More discussion on research of the SpeechEasy device

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More discussion on research of the SpeechEasy device

speecheasy

photo: Janus Development Group

An interesting discussion is taking place in the comments of our May 2009 post “A great research article on the SpeechEasy.” We’d like to bring this exchange to the forefront rather than have it remain virtually buried in last May’s archives. The post featured a short video of Chamonix introducing a research article by then-AIS intern, now PhD (congratulations!), Ryan Pollard on the SpeechEasy, an altered auditory feedback device that was developed to reduce stuttering.

Dr. Joseph Kalinowski, a professor at East Carolina University and co-inventor of the SpeechEasy, commented earlier this month on that post. Here is his comment:

I “graduated” from CRC – the center Cathy ran in 1981 and that was a life changing experience. Her work, dedication and all she does for those who stutter are remarkable gifts to all of us who stutter. I personally will never be able to repay her for her efforts in my life but my colleagues and I have, in some small way paid it forward to others who stutter. Our work with the Speech Easy and altered auditory feedback (AAF) is more of a tribute than a challenge to all those who work so hard in the behavioral/cognitive modality.

My colleagues and I suggest that stuttering therapy should consist of anything that helps that individual who stutters. That may be behavioral/cognitive therapy alone, altered auditory feedback devices, AAF and behavioral/cognitive strategies together or no therapy at all. The client should make choices based on what works for them. We respect consumer choice!

We recently had a replied to Pollard article in JSHLR, that reply pointed out a number of methodological and interpretive concerns on our part. This reply should appear in JSHLR in the next few issues, the authors of the study will reply in kind. We will let the readership of that journal decide for them what was really found in that study.

We know a few things for certain:

1. Altered auditory feedback is a powerful stuttering inhibitor (choral speech, shadow speech, delayed auditory feedback (DAF), frequency altered feedback (FAF), reverberation, etc.

2. The Speech Easy generates a form of AAF that is helpful to many people who stutter, and although the Pollard study showed a lack overt improvement, most of the users in that study were pleased with the SpeechEasy. Some purchased the SpeechEasy, while others said it was something that would use if it were provided for free (e.g., insurance, vocational rehabilitation). That is very strange….. All other peer-reviewed journal publications on the Speech Easy revealed significant, long-lasting improvements. With this in mind, more research will reveal the true nature of AAF in stuttering therapy.

We are all working for the betterment of those who stutter. It may appear that we are on different roads but that is illusionary, we all want the day to come when oral communication by a person who stutters is free of overt an covert symptoms (e,g avoidances, substitutions, circumlocutions), is natural sounding, and effortless. No therapy modality (drugs, behavioral/cognitive therapy, AAF) perfectly achieves that goal as of today. We all continue our quest and hope others see our vigorous debates as a sign of a vibrant, intellectual community that is in pursuit off the best answers. The road is long, and some of the travelers are tired and getting old, but we know that others will continue the quest for unbridled fluency and one day that dream will come true.

I wish you, Cathy and all those at the center the best of luck and am grateful for all you do.

We thank Dr. Kalinowski for taking part in the discussion. Here is what Chamonix has written in response:

Hi Joe – Thanks so much for your comment. 1981 – that’s quite a history with Catherine (Cathy to you!). This place and the therapy have changed a LOT since then, but so has the field and the information we have, so it should change.

I have done hundreds of consultations, and many of the clients have tried the SpeechEasy device and were unhappy with the results. But I’ve also read research articles that show some clients who continue to successfully use it.

When a new client asks me, “What about these things that you stick in your ear?” I share with them what many clients have shared with me, articles that I am familiar with that have been published, and updates at conferences that I attend. I refer them to an SLP who distributes the device here in NYC if they want to try it for themselves. I never tell a client what will work for them or what they should do. I am only supplying information.

One of the issues that I feel made the SpeechEasy controversial in our field was when it began to be touted as a cure for stuttering. Oprah had a show on “medical miracles,” and the SpeechEasy was shown. It’s not so easy as “stick this in your ear and you’ll never stutter again,” but somehow that is how things came across years ago. I think the controversy is dying down now that AAF devices are recommended as a tool that can help some people and are recommended with speech therapy for best results.

