ECU Logo
 
Stuttering Research and Comment from the Researchers at ECU




 


©2005 Authored by Joe Kalinowski, Ph.D., The content herein reflects the view(s) of the author(s) and is not an endorsement of the University. 
Contact Dr. Kalinowski.



Stuttering is what you do to get out of a central block? ( So is prolonging...)

Instead of being the core stuttering ‘problem’, syllabic repetitions may be a biological mechanism, or ‘solution’, to the central involuntary stuttering block. Simply put, stuttering is an endogenous transitory state of ‘shadowed speech’, a choral speech derivative that allows for a neural release of the central block.

We have previously posited that the production of syllabic repetitions may be a natural compensatory strategy for overcoming the neural stuttering block, making them the peripheral solutions to the central problem . However, we have yet to describe the mechanism or process underlying this behavior. One way to view the production of syllabic repetitions is as an endogenous form of shadowed speech . Shadowing implies that one speaker directly imitates another. When syllables are repeated, the same speaker simply shadows himself or, self-imitates. A self imitated gestural sequence is more likely to be successfully accomplished if the sequence is short. For this reason, syllabic repetitions are optimal as syllables are the smallest and most fundamental units of acoustic speech. Repeated self-imitations of simple gestures are likely to engage mirror systems and allow fluency to be reinstated in the same manner as choral speech and its derivations . It may therefore be fair to state that repetitive stuttering behaviors are actually a form of choral speech. They both employ forms of gestural imitation and provide access to mirror systems for reinstating fluency. However, the ‘pseudochoral’effect that is induced during the production of syllabic repetitions is conspicuous and socially punitive, making its exogenous counterpart (i.e., a choral signal derived via second gestures) preferable as a stuttering inhibitor .common goal: the engagement of mirror neuronal circuitry. The main difference between the two forms lies in the efficiency and effectiveness that mirror neuronal involvement is accomplished. With that in mind, we suggest employing second gestures that efficiently engage mirror systems for high levels of gestural recovery and stuttering inhibition without introducing a disruptive presence into the communicative act.

Simply put, stuttering is an endogenous transitory state of ‘shadowed speech’, a choral speech derivative that allows for a neural release of the central block.

Kalinowski, J., Saltuklaroglu, T., Guntupalli, V, & Stuart, A. (2004). Gestural Recovery and the Role of Forward and Reversed Syllabic Repetitions as Stuttering Inhibitors in Adults, Neuroscience Letters, 363, 144-149.

Video Tapes and Research Articles

Drs. Kalinowski, Stuart, & Rastatter are offering a free 10 minute videotape on Altered Auditory Feedback (AAF) to any clinician, student,and/or any interested researcher who requests one. The videotape does not promote a product or a therapy. One of the purposes of the videotape is to demonstrate the dramatic effect of Altered Auditory Feedback on the fluency of people who stutter. " In addition to the videotape, we will send you a sampling of reprints of peer reviewed articles pertaining to Altered Auditory Feedback which have been published by members of the research team. Specific reprint requests are also welcomed. (Please make sure to send your full mailing address.) (We now have PAL formatted tapes, so European requests will now be filled.) 

E-mail: kalinowskij@ecu.edu  with tape request. Please provide a postal address. Videotapes will arrive in a few days to a week later.

Research News
International Journal of Psychophysiology, April 2006, Psychophysiological responses of adults who do not stutter while listening to stuttering., Vijaya Guntupalli, Joseph Kalinowski, Chayadevie Nanjundeswaran, Tim Saltuklaroglu, D. Erik Everhart Department of Communication Sciences and Disorders, East Carolina University, Oglesby Drive, Greenville, NC, USA.

The present study examined the psychophysiological responses of fluent listeners to stuttered speech. Specifically, skin conductance and heart rate changes were measured from adults who do not stutter while watching one-minute video speech samples of moderate to severe persons who stutter reading aloud. Fifteen adult participants observed three stuttered and three fluent speech samples, presented in random order with a two-minute interstimulus intervals. Results revealed that observing stuttered speech evoked a significant increase in skin conductance and a significant deceleration in heart rate relative to watching fluent speech samples. These findings suggest that listeners are physiologically aroused by stuttering and appear to maintain feelings of unpleasantness to stuttered speech. Further, deceleration in heart rate during stuttered samples also suggest that listeners may be paying more attention to the stuttered speech samples as compared to the fluent speech samples. We speculate that aberrant and anomalous stuttering behaviors probably simulate the mirror neuronal mechanism eliciting the emotional arousal associated within them. Such physiological arousal may provide the emotional genesis to the listener's negative stereotypical perceptions towards people who stutter.  Click here for more information.

Research News
Int J Neurosci. 2004 Apr;114(4):435-50. Towards a common neural substrate in the immediate and effective inhibition of stuttering. Saltuklaroglu T, Kalinowski J, Guntupalli VK. Stuttering can be effectively inhibited via exogenous sensory signals (e.g., speaking in unison or using altered auditory feedback) or by using endogenous motoric strategies (e.g., singing or therapeutically implementing long vowel prolongations to reduce speech rates). We propose that these channels, which superficially appear to be diametrically opposite, centrally converge in the engagement of mirror neurons for fluent gestural productions. Sensory changes incurred via exogenous speech signals allow for direct engagement of mirror systems, while endogenous motor strategies appear to require significant departures from normal speech production (e.g., highly unnatural or droned speech) to engage mirror systems. Thus, paradoxically, stuttering is prone to resurface during attempts to impose naturalness upon therapeutic speech.

