Auditory processing and the role of DAF

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How does the SpeechEasy Device help people who stutter? 
The device uses auditory altered feedback to create the choral effect, or the perception that one is speaking in unison with others. Choral speaking has long been a method used in therapy to increase fluency or decrease stuttering.

 

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In fact Guitar (1998; Guitar & Peters, 1980) believes that stuttering arises through

the combination of four components: altered neurological organization of

speech and a vulnerable temperament, together with developmental and

environmental factors. Guitar’s most likely goal for the teenager who stutters

is controlled fluency, as now the possibility of complete recovery with or

without therapy is diminishing. Fluency is instated through the combined

use of speech modification (such as cancellation and pull-outs) and fluency

shaping techniques. Guitar refers to these techniques as fluency enhancing

behaviours (FEBs). In addition, delayed auditory feedback (DAF) is also

used as a therapeutic adjunct with some children. Children are initially taught

to slow speech rate using DAF. Then through the clinician’s modelling of a

slower rate of speech, gentle glottal onsets and soft consonant contacts are

subsequently introduced. Fluency is built up at word level and then short

phrase using slow controlled rate of speech together with the FEBs. Once

speech is consistently fluent at this level, the child moves on to structured

conversation, spoken at 40 syllables per minute. Following this period, the

FEBs are used to change from hard stuttering to easy stuttering, with changes

in rate required when moments of stuttering are anticipated. Voluntary stuttering

is also used at this stage to help show the client how to “downshift” his

speech rate before he tries it with real stuttering moments.

Auditory processing and the role of DAF
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Ryan’s DAF-based therapy:

In Ryan’s view, speech is an operant and thus best treated by operant therapy

(Ryan, 2001). Although Ryan considers speech-related anxiety

and attitudinal components also to be operant behaviours, these are not

targeted in therapy, as it is assumed that they will improve alongside the

improvement in primary stuttering. Ryan prefers the use of his GILCU

approach when dealing with primary school children, but where stuttering is

more persistent and GILCU is insufficient to deal with the problem, he utilizes

a similar DAF approach to that which he uses with adults (Ryan, 1974,

1984, 2001). This program incorporates 26 steps and differs from the GILCU

version in which there is no manipulation of speech variables and fluency is

achieved through praise for fluency and gentle admonishment for stuttering

. Instead, a slow prolonged speech pattern is instantiated,

during an establishment phase, by using DAF. Before therapy

commences, parents and teaching staff are contacted and their help sought

with home and school practice. Parents are also brought in to watch a therapy

session to ensure they can accurately identify stuttering behaviours.

The establishment phase of the program begins with the child being taught

how to produce slow prolonged speech before DAF is introduced at a 250 ms

(¼ second) delay. Stuttering or an increase in speech rate is met with instruction

to stop and to use the slow prolonged speech pattern. As the child moves

through the steps, DAF delay is gradually decreased (in 50 ms increments)

until the child is able to speak at a conversational level without any DAF.

When the child has reached this stage, he must undertake 5 minutes each of

oral reading, monologue and conversation with less than 0.5 percent stuttering.

If the child achieves this, he moves to the transfer phase. If not, elements

of the establishment phase must be repeated.

The structured transfer phase comprises speaking in a variety of settings,

including the home, at school and on the telephone. All transfer tasks are

carefully graded so, for example, telephone conversation transfer tasks range

from a one-word comment spoken into an unplugged phone to a full threeminute

conversation with a stranger. Transfer extends to fluent speaking at

school (which is monitored by teaching staff) and at home (monitored by

parents) with increasing numbers of family, friends and neighbours.

During the final maintenance phase, which lasts 22 months, the child is

seen on 5 occasions, with fewer contacts toward the end of the maintenance

phase. If the child is maintaining less than 0.5 percent stuttering at that

assessment and reported to be maintaining high levels of fluency elsewhere, a

further session is scheduled. If the child fails to meet these criteria, he must

repeat earlier parts of the program. Typically, establishment requires ten

hours, transfer requires nine hours and maintenance around two to three

hours. Ryan (1984) claims that pooled data from a number of clinics on over

500 clients demonstrate that the average child commenced the course with

7 percent stuttering, and left with less than 1 percent stuttering. At one-year

post clinic, more than 90 percent had maintained stuttering levels at 1 percent

or below.

 

principal

in the 1990s a number of changes brought back DAF and as we shall see later, also frequency altered feedback as a viable therapeutic device.
A primary force was the work of Kalinowski and colleagues, who demon-strated that DAF could work effectively at normal and even fast rates of speech (Kalinowski et al., 1993, 1995). An additional factor was that DAF devices were now becoming more portable, and tiny in-the-ear devices have become commercially available in recent years. The combination of these factors has led to a rather different approach to the use of DAF

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