Discovering the Power of Fluency Through AT

by John M. Williams

I have stuttered severely for 53 years. I have never liked it. Hundreds of times I have cursed it.

Stuttering is a communication disorder in which the flow of speech is broken by repetitions, prolongations, or abnormal stoppages of sounds and syllables. Unusual facial and body movements are associated with stuttering. It affects four times as many males as females and about three million people in the US.

Four factors contribute to the development of stuttering: genetics (approximately 60% of those who stutter have a family member who does); child development (children with other speech and language problems or developmental delays are more likely to stutter); neurophysiology (recent research has shown that people who stutter process speech and language in different areas of the brain than those who do not stutter); and family dynamics (high expectations and fast- paced lifestyles can contribute to stuttering). Stuttering may occur when a combination of factors unite and may have different causes in different people, and therapy is often needed to control it.

Throughout my life, I tried a variety of therapies and assistive technology (AT) devices to try to assist me in achieving fluent speech. The therapies worked briefly. One worked for decades. Their effectiveness collapsed because I lacked the discipline to carry through on the therapies. For various reasons the devices were not effective.

As a writer on AT, I thought it might be interesting for readers of Orbit to compare one I have found useful for my disability with any they might use for their own. What makes an AT effective for a given disability? Can a successful technology for stuttering tell us anything about technologies for spinal cord impairment, for example? I’ll revisit these questions in a bit.

In 2001, I was introduced to the SpeechEasyâ„¢ (www.speecheasy.com). After a week of using it, I returned it to the manufacturer. For me, it had more negatives than positives. It was not the miracle cure for stuttering that I had heard. It felt cumbersome wearing it in my ear. It picked up too many strange noises that were distractions.

Some years ago I had decided that I would live the rest of my life stuttering. It was a situation that I did not like. Deep inside me, I kept hungering for a cure or a miracle that would either give me total fluency 100%-or close to it.

In 2005, I was reintroduced to an upgraded version of the SpeechEasy. This time, the product was molded to fit comfortably into my ear. I was given practice sessions at East Carolina University where I was taught to care for it. Success with this technology requires being educated in its use and daily practice.

Wearing the SpeechEasy, my daily 10-minute practice sessions occur in the morning and evening. During practice, I read out loud. As I approach a word that I know is difficult, I stretch the vowel sounds before the word. I duplicate the stretching exercise while speaking. Also during practice, I use the “uh” method: When I stop reading to take a breath, I resume reading by using “uh.” This program increases my fluency in conversational speech, in delivering speeches and in reading.

I wore the “In the Canal” version of the SpeechEasy for a month. I warmed up by reciting either the months of the year or a prayer out loud. The SpeechEasy resembles a hearing aid. One of the co-creators of the SpeechEasy is an audiologist. The other is a speech therapist who stutters. The SpeechEasy emulates choral speech-a phenomenon that induces fluency in people who stutter. The device creates this choral pattern through Altered Audio Feedback (AAF) that consists of a combination of Delayed Audio Feedback (DAF) and Frequency Altered Feedback (FAF).

Since I judge the effectiveness of the product in the presence of others, I wear the SpeechEasy from 6 to 8 hours daily when I am in a group, giving a speech or talking on the telephone. I do not wear it when I am writing, reading, watching TV, walking, riding a train or flying. The adjustable volume on the microphone in it is so sensitive that it can make sirens and screeching brakes unbearable, and it has even picked up comments from passersby that I believe they would not want me to hear. That’s why I don’t wear the device outdoors.

The SpeechEasy has increased my fluency on the telephone, in small groups and in delivering speeches.

The more fluency I have, the more confidence I build. Many people have commented on my fluency on the telephone. They did not know I was wearing the SpeechEasy. One of the benefits of increased fluency is an increase in my energy level. The less I stutter the more stamina I have, and, therefore, my productivity rises.

My greatest success with the SpeechEasy occurred in London, England, in September where I spoke before hundreds of people at an E-commerce conference. I delivered a 30-minute speech on the Benefits of Digital Printing to People with Disabilities. I rehearsed the speech a dozen times using the SpeechEasy each time. I put 12 feared words, that historically I have stuttered on- words like orator, innate, history, hill-in the speech. Three words before I came upon the feared word I elongated the first syllable and slid over the next three words. I heard my fluency as I spoke these feared words. It was a personal triumph that will remain with me a lifetime. Overall, my stuttering rate has dropped by 80%. When I am not wearing it, the carryover effect is longer than an hour.

So what does this product tell us about AT in general? Like any successful AT device, the SpeechEasy works best when the user is disciplined and knowledgeable about the technology’s proper usage and care. The device should be comfortable to the user, and the user should feel that he or she is in control of the technology, not the other way around.

A more unfortunate similarity between SpeechEasy and other AT devices is the cost: about $5,000, and private insurance does not pay for the product. While the price is high, it is a worthwhile investment for people who stutter. It can do what any well-developed AT device does: It can change lives.

John M. Williams has been writing about assistive technology for more than 25 years. A sample of his book Assistive Technologies: Creating a Universe of Opportunities for People with Disabilities can be seen at www.atn-ctcf.org.