Delayed Auditory Feedback

GOAL!

References

Sark, S., Kalinowski, J., Stuart, A., Armson, J. (1996). Stuttering amelioration at various auditory feedback delays and speech rates. European Journal of Disorders of Communication, 31, 259-269.

Van Borsel, J., Reunes, G., Van den Bergh, N. (2003). Delayed auditory feedback in the treatment of stuttering: clients as consumers. International Journal of Language and Communication Disorders, 38(2), 119-129.

Radford, N., Tanguma, J., Gonzalez, M., Nericcio, M.A., Newman, D. (2005). A case study of mediated learning, delayed auditory feedback, and motor repatterning to reduce stuttering. Perceptual and Motor Skills, 101, 63-71.

Ryan, Bruce and Barbara Van Kirk Ryan (1995). "Programmed stuttering treatment for children: Comparison of two establishment programs through transfer, maintenance, and follow-up. Journal of Speech and Hearing Research, 38(1).

Carryover

Once he achieves the first goal, then he gradually reduces his dependence on the device. He decreases the delay and increases his speaking rate. He can use the device at the beginning of conversations, and then turn it off when he feels capable of speaking on target. He can discontinue using the device in low-stress conversations. Then he can discontinue using the device in medium-stress conversations, reserving the device only for stressful conversations such as public speaking or interviews for jobs. Eventually he should need the device only occasionally.

Therapy Procedures

After he can count to 10 using the slow-speech target correctly (e.g., all syllables stretched equally, all syllables stretched to one or two seconds, no pauses between words, and no dysfluencies) without the DAF device, then use the device to have a conversation at the same slow speaking rate. When he can achieve the slow speech target with 100% fluency using the DAF device for utterances with the length and complexity of normal conversations, then he should only use it in increasingly stressful conversations. The first goal is speech that is 100% fluent and on-target (i.e., slow) in any conversation. For a severe stutterer, this may mean using one- or two-seconds per syllables speech with the device set at 200 milliseconds.

Long Term Goals for therapy

Delayed Auditory Feedback

• To increase the length and complexity of the utterance, and increase the stress of the speaking situation, while using the DAF device to support on-target fluent speech.

• To reduce the need for the DAF device, until the stutterer no longer needs the device.

What is DAF?

Technique by which the original acoustic speech signal is artificially modified and then fed back via headphones

Delay can be set between 50 and 70 milliseconds to reduce stuttering about 70% at a normal speaking rate.

Can be used to support the fluency shaping target of slow speech with stretched vowels. The delay is usually set at 200 milliseconds and then reduced to shorter delays over the course of the therapy program. For this a SLP must train the stutterer. When he can complete a simple speaking task, such as counting to ten, using the slow speech target correctly, then he can use a DAF device.

Why Delayed Auditory Feedback (DAF)?

Jenna Gravitt, E. Riley Newman, McKenzie Teschner, Taylor Walker

• Several studies reported positive effects in adults as well (Van Borsel et al., 2002).
• Significant effect in individuals with a severe stutter (Sparks et al., 2002).
• May be less effective in individuals in whom blocks constitute the majority of their fluency than in individuals with repetitions and prolongations.
• Most effective in individuals with developmental stuttering rather than in cases of stuttering of later-onset.

Steve Rogers

• 23 year old male
• Age of onset: 2 years old (Developmental)
• Advanced stuttering
• Secondary Behaviors: escape,
• Repetitions, prolongations, abnormal speaking rate
• Feelings: frustration, shame, negative self concept
• Previous therapy during school age
• Purpose for returning to therapy: getting a job