My belief is that each person who stutters is different and has a different neurological, psychological, and genetic make-up. Something is going on in the brain that causes stuttering to occur, which researchers are still trying to determine where and how. There is no one cure-all for stuttering (at least not on February 19, 2010) and people can benefit from many things or a combination of things, like cognitive therapy, physical speech techniques, AAF devices, and possibly even Pagoclone. The client needs to decide what is best for them, and we get the privilege of working with them to expose them to various things that could really be helpful and life-changing.

And finally, Dr. Ryan Pollard also responded to Dr. Kalinowski’s comment. Here is his reply:

Kalinowski and colleagues’ letter to the editor and our response to their “methodological and interpretive concerns” will be published in a forthcoming issue of the Journal of Speech, Language and Hearing Research. We encourage the interested reader to look for it.

Until then, I might point out an important error in Mr. Kalinowski’s post. He inaccurately states that, “all other peer-reviewed journal publications on the SpeechEasy revealed significant, long-lasting improvements.” In truth, two studies have reported longitudinal evidence of positive group effects. One study examined eight subjects in the laboratory after 4 months and 12 months of wearing the device (Stuart et al., 2004, 2006). Another study collected surveys from people who had already liked the SpeechEasy enough to purchase it (Kalinowski et al., 2004). Both were conducted by the developers of the SpeechEasy.

However, there are also two longitudinal experiments that were conducted in naturalistic settings (i.e., outside the laboratory) (O’Donnell et al., 2008; Pollard et al., 2009). The results from both of these studies suggest that the SpeechEasy is beneficial for some but not for others, and, importantly, the effects of the device may wear off over time for many users. There’s a term in research called “external validity,” which refers to how easily the findings of a study can be generalized to a larger population in the real world. Both our study and the O’Donnell et al. paper had relatively strong external validity because we examined subjects’ speech in the types of places where people who stutter actually live their lives.

Thanks again to Dr. Kalinowski and Ryan for offering their input. That’s a lot of point/counterpoint for you, the reader, to digest, but it’s important and relevant debate as new research continues to break ground in the field of stuttering. Let’s continue the discussion.

Have you used or do you use the SpeechEasy device? We would appreciate your thoughts and reviews.

By | 2017-02-19T06:27:06+00:00 February 19th, 2010|Headlines, Research|7 Comments


7 Comments

  1. Joan Parsons February 22, 2010 at 4:06 pm - Reply

    As one of the early purchasers of the SpeakEasy Device in the early 2,000’s for my then 12 year old son, I must comment not only about the complete lack of efficacy of the product, but the attitude of the researchers that there was something ‘wrong with my son’s brain’ when it became clear that he was unable to gain any improvements from the device. The entire experience, and in particular this comment from the lead researcher, was devastating for my son and for us his parents – so much so that he refused any form of speech therapy from that point forward.

    Catherine Montgomery was a great support to us during this time, and helped our family to put the experience into a helpful perspective.

    Regarding SpeakEasy’s willingness to work with you if you are dissatisfied, we found that to be totally false. We wasted $5,000 on this device, and I am happy to finally have a forum in which to make our experience public.

  2. Maximo Diego III February 22, 2010 at 5:01 pm - Reply

    I want to comment on the SpeechEasy device, I purchased the SpeechEasy device in 2002 and found it to be very effective for approximately the first 6 months of use, I do believe that I adapted to it, and it’s effectiveness wore off. However, I still use the SpeechEasy device when I need to give oral presentations to large groups of people (anywhere from 10 to 50 people) at work or interviews, and it provides me with the extra confidence boost to implement my speech management skills. I served as a reference for people who were considering purchasing the SpeechEasy device and my advice to them was first and foremost, they needed to attend an intensive speech therapy program such as AIS or Hollins, only then would I recommend purchasing the device. I find the device to be helpful at work (I do not use it outside of work) and helpful in encouraging/reminding me to use my speech skills. I continue to practice my speech managment skills, I attend refreshers as often as possible (most recent was at Hollins in September 2009), and visit as often as possible with a speech therapist in NJ. I will always encourage everyone to try anything and everything for their speech and learn from it (I haven’t tried hypnosis yet, but I’m thinking about it : – )!)

