Claudia Regina Furquim de Andrade

Slides:



Advertisements
Similar presentations
KeTra.
Advertisements

The Stocker Probe Technique Beatrice Stocker, 1976
Effects of Competence, Exposure, and Linguistic Backgrounds on Accurate Production of English Pure Vowels by Native Japanese and Mandarin Speakers Malcolm.
Generating Fluent Speech: A Comprehensive Speech Processing Approach Barbara Dahm, M.ED., CCC-SLP Maggie Comeau Lindy Mamerow Sarah Skahan.
Color Me Fluent Sarah Benjamin & Annette Boldt. Introduction Created by Alice Anne G. Farley Incorporates learning theory, behavior modification, and.
The SpeechEasy  Device: Augmentative Communication for Stuttering Presentation by Tim Saltuklaroglu, M.S. East Carolina University March 27, 2003.
A double-edged sword: producing repetitions and prolongations inhibits stuttering and propagates emotional arousal via the mirror system Joseph Kalinowski,
Using Live Supervision to Deliver Family Intervention Training Rick Allan and Anita Savage Grainge Footer.
ASSESSMENT.
Comprehensive Stuttering Program By Einer Boberg & Deborah Kully (1985)
Understanding Students with Autism
Stuttering Stephen M. Tasko Ph.D. CCC-SLP Associate Professor
CSD 5400 REHABILITATION PROCEDURES FOR THE HARD OF HEARING Auditory Training.
ETIM-1 CSE 5810 CSE5810: Intro to Biomedical Informatics Mobile Computing to Impact Patient Health and Data Exchange and Statistical Analysis Presenter:
The Lidcombe Program University of Wisconsin-Stevens Point Lorrie Mittelstaedt Stacey Lamers
Altered Auditory Feedback Some Perspectives... What is Altered Auditory Feedback (AAF)? A definition: “AAF is a collective term for conditions that involve.
INFORMATION FROM: DUNCAN, B.L., MILLER, S.D., WAMPOLD, B.E., & HUBBLE, M.A. (EDS). (2010). THE HEART & SOUL OF CHANGE: DELIVERING WHAT WORKS IN THERAPY.
Motor control, motor Learning and recovery of function
CSD 5100 Introduction to Research Methods in CSD Observation and Data Collection in CSD Research Strategies Measurement Issues.
CNS Speech Lab Dept. of Cognitive and Neural Systems Boston University Frank Guenther, Ph.D Director.
Speech Perception 4/4/00.
Speech Based Optimization of Hearing Devices Alice E. Holmes, Rahul Shrivastav, Hannah W. Siburt & Lee Krause.
Frank E. Musiek, Ph.D., Jennifer Shinn, M.S., and Christine Hare, M. A.
Stuttering and Fluency 1 Stuttering Definitions What is stuttering? What causes stuttering? Development of stuttering Factors which contribute to stuttering.
The Camperdown Program By: Katie Harke Shannon Olk Jackie Stankowski.
EXPERIMENTAL EPIDEMIOLOGY
Chapter Eleven Individuals With Speech and Language Impairments.
Communication Disorders SPEECH IMPAIRMENT Lily C. Bordallo Dr. Cyrus.
Multisensory Phonics Instruction & Oral Reading Fluency Learning Strategy Presentation – EDUC Dr. Flores Houston Baptist University Mary Margaret.
Current Approaches to Management of DAS Michelle D. White.
ABSTRACT The purpose of the present study was to investigate the test-retest reliability of force-time derived parameters of an explosive push up. Seven.
Control of prosodic features under perturbation in collaboration with Frank Guenther Dept. of Cognitive and Neural Systems, BU Carrie Niziolek [carrien]
Statistical Randomization Tests: Issues and Applications Randomization Tests versus Permutation Tests Randomization Tests versus Permutation Tests Test.
 Stuttering (also known as stammering) is a communication disorder in which the flow of speech is broken by repetitions, prolongations, or abnormal stoppages.
               n n n d d d z z z       Elettoglotographic study from Brazilian Portuguese fricative voiced sounds Dra. Luciana de.
Psychodynamic Psychotherapy: A Systematic Review of Techniques, Indications and Empirical Evidence Falk Leichsenring & Eric Leibing University of Goettingen,
Contact Info: Defining speech and language fluency profiles before and after the onset of stuttering: Preliminary findings.
Research Methodology Proposal Prepared by: Norhasmizawati Ibrahim (813750)
A quick reference to literature searches
Table 1. FUNCTIONAL ASSESSMENTS
Speech rehabilitation in Recessive Spastic Ataxia Charlevoix-Saguenay (ARSACS) Adam P Vogel1,2,3, (PhD), Natalie Rommel (MSc) 4, Matthis Synofzik (MD)
Paediatric Medicine: The Paediatric Investigation Plan
Melanie Boysen & Gwendolyn Walton
Evaluation Requirements for MSP and Characteristics of Designs to Estimate Impacts with Confidence Ellen Bobronnikov March 23, 2011.
DATA COLLECTION METHODS IN NURSING RESEARCH
A stroke is the leading cause of permanent impairment and disability
4aPPa32. How Susceptibility To Noise Varies Across Speech Frequencies
CALMS Approach to Stammering
Attention Components and Creative Potential: An ERP Exploration
Neurofeedback of beta frequencies:
The Use of Mobile Technology in the Treatment of Prosodic Deficits in ASDs and other Developmental Disabilities Elizabeth Schoen Simmons1, Rhea Paul2,
CODE FREEZE Svetlana Taylor, Eden Thompson, Jenny Vandiver
General Treatment Approaches to Change Speech/Stuttering Behaviors
The Impact of a Structured Balance Training Program on Elderly Adults
PSYCHOGENIC STUTTERING: TREATMENT
The involvement of visual and verbal representations in a quantitative and a qualitative visual change detection task. Laura Jenkins, and Dr Colin Hamilton.
Table 1: Lugu-Neris Study
Vivian Sisskin, M.S., CCC-SLP, BRS-FD Lecturer and Clinical Supervisor
The National Autism Center’s National Standards Report
SHAHID BEHESHTI UNIVERSITY (MC)
Visuomotor Tracking Abilities of Adults who Stutter, Adults with Parkinson’s disease and Normally Fluent Healthy Adults Victoria Tumanova Department of.
Motor control, motor Learning and recovery of function
SPPA 5530 Stuttering & Other Fluency Disorders
Management of Type II Diabetes
Analysis of Lumbo-Pelvic Coordination Variability during a Sit-to-Stand Task in Adults with Low Back Pain Patrick Ippersiel, PhD (c)* a,b , Dr. Shawn Robbins,
CI804 Wichita State University May 3, 2012
Alternative Treatments for Stuttering
STUTTERING BY: KENISHA MOORE.
Discussion and Future directions
Post-Exertional Malaise in People with Cancer Related Fatigue
Presentation transcript:

