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No I'm not listening to music

Christine Simpson, Jan Logan | 01.03.2009

When she had to return a custom-built device, Christine Simpson thought she'd try installing altered auditory feedback (AAF) software on her mobile phone and work computer.

Last September I was offered an opportunity to try out a VoiceAmp fluency device for a few days. For those of you not familiar with these AAF devices, they use Delayed Auditory Feedback (DAF) and often Frequency Altered Feedback (FAF). DAF delays your voice to your ears a fraction of a second. FAF shifts the pitch of your voice. DAF and FAF are forms of 'AAF' and are generally used together. The device plays