Assistive Technology Makes a Difference in the Lives of People Who Stutter
By John M. Williams
On the outside, the student standing next to his desk looks like a normal 10-year-old: alert, energetic and full of dreams. Right now, he would probably rather be anywhere but standing before his classmates. He weighs his words carefully, because repetitions (li-li-like this), prolongations (lllllike this) and abnormal stoppages (no sound) are a regular part of his speech. Slightly contorted facial and body movements, as well as involuntary behaviors like breathing abnormalities (shallow, rapid), rapid heart rate, elevated blood pressure, sweaty palms, flushing of the skin, eye blinking, and dilation of pupils, can leave him tired and exhausted. Not to mention the emotions behind the physical: fear, anger, relief, embarrassment and guilt.
A person who stutters may grow up feeling discrimination, rejection, failure and ridicule. These fears can lead to a lack of self-esteem and less confidence, causing a person to appear shy, unintelligent or non-assertive. For people who stutter, their beliefs might make the problem worse. For example, they might believe or feel that stuttering is shameful or wrong, feeling seriously different from others. Such beliefs may lead to feelings of isolation, loneliness and humiliation.
Many years' later, that same young man, Ben Kordsmeier, is reversing his years of living with a challenging speaking pattern. Behind his right ear he wears a little device called the SpeechEasy, and after two years he is confident of his ability to speak fluently. As he finishes a fluent sentence, he smiles broadly. He is full of energy compared to his past when he stuttered nearly all the time. "I am no longer afraid to stutter," he says fluently.
Kordsmeier not alone. Thirteen-year-old Dane Stephens and 15-year-old Austin White have identical feelings about their SpeechEasy experience. For most of their lives, these boys have stuttered.
"There is power in fluency," says Stephens, who since using the SpeechEasy device says his peers no longer tease him. He is less tired, less angry about stuttering, is making more friends and feels more positive about his abilities.
The SpeechEasy is a portable and inconspicuous fluency enhancer for people who stutter. It fits in or behind the ear, depending on which model you chose, and is designed to emulate choral speech - a phenomenon that has for many years been known to induce fluency among people who stutter. By the user hearing his or her own voice via a pitch shift and slight time delay, SpeechEasy creates the illusion of speaking in unison with another speaker, emulating choral speech.
The SpeechEasy user listens to his or her own voice with a combination of Delayed Auditory Feedback (DAF), Frequency Altered Feedback (FAF) and Altered Auditory Feedback (AAF). AAF simply means hearing your own voice in a manner that is slightly different from the way you normally hear it. DAF allows the user to hear his or her own voice with a slight delay, similar to an echo. FAF allows the user to hear his or her own voice with a shift in the pitch, so the signal heard is either at a slightly higher or slightly lower pitch than the users own voice.
Using technology to control stuttering or obtain fluency does not happen overnight. Success with SpeechEasy requires a combination of speech therapy and proper usage and care of the product. The earlier stuttering is recognized and treated therapeutically by a speech-language therapist, the more effective the intervention will be. Parents or guardians who notice their child stuttering should seek advice from the Special Education Services (SES) as soon as possible.
Lots of people think they have stuttered from time to time. But stuttering is much more complex than occasionally repeating or stumbling over words. Stuttering does not mean that the person is excited or cannot think of the word they want to say. It is an involuntary behavior and people who stutter cannot help it.
None of the three boys believe they are intellectually deficient. In fact, there is no evidence of differences intellectually or emotionally between children who stutter and those who do not. It is vitally important that a child who does stutters does not come to believe stuttering is a reason to withdraw from interacting with other people. The goal of parents or teachers should be to help prevent negative emotions from becoming part of the child's stuttering experience. This means that even if the child does not speak fluently he or she can at least speak freely.
The American Speech Language Hearing Association (www.asha.org), which is a credentialing association of more than 120,000 members and affiliates, including audiologists, speech-language pathologists, and speech, language, and hearing scientists, defines stuttering "as a disorder of speech fluency that interrupts the forward flow of speech." How that disorder manifests in someone's life, and for how long, can vary.
People used to believe stuttering was caused by nervousness, bad parenting, genetics, inability to coordinate the speech muscles, psychological problems, and talking too fast. We now know that four factors contribute to the development of stuttering:
- Genetics (approximately 60% of those who stutter have a family member who does also);
- Child development (children with other speech and language problems or developmental delays are more likely to stutter);
- Neurophysiology (recent research has shown people who stutter process speech and language differently in the brain); and
- Family dynamics (high expectations and fast-paced lifestyles can contribute to stuttering).
Stuttering may occur when a combination of factors comes together and may have different causes in different people. It is probable that what causes stuttering differs from what makes it continue or get worse.
A spokesperson for The Stuttering Foundation of America (www.stutteringhelp.org) says out of about three million people in the United States who stutter (1% of the population), about four times as many of them are males - a possible indicator of genetics. Additional evidence pointing to genetics is speech pathways in the brain that are less efficient. The inefficiency of the pathways makes it difficult for a child to meet fluency demands by getting their words out quickly. Genetics may also influence the temperament of the child, which makes some children react negatively to their own early stuttering behavior. Combined, these elements may increase the likelihood that a child will stutter.
Another genetic factor may be a child's tendency to persist with or recover from their stuttering. Some children outgrow stuttering on their own, possibly because their brains reorganize the speech pathways, or because they eliminate their negative reactions to their behavior. However, some children may continue to stutter into adulthood, possibly because they maintain inefficient brain pathways and posses a reactive temperament within their environment.
Kordsmeier says he has an uncle and cousin who stutter. Stephens and White say they do not have any relatives or friends who stutter. Being the only student in school and in their community-at-large who stutters is a lonely situation.