Claudia Regina Furquim de Andrade Full Professor e.mail: clauan@usp.br tel: +55 11 30918406 Division of Speech- Language and Hearing Pathology – Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil

Fabíola Ana Paula Fernanda Julia

Speech is a complex neural function that involves segmental (linguistic) and suprasegmental (paralinguistic) components, processed by different neural pathways. When integrated and synchronized, these components are critical for maintaining a smooth and continuous flow, which we call fluency. Breaks in this flow represent disfluencies, which are classified as common (hesitations, interjections, revisions, unfinished words and repetition of words, segments or phrases) or stuttering (repetition of sounds or syllables, prolongations, blockages, pauses and intrusions)

Directions Into Velocities of Articulators – DIVA Frank H Directions Into Velocities of Articulators – DIVA Frank H. Guenther Department of Cognitive and Neural Systems –CNS (Boston University) Harvard-MIT Speech and hearing Biosciences and Technology Program Athinoula A. Martinos Center for Biomedical Imaging (Massachusetts General Hospital)

Developmental Stuttering

A possible cause is that it is genetically transmitted: Stuttering is understood as a metabolic hereditary disorder, that presents different characteristics of chronicity and different severity levels; A possible cause is that it is genetically transmitted: An inability to perform automatic updates of the internal models (relative to the dynamics of the effector motor execution system), having a sensorial consequence of movement repetitions or blocks that prevent the completion of the motor order. This leads to the continuous re-setting of the system. Max, 2007; van Lieshout, Hulstijn e Peters, 2007 – based on Internal models of sensory motor control

Numerous studies have demonstrated the benefit of devices delivering altered auditory feedback as a therapeutic alternative for those who stutter. Background

Purpose: To perform a systematic review of studies related to the effects of delayed auditory feedback on speech fluency in individuals who stutter

Research strategy: Concepts of the Cochrane Handbook were followed: formulation of initial question (theme to be reviewed), location and selection of studies (PubMed database) and compatibilization among researchers (aiming to minimize possible citation losses)

Selection criteria: The following were excluded: citations in languages other than English, citations that did not allow access to full text, repeated citations due to the overlap of keywords, studies developed exclusively with fluent individuals, case reports, reviews of the literature, letters to the editor, and texts that were not directly related to the theme. Hence, texts that were related to treatment with delayed auditory feedback (DAF) and frequency-altered feedback (FAF) were analyzed.

