Case Studies
Commentary & Speech Therapy Children's Case Studies From
Connie Dugan, M.A., CCC-SLP
ASHA Board Recognized Fluency Specialist
Chicago, IL
The client J. is a 12 year old youth. His development was normal in every way except for speech which was somewhat delayed. By two and a half years his speech "caught up" except that he exhibited beginning stuttering and articulation difficulty with /k/ and /g/. By the age four his stuttering became less typical and he demonstrated pitch changes, hard blocks, and word avoidance. J. has received therapy since age four and been treated by a highly experienced and well regarded fluency specialist for most of this time. The young man, his parents, and his speech-language pathologist agree that has made significant progress but still cannot manage his speech as well as he would like.
The client is an excellent student. He is proactive about taking part in special school activities such as science fairs. The client presented as a mature for his age, articulate, and quietly engaging. He voiced positive attitudes about his speech and appears highly motivated to continue to improve his fluency. It was noted that he has very good eye contact even when he blocks. The family unit appeared 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.
The client was interviewed by telephone approximately 22 months after receiving his device. He stated that he wears the SpeechEasy and "some of the time" at school. He does not like to wear it in the cafeteria, for example, because of noise. He stated that he particularly likes to use it for presentations. He stated 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 did not have his device for one of these as it was in the lab for repair. His mother stated that he took care to remember he was capable of doing well for his presentation with or without his SpeechEasy.
