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An issue was raised whether to include two studies of SpeechEasy devices that were presented at professional conferences but not published. A discussion of this issue is at Wikipedia_talk:Reliable_sources#Are_papers_presented_at_scientific_conferences_reliable.3F. Based on the discussion I've included the two studies.-- TDKehoe 17:48, 21 September 2007 (UTC)
Wikipedia:Manual of Style#Images says "Cases where specific image width are considered appropriate include: ...When using detailed maps, diagrams or charts...On a lead image that captures the essence of the article." These cases described the lead photo and the two charts, so I suggest setting them at 320px.-- TDKehoe 21:45, 23 September 2007 (UTC)
The way the devices are listed, they can't be linked to. E.g., if another website wanted to refer to all of the studies of SpeechEasy devices, there's no way to link to just the SpeechEasy section. These should be changed to sub-sections.-- TDKehoe 23:28, 23 September 2007 (UTC)
User:Slp1 removed the following section because it was "US specific funding information." I disagree with that edit. IMHO, US-specific information can best be improved by adding information about other countries, not by removing information about the United States.-- TDKehoe 15:07, 30 September 2007 (UTC) --
Most Americans who stutter qualify for free or subsidized anti-stuttering devices:
In other countries, stutterers who want their national health programs to provide anti-stuttering devices should work with their national stuttering support organization.
TdKehoe, as you have acknowledged involvement with CasaFuturaTech, this article needs to carefully cited and held to all Wiki standards. I'm sure you've already aware of Wiki's conflict of interest guidelines.
That's a start; I'll be glad to peek in periodically on your progress. SandyGeorgia ( Talk) 02:28, 20 November 2007 (UTC)
I did all of the reference cleanup work I could, but 1) we should not be reporting on single case studies, 2) many of the sources don't have enough info to track them down, 3) many of the sources are conference presentations rather than peer-reviewed sources, and so on. I added an inline query because PubMed returned different information about one study than what was listed here. In general, we should be reporting on peer-reviewed information that is available in PubMed. You can search PubMed by entering the study name, locate the PMID number, and feed it into Diberri to get a complete and correct journal citation. I'll check in again after you've had a chance to do more work here. SandyGeorgia ( Talk) 18:05, 20 November 2007 (UTC)
I was the one who originally notified you of conflict of interest concerns on this article and your contributions to it. While I agree completely with SandyGeorgia's comments above, I have other concerns on a complete lack of citations for much of the material in the article. Please see Wikipedia's policies and guidelines on no original research and verifiability.
Here are some more comments on the article as it now is (most of these are more sepecifics on Sandy's comments above):
Please address these concerns as soon as possible. thanks, Ruhrfisch ><>°° 00:03, 24 November 2007 (UTC)
I've been busy with other projects and the new edition of A Handbook on Stuttering (the most respected secondary source in the field) just arrived. I'll try to add references in the next week or so. Regarding papers presented at conferences, they're either published later or were minor studies, so removing them makes no difference. The exception is studies that are "in press" with a peer-reviewed publication (a process that can take years) but have been presented at one or more conferences. The Pollard study is an example of this. I suggest including the Pollard study and when it is published it's easy enough to change the reference from the conferences to the publication.-- TDKehoe 16:08, 3 December 2007 (UTC)
The article has certainly improved, which is a good start! I still have grave concerns about it, and I would echo the comments made above. In addition I would question the entire section "Studies of anti-stuttering devices" in its current form. I do not find it encyclopedic to have a listing of studies, and note that other similar articles about assistive technology do not include it e.g Hearing aid. I too do not believe that in this context presentations at conferences qualify as reliable sources (especially since I have presented at many of the same conferences, and wouldn't dream of using these as reliable sources for an article on WP!). I should also point out that many of the authors of these studies are directly involved in the companies that produce anti-stuttering devices including Kalinowski and Saltuklaroglu. They are involved with the SpeechEasy, and the methods they have used in their research and promotion of the device have been deemed "pseudoscience" by other members of the profession in a peer-reviewed journal article in the American Journal of Speech-Language Pathology. [5] This has been followed by a lively correspondence on the subject. [6] [7] In addition, a systematic review of stuttering treatment methods found no studies of anti-stuttering devices that met minimal criteria for scientific control etc. [8]
I do not feel that the current section, as written, is appropriate for all of these reasons. I suggest that it be replaced with a short summary paragraph about the efficacy of the devices, which could include overviews of the research on effectiveness as noted in books and review articles. The section would also include some of the of the criticisms noted above. Any feedback?. Slp1 ( talk) 15:02, 24 November 2007 (UTC)
The reason to use a list of studies is to avoid bias. Making generalizations invites mistakes and biases. On the other hand, a list of studies is more difficult to read, and some studies may contradict other studies, thus confusing readers. This is why encyclopedias make broad generalizations instead of listing studies. If unbiased, accurate generalizations can be made, then this is better than a list of studies. However, a list of studies is better than biased, inaccurate generalizations. For example:-- TDKehoe 16:55, 3 December 2007 (UTC)
Does this statement need five sources? Is there one source that is more comprehensive, or more of a review, than the others, so that it can be reduced to one or two definitive sources? Since the studies are disputed, I'm unclear why we include all of them? Also, there's an extra word in there.
Something is goofed up in this sentence:
The prose here needs re-working to avoid based, based, based.
