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Course Type: Video – 1 1/2 hours

ASHA Course Code: Fluency Disorders (e.g., stuttering, cluttering) – 1010

Advances in technology have allowed speech-language pathologists and developers to address intervention approaches in new and exciting ways.

In this presentation, we will share ways we are addressing accountability and motivation to practice. We are presenting on how an artificial intelligence and speech-recognition-based video game can be used to motivate fluency practice in conjunction with and beyond the clinic. This hybrid approach of combining modern technology with traditional speech therapy for children who stutter (CWS) is a novel approach of practicing speech independently while receiving immediate feedback. In addition, we will share templates of data of weekly practice to illustrate the added benefit of automatic record keeping and how measurable outcome data can be shared during an IEP meeting and how accountability data can be documented. Furthermore, we will demonstrate how this automatic means of displaying records can be used as a tool to advance and guide accountability during treatment.

Level, Authors, and Disclosures

Erich Reiter, M.Sc.,. CCC-SLP received financial compensation from Bilinguistics for this presentation.


Erich Reiter, M.Sc. CCC-SLP, Computational Linguist

Erich holds a M.Sc. in Speech and Communication Disorders from the Massachusetts General Hospital Institute of Health Professions, and an M.Sc. in Computational Linguistics from the University of Buffalo. Erich started his career in 2004 working as a speech recognition engineer in the Silicon Valley for Nuance Communications, the original makers of SIRI. In 2012, after losing a friend to ALS, a new interest in technology for people with speech disorders emerged. Erich left Nuance in 2014 to become a speech and language pathologist.

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The video game — Fluency Friends — has been in development for several years and is based on the Fluency Development System for Young Children (Meyers and Woodford, 1992) which teaches motoric, prosodic, and cognitively-based fluency exercises specifically for young children. (Adults have been part of our study and with preliminary success as well). This therapy program is comprised of many techniques to help a person speak more fluently and sound more natural. It also contains elements of social discourse such as turn-taking and talking under pressure. The video game additionally incorporates mindfulness and breathing techniques to offer players learning opportunities on how to control anxiety and stress (Hardy, 2015), (Kuypers, 2011).
Early prototypes of the game were tested at a 1-week specialized camp for CWS and again in the home and clinic settings. Each prototype contained several speech-controlled mini-games focusing on rate of speech, pitch, amplitude, vocal-cord coordination.

The current version of Fluency Friends has evolved into a narrative-based video game that provides intrinsic motivation through gaming elements such as a relatable story for CWS — a quest to get their voice back —which includes many challenges and battles, collecting rewards and getting upgrades for voice use. There are many elements that are relevant to speech and language pathologists included in the game such as scaffolding, immediate feedback to players as they play the game, and automatic data-collection to track the progress of the player.

At the conference, we will report on our latest research using the video game. We have prepared a new research study on roughly 100 children who stutter and will soon start analyzing data. The goal of the investigation was to compare and contrast conventional treatment of hour of fluency therapy per week with a clinician, compared to one-hour weekly conventional therapy plus multiple weekly practice sessions with the video game. We will illustrate and discuss the results of the study by explaining how an artificial intelligence-based video game backed by speech recognition technology tuned specifically for people who stutter can motivate independent practice, promote speech motor skills, and prosody in children who stutter.

Subjects discussed are CWS who qualify as having moderate to severe stuttering in accordance with the SSI-4 (Riley and Bakker, 2009), without any other speech or language co-morbidities. Subjects have been assessed by fluency specialists and speech and language pathologists with expertise in fluency.

This presentation will include the measured effects of playing the game regularly for 3 months using user-reported outcome measures and acoustic and linguistic measurements that are relevant to the exercises in the video game.

Participants will:

  • Describe how a video game using artificial intelligence and speech recognition can be used to enhance traditional fluency therapy.
  • Provide two reasons that a video game that monitors practice in real-time can be an effective tool for children who stutter.
  • Describe the differences in speech productions identified in a research study that compared two groups of people who stutter—those who practiced fluency therapy every day playing a fluency-based video game compared to those who have traditional therapy 1x per week.

Time Ordered Agenda
10 minutes—Introduction and background of Speak Freely vs Speak Fluently vs Looking at the client needs
10 minutes Introduction to an innovative speech fluent approach
20 minutes—Overview and Background of the multidisciplinary integration: Speech Pathology, Linguistics, Speech Recognition Technology, Neuro research on
stuttering, and video game design.
10 minutes – Explain and review the video game study.
20 minutes – Results of the study
30 minutes – Questions and Answers

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