Five studies were performed to explore the feasibility of treating severe chronic stuttering with EMG feedback. EMG spiking from the throat was found to correlate with stuttering, and to differentiate between stuttering and fluent speech. EMG spiking tended to disappear when stuttering was reduced by metronome-paced speech and by speech therapy. Likewise, when EMG spiking was reduced by feedback training, stuttering was concurrently reduced. Presentation of the feedback tone without instructions or information produced no reduction in stuttering or EMG spiking. Pseudofeedback was also generally ineffective. It was concluded that the feedback effect is apparently not an artifact of instructions, masking, distraction, adaptation, slowing of speech, or of a stutter-contingent aversive tone, nor is it a Hawthorne or placebo effect. Implications of the results are discussed. / Arts, Faculty of / Psychology, Department of / Graduate

Thesis (MPhil (Centre for Health Sciences Education)--University of Stellenbosch, 2010. / AFRIKAANSE OPSOMMING: Doel: Te min spraak-taalterapeute (STT’e) wêreldwyd spreek vlotheidsversteurings aan. Dit mag aan hul gevoelens van onbevoegdheid in die hantering van persone wat hakkel toegeskryf word. Nuut-gegradueerde STT’e, in die Suid-Afrikaanse konteks, het dikwels nie toegang tot ondersteuning en leiding van ervare klinici om hul vaardighede en bevoegdheid in die hantering van persone wat hakkel, te ontwikkel nie. Die doel van hierdie studie was om voorgraadse STTstudente se persepsies van hul eie bevoegdheid om persone wat hakkel te hanteer, te ondersoek en beskryf 1) direk na die voltooiing van hul teoretiese module en voor kliniese plasing, en 2) na blootstelling aan ‘n bykomende opleidingskomponent waar hulle waargeneem het hoe intervensieprosedures op ‘n gesimuleerde pasiënt toegepas word. Metodes: ‘n Beskrywende opnameontwerp, met pre- en post-intervensie-vraelyste is gebruik om die andragogiese benadering se impak op studente, voor en nadat hulle die bykomende opleidingsgeleentheid ontvang het, te evalueer. Resultate: Voor die intervensie het die meeste studente hulself nie as bevoegd geag om persone wat hakkel te evalueer of behandel nie. Na die intervensie is statisties beduidende veranderinge in die studente se self-ervare bevoegdheid vir die meeste aspekte verwant aan die evaluering en behandeling van mense wat hakkel, gerapporteer. Opsomming: Daar is tot die gevolgtrekking gekom dat die studente hierdie tipe innoverende opleidingsmetodologie hoog op prys stel en dat dit ‘n nodige aanvulling tot studente se bestaande kliniese plasings is.

Background: People who stutter produce speech that is characterized by intermittent, involuntary part-word repetitions and prolongations. In addition to these signature acoustic manifestations, those who stutter often display repetitive and fixated behaviours outside the speech producing mechanism (e.g. in the head, arm, fingers, nares, etc.). Previous research has examined the attitudes and perceptions of those who stutter and people who frequently interact with them (e.g. relatives, parents, employers). Results have shown an unequivocal, powerful and robust negative stereotype despite a lack of defined differences in personality structure between people who stutter and normally fluent individuals. However, physiological investigations of listener responses during moments of stuttering are limited. There is a need for data that simultaneously examine physiological responses (e.g. heart rate and galvanic skin conductance) and subjective behavioural responses to stuttering. The pairing of these objective and subjective data may provide information that casts light on the genesis of negative stereotypes associated with stuttering, the development of compensatory mechanisms in those who stutter, and the true impact of stuttering on senders and receivers alike. Aims: To compare the emotional and physiological responses of fluent speakers while listening and observing fluent and severe stuttered speech samples. Methods & Procedures: Twenty adult participants (mean age = 24.15 years, standard deviation = 3.40) observed speech samples of two fluent speakers and two speakers who stutter reading aloud. Participants' skin conductance and heart rate changes were measured as physiological responses to stuttered or fluent speech samples. Participants' subjective responses on arousal (excited-calm) and valence (happy-unhappy) dimensions were assessed via the Self-Assessment Manikin (SAM) rating scale with an additional questionnaire comprised of a set of nine bipolar adjectives. Outcomes & Results: Results showed significantly increased skin conductance and lower mean heart rate during the presentation of stuttered speech relative to the presentation of fluent speech samples (p<0.05). Listeners also self-rated themselves as being more aroused, unhappy, nervous, uncomfortable, sad, tensed, unpleasant, avoiding, embarrassed, and annoyed while viewing stuttered speech relative to the fluent speech. Conclusions: These data support the notion that stutter-filled speech can elicit physiological and emotional responses in listeners. Clinicians who treat stuttering should be aware that listeners show involuntary physiological responses to moderate-severe stuttering that probably remain salient over time and contribute to the evolution of negative stereotypes of people who stutter. With this in mind, it is hoped that clinicians can work with people who stutter to develop appropriate coping strategies. The role of amygdala and mirror neural mechanism in physiological and subjective responses to stuttering is discussed.