SandyGeorgia ( Talk) 17:27, 1 December 2007 (UTC)
"Electronic fluency aids" is a poor choice of title because the field of fluency disorders includes stuttering (properly called developmental stuttering); cluttering; spastic dysphonia; a wide variety of neurogenic fluency disorders including speech disorders associated with Parkinson's disease, strokes, and head injuries; and psychogenic fluency disorders. While the same devices are often used to treat both stuttering and other fluency disorders, this article covers only the use of the devices with stuttering. I dislike the term "anti-stuttering device" because it suggests a device that you put on and your stuttering is instantly and completely gone. I would like the devices to be called "stuttering treatment devices" because this suggests that the devices are one way (among many) to treat stuttering, that the devices can be used with other stuttering treatments, etc. However this term hasn't caught on. My suggestion is to title the article "Stuttering treatment devices" but make "Anti-stuttering devices" a search phrase that links to this article.-- TDKehoe 17:08, 3 December 2007 (UTC)
delayed auditory feedback (DAF) merger... sure whatever. I've never read about Electronic fluency device but I'm not usually reading that stuff either. -- CyclePat ( talk) 06:46, 7 December 2007 (UTC)
I added some references and removed some overbroad generalizations. I also added references for the two graphics. I was going to add references to some sections such as the size of devices or that some devices remove background noise, but these references would be to commercial websites (including my company's website); would that be a conflict of interest?-- TDKehoe ( talk) 20:22, 8 December 2007 (UTC)
I disagree with several of your recent edits:
I have other concerns but that is enough for now. I am beginning to get a bit frustrated by this process of continually needing to give this kind of feedback, which seems to leave so little time for actual article editing. Slp1 ( talk) 21:46, 8 December 2007 (UTC)
I've added a biofeedback section. When I have time I'll add studies of CAFET system and other non-EMG devices. Again, to add references for some items I'll need to reference commercial websites such as Dr. Fluency and Hollins. Is this acceptable?-- TDKehoe ( talk) 21:08, 8 December 2007 (UTC)
1. "Electronic fluency devices (also known as..." The FDA uses the term "anti-stammering device." "Assistive devices" and "electronic aids" are too broad terms to be meaningful in this context.-- TDKehoe ( talk) 16:39, 23 December 2009 (UTC)
2. "Computerized feedback devices" This term is incorrect. The paragraph describes biofeedback devices, some of which are computerized and some aren't. Biofeedback is the measurement and display of a bodily process to improve the user's awareness and control of that process. The paragraph is correct that microphones are used for vocal volume (loudness) but neglects to mention that other instruments are sometimes used, such as the chest straps used by the CAFET and Dr. Fluency to monitor breathing, or electromyographs used to monitor speech motor activity. "Computerized feedback devices" described many devices that don't provide biofeedback, such as SpeechEasy, Casa Futura Technologies' SmallTalk, and VoiceAmp, which are computerized and provided altered-auditory feedback. This paragraph would be more clear if it mentioned biofeedback devices by name, such as CAFET and the Hollins FluencyNet. The sentence "No peer-reviewed studies have been published showing the effectiveness of commercial systems in a clinical context." is literally correct but misleading. The paragraph describes non-commerical devices as well as commercial devices, and then makes a specific statement about commercial devices while ignoring the many studies of non-commerical devices (some of which lead to the development of commercial devices). For example, Craig, A., et al. “A Controlled Clinical Trial for Stuttering in Persons Aged 9 to 14 Years,” Journal of Speech and Hearing Research, 39:4, 808-826, August 1996 and Hancock, et al. “Two- to Six-Year Controlled-Trial Stuttering Outcomes for Children and Adolescents,” Journal of Speech and Hearing Research, 41:1242-1252, December 1998 is an excellent study of an electromyographic biofeedback device. They studied 98 children between the ages of 9 and 14 years old, had a control group, and did follow-ups at one year and four years.-- TDKehoe ( talk) 16:39, 23 December 2009 (UTC)
3. "Altered auditory feedback devices...Edinburgh Makser." That should be "Masker." The device is not discontinued, it has been incorporated into the VoiceAmp. Also, this paragraph confuses two types of masking, white noise and sine wave. The latter is used in the Edinburgh Masker. -- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
4. "Frequency-altered feedback...most studies have noted that DAF is more powerful than FAF in reducing stuttering." The referenced paper says (Lincoln, page 73: "Howell et al. (1987) are credited with discovering the effect of FAF on stuttering and subsequently reported that FAF was more effective in reducing stuttering than DAF. While the effect of FAF has subsequently been replicated, the finding that it is more powerful in reducing stuttering when compared to DAF has not." Lincoln is saying that the subsequent studies found DAF and FAF to be more or less equally effective, i.e., that one has not been found to be consistently more effective than the other. Also, this paragraph describes pitch-shifting FAF, which is used in Casa Futura Technologies devices and the Yamaha rack-mounted effects processors, and all of the published studies investigated. The paragraph fails to mention that there is another type of FAF (frequency-shifting) which is used in SpeechEasy and VoiceAmp devices and has never been investigated in a peer-reviewed study.-- TDKehoe ( talk) 17:20, 23 December 2009 (UTC)
5. "Effectiveness...studies have been critiqued for failing to demonstrate ecological validity; in particular that AAF effects continue over the long term and in everyday speaking situations." The following studies (listed in the references) were either long-term or in everyday speaking situations or both: Zimmerman, 1997; Van Borsel, 2003; Radford, 2005; Stuart, 2006; O'Donnell, 2008; Pollard, 2009.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
