Evaluation of a stuttering treatment based on reduction of short phonation intervals.

This paper reports the results of an efficacy study of a stuttering treatment program known as Modifying Phonation Intervals (MPI), which trains stuttering speakers to reduce the frequency of relatively short phonation intervals (PIs) during connected speech across speaking tasks and situations. Five young adult male stuttering speakers were treated in this computer-based program that systematically trains speakers to reduce selected short PIs found to functionally control stuttering. The treatment process was evaluated using multiple-baseline designs. Treatment was largely self-managed and based on a performance-contingent schedule of within-clinic speaking tasks (Establishment), beyond-clinic speaking tasks (Transfer), and systematic decreases in assessment occasions (Maintenance). Assessments were made at regular intervals before, during, and after treatment. All speakers achieved stutter-free and natural-sounding speech during within- and beyond-clinic speaking tasks at the completion of Maintenance. All were tested 12 months after completion of Maintenance, and all maintained the results. The findings from this study suggest that this procedure may make a significant contribution to stuttering treatment practice.

[1]  R. Ingham,et al.  Measurement and modification of speech naturalness during stuttering therapy. , 1985, The Journal of speech and hearing disorders.

[2]  E. Boberg,et al.  Long-term results of an intensive treatment program for adults and adolescents who stutter. , 1994, Journal of speech and hearing research.

[3]  R. Ingham The effects of self-evaluation training on maintenance and generalization during stuttering treatment. , 1982, The Journal of speech and hearing disorders.

[4]  R. Ingham,et al.  Modifying electroglottograph-identified intervals of phonation: the effect on stuttering. , 1992, Journal of speech and hearing research.

[5]  C. G. Reed,et al.  An experimental treatment using verbal punishment with two preschool stutterers , 1977 .

[6]  R. Ingham Current status of stuttering and behavior modification. II: Principal issues and practices in stuttering therapy , 1993 .

[7]  O. Bloodstein A handbook on stuttering , 1969 .

[8]  D. Prins Models for treatment efficacy studies of adult stutterers , 1993 .

[9]  H. M. Brash,et al.  The Long Term Use of an Automatically Triggered Auditory Feedback Masking Device in the Treatment of Stammering , 1979 .

[10]  P. Ramig,et al.  Temporal characteristics in the fluent speech of child stutterers and nonstutterers , 1986 .

[11]  R. Martin,et al.  An experimental treatment with two preschool stuttering children. , 1972, Journal of speech and hearing research.

[12]  J. Hillis Ongoing Assessment in the Management of Stuttering: A Clinical Perspective , 1993 .

[13]  H F Peters,et al.  Perceptual judgment of abruptness of voice onset in vowels as a function of the amplitude envelope. , 1986, The Journal of speech and hearing disorders.

[14]  R. L. Webster A few observations on the manipulation of speech response characteristics in stutterers. , 1977, Journal of communication disorders.

[15]  W. Manning,et al.  The frequency of disfluencies during phonatory transitions in stuttered and nonstuttered speech. , 1976, Journal of communication disorders.

[16]  R. Curlee Evaluating treatment efficacy for adults: Assessment of stuttering disability , 1993 .

[17]  J. E. James,et al.  Behavioral self-control of stuttering using time-out from speaking. , 1981, Journal of applied behavior analysis.

[18]  G. Andrews,et al.  Short- and long-term outcome in an intensive treatment program for adult stutterers. , 1981, The Journal of speech and hearing disorders.

[19]  W. H. Moore Some effects of progressively lowering electromyographic levels with feedback procedures on the frequency of stuttered verbal behaviors , 1978 .

[20]  J. Costello The establishment of fluency with time-out procedures: three case studies. , 1975, The Journal of speech and hearing disorders.

[21]  M. Wingate Stuttering: Theory and Treatment , 1976 .

[22]  R. Ingham Modification of maintenance and generalization during stuttering treatment. , 1980, Journal of speech and hearing research.

[23]  L. A. Jeffress,et al.  Identification of brief pauses in the fluent speech of stutterers and nonstutterers. , 1971, Journal of Speech and Hearing Research.

[24]  G. Andrews,et al.  Stuttering: speech pattern characteristics under fluency-inducing conditions. , 1982, Journal of speech and hearing research.

[25]  R. Martin,et al.  Stuttering and speech naturalness. , 1984, The Journal of speech and hearing disorders.

[26]  Alan E. Kazdin,et al.  International Handbook of Behavior Modification and Therapy , 1982 .

[27]  A. Kazdin Research design in clinical psychology, 3rd ed. , 1998 .

[28]  S. O'brian,et al.  Reliability of clinicians' judgments about prolonged-speech targets. , 1998, Journal of speech, language, and hearing research : JSLHR.

[29]  John Paul Brady,et al.  Metronome-conditioned speech retraining for stuttering , 1971 .

[30]  A. Bandura Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.

[31]  M. Onslow,et al.  Direct early intervention with stuttering: some preliminary data. , 1990, The Journal of speech and hearing disorders.

[32]  G J Borden,et al.  Onset of voicing in stuttered and fluent utterances. , 1985, Journal of speech and hearing research.

[33]  J. Ingham,et al.  Guidelines for documentation of treatment efficacy for young children who stutter. , 1998, Journal of speech, language, and hearing research : JSLHR.

[34]  Alan E. Kazdin,et al.  Research Design in Clinical Psychology , 2021 .