The trauma of stuttering partially stems from the fact that there are no quick and easy solutions, and there is no cure. It takes a lot of hard work and practice to control the involuntary stuttering behaviors. Some stuttering remedies focus on the person speaking in a novel manner. For example, talking in time to rhythmic movements of an arm or talking in a monotone. These offer only temporary solutions. The novel mannerisms can become habituated, and then they no longer help the person control their stuttering.
Slowing the rate of speech, relaxation techniques, and learning to smooth out the involuntary stuttering behaviors can help a person overcome stuttering. Speech Language Pathologists tell people in therapy they should not conceal their stuttering, nor should they substitute words. They should also stick with the words they are saying, and speak slowly.
One way people who stutter manage their speech is using assistive technology products (ATP) like the SpeechEasy. The Individuals with Disabilities Education Act (IDEA), the federal special education law, says ATPs can be used in educational settings to provide accommodations for people with disabilities.
Famous and accomplished individuals who stuttered include the Roman Balbus Blaesius; Aristotle, Sir Isaac Newton, Clara Barton, author Lewis Carroll, Washington Irving, naturalist Charles Darwin, President Thomas Jefferson and Winston Churchill. The last name of Roman Balbus Blaesius is now the Italian word for stuttering.
More modern figures who stutter are Senator Joseph Biden, singer Carly Simon, Olympic diving champion Greg Luganis, professional football players Lester Hayes and Bo Jackson; novelist John Updike, Annie Glenn (wife of Astronaut and former Ohio Senator John Glenn); singers Mel Tillis and Robert Merrill; former CEO of General Electric Jack Welsh; actors Jimmy Stewart, Marilyn Monroe, Peggy Lipton, Dean Jagger, James Earl Jones, Bruce Willis and Anthony Quinn;, former basketball great Bill Walton and ABC's John Stossel. Kordsmeier, Stephens and White are in good company. "It makes me feel proud to be among these famous individuals," Stephens said.
Laura Doty, author of an article on "Famous People Who Stutter," hypothesizes that people learn to work around their limited speech abilities: "Marilyn Monroe's signature breathy way of speaking may have been her way of treating her stuttering. She seems to have been taught by a speech coach to use exaggerated mouth movements and a breathy and affected speaking style to control her stuttering."
Doty further notes that fluency often came with hard work for some: "Winston Churchill was considered the best orator in Parliament despite the fact that he was a stutterer. He went to great lengths to hide and avoid stuttering. A great deal of preparation went into all his speeches. Churchill wrote them out well in advance, often weeks, of when he would have to give them. He memorized them forwards and backwards so he could practice them. Before beginning to give a speech, Churchill would hum discreetly to himself to get his vocal folds vibrating."
Embarrassed by his stuttering, Sir Isaac Newton demanded that the windows of Parliament be closed so the public would not hear him stutter.
Stuttering was one of reasons that Lewis Carroll, who wrote Alice in Wonderland, was rejected from the Catholic priesthood. Frustrated and deeply pained about his stuttering, he wrote this poem:
Learn well your grammar,
And never stammer,
Write well and neatly,
And sing soft sweetly,
Drink tea, not coffee;
Never eat toffee.
Eat bread with butter.
Once more don't stutter.
With today's technology for fluency gains, users do not demand that windows are closed to shield them from embarrassing incidents when speaking. SpeechEasy users receive therapy and part of that therapy means being trained on the SpeechEasy. Each of the three boys receives speech therapy anywhere from once to twice monthly. Part of their SpeechEasy training is learning to use the product so they pay attention to the auditory feedback. Most users learn that after a few days of actively reminding themselves to listen to the device, the process becomes automatic.
"It wasn't long after I started using the SpeechEasy that I would remember to concentrate on what I was saying. Once I started doing that, my speech started being fluent," said White. He has been using the SpeechEasy for two years and feels comfortable using it.
Part of the continuing therapy associated with the SpeechEasy is stretching vowel sounds to achieve the voice inhibition through difficult sounds. As the boys approach a sound they know is difficult they stretched out the vowel sounds on a few words prior to the difficult sound. They can apply this technique by stretching the vowel sound on small word throughout their reading or during a conversation.
"By stretching vowel sounds, I have more fluency," says Stephen.
When either putting the SpeechEasy into their ear or behind it, the boys do warm up exercises for about a minute to become accustomed to listening to the device/ They either count from 0 to 10, or recite the months of the yea or say something.
The SpeechEasy has to be specially fitted for each user. There are three types: One fits completely in the Ear Canal. The other fits just inside the Canal. The third type fits behind the ear. It is easily inserted and removed. It comes with a battery, microphone, volume control and vent. To achieve maximum effectiveness, the SpeechEasy should be cared for and cleaned daily. When not in use, it should be stored in a box. A set of instructions tells users how to care for it. Batteries are easily replaceable.
Kordsmeier doesn't like cleaning it and often has to be reminded. However, he knows it works best when it is cleaned.
The boys like the SpeechEasy. They wear it almost all the time in school and in social activities. They do not wear it when showering, playing, swimming, or in places such as restaurants, where there is a lot of noise. They love the benefits it brings them. When the boys are not wearing the SpeechEasy, they say the carry over affect ranges from 90 minutes to two hours, especially after they have worn it all day.
White echoes the other two boys' compliments on SpeechEasy's benefits when he says, "The SpeechEasy improved my whole life for the better."
The boys say as a result of the device they are accepted as being normal among their peers. Being accepted by their peers is an important aspect of growing up.
John M. Williams has stuttered for 53 years. He has written many articles on stuttering. He can be reached by writing to him at jmmaw@aol.com.
Links
|