  3. John February 22, 2010 at 5:58 pm - Reply

    I was allowed to test drive the product for three days. As long as I was in a quiet environment, Speecheasy worked well for me. But I work as a sportwriter so there’s not many times when I’m in a quiet setting. The persistent echoing of fans screaming, bands playing and whistles blowing was too much.

  4. Ryan Pollard February 22, 2010 at 10:48 pm - Reply

    This post is in reply to Joan Parsons. Joan, I have heard about your and your son’s experience with trying out the SpeechEasy. I am glad to get confirmation of its veracity, but I am also sickened that it is in fact true. Please know that Dr. Kalinowski’s comment to your son was unconscionable. I say that not just as a clinician and researcher, but as a stutterer myself. I can’t image the damage that it did to your son and to yourself to hear those words from someone you put faith in as an expert. For what it’s worth, I, too, am glad that you finally have a forum in which to make your experience public. I would like every clinician and researcher in our field to know your story.

    I began researching the SpeechEasy several years ago not because I thought it was a worthless treatment option, but rather because of how it was initially marketed. It was portrayed by its developers as a revolutionary treatment for curing chronic stuttering. Almost without exception, several popular television programs and news outlets depicted the device as a new “miracle cure” for stuttering. Those sensationalistic reports gave hope to many people who stutter (and their families), and unfortunately many of them were disappointed. This is not to say that the device isn’t appropriate for some people. It certainly is, as I have personally witnessed and as I’m sure some people on this forum can attest. Thankfully, both the developers of the SpeechEasy and the company who now sells it have toned down their extravagant claims in recent years. I feel like those who are interested in the SpeechEasy and other AAF devices are now getting more balanced and factual information. My colleagues and I have tried to be a part of that more even-handed perspective, and I think AIS has done the same. I believe the experiences of people like you and your son are equally important. Thank you for sharing.

  5. Jim McClure February 23, 2010 at 6:05 pm - Reply

    It’s good to see that the SpeechEasy is now being marketed ethically. As others have indicated, this was not the case when it was first introduced.

    The National Stuttering Association’s 2009 survey of people who stutter included a couple of questions on assistive devices. 73 people (of the 686 adults surveyed) had used assistive devices. 11% considered the device very successful in managing their stuttering, another 37% said the device was somewhat successful and 52% said it was not at all successful. This is generally a lower success rate than respondents reported for speech therapy. There was no significant difference between the SpeechEasy and other assistive devices. 75% of assistive device users said they currently use their devices rarely or never. However, those who used an assistive device in combination with speech therapy had a more successful experience. The full survey report is at http://www.westutter.org/stutteringInformation/NSA_Survey_Results.html

    Larry Molt of Auburn University is currently conducting a long-term study on the SpeechEasy. In a presentation last July at the NSA’s research symposium, he noted that while fluency gains diminish over time for some people, many users have more self-confidence even though their fluency has actually deteriorated.

    The bottom line seems to be that while the SpeechEasy is not the magical cure that many people are hoping for, it does seem to a useful tool that can help some people in combination with speech therapy. The more treatments available that help some people — whether it’s an assistive device, medication or a variation on speech therapy — the more likely it is that people who stutter can find something, or some combination of things, that will help.

  6. Kailey Holcombe February 24, 2010 at 10:49 am - Reply

    I tried the speech easy when it first came out. It worked! After three months, however, it didn’t seem too anymore. I was advertised as being a “cure for stuttering.” I remember watching a video or something about how amazing it was. Used with therapy,I think it can help people, but when the speecheasy stops being effective(which in alot of cases it will), my advice to anyone who stutters is to continue therapy. You will see results with pratice! 🙂

  7. Eric February 25, 2010 at 11:49 am - Reply

    Some users of the SpeechEasy left their opinions on our Facebook page if you’re looking for more input.

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