Van Borsel John, Sierens Sarah, Pereira Mônica Medeiros de Britto
Ghent University Hospital, Ghent, Belgium.
Pro Fono. 2007 Jul-Sep;19(3):323-32. doi: 10.1590/s0104-56872007000300011.
There is some indication that the use of delayed auditory feedback (DAF) is a potentially helpful technique in the treatment of stuttering. Several devices for DAF are also commercially. However, not all individuals who stutter experience a positive effect on speech fluency when speaking under DAF. And those who do show a positive effect, may differ considerably as to the degree and the conditions in which the effect is seen. Therefore, the decision whether or not to attempt the use of DAF in an given client is usually not straightforward.
Starting from a literature review, the present paper discusses and illustrates factors to take into account when considering the use of RAA in an individual client. Four types of factors are distinguished: factors inherent to the client such as gender, age, stuttering severity, dysfluency pattern, origin of stuttering, and biological subtype; factors outside the client including delay time, intensity, manner of delivery, speech mode, and speech situation; possible side-effects like a reduction in speech rate, an increase of speaking fundamental frequency and vocal intensity, lengthening of vowels, and a possible effect on speech naturalness; others namely cosmetics, finances, and the long-term effect.
The review shows that most likely multiple factors play a role, but with the currently available data it is very hard to predict whether a given individual will or will not benefit from the use of DAF. Overall, the evidence for the influence of the different factors is still meager. Moreover, some studies present data of a quality that can hardly be considered "evidence".
有迹象表明,使用延迟听觉反馈(DAF)是治疗口吃的一种潜在有效技术。市场上也有几种用于DAF的设备。然而,并非所有口吃者在DAF环境下说话时,言语流畅性都会产生积极效果。而且那些确实显示出积极效果的人,在效果的程度和出现效果的条件方面可能有很大差异。因此,对于特定患者是否尝试使用DAF的决定通常并非易事。
本文从文献综述出发,讨论并阐述在考虑对个体患者使用反应性听觉活动(RAA)时应考虑的因素。区分了四种类型的因素:患者自身固有的因素,如性别、年龄、口吃严重程度、言语不流畅模式、口吃起源和生物学亚型;患者之外的因素,包括延迟时间、强度、传递方式、言语模式和言语情境;可能的副作用,如语速降低、说话基频和嗓音强度增加、元音延长以及对言语自然度的可能影响;其他因素,即外观、费用和长期效果。
综述表明,很可能多种因素起作用,但根据目前可用的数据,很难预测特定个体是否会从使用DAF中受益。总体而言,不同因素影响的证据仍然不足。此外,一些研究提供的数据质量很难被视为“证据”。