Stuttering Inhibition during the Perception of Infrared Kinematic Marker Movements Research by: Daniel Hudock, Ph.D. 1, Lin Sun, M.Ed. 2, Skye Lewis, M.S. 1, Laura Ball, Ph.D. 3, Nicholas Altieri, Ph.D. 1, Joseph Kalinowski, Ph.D. 2 1 – Idaho State University 2 – East Carolina University 3 – Massachusetts General Hospital

Auditory Speech Signals and Stuttering Choral speech reduces overt stuttering from % (Bloodstein & Bernstein-Ratner, 2007; Cherry & Sayers, 1956) Delayed Auditory Feedback (DAF) and Frequency Altered Feedback (FAF) reduce stuttering from 70 – 80% (Kalinowski, Armson, Roland- Mieszkowski, Stuart, & Gracco, 1993; Hargrave, Kalinowski, Stuart, Armson & Jones, 1994; Howell, El-Yaniv & Powell, 1987; Macloed, Kalinowski, Stuart & Armson, 1995; Stuart, Kalinowski, Armson, Stentsrtom & Jones, 1996) Auditory second speech signals effect on stuttering Filtered speech (Rami, Kalinowski, Rastatter, Holbert & Allen, 2005) Sinusoidal speech synthesis (Saltuklaroglu & Kalinowski, 2006) Temporally compressed and expanded speech (Guntupalli, Kalinowski, Saltuklaroglu & Nanjundeswaran, 2005) Stuttered or fluent speech (Saltuklaroglu, Kalinowski, Dayalu, Stuart, & Rastatter, 2004) Forward flowing or reversed speech (Kalinowski, Saltuklaroglu, Guntupalli & Stuart, 2004)

Non-Speech Signals and Stuttering Masking Auditory Feedback (MAF) – Also known as white-noise (Bloodstein & Bernstein-Ratner, 2007; Cherry & Sayers, 1956; Kalinowski, et al., 1993) Pure-tones (Saltuklaroglu & Kalinowski, 2006) Auditory reverberation (Kuniszyk-Jozkowiak,Smolka & Adamczyk, 1996) Visual feedback (Kuniszyk-Jozkowiak,Smolka & Adamczyk, 1996) Tactile feedback (Kuniszyk-Jozkowiak,Smolka & Adamczyk, 1996)

Visual Speech Signals and Stuttering Visual Choral Speech (VCS) (Kalinowski, Stuart, Rastatter, Snyder & Dayalu, 2000; Saltuklaroglu, Dayalu, Kalinowski, Stuart & Rastatter, 2004) Same versus different linguistic content (Saltuklaroglu, et al., 2004) Visual non-speech gestures (Guntupalli, Nanjundeswaran, Kalinowski & Dayalu, 2011) Simultaneous Visual Feedback (SVF) (Hudock, Dayalu, Saltuklaroglu, Stuart, Zhang & Dayalu, 2011; Snyder, Hough, Blanchet, Ivy & Waddell, 2009) Delayed Visual Feedback (DVF) (Hudock, et al., 2011; Snyder, et al., 2009)

General Explanation of Speech Production From Golfinopoulos Tourville and Guenther, (2009)

Theoretical Models of Why Stuttering is Reduced Under Feedback From: Max, Guenther, Gracco, Ghosh, and Wallace (2004)

Theoretical Models of Why Stuttering is Reduced Under Feedback Continued Mirror System Hypothesis (Saltuklaroglu & Kalinowski, 2003) EXPLAN model (Howell, 2004) Ventral and Dorsal Streams Hypothesis (Hickok & Poeppel, (2007)

Hypothesis The current study sought to explore the effect of visual feedback on stuttering during presentation of full-face and kinematic markers with and without delay. It was hypothesized that stuttering frequency would be differentially affected by full-face and kinematic markers and SVF and DVF conditions. It was also hypothesized that stuttering would be reduced to greater extents during delay conditions as compared to SVF.

Methods Participants - 7 English speaking male adults who stutter participated in the current study Stimuli - Sentence were retrieved from Kalinowski et al. (2000) Procedure – Eight kinematic markers (see figure 1) were placed proximally to participants lips. They then read and memorized 8 – 12 syllable length phrases, which they verbally recited while viewing the feedback monitor. In order to reduce any possible carryover effects researchers had participants produce two-minute spontaneous conversation samples without feedback between the five conditions. Figure 1

Results Inferential Analysis Repeated measures ANOVA [F(1.486,8.914) = , p = 0.001) Post-hoc analysis with Bonferoni corrections applied Baseline relative to all conditions (p < 0.05)* Full-face compared to kinematic markers (p > 0.05) SVF compared to DVF (p < 0.05)* Descriptive Results SVF – 40% DVF – 61%

Discussion Stuttering was reduced to the same extent during both kinematic marker and full-face conditions Flexibility of the speech perception system DVF reduced stuttering to a greater extent than SVF Temporal alignment and coverage of feedback during nonproduction times (I.e., between words where speech was not being produced feedback was still being seen) Speech signals that are perceived as being externally produced reduce stuttering to a greater extent