6. "Effectiveness...Using AAF via the SpeechEasy was effective in reducing stuttering in scripted telephone calls and giving presentations according to two studies.[18][20]" Neither of these studies were of the SpeechEasy device. The SpeechEasy was introduced in 2001 and the studies were published in 1997. Study #18 used a Casa Futura Technologies Desktop Fluency System. I don't have a copy of study #20 but it was likely either the same Casa Futura Technologies device or Yamaha rack-mounted effects processor.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
7. "Effectiveness... There are few published studies on the effect of the AAF in the daily activities of life." The references list three such studies: Zimmerman, 1997; O'Donnell, 2008; Pollard, 2009.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
8. "Effectiveness...the longterm effects of altered feedback are unclear." The references list five long-term studies: Van Borsel, 2003; Radford, 2005; Stuart, 2004 and 2006; O'Donnell, 2008; Pollard, 2009. The five studies had different results because different devices were used, different speaking situations were tested, speech therapy was or wasn't used in conjunction with the devices, etc. It might be more accurate to say that "the long-term effects of altered-auditory feedback are different for different devices, different speaking tasks, whether the devices are used in conjunction with speech therapy, or other factors."-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
9. "Effectiveness...the effect of AAF may fade after a few minutes of exposure,[24]" The referenced study was of 10-minute exposure to AAF. I'm skeptical that a study lasting 10 minutes can be extrapolated out to months or years. I.e., I suggest moving this reference to the section on short-term studies.-- TDKehoe ( talk) 16:54, 23 December 2009 (UTC)
10. "Effectiveness...some anecdotal reports suggest that over time users receive continued but lessened effects from their device." Please reference the Wikipedia policy allowing anecdotal reports to be cited when scientific studies published in peer-reviewed journals are available that contradict the anecdotal reports. Why does this paragraph start with general statements apparently referring to all fluency devices, and then talk only about SpeechEasy devices, and not mention the long-term studies of other devices, e.g., Van Borsel, 2003; Radford, 2005? The way this paragraph is written it confuses the reader between general statements about all fluency devices and statements about specific devices, sometimes mentioning the devices by name but at other times not mentioning the devices by name.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
11. "Effectiveness...They reported that the device was difficult to use in noisy situations as the device amplifies all voices and sounds." This paragraph also starts with a general statement and then talks about a specific device without mentioning what device is being discussed. This confuses readers as to whether all devices have this issue or whether only one device has this issue.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
12. "Use with children...There is little experimental evaluation of the therapeutic effect of AAF on children who stutter." Radford (2005) is a long-term (one year) study of an eleven-year-old boy.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
13. There are 13 mentions of SpeechEasy devices in this article, one mention each of four other devices (three no longer on the market), and no mentions of VoiceAmp or Casa Futura Technologies devices (these three companies have more or less equal market share, with Fluency Master a more distant fourth). The reference list has three studies of Casa Futura Technologies devices (Zimmerman, 1997;Van Borsel, 2003; Radford, 2005) and four studies of SpeechEasy devices (Stuart 2004 and 2006; Armson, 2006; O'Donnell, 2008; Pollard, 2009). I'm aware of 14 other studies of Casa Futura Technologies devices, I'm not aware of any other studies of SpeechEasy devices. Also the sentence "Current devices may be similar in size and appearance to a hearing aid, including in-the-ear and completely-in-the-canal models" is another reference to SpeechEasy, which makes the only ITE and CIC devices. Vocaltech and Casa Futura Technologies devices don't look like hearing aids, they look more like iPods. Did a SpeechEasy employee or a dealer edit this article to promote SpeechEasy? Maybe someone could go through the edit history and see if one person made all 13 mentions of SpeechEasy.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
14. In general this article is confusing. It makes general statements and then supports the general statement with a specific study of one device used in one speaking situation. It would be less confusing to readers if descriptions of studies specified what device was used, what the speaking situation was, whether speech therapy was used in conjunction with the device, etc. There are only seven studies in peer-reviewed scientific journals that I know of that investigated long-term and/or high-stress use of the devices (Zimmerman, 1997;Van Borsel, 2003; Radford, 2005; Stuart 2004 and 2006; Armson, 2006; O'Donnell, 2008; Pollard, 2009). It might be better to summarize the seven studies, then present the conclusions that can be drawn from a meta-analysis of the studies, e.g., the issues of "wearing off" of effectiveness over time, long-term carryover fluency (training the user to no longer need the device), high-stress vs. low-stress speaking situations, and using devices in conjunction with stuttering therapy vs. no therapy. Those four issues pretty much cover effectiveness. Another important issue is hearing loss (both temporary and permanent) but no studies have investigated this. I've written summaries of the seven studies at [20], I'll give permission to copy my summaries, although they may be too technical for Wikipedia standards. I believe that I uploaded the graphics to Wikipedia a few years ago. If an editor wishes to read the original studies, I have PDF versions of most of them.-- TDKehoe ( talk) 17:13, 23 December 2009 (UTC)
Welcome back, Thomas, and I hope all is well with you. Thanks for your extensive comments and feedback on the article. I appreciate that you have chosen to comment rather than edit the article directly. I have added some numbers to your comments, and will attempt to respond them briefly using these as indicators.
