Efficacy of the Modifying Phonation Intervals (MPI) Stuttering Treatment Program With Adults Who Stutter

Purpose This study compared a new adult stuttering treatment program (Modifying Phonation Intervals, or MPI) with the standard of care for reducing stuttered speech in adults (prolonged speech). Method Twenty-seven adults who stutter were assigned to either MPI or prolonged speech treatment, both of which used similar infrastructures. Speech and related variables were assessed in 3 within-clinic and 3 beyond-clinic speaking situations for participants who successfully completed all treatment phases. Results At transfer, maintenance, and follow-up, the speech of 14 participants who successfully completed treatment was similar to that of normally fluent adults. Successful participants also showed increased self-identification as a “normal speaker,” decreased self-identification as a “stutterer,” reduced short intervals of phonation, and some increased use of longer duration phonation intervals. Eleven successful participants received the MPI treatment, and 3 received the prolonged speech treatment. Conclusions Outcomes for successful participants were very similar for the 2 treatments. The much larger proportion of successful participants in the MPI group, however, combined with the predictive value of specific changes in PI durations suggest that MPI treatment was relatively more effective at assisting clients to identify and change the specific speech behaviors that are associated with successful treatment of stuttered speech in adults.

Comparing Abilities of Children With Profound Hearing Impairments to Learn Consonants Using Electropalatography or Traditional Aural.Oral Techniques

Two groups of nine children with profound hearing impairments and low intelligibility were taught to produce the consonants /t,d,k,g,s,z∫/ using either electropalatographic (palatometry) or traditional aural-oral techniques. Testing was completed pre-, immediately post-, and 6 months post-treatment by examining productions of CV syllables (V=/i,a/) using electropalatography-determined linguapalatal contacts and listener identifications. Intelligibility was also measured using the CID Picture Speech Intelligibility Evaluation (SPINE) test. Both groups improved their consonant productions as a result of 26 50-minute sessions. Sessions were given twice daily over 3- to 4-week training periods. Immediately post-treatment, the electropalatography-trained subjects produced better consonants as measured by linguapalatal contact patterns and listener identifications. The linguapalatal-contact patterns learned by the electropalatography-trained group better matched normal speaker productions than did those of the traditionally trained group. Both groups showed equal improvement for both post-treatment conditions when tested with the CID SPINE test. Although further research is needed, the results of this study suggest that electropalatographic techniques are, at least, equal alternatives to traditional aural-oral speech training techniques for speakers with profound hearing impairments.

Stuttering and Speech Naturalness

Thirty listeners used the 9-point speech naturalness rating scale described by Martin, Haroldson, and Triden (1984) to score 1-minute spontaneous speaking samples from 15 normally fluent speakers and 15 stutterers who had completed the initial phases of a prolonged speech treatment program. The same listeners were later asked to judge whether each sample was from a stutterer or from a normal speaker. Reliable listeners identified almost identical numbers of samples from both speaker groups as "normal speakers," but the stutterers received significantly higher scores on the rating scale, indicating that their speech was judged more unnatural sounding. The speech samples incorporated those used in a related study by Ingham and Packman (1978), thus permitting a reevaluation of the findings of that study.

The Attribution of Personality Traits

Three videotaped recordings were made of an adult male speaking in an interview situation. Tapes differed as a function of the fluency exhibited by the interviewed speaker (i.e., fluent speech, primary stuttering, secondary stuttering). Three audiotapes were recorded from the videotapes yielding six stimulus tapes. Independent groups of college students saw and/or heard one of the stimulus tapes, each described as an interview with a "male who stutters." The fluent audio- and videotapes were replayed to two additional groups but were described only as an interview with a "male." Groups rated the personality of the speaker after tape presentation. Results revealed no difference in personality trait assignment as a function of experimental variables. However, in a second experiment two groups of college students rated a hypothetical normal speaker and a hypothetical stutterer as significantly different in personality attributes. Results are discussed with reference to stereotyping behavior.

Articulatory Behaviors Associated with Stuttering

High speed (150 fps) einefluorographie techniques were used to record articulatory movements during fluent and dis fluent speech from four stutterers and control utter- ances from one normal speaker. Analyses of 11 perceptually disfluent utterances are reported. The results show: (1) interarticulator positions occurring in both perceptually fluent and disfluent utterances of stutterers were unlike those in fluent utterances of a normal speaker; (2) aberrant interarticulator positions preceded repetitive movements and static posturing; (3) consistent interarticulator repositioning which precedes termi- nation of an oscillatory movement or static position often results in: (a) the lowering of the jaw or lip, and/or (b) tongue shapes which resemble shapes found in normal speak- ers' fluent productions or the resting tongue shapes of the stutterer: The systematic re- positioning and other patterns found are discussed in terms of possible neuromotor mechanisms involved in disfluency. It is suggested that reflex interactions among the muscles of articulation might account for some of these effects. A brief discussion of theoretical and therapeutic implications is included.

Perceptual Assessment of Normalcy of Speech Following Stuttering Therapy

Stuttering therapy procedures such as rhythmic or prolonged speech have been criticized because afterward the subject may speak fluently but also abnormally. Although assessments of the normalcy of speech behavior have been rare, some recent procedures have included perceptual assessments of certain dimensions of speech behavior. This study reports an evaluation procedure where listeners endeavored to distinguish between intermingled speech samples obtained from treated stutterers and a peer group of normally fluent speakers. Different groups of listeners were asked to judge the prosody, rate, fluency, and naturalness of posttreatment samples from a group of stutterers treated with a prolonged speech procedure, and a matched peer group of normally fluent speakers. No significant differences were found between the assessments of stutterers and normally fluent speakers. However, when another group of listeners was asked to decide whether the speech samples were from treated stutterers or normal speakers, the stutterers received significantly fewer normal speaker judgments. Interrelationships between the judgment scales were evaluated along with a forced-choice procedure for assessing the normalcy of individual speech samples.

Acceptability Ratings of Normal, Esophageal, and Artificial Larynx Speech

To provide information about the ultimate acceptability of various types of alaryngeal speech, 37 listeners rated nine speakers with normal phonation in relation to two groups of superior alaryngeal speakers: five who used esophageal speech and four who used artificial larynges. Normal speech was rated significantly more acceptable than any form of alaryngeal speech studied. Speech produced with a Tokyo artificial larynx was rated significantly more acceptable than all other types of alaryngeal speech. Superior esophageal speech was significantly preferred over Western Electric reed and Bell electrolarynx speech. Listeners also categorized each of the 18 speakers as a normal speaker or not a normal speaker. The nine alaryngeal speakers were all classified as nonnormal, while eight of the nine normal subjects were classified as normal.