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Lori Melnitsky

Successful Stuttering Treatment-What the research says?

The Modified Phonation Interval-2 (MPI-2) is more effective… Read on…

Effective Stuttering Treatment for Adults-The research counts…

Statistics show that more than 72 million people globally are affected by stuttering, a figure that represents one percent of the global population. While stuttering – the disorder where an individual repeats and prolongs syllables and sounds – is not a life-threatening condition, it can cause emotional and psychological problems as it interferes with effective interactions with others and erodes self-confidence and self-esteem.

Researchers continue to investigate ways in which this condition can be managed, helping adults as well as children who stutter gain confidence and lead a more fulfilling life. Some of these studies have provided solutions which have helped those with a stutter manage their condition effectively. Two recent studies conducted by renowned researchers from UC Santa Barbara have provided a new insight in the treatment of stuttering. They have a new understanding on the physiological basis of the condition as well as information on its treatment.

The first study, published in the American Journal of Speech Language Pathology, compared a new treatment regime which was developed at UCSB to the best practices protocol. The other study, which can be found at the Journal of Speech Language and Hearing Research, used imaging to assist in identifying the abnormal areas of white matter in the brain of people who stutter, more specifically, adults. One thing is clear based on the two papers: neuro-anatomic abnormality will be present in people who stutter but despite this, they can still learn fluent speech.

Modifying Phonation Intervals (MPI)

The current standard protocol in the MPI stuttering treatment program involves teaching a person who stutters to prolong speech. But the new approach that is prescribed by the new studies is different. The intensive program teaches someone with a stutter to reduce the frequency and produce very short of intervals of phonation in their speeches. The MPI software gives immediate feedback where the individual is informed of the occurrence of the short phonated intervals to assist in learning to reduce their occurrence, ultimately improving fluency.

A long period of research and numerous tests where MPI software was studied in phase 2 clinical trials found that a reduction of the frequency of the short phonated intervals led to long lasting and natural speech where most of those who participated in the study developed fluent speech. The researchers called it a five-minute job where, for the first phase, participants are put under the treatment for at least two to three hours a day, six days a week, for three weeks. The treatment normally has four phases where the whole program is managed by the clinician and the participant, with the clinician using a master program to teach the person with a stutter on how the program is followed.

As the patient progresses, the process is made complex, the speaking tasks are incremental until the are able to conquer their fear and speak in initially perceived difficult situations. Researchers are currently developing a more advanced tool where virtual reality together with the MPI treatment program can be combined to explore whether the difficult speech situations can be created through virtual reality. The effectiveness of the program has been appreciated as the studies’ findings emphasized its ability to identify and use specific speech behaviors needed for a successful treatment. Fifty percent of those who received MPI treatment succeeded in maintaining fluent speech one year after completing the program in comparison to those who got prolonged speech treatment.

The studies showed that there is a great level of success in use of the MPI programs as they recorded a great proportion of successful participants. They also suggest that when MPI is combined with predictive value for particular changes in PI durations, the treatment is relatively more successful in helping the people who stutter identify and change behavior which is linked with successful treatment regime in adults.

Outcomes for successful participants were very similar for the two treatments. The much larger proportion of successful participants in the MPI group, however, combined with the predictive value of specific changes in PI durations suggest that MPI treatment was relatively more effective at assisting patients to identify and change the specific speech behaviors that are associated with successful treatment of stuttered speech in adults. The researchers recommend further research to help understand the actual causes of stuttering and suggest studying the brains of those who have recovered to find out where the white matter changes as the treatment progresses. With this kind of study, the missing linked can be found and the management of people with a stutter gets a big boost. Continued research will continue to give solutions on how people who stutter can improve on their speech which will help to improve their self confidence and self-esteem.

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