APPs For Fluency Work
Balbus Speech, http://balbusspeech.com/ , launched an app today that may benefit some people who stutter. I was delighted to witness a demo of this iOS app, Speech4Good, last month. I don’t own an Apple product, so I cannot download the app. However, it looks very promising. It offers daf, speech waveform and ability to take notes which can be e-mailed to others.
This is the age of the “app.” An app is an “application” for mobile devices such as smart phones and tablet computers. My nookcolor (1) has a small selection of apps. My husband’s Droid smart phone can access apps designed for the Android operating system (2). A few of my students have the iPhone and iTouch that access apps made for devices that use iOS (3). “apps… have introduced immediately accessible activities for use in treatment and at home. “ (4)
Mobile devices are everywhere. Talking on a cell phone is common place. So using an app to practice speech can now appear as natural as anyone else who is using a phone. (Though I must admit, adults talking with a Bluetooth device (5) as they grocery shop still spook me!)
The Fluency Tracker (6) allows a speaker to count stuttered words, choose from a selection of feeling words, and take notes. This app raises the nagging question, “What is stuttering?” Imagine if the speaker and a listener were both using this app. I wonder if their counts would be the same? Would the speaker record subtle moments of muscle tension and hesitations imperceptible to the listener? Would the listener record secondary behaviors of which the speaker was unaware? The experience of stuttering from the perspective of the person who stutters vs the listener has been a long time topic for discussion.
The reliability of counting stuttered words is another critical concept to keep in mind. Reliability refers to a person’s ability to count stuttered words across situations. So for example, if you count fewer stuttered words while talking to a friend in a restaurant as opposed to talking to a waitress, was it because you stuttered less or because your attention to counting was different? Speech characterized by clusters of dysfluency - multiple stuttered sounds and syllables across only a few words - would be difficult to count accurately and reliably in real time, I would think.
I like how you can take notes and indicate emotional states with the Fluency Tracker. Otherwise, fluency counts could be meaningless. A speaker’s thoughts and feelings in combination with environmental variables are all relevant to planning step-by-step behavioral change.
I think the Fluency Tracker would be handy for counting lots of other skills besides stuttering. A person could count fluency enhancing strategies (speech tools), self-talk and visualization, or specific behavioral goals. How fun it would be to see a graph showing increased use of easy onset, pausing, or cancellation across situations and over time! Or how about counting the kinds of visualization or self-talk used throughout a day?
The daf assistant (7) and the daf professional (8) are apps that provide delayed auditory feedback and frequency altered feedback. The speaker needs to wear a headset or earbuds with microphone. (9) These two apps have different features and may be useful for people who find that aaf improves their speech fluency. This is not the case for everyone. The same issues of accurate, reliable measurement as well as journaling thoughts, feelings, and environmental variables apply for this app as for the Fluency Tracker, IMHO. Both apps could be part of a multi-faceted treatment program within a framework of Evidence Based Practice.
The American Speech Language Hearing Association has resources for the SLP who would like to learn more about the appropriate use of apps in treatment. (10) Apps for Speech Therapy (11) and Moms with Apps (12) are two Blogs cited by ASHA that look interesting.
I have not seen any peer reviewed research about use of apps. But I think that clinicians raise some of the questions that researchers ultimately study. I envision apps as a way to shift more power, control, responsibility and ownership of carryover into the hands of the student/client. I look forward to research on the effectiveness of apps as a tool in speech therapy for stuttering.
(4) DeCurtis, L. L. & Ferrer, D, (2011, September 20) Toddlers and Technology: Teaching the Techniques. The ASHA Leader