Balbus
Speech , 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.
Judy
(1) link changed
(4) DeCurtis,
L. L. & Ferrer, D, (2011, September
20) Toddlers and Technology: Teaching the Techniques. The ASHA Leader
(6) broken link
(9) broken link
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