The article article about Hearing_aids has a section about third-party payers such as national health services that subsidize the cost of hearing aids. Is it allowable for the Electronic_fluency_devices to have a similar section?-- TDKehoe ( talk) 18:20, 19 January 2010 (UTC)
The paragraph on "Masking" contains several mistakes. The Edinburgh Masker did not produce white noise, it produced sine waves synchronized to the user's fundamental frequency of phonation; effectiveness did not fade with time; and no study compared its effectiveness to DAF or FAF. “The Long Term Use of an Automatically Triggered Auditory Feedback Masking Device in the Treatment of Stammering,” Ann Dewar, A.D. Dewar, W.T. S. Austin, H.M. Brash, British Journal of Disorders of Communication, Vol. 14, No. 3., winter 1979/80 stated: “The sound produced by the instrument is a ‘humming’ noise of mixed low frequencies and harmonics of up to approximately 500 Hz with peak frequencies of 125-250 Hz but varying with the mean frequency of the subject’s vocal cords.” (page 220) That study found that of 195 stutterers (144 classed as severe, 43 as moderate, and 8 as slight) 89% “responded well to the device.” Of the 21 who did not respond well initially, 9 had silent blocks, 2 of whom then received therapy and were able to use the device; 6 showed a “satisfactory response to the device” but refused to use the device for “cosmetic or other reasons”; 3 wore hearing aids; and the remainder had stuttering accompanied by other disorders (dysarthria, Parkinsonism, mentally retarded). 67 subjects were then followed for periods from 6 to 28 months (average, 12 months). All responded to a questionnaire, and some were contacted by telephone, mail or direct clinical observation. The result was that 42% reported that the device was of “great” benefit, 40% of “considerable” benefit, and 18% of “slight” benefit. 67% reported carryover fluency (“as a result of using the Masker, their unaided speech fluency had improved”). Five said that they had “become fully fluent as the result of the using the Masker and have not needed to use the device for some time.” 70% said that there was no adaptation or “wearing off” of effectiveness, 25% said it was “slightly less” effective and 5% said it was “much less” effective. The devices of 14 subjects who’d reported loss of effectiveness were examined and all were found to be faulty, e.g., low batteries or broken wires. The average user used the device 3.3 hours per day. The volume in the users’ ears was measured in ten subjects and found to average 77.6 dBA, with a range of 70 to 85 dBA. The hearing of 5 subjects was tested and no indications of hearing damage were found. Another study (Block, S., Ingham, R.J., & Bench, R.J. (1996). The effects of the Edinburgh Masker on stuttering. Australian Journal of Human Communication Disorders, 24, 11-18.) found that the device reduced stuttering 50% both in the speech clinic and beyond. Herb Goldberg, who provided nearly 3000 devices to American stutterers, wrote to me on September 9, 1994, “I am in contact with over 500 people who use or have used the Masker. In most cases the end result is the person uses the device less and less as time passes due to less need for it.”-- TDKehoe ( talk) 19:04, 22 February 2010 (UTC)
No one has responded to this request for a correction. I'll go ahead and make the changes.-- TDKehoe ( talk) 21:54, 25 December 2021 (UTC)
![]() | This edit request by an editor with a conflict of interest has now been answered. |
This sentence is misleading:
A 2006 review of stuttering treatments noted that none of the treatment studies on altered auditory feedback met the criteria for experimental quality.
The above sentence should be removed or changed to:
A 2006 review of stuttering treatments noted that three treatment studies of the SpeechEasy device did not the criteria for experimental quality.
The sentence in question suggests that the Bothe (2006) article was a review of all altered auditory feedback (AAF) treatment studies. There are hundreds of such studies, many done in speech labs with large, heavy devices. For example, the original delayed auditory feedback (DAF) devices in the 1960s were modified reel-to-reel tape recorders. The Bothe (2006) article reviewed three studies, all of the wearable SpeechEasy device. The article stated why most AAF studies were excluded: “Laboratory-bound investigations of fluency-inducing conditions…were excluded as not meeting [the review] criterion.” In other words, they only wanted to review studies of wearable AAF devices.
The Lincoln (2006) article reviewed 17 treatment studies of wearable AAF devices from at least four companies. The Lincoln (2006) review is discussed in this article and is, in my opinion, a superior review article. This article only mentions the Bothe (2006) review once, and the sentence is misleading if not inaccurate. The sentence should be removed. Alternatively the sentence should be modified to clarify that only three studies, all of devices from the same company, were examined. The sentence shouldn't suggest that all studies of the SpeechEasy device were examined. This article references seven studies of SpeechEasy devices, plus two letters to editors about the devices.-- TDKehoe ( talk) 03:20, 30 December 2021 (UTC)
Making broad generalizations such as "electronic fluency devices have this effect" or "electronic fluency devices don't have that effect" are misleading and confusing. It would be better to specify, "this device was shown to have this effect" or "that device was shown to have that effect." I went through the article and specified that Edinburgh Masker and SpeechEasy devices were used in studies of Edinburgh Masker and SpeechEasy devices. I don't have any financial connection to those devices. I didn't specify that studies about Casa Futura Technologies devices used Casa Futura Technologies devices, nor did I add any references to studies of Casa Futura Technologies devices, as I have a financial interest in this company. References [10] [19] [20] [24] [27] [37] [42] used Casa Futura Technologies devices. The article would be more clear if the sentences with these referenced that Casa Futura Technologies devices were used.-- TDKehoe ( talk) 22:26, 25 December 2021 (UTC)
No one has responded to this talk section so I went ahead and clarified that two studies used Casa Futura Technologies devices. The studies were independently done and not funded by Casa Futura Technologies.-- 71.211.157.117 ( talk) 17:01, 27 December 2021 (UTC)
![]() | The following Wikipedia contributor has declared a personal or professional connection to the subject of this article. Relevant policies and guidelines may include conflict of interest, autobiography, and neutral point of view. |
![]() | Electronic fluency device received a peer review by Wikipedia editors, which is now archived. It may contain ideas you can use to improve this article. |
![]() | Electronic fluency device received a peer review by Wikipedia editors, which is now archived. It may contain ideas you can use to improve this article. |
An issue was raised whether to include two studies of SpeechEasy devices that were presented at professional conferences but not published. A discussion of this issue is at Wikipedia_talk:Reliable_sources#Are_papers_presented_at_scientific_conferences_reliable.3F. Based on the discussion I've included the two studies.-- TDKehoe 17:48, 21 September 2007 (UTC)
Wikipedia:Manual of Style#Images says "Cases where specific image width are considered appropriate include: ...When using detailed maps, diagrams or charts...On a lead image that captures the essence of the article." These cases described the lead photo and the two charts, so I suggest setting them at 320px.-- TDKehoe 21:45, 23 September 2007 (UTC)
The way the devices are listed, they can't be linked to. E.g., if another website wanted to refer to all of the studies of SpeechEasy devices, there's no way to link to just the SpeechEasy section. These should be changed to sub-sections.-- TDKehoe 23:28, 23 September 2007 (UTC)
User:Slp1 removed the following section because it was "US specific funding information." I disagree with that edit. IMHO, US-specific information can best be improved by adding information about other countries, not by removing information about the United States.-- TDKehoe 15:07, 30 September 2007 (UTC) --
Most Americans who stutter qualify for free or subsidized anti-stuttering devices:
In other countries, stutterers who want their national health programs to provide anti-stuttering devices should work with their national stuttering support organization.