Made available in DSpace on 2016-04-27T18:11:55Z (GMT). No. of bitstreams: 1 Thais Inocencio Pires.pdf: 872835 bytes, checksum: b1e5cabfbe7f4c096f5191f7cd737d08 (MD5) Previous issue date: 2012-02-10 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / Introduction: Speech fluency can be viewed as a complex event involving the organic, psychic and social dimensions. From this perspective, complaints about problems of speech fluency brought to the clinic by the family, call for the development of a therapeutic process that involves the entire family unit. Objective: To study, through the speech of parents, the effects and effectiveness of a therapeutic process for speech fluency problems based on a historical-dialectical approach. Method: qualitative research using semi-structured interviews with three families that have therapeutic work with the researcher. The interview began with the phrase: Tell me about your child's therapeutic process. The interviewer intervened to ensure that respondents talked about the vision they had about their children, his speech and the changes they observed. The transcribed interviews were categorized according to Bardin's Content Analysis (2009) in four categories: Therapeutic Approach; Experiences and Affections; Causes and Vision that Parents have about the Child, the Language and his Stuttering, the last one structured in three sub - categories: Feelings and Thoughts on Stuttering and Language; Social Situations and Characteristics of Communication. Results / Discussion: The therapeutic effects observed from the analysis of the categories were: in Therapeutic Approach parents reported that, unlike other approaches, whit the dialectical historical approach they felt part of the therapeutic process. In Experiences and Affections reports that speech moments before felt as harassed and helpless, came to be shared and seized as part of the process of speech production and that they understood that their feelings have an effect on the speech of the child. In Vision that Parents have about the Child, the Language and his Stuttering was reports about how the speech of their children was; about the changes observed; about the stigma they and their children carried and about their understanding that the social contexts intensified stuttering. Conclusion: These effects indicate that the therapeutic process supported on the historical dialectical approach was effective for the participants in this study. It also indicates that effectiveness is not only measured by the decrease in stuttering and disfluency of children, but mainly by change of attitude of parents toward this form of speech, which enabled such a decrease. This result points to the need and importance of further studies about this type of approach / Introdução: A fluência de fala pode ser encarada como um acontecimento complexo por envolver as dimensões orgânica, psíquica e social. Nessa perspectiva, as queixas sobre os problemas de fluência trazidas à clínica fonoaudiológica pela família, convocam ao desenvolvimento de um processo terapêutico que envolva todo o núcleo familiar. Objetivo: Estudar, por intermédio do discurso de pais, os efeitos e a efetividade de um processo terapêutico para problemas de fluência de fala baseados em uma abordagem dialético-histórica. Método: Trata-se de pesquisa qualitativa para a qual foram feitas entrevistas semi-estruturadas a três famílias em atendimento terapêutico com a pesquisadora. A entrevista iniciou-se com a frase: Fale-me sobre o processo terapêutico de seu filho. O entrevistador interferiu de modo a garantir que os entrevistados falassem sobre a visão que tinham e têm de seus filhos e de sua fala, além das mudanças que observaram. As entrevistas transcritas, foram categorizadas de acordo com a Análise de Conteúdo de Bardin (2009) em 4 categorias: Abordagem Terapêutica; Vivências e Afetos; Causas e Visão que os Pais têm do Filho, da Linguagem e da Gagueira, está estruturada em 3 subcategorias: Sentimentos/Pensamentos sobre a Gagueira/Linguagem; Situações Sociais e Características da Comunicação. Resultados/Discussão: Os efeitos terapêuticos observados a partir da análise das categorias foram: em Abordagem Terapêutica relatos dos pais que, diferentemente de outras abordagens, na abordagem dialético-histórica sentiram-se parte integrante do processo terapêutico. Na categoria Vivências e Afetos, relatos de que momentos de fala antes sentidos como aflitivos e exaustivos, passaram a ser compartilhados e apreendidos como parte integrante do processo de produção de fala e de que compreenderam de que os seus sentimentos tem efeitos sobre a fala das crianças. Na categoria Causas, relatos que relacionaram o surgimento da gagueira a algum evento importante de suas vidas. Na categoria Visão que os Pais têm do Filho, da Linguagem e da Gagueira, relatos sobre como era a fala de seus filhos; sobre as mudanças observadas nessa fala; sobre o estigma que eles e seus filhos carregavam e sobre sua compreensão de que os contextos sociais intensificavam a gagueira. Conclusão: Esses efeitos indicam que o processo terapêutico apoiado na vertente dialético histórica foi efetivo para os participantes desta pesquisa. Indica também que essa efetividade não se avalia apenas pela diminuição da gagueira e da disfluência das crianças, mas, principalmente, pela mudança da atitude dos pais em relação a esta forma de fala, que permitiu tal diminuição. Tal resultado aponta para a necessidade e importância de realizar outros estudos a respeito desse tipo de abordagem