose it to high heat. It is easy to take care of.
I haven't found a way to predict who is a good candidate or not unless the client knows whether or not she responds to AAF. If a client does respond to AAF, he should respond to the SpeechEasy because that is what the SpeechEasy provides. I have begun a new hobby, collecting tautologies: The SpeechEasy helps those it helps to the extent to which it helps them.
I am thrilled and relieved the SpeechEasy is available. I think I am a pretty good therapist, but so often I can't help clients become as comfortable as they deserve to be. The SpeechEasy is another tool and option. I find working with the device requires all my clinical skills. I believe one should have more, not less, experience to help potential wearers. I can't say enough about the respect I have for the manufacturer, Janus Corporation. They are the nicest, most honest and helpful bunch you could imagine. I began working with the SpeechEasy with some "fear and trepidation" because of "snake oil" that has been inflicted on hopeful stutterers through time. The SpeechEasy is not "snake oil," and I am irked by misinformation I read on the lists and hear from colleagues and acquaintances who haven't worked with the device or been open minded enough to learn about it.
Advice:
Honor your right to do what is best for your individual situation and preferences (go to stutterisa.org/isa001.html#billofrights for more information).
If you are interested in a device do your homework.
Find out if you respond to DAF/FAF. You can download a program that produces AAF for a free seven day trial (www.artefactsoft.com). If you are more fluent with it, chances are you are a good candidate for the SpeechEasy. There are microphone/earphone combinations ($20 up), FAF to maximum and DAF to 50-100 ms and volume to comfort.
Read and study FAQ's at www.speecheasy.com I have found them to be accurate and current.
Take a look at the Discussion Board at the same site and read positive and negative and random comments written by users. But, remember that response to the SpeechEasy is individualistic. Someone else's experience means next to nothing about your response.
Monitor your expectations, monitor your expectations, monitor your expectations! The SpeechEasy is a great tool. It is not a panacea.
View the photographs at www.speecheasy.info. The device is little. It isn't invisible. If you need invisible, don't get one.
If you decide to try a device, find a dispenser who is knowledgeable about stuttering You need someone close to you to help with the adjustment period, develop a practice plan, make any settings changes, install upgrades, and arrange repairs if they are needed.
If you get a device, follow the recommended practice protocol provided by your dispenser, and let your "home base" SLP help. Many people need to use active techniques in addition to the passive response to the SpeechEasy. I have some of my practice suggestions on my web site www.conniedugan.com
Most importantly, continue doing all the other helpful things you are doing to be yourself and communicate freely.
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