TdKehoe, as you have acknowledged involvement with CasaFuturaTech, this article needs to carefully cited and held to all Wiki standards. I'm sure you've already aware of Wiki's conflict of interest guidelines.
That's a start; I'll be glad to peek in periodically on your progress. SandyGeorgia ( Talk) 02:28, 20 November 2007 (UTC)
I did all of the reference cleanup work I could, but 1) we should not be reporting on single case studies, 2) many of the sources don't have enough info to track them down, 3) many of the sources are conference presentations rather than peer-reviewed sources, and so on. I added an inline query because PubMed returned different information about one study than what was listed here. In general, we should be reporting on peer-reviewed information that is available in PubMed. You can search PubMed by entering the study name, locate the PMID number, and feed it into Diberri to get a complete and correct journal citation. I'll check in again after you've had a chance to do more work here. SandyGeorgia ( Talk) 18:05, 20 November 2007 (UTC)
I was the one who originally notified you of conflict of interest concerns on this article and your contributions to it. While I agree completely with SandyGeorgia's comments above, I have other concerns on a complete lack of citations for much of the material in the article. Please see Wikipedia's policies and guidelines on no original research and verifiability.
Here are some more comments on the article as it now is (most of these are more sepecifics on Sandy's comments above):
Please address these concerns as soon as possible. thanks, Ruhrfisch ><>°° 00:03, 24 November 2007 (UTC)
I've been busy with other projects and the new edition of A Handbook on Stuttering (the most respected secondary source in the field) just arrived. I'll try to add references in the next week or so. Regarding papers presented at conferences, they're either published later or were minor studies, so removing them makes no difference. The exception is studies that are "in press" with a peer-reviewed publication (a process that can take years) but have been presented at one or more conferences. The Pollard study is an example of this. I suggest including the Pollard study and when it is published it's easy enough to change the reference from the conferences to the publication.-- TDKehoe 16:08, 3 December 2007 (UTC)
The article has certainly improved, which is a good start! I still have grave concerns about it, and I would echo the comments made above. In addition I would question the entire section "Studies of anti-stuttering devices" in its current form. I do not find it encyclopedic to have a listing of studies, and note that other similar articles about assistive technology do not include it e.g Hearing aid. I too do not believe that in this context presentations at conferences qualify as reliable sources (especially since I have presented at many of the same conferences, and wouldn't dream of using these as reliable sources for an article on WP!). I should also point out that many of the authors of these studies are directly involved in the companies that produce anti-stuttering devices including Kalinowski and Saltuklaroglu. They are involved with the SpeechEasy, and the methods they have used in their research and promotion of the device have been deemed "pseudoscience" by other members of the profession in a peer-reviewed journal article in the American Journal of Speech-Language Pathology. [5] This has been followed by a lively correspondence on the subject. [6] [7] In addition, a systematic review of stuttering treatment methods found no studies of anti-stuttering devices that met minimal criteria for scientific control etc. [8]
I do not feel that the current section, as written, is appropriate for all of these reasons. I suggest that it be replaced with a short summary paragraph about the efficacy of the devices, which could include overviews of the research on effectiveness as noted in books and review articles. The section would also include some of the of the criticisms noted above. Any feedback?. Slp1 ( talk) 15:02, 24 November 2007 (UTC)
The reason to use a list of studies is to avoid bias. Making generalizations invites mistakes and biases. On the other hand, a list of studies is more difficult to read, and some studies may contradict other studies, thus confusing readers. This is why encyclopedias make broad generalizations instead of listing studies. If unbiased, accurate generalizations can be made, then this is better than a list of studies. However, a list of studies is better than biased, inaccurate generalizations. For example:-- TDKehoe 16:55, 3 December 2007 (UTC)
Does this statement need five sources? Is there one source that is more comprehensive, or more of a review, than the others, so that it can be reduced to one or two definitive sources? Since the studies are disputed, I'm unclear why we include all of them? Also, there's an extra word in there.
Something is goofed up in this sentence:
The prose here needs re-working to avoid based, based, based.
