Question
I am currently following an adult fluency client through steps to maintain her fluency in various situations that cause her stress. She has been successful with much of the cognitive educational side of our work and her dysfluencies have decreased. What are the pros and cons of assistive fluency devices?
Answer
You have asked an important and controversial question, one that is not easily dealt with in limited space. In my reply, I will attempt to hit some highlights, and then refer you to a very comprehensive source that tries to give a balanced perspective on the pros and the cons of assistive fluency devices.
There are several parts to your question that are potentially important. Clarification of these issues might be helpful in planning strategies to help your client.
(1) First, you indicated that ''disfluencies have decreased.'' I wonder if you are referring to just the frequency of the stuttering, or whether you are also referring to severity: associated effort/tension/struggle, the duration of moments of stuttering, or the type of stuttering-- e.g., silent blocks, hard contacts/tense pauses, or sound, syllable and word repetitions. What about avoidances? Are the disfluencies decreased because the person is postponing or avoiding stuttering by substituting words, paraphrasing and circumlocuting, or not participating in verbal communication in situations of high communicative stress.
(2) Secondary, there is also the issue of Celexa. This may be important, but I cannot tell because I am not sure of the details of why it is being used. Celexa is frequently used to treat depression, but it might make a difference if the depression is ''generalized'' or related more specifically to the stuttering.
(3) Finally, I note your reference to the fact that she might be looking for ''another quick fix.'' There are a number of ''quick-fix'' procedures that may be temporarily successful, but these are a far cry from the more permanent relief that is ultimately desired. ''Quick-Fix'' programs are rarely permanent.
Assistive fluency devices such as Speak Easy, Fluency Master or the Pocket Fluency System can facilitate improved fluency is a number of individuals. These tend to work best for persons whose stuttering is overt and vocalized. They tend not to work as well for persons whose stuttering contains primarily silent blocks. These systems also do not work well when the person is frequently speaking in environments with significant background noise.
Whether intended by the inventor to actually do so, or whether intended as such by the companies that market and produce these devices, they are not ''cures'' for stuttering. When tears streak down Oprah Winfrey's face as she
extols the virtue of a miracle device, this is misleading to the public and has the potential to build unrealistic hope and optimism in folks whom the device may not prove helpful over the long haul. The SpeakEasy is a prosthesis which, while worn, is helpful for some. Long term outcome studies are still being conducted, so we really do not yet know what the user will think about the device after a long period of use.
There are those who sing the praises of fluency enhancing devices. There are others who have tried them and been totally unimpressed.
For a balanced perspective, I encourage you to visit the Stuttering Home Page. Judy Kuster has done a marvelous job in compiling an objective summary of many of the important issues that are involved. An interview with Judy Kuster about her Stuttering Home Page was done by Speech Pathology Online originally in February of 2003 and that interview and its links are still available via this site.
REFERENCE:
https://www.mnsu.edu/comdis/kuster/TherapyWWW/dafjanus.html