Data analysis: Data were analyzed according to research indicators and according to study quality markers. Results: The results indicated that the use of altered auditory feedback devices for the reduction of stuttering events still do not have robust support for their applicability. Methodological variability does not allow a consistent answer, or a trend about the effectiveness of the device, to be drawn.

Conclusion: Although the limitations in the studies prevent generalizations about the effectiveness of the device for the reduction of stuttering, these same limitations are important resources for future research planning.

The literature review on AAF (altered auditory Feedback) indicated the SpeechEasy as the device that has been mostly investigated for its effects . The SpeechEasy is a device that combines both the effects of DAF (delayed auditory feedback) and FAF (frequency altered feedback), delivering at the same time a delay in the auditory feedback and a modification in frequency. The fitting of the device is made using a computer program. The delay in the auditory feedback varies from 0 to 220ms and alterations in frequency varies from -2000Hz to +2000Hz. The SpeechEasy is considered the most modern and complete AAF device availabe in the market.

Objective: To investigate variations in speech motor skills in adults who stutter and those who do not, using the SpeechEasy® altered auditory feedback device.

Methods: Twenty adults participated, 10 of whom stuttered (nine males and one female - mean age 30.9 years) and 10 of whom were fluent controls (nine males and one female - mean age 25.2 years). The study compared the performance of participants in four tasks: spontaneous speech, alternating diadochokinesis, sequential diadochokinesis and target phrase production, with and without the device. The following variables were analyzed acoustically: (1) diadochokinesis tasks: syllable duration, mean duration between syllables, peak intensity and diadochokinesis rate; (2) target phrase production task: reaction time, voice onset time (VOT) duration, total production duration, fundamental frequency and intensity.

Results: The spontaneous speech task was the only task to show significant differences in both the intragroup and intergroup comparisons. In this task, the use of SpeechEasy® resulted in significant improvement in speech fluency, as measured by the percentage of stuttered syllables, for the group who stuttered. For the fluent group, the device produced the opposite effect: a significant increase in the frequency of stuttered disfluencies was observed with the device. No significant differences were found in either intragroup or intergroup comparisons relating to the acoustic aspects of the diadochokinesis and target phrase production tasks.

Conclusion: The results indicated that the use of SpeechEasy® improved the fluency of participants who stutter, without appearing to interfere with speech naturalness.

The effectiveness of a device delivering altered auditory feedback (SpeechEasy®) was compared to behavioral techniques in the treatment of stuttering in a randomized clinical trial. Aims

Two groups of adults who stutter participated: Group 1 consisted of 10 males and 1 female aged 21-42 years (M =30.0). Participants in Group 1 were fit with a SpeechEasy® and were not given any additional training (i.e., supplementary fluency enhancing techniques). Participants used the device daily for six months Group 2 consisted of 6 males and 1 female, aged 20-50 years (M = 35.6). Participants in Group 2 received treatment in the form of a 12-week fluency promotion protocol with techniques based on both fluency shaping and stuttering modification Methods & Procedures

There were no statistically significant differences (p > There were no statistically significant differences (p > .05) between groups in participants’ stuttered syllables following treatment; Both therapeutic protocols achieved approximately 40% reduction in number of stuttered syllables from baseline measures, with no significant relapse after three or six months post-treatment; Conclusions & Implications: The results suggest that the SpeechEasy® device can be a viable option for the treatment of stuttering. Outcomes & Results

Conclusions & Implications The results suggest that the SpeechEasy® device can be a viable option for the treatment of stuttering Conclusions & Implications

Preliminary results (ASHA CONVENTION 2016) Title: Correlation of auditory a electrophysiological measurements and fluency improvement in adults who stutter. The purpose of this study was to compare the performance of people who stutter during solo and choral Reading with auditory electrophysiological measurements. Participants who stuttered presented lower stuttering frequency during choral reading. Auditory electrophysiological measurements were not capable of determining accurate prediction of fluency improvement via auditory input.

Future perspectives Quality of life and SpeechEasy; Influency of SpeechEasy in differents speech tasks; Use of SpeechEasy by individuals with Parkinson’s Disease. Future perspectives

Acknowledgements This work was supported by São Paulo Research Foundation (FAPESP grants #2011/10000-2 and #2014/05265-5) and by Brazilian National Research Council (CNPq grant #201445/2014-0).