SandyGeorgia ( Talk) 17:27, 1 December 2007 (UTC)
"Electronic fluency aids" is a poor choice of title because the field of fluency disorders includes stuttering (properly called developmental stuttering); cluttering; spastic dysphonia; a wide variety of neurogenic fluency disorders including speech disorders associated with Parkinson's disease, strokes, and head injuries; and psychogenic fluency disorders. While the same devices are often used to treat both stuttering and other fluency disorders, this article covers only the use of the devices with stuttering. I dislike the term "anti-stuttering device" because it suggests a device that you put on and your stuttering is instantly and completely gone. I would like the devices to be called "stuttering treatment devices" because this suggests that the devices are one way (among many) to treat stuttering, that the devices can be used with other stuttering treatments, etc. However this term hasn't caught on. My suggestion is to title the article "Stuttering treatment devices" but make "Anti-stuttering devices" a search phrase that links to this article.-- TDKehoe 17:08, 3 December 2007 (UTC)
delayed auditory feedback (DAF) merger... sure whatever. I've never read about Electronic fluency device but I'm not usually reading that stuff either. -- CyclePat ( talk) 06:46, 7 December 2007 (UTC)
I added some references and removed some overbroad generalizations. I also added references for the two graphics. I was going to add references to some sections such as the size of devices or that some devices remove background noise, but these references would be to commercial websites (including my company's website); would that be a conflict of interest?-- TDKehoe ( talk) 20:22, 8 December 2007 (UTC)
I disagree with several of your recent edits:
I have other concerns but that is enough for now. I am beginning to get a bit frustrated by this process of continually needing to give this kind of feedback, which seems to leave so little time for actual article editing. Slp1 ( talk) 21:46, 8 December 2007 (UTC)
I've added a biofeedback section. When I have time I'll add studies of CAFET system and other non-EMG devices. Again, to add references for some items I'll need to reference commercial websites such as Dr. Fluency and Hollins. Is this acceptable?-- TDKehoe ( talk) 21:08, 8 December 2007 (UTC)
1. "Electronic fluency devices (also known as..." The FDA uses the term "anti-stammering device." "Assistive devices" and "electronic aids" are too broad terms to be meaningful in this context.-- TDKehoe ( talk) 16:39, 23 December 2009 (UTC)
2. "Computerized feedback devices" This term is incorrect. The paragraph describes biofeedback devices, some of which are computerized and some aren't. Biofeedback is the measurement and display of a bodily process to improve the user's awareness and control of that process. The paragraph is correct that microphones are used for vocal volume (loudness) but neglects to mention that other instruments are sometimes used, such as the chest straps used by the CAFET and Dr. Fluency to monitor breathing, or electromyographs used to monitor speech motor activity. "Computerized feedback devices" described many devices that don't provide biofeedback, such as SpeechEasy, Casa Futura Technologies' SmallTalk, and VoiceAmp, which are computerized and provided altered-auditory feedback. This paragraph would be more clear if it mentioned biofeedback devices by name, such as CAFET and the Hollins FluencyNet. The sentence "No peer-reviewed studies have been published showing the effectiveness of commercial systems in a clinical context." is literally correct but misleading. The paragraph describes non-commerical devices as well as commercial devices, and then makes a specific statement about commercial devices while ignoring the many studies of non-commerical devices (some of which lead to the development of commercial devices). For example, Craig, A., et al. “A Controlled Clinical Trial for Stuttering in Persons Aged 9 to 14 Years,” Journal of Speech and Hearing Research, 39:4, 808-826, August 1996 and Hancock, et al. “Two- to Six-Year Controlled-Trial Stuttering Outcomes for Children and Adolescents,” Journal of Speech and Hearing Research, 41:1242-1252, December 1998 is an excellent study of an electromyographic biofeedback device. They studied 98 children between the ages of 9 and 14 years old, had a control group, and did follow-ups at one year and four years.-- TDKehoe ( talk) 16:39, 23 December 2009 (UTC)
3. "Altered auditory feedback devices...Edinburgh Makser." That should be "Masker." The device is not discontinued, it has been incorporated into the VoiceAmp. Also, this paragraph confuses two types of masking, white noise and sine wave. The latter is used in the Edinburgh Masker. -- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
4. "Frequency-altered feedback...most studies have noted that DAF is more powerful than FAF in reducing stuttering." The referenced paper says (Lincoln, page 73: "Howell et al. (1987) are credited with discovering the effect of FAF on stuttering and subsequently reported that FAF was more effective in reducing stuttering than DAF. While the effect of FAF has subsequently been replicated, the finding that it is more powerful in reducing stuttering when compared to DAF has not." Lincoln is saying that the subsequent studies found DAF and FAF to be more or less equally effective, i.e., that one has not been found to be consistently more effective than the other. Also, this paragraph describes pitch-shifting FAF, which is used in Casa Futura Technologies devices and the Yamaha rack-mounted effects processors, and all of the published studies investigated. The paragraph fails to mention that there is another type of FAF (frequency-shifting) which is used in SpeechEasy and VoiceAmp devices and has never been investigated in a peer-reviewed study.-- TDKehoe ( talk) 17:20, 23 December 2009 (UTC)
5. "Effectiveness...studies have been critiqued for failing to demonstrate ecological validity; in particular that AAF effects continue over the long term and in everyday speaking situations." The following studies (listed in the references) were either long-term or in everyday speaking situations or both: Zimmerman, 1997; Van Borsel, 2003; Radford, 2005; Stuart, 2006; O'Donnell, 2008; Pollard, 2009.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
