What is it about?

Studies demonstrate that altering the feedback that individuals receive when hearing their own voices can result in immediate reduction in stuttering at normal speaking rates without training, mental effort, or abnormal-sounding or abnormally slow speech according to advertising for one company that offers desktop devices for speech-language pathologists to use with young children (Casa Futura, 2018). In 2005, a case study was conducted with an eleven-year-old boy who stuttered to determine if DAF was an effective treatment. After 14 hours of therapy utilizing DAF along with counseling (mediated learning), stuttering decreased by 4.8%. One year later, formal speech testing indicated that the gains from the previous period were sustained. Therapy was reinitiated to include the DAF, mediated learning, and non speech motor exercises recommended for inclusion by the company. There were minimal additional reductions in fluency (4.1% as compared to 4.8%); however, the take away is that DAF was effective as a treatment, though the influence of motor exercises was inconclusive.

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Why is it important?

Stuttering is a complex disorder. Moreover, the literature is often a source of contradictory conclusions about what does and does not "work." This supposed contradiction may be influenced by the particular characteristics of the individual who stutters that may render that individual better-suited to a particular therapeutic approach. Moreover, researcher-clinicians who stutter may bring distinctively different frames of reference to the study of stuttering and what resulted in their effective management. It is critical to revisit the notion that "one size does not fit all" when it comes to effective stuttering treatments and to consider a broader range of treatments for inclusion in clinical trials, with the authors' admonition to consider DAF with counseling, particularly notions of mediated learning (coaching the individual to influence their thinking about talking).

Perspectives

Devising the case study was a great pleasure, as I was working with a graduate student in speech-language pathology and David Kehoe of Casa Futura, an individual who had a significant history of stuttering and who had discovered the benefits of technology for managing his communication. Others may choose behavioral strategies alone or combine these with other strategies. However, I had seen the effectiveness of technology for those clients receptive to it, as was the case with this 11-year-old in 2005 and his parents. Moreover, I did some investigation and chose the DAF desktop version as developed by Casa Futura because it was a relatively low-cost, dedicated device. The company did not approach me and I have no financial interest in the device. Although the case study is utilized on the company's website to date, there was no financial compensation involved and the results were what they were. Hopefully, others will consider studies utilizing various instrumentation outside of the realm of the companies that are manufacturing the devices. I would hope that authors would read and consider the conclusions of this case study as a basis for future studies and citation of the work.

Dr. Nola T. Radford
University of TN Health Science Center

Read the Original

This page is a summary of: A CASE STUDY OF MEDIATED LEARNING, DELAYED AUDITORY FEEDBACK, AND MOTOR REPATTERNING TO REDUCE STUTTERING, Perceptual and Motor Skills, January 2005, SAGE Publications,
DOI: 10.2466/pms.101.5.63-71.
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