Archives of Acoustics, 40, 4, pp. 469–474, 2015
10.1515/aoa-2015-0046

EtCO2-Based Biofeedback Method of Breath Regulation Increases Speech Fluency of Stuttering People

Barbara STANKIEWICZ
Nałęcz Institute of Biocybernetics and Biomedical Engineering
Poland

Krzysztof ZIELIŃSKI
Nałęcz Institute of Biocybernetics and Biomedical Engineering
Poland

Marek DAROWSKI
Nałęcz Institute of Biocybernetics and Biomedical Engineering
Poland

Marcin MICHNIKOWSKI
Nałęcz Institute of Biocybernetics and Biomedical Engineering
Poland

Respiratory disturbances frequently accompany stuttering. Their influence on lung ventilation can be assessed by measurement of the end-tidal CO2 concentration (EtCO2). The effectiveness of the CO2-based visual feedback method of breath regulation (VF) designed for stuttering therapy was tested in this study. The aim of the study was to answer the question if the VF helps to reduce respiratory disturbances in stuttering and increase speech fluency. 20 stuttering volunteers aged 13–45 years took part in the 3-parts test consisting of: 1. speaking without any techniques improving speech fluency, 2. learning the VF method, 3. VF-assisted speaking. The CO2/time signal and an acoustic signal of an utterance were recorded during the test. Significant increase of FE – the factor of breath ergonomics during speaking (based on both signals), from 47% to 71% (P < 0.01), and significant decrease of %SS – the percent of syllables stuttered, from 14% to 10% (P < 0.01) were received for VF-assisted utterances compared to the utterances without VF assistance. The results indicate that the VF can help to eliminate respiratory disturbances in stuttering and increase speech fluency.
Keywords: stuttering therapy; respiratory disturbances; end-tidal CO<sub>2</sub>; an acoustic signal of an utterance; visual feedback.
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Copyright © Polish Academy of Sciences & Institute of Fundamental Technological Research (IPPT PAN).

References

Andrade C.R., Cervone L.M., Sassi F.C. (2003), Relationship between the stuttering severity index and speech rate, Sao Paulo Medical Journal, 121, 2, 81–84.

Bakker K., Biagioni R.N., Byrne M.R., Byrne T.A., Netsell R.W. (2002), System and method for assessing breathing and vocal tract sound production of a user, US patent No: 6,423,013, Retrieved September 21st, 2007, from http://patft.uspto.gov/netahtml/PTO/srchnum.htm.

Bloodstein O., Bernstein Ratner N. (2008), A handbook on stuttering, 6th Ed., Tomson/Delmar Learning, Clifton Park, New York.

Choo A.L., Robb M.P., Dalrymple-Alford J.C., Huckabee M.L., O’Beirne G.A. (2010), Different lip asymmetry in adults who stutter: electromyographic evidence during speech and non-speech, Folia Phoniatrica et Logopaedica, 62, 3, 143–147.

Conelea C.A., Rice K.A., Woods D.W. (2006), Regulated Breathing as a treatment for stuttering: a review of the empirical evidence, Journal of Speech-Language Pathology and Applied Behavior Analysis, 1, 2, 94–102.

Denny M., Smith A. (2000), Respiratory control in stuttering speakers evidence from respiratory High-Frequency Oscillations, Journal of Speech, Language, and Hearing Research, 43, 4, 1024–1037.

De Felicio C.D., Rodrigues Gomes Freitas R.L., Vitti M., Hallak Regalo S.C. (2007), Comparison of upper and lower lip muscle activity between stutterers and fluent speakers, International Journal of Pediatric Otorhinolaryngology, 71, 8, 1187–1192.

Freeman K.A., Friman P.C. (2004), Using simplified Regulated Breathing with an adolescent stutterer, Behavior Modification, 28, 2, 247–260.

Hixon T.J. and Collaborators [Eds.], (1991), Respiratory functions in speech and songs, Singular Publishing Group, San Diego.

Hoit J.D., Lohmeier H.L. (2000), Influence of continuous speaking on ventilation, Journal of Speech, Language, and Hearing Research, 43, 5, 1240–1251.

Hoit J.D., Hixon T.J. (1991), Body type and speech breathing, [in:] Respiratory functions in speech and songs, Hixon T.J. and Collaborators [Eds.], pp. 401–224, Singular Publishing Group, San Diego.

Lincoln M., Packman A. (2003), Measuring stuttering, [in:] The Lidcombe Program of early stuttering intervention: a clinican’s guide, Onslow M., Packman A., Harrison E. [Eds.], p. 53, TX: Pro-Ed, Austin.

Loucks T.M.J., De Nil L.F., Sasisekaran J. (2007), Jaw-phonatory coordination in chronic developmental stuttering, Journal of Communication Disorders, 40, 3, 257–272.

Lumb A.B. [Ed.], (2010), Nunn’s Applied Respiratory Physiology, 7th Ed., Churchill Livingstone Elsevier, Oxford.

Pail O. (2003), Apparatus and methods for indicating respiratory phases to improve speech/breathing synchronization, US patent no: 6,561,987, Retrieved September 27th, 2007, from http://patft.uspto.gov/netahtml/PTO/srchnum.htm.

Pruszewicz A. [Ed.], (1992), Clinical phoniatry [in Polish], PZWL, Warsaw.

Raczek B., Adamczyk B. (2000), Speech ergonomics assessment in stutterers based on exhaled CO2 concentration. Preliminary study, Biocybernetics and Biomedical Engineering, 20, 4, 67–76.

Raczek B., Adamczyk B. (2004), Concentration of carbon dioxide in exhaled air in fluent and non-fluent speech, Folia Phoniatrica et Logopaedica, 56, 2, 75–82.

Russel B.A., Cerny F., Stathopoulos E.T. (1998), Effects of varied vocal intensity on ventilation and energy expenditure on women and men, Journal of

Speech, Language, and Hearing Research, 41, 2, 239–248.

Russel B.A., Cerny F. (2002), Estimating PCO2 during speaking: a postscript on Hoit and Lohmeier (2000), Journal of Speech, Language, and Hearing Research, 45, 6, 1134–1141.

Stankiewicz B., Zielinski K., Darowski M., Adamczyk B. (2006), Visual feedback based on expired CO2 as a therapy method for respiratory disturbances in stuttering, Archives of Acoustics, 31, 4, 439–444.

Stankiewicz B., Adamczyk B., Zieliński K., Darowski M. (2007), Diagnosis of respiratory disturbances associated with stuttering [in Polish], patent No

Stankiewicz B., Zielinski K., Darowski M. (2012), The method and device for breath regulation [in Polish], patent pending, No 401795.

Zocchi L., Marc Estenne M., Johnston S., Del Ferro L., Ward M.E., Macklem P.T. (1990), Respiratory muscle incoordination in stuttering speech,

American Review of Respiratory Disease, 141, 6, 1510–1515.




DOI: 10.1515/aoa-2015-0046