6. "Effectiveness...Using AAF via the SpeechEasy was effective in reducing stuttering in scripted telephone calls and giving presentations according to two studies.[18][20]" Neither of these studies were of the SpeechEasy device. The SpeechEasy was introduced in 2001 and the studies were published in 1997. Study #18 used a Casa Futura Technologies Desktop Fluency System. I don't have a copy of study #20 but it was likely either the same Casa Futura Technologies device or Yamaha rack-mounted effects processor.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
7. "Effectiveness... There are few published studies on the effect of the AAF in the daily activities of life." The references list three such studies: Zimmerman, 1997; O'Donnell, 2008; Pollard, 2009.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
8. "Effectiveness...the longterm effects of altered feedback are unclear." The references list five long-term studies: Van Borsel, 2003; Radford, 2005; Stuart, 2004 and 2006; O'Donnell, 2008; Pollard, 2009. The five studies had different results because different devices were used, different speaking situations were tested, speech therapy was or wasn't used in conjunction with the devices, etc. It might be more accurate to say that "the long-term effects of altered-auditory feedback are different for different devices, different speaking tasks, whether the devices are used in conjunction with speech therapy, or other factors."-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
9. "Effectiveness...the effect of AAF may fade after a few minutes of exposure,[24]" The referenced study was of 10-minute exposure to AAF. I'm skeptical that a study lasting 10 minutes can be extrapolated out to months or years. I.e., I suggest moving this reference to the section on short-term studies.-- TDKehoe ( talk) 16:54, 23 December 2009 (UTC)
10. "Effectiveness...some anecdotal reports suggest that over time users receive continued but lessened effects from their device." Please reference the Wikipedia policy allowing anecdotal reports to be cited when scientific studies published in peer-reviewed journals are available that contradict the anecdotal reports. Why does this paragraph start with general statements apparently referring to all fluency devices, and then talk only about SpeechEasy devices, and not mention the long-term studies of other devices, e.g., Van Borsel, 2003; Radford, 2005? The way this paragraph is written it confuses the reader between general statements about all fluency devices and statements about specific devices, sometimes mentioning the devices by name but at other times not mentioning the devices by name.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
11. "Effectiveness...They reported that the device was difficult to use in noisy situations as the device amplifies all voices and sounds." This paragraph also starts with a general statement and then talks about a specific device without mentioning what device is being discussed. This confuses readers as to whether all devices have this issue or whether only one device has this issue.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
12. "Use with children...There is little experimental evaluation of the therapeutic effect of AAF on children who stutter." Radford (2005) is a long-term (one year) study of an eleven-year-old boy.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
13. There are 13 mentions of SpeechEasy devices in this article, one mention each of four other devices (three no longer on the market), and no mentions of VoiceAmp or Casa Futura Technologies devices (these three companies have more or less equal market share, with Fluency Master a more distant fourth). The reference list has three studies of Casa Futura Technologies devices (Zimmerman, 1997;Van Borsel, 2003; Radford, 2005) and four studies of SpeechEasy devices (Stuart 2004 and 2006; Armson, 2006; O'Donnell, 2008; Pollard, 2009). I'm aware of 14 other studies of Casa Futura Technologies devices, I'm not aware of any other studies of SpeechEasy devices. Also the sentence "Current devices may be similar in size and appearance to a hearing aid, including in-the-ear and completely-in-the-canal models" is another reference to SpeechEasy, which makes the only ITE and CIC devices. Vocaltech and Casa Futura Technologies devices don't look like hearing aids, they look more like iPods. Did a SpeechEasy employee or a dealer edit this article to promote SpeechEasy? Maybe someone could go through the edit history and see if one person made all 13 mentions of SpeechEasy.-- TDKehoe ( talk) 04:50, 23 December 2009 (UTC)
14. In general this article is confusing. It makes general statements and then supports the general statement with a specific study of one device used in one speaking situation. It would be less confusing to readers if descriptions of studies specified what device was used, what the speaking situation was, whether speech therapy was used in conjunction with the device, etc. There are only seven studies in peer-reviewed scientific journals that I know of that investigated long-term and/or high-stress use of the devices (Zimmerman, 1997;Van Borsel, 2003; Radford, 2005; Stuart 2004 and 2006; Armson, 2006; O'Donnell, 2008; Pollard, 2009). It might be better to summarize the seven studies, then present the conclusions that can be drawn from a meta-analysis of the studies, e.g., the issues of "wearing off" of effectiveness over time, long-term carryover fluency (training the user to no longer need the device), high-stress vs. low-stress speaking situations, and using devices in conjunction with stuttering therapy vs. no therapy. Those four issues pretty much cover effectiveness. Another important issue is hearing loss (both temporary and permanent) but no studies have investigated this. I've written summaries of the seven studies at [20], I'll give permission to copy my summaries, although they may be too technical for Wikipedia standards. I believe that I uploaded the graphics to Wikipedia a few years ago. If an editor wishes to read the original studies, I have PDF versions of most of them.-- TDKehoe ( talk) 17:13, 23 December 2009 (UTC)
Welcome back, Thomas, and I hope all is well with you. Thanks for your extensive comments and feedback on the article. I appreciate that you have chosen to comment rather than edit the article directly. I have added some numbers to your comments, and will attempt to respond them briefly using these as indicators.