Simply put, slowing down or using second speech signal seems to act on the brian in a similar manner although an auditory signal appears more efficient and can be changed passively.

Research News
Ann Biomed Eng. 2003 Feb;31(2):233-7. Self-contained in-the-ear device to deliver altered auditory feedback: applications for stuttering. Stuart A, Xia S, Jiang Y, Jiang T, Kalinowski J, Rastatter MP. Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC 27858-4353, USA. stuarta@mail.ecu.edu The design and operating characteristics of the first self-contained in-the-ear device to deliver altered auditory feedback is described for applications with those who stutter. The device incorporates a microdigital signal processor core that reproduces the high fidelity of unaided listening and auditory self-monitoring while at the same time delivering altered auditory feedback. Delayed auditory feedback and frequency-altered feedback signals in combination or isolation can be generated to the user in a cosmetically appealing custom in-the-canal and completely-in-the-canal design. Programming of the device is achieved through a personal computer, interface, and fitting software. Researchers and clinicians interested in evaluating persons who stutter outside laboratory settings in a natural environment and persons who stutter looking for an alternative or adjunct to traditional therapy options are ideal candidates for this technology. In both instances an inconspicuous ear level alternative to traditional body worn devices with external microphones and earphones is offered.
PubMed

This paper describes the fluency aid and its specific attributes. The article describes FAF and DAF parameters and how how the choral effect illusion was miniaturized into the first self-contained in-the-ear device. Wow, after all these years!!!!

Research News
Int J Neurosci. 2004 Apr;114(4):435-50. Towards a common neural substrate in the immediate and effective inhibition of stuttering. Saltuklaroglu T, Kalinowski J, Guntupalli VK. Stuttering can be effectively inhibited via exogenous sensory signals (e.g., speaking in unison or using altered auditory feedback) or by using endogenous motoric strategies (e.g., singing or therapeutically implementing long vowel prolongations to reduce speech rates). We propose that these channels, which superficially appear to be diametrically opposite, centrally converge in the engagement of mirror neurons for fluent gestural productions. Sensory changes incurred via exogenous speech signals allow for direct engagement of mirror systems, while endogenous motor strategies appear to require significant departures from normal speech production (e.g., highly unnatural or droned speech) to engage mirror systems. Thus, paradoxically, stuttering is prone to resurface during attempts to impose naturalness upon therapeutic speech.

Simply put, slowing down or using second speech signal seems to act on the brian in a similar manner although an auditory signal appears more efficient and can be changed passively.

 

 

 

Declaring War on Fluency

 

By William Perkins, Ph.D.

 

Who's to blame when your fluency therapy didn't free you from stuttering? I was the pioneer of the DAF rate control basis for fluency from 1964 to 1980; I labored under the illusion that if the slow, reasonably normal-sounding fluency we easily established could be maintained long enough, it should eventually become automatic. Learned skills, such as walking, start out being voluntarily controlled and gradually become automatic. Likewise, voluntarily controlled fluency should become automatic if practiced diligently enough and long enough. I thought it self evident that fluency was the problem. That was the attraction or fluency therapy. This was the assumption that protected me from blame for almost two decades. It seemed obvious that if fluency were maintained long enough it would become natural, automatic speech and the problem would be solved. Meanwhile the objections mounted:  I feel like a speech actor I’m so busy being fluent. I can't think of what I’m talking about!  Failure to maintain fluency was the clearest evidence of dissatisfaction as speakers gave up hope that this therapy would ever lead to natural speech free of stuttering.

 

Therapy failure and blame

Not until I began listening seriously to what those who stutter were saying did I finally realize that they were not to blame for these failures of fluency therapy. I'm a slow learner. So it took neatly 20 years of fluency failures and escalating complaints for me to conclude, better late than never, that something was fundamentally wrong with the assumption that fluency is the problem. From the listener's experience, this assumption seems indisputable. But for the speaker, it misses the point completely the speaker's experience is one of stuttered blockages that cannot be prevented.


Thus the blame lay in the professional failure to recognize that fluency is not the proper objective of therapy. Voluntarily controlled fluency could be helpful if it ever became automatic, BUT IT NEVER DID. The reasons turned out to be why the speaker is helpless to prevent involuntary blockage. I discovered that the neural mechanisms of naturally fluent speech production couldn't be brought under voluntary control no matter how long you try. Expecting to speak naturally with voluntarily controlled fluency is like pasting feathers to your arms and expecting to fly. Fluency is simply a natural by-product of the speaking system functioning automatically.  When I figured that out, the solution to stuttering fell into place. It explains why my colleagues and I have been to blame for fluency failures. For this reason I feel compelled to declare war on fluency. Voluntarily controlled fluency is the wrong scientific objective, to say nothing of the wrong treatment objective. Indeed, the very existence of self-help groups speaks to the failure of professional therapy to address the needs of those who stutter, which is not about making speech acceptable to listeners. It's about coping with the feelings that create stuttering and understanding how they offer a path to full recovery.


This letter was published in an issue of the National Stuttering Association Newsletter.


Dr. William H. Perkins received the Distinguished Emeritus Award at the University of Southern California for his fifty years of stuttering research. Recipient of the prestigious Honors of the American Speech and Hearing Association, his latest book is Tongue Wars: Recovery from Stuttering.