The article article about Hearing_aids has a section about third-party payers such as national health services that subsidize the cost of hearing aids. Is it allowable for the Electronic_fluency_devices to have a similar section?-- TDKehoe ( talk) 18:20, 19 January 2010 (UTC)
The paragraph on "Masking" contains several mistakes. The Edinburgh Masker did not produce white noise, it produced sine waves synchronized to the user's fundamental frequency of phonation; effectiveness did not fade with time; and no study compared its effectiveness to DAF or FAF. “The Long Term Use of an Automatically Triggered Auditory Feedback Masking Device in the Treatment of Stammering,” Ann Dewar, A.D. Dewar, W.T. S. Austin, H.M. Brash, British Journal of Disorders of Communication, Vol. 14, No. 3., winter 1979/80 stated: “The sound produced by the instrument is a ‘humming’ noise of mixed low frequencies and harmonics of up to approximately 500 Hz with peak frequencies of 125-250 Hz but varying with the mean frequency of the subject’s vocal cords.” (page 220) That study found that of 195 stutterers (144 classed as severe, 43 as moderate, and 8 as slight) 89% “responded well to the device.” Of the 21 who did not respond well initially, 9 had silent blocks, 2 of whom then received therapy and were able to use the device; 6 showed a “satisfactory response to the device” but refused to use the device for “cosmetic or other reasons”; 3 wore hearing aids; and the remainder had stuttering accompanied by other disorders (dysarthria, Parkinsonism, mentally retarded). 67 subjects were then followed for periods from 6 to 28 months (average, 12 months). All responded to a questionnaire, and some were contacted by telephone, mail or direct clinical observation. The result was that 42% reported that the device was of “great” benefit, 40% of “considerable” benefit, and 18% of “slight” benefit. 67% reported carryover fluency (“as a result of using the Masker, their unaided speech fluency had improved”). Five said that they had “become fully fluent as the result of the using the Masker and have not needed to use the device for some time.” 70% said that there was no adaptation or “wearing off” of effectiveness, 25% said it was “slightly less” effective and 5% said it was “much less” effective. The devices of 14 subjects who’d reported loss of effectiveness were examined and all were found to be faulty, e.g., low batteries or broken wires. The average user used the device 3.3 hours per day. The volume in the users’ ears was measured in ten subjects and found to average 77.6 dBA, with a range of 70 to 85 dBA. The hearing of 5 subjects was tested and no indications of hearing damage were found. Another study (Block, S., Ingham, R.J., & Bench, R.J. (1996). The effects of the Edinburgh Masker on stuttering. Australian Journal of Human Communication Disorders, 24, 11-18.) found that the device reduced stuttering 50% both in the speech clinic and beyond. Herb Goldberg, who provided nearly 3000 devices to American stutterers, wrote to me on September 9, 1994, “I am in contact with over 500 people who use or have used the Masker. In most cases the end result is the person uses the device less and less as time passes due to less need for it.”-- TDKehoe ( talk) 19:04, 22 February 2010 (UTC)
No one has responded to this request for a correction. I'll go ahead and make the changes.-- TDKehoe ( talk) 21:54, 25 December 2021 (UTC)
![]() | This edit request by an editor with a conflict of interest has now been answered. |
This sentence is misleading:
A 2006 review of stuttering treatments noted that none of the treatment studies on altered auditory feedback met the criteria for experimental quality.
The above sentence should be removed or changed to:
A 2006 review of stuttering treatments noted that three treatment studies of the SpeechEasy device did not the criteria for experimental quality.
The sentence in question suggests that the Bothe (2006) article was a review of all altered auditory feedback (AAF) treatment studies. There are hundreds of such studies, many done in speech labs with large, heavy devices. For example, the original delayed auditory feedback (DAF) devices in the 1960s were modified reel-to-reel tape recorders. The Bothe (2006) article reviewed three studies, all of the wearable SpeechEasy device. The article stated why most AAF studies were excluded: “Laboratory-bound investigations of fluency-inducing conditions…were excluded as not meeting [the review] criterion.” In other words, they only wanted to review studies of wearable AAF devices.
The Lincoln (2006) article reviewed 17 treatment studies of wearable AAF devices from at least four companies. The Lincoln (2006) review is discussed in this article and is, in my opinion, a superior review article. This article only mentions the Bothe (2006) review once, and the sentence is misleading if not inaccurate. The sentence should be removed. Alternatively the sentence should be modified to clarify that only three studies, all of devices from the same company, were examined. The sentence shouldn't suggest that all studies of the SpeechEasy device were examined. This article references seven studies of SpeechEasy devices, plus two letters to editors about the devices.-- TDKehoe ( talk) 03:20, 30 December 2021 (UTC)
Making broad generalizations such as "electronic fluency devices have this effect" or "electronic fluency devices don't have that effect" are misleading and confusing. It would be better to specify, "this device was shown to have this effect" or "that device was shown to have that effect." I went through the article and specified that Edinburgh Masker and SpeechEasy devices were used in studies of Edinburgh Masker and SpeechEasy devices. I don't have any financial connection to those devices. I didn't specify that studies about Casa Futura Technologies devices used Casa Futura Technologies devices, nor did I add any references to studies of Casa Futura Technologies devices, as I have a financial interest in this company. References [10] [19] [20] [24] [27] [37] [42] used Casa Futura Technologies devices. The article would be more clear if the sentences with these referenced that Casa Futura Technologies devices were used.-- TDKehoe ( talk) 22:26, 25 December 2021 (UTC)
No one has responded to this talk section so I went ahead and clarified that two studies used Casa Futura Technologies devices. The studies were independently done and not funded by Casa Futura Technologies.-- 71.211.157.117 ( talk) 17:01, 27 December 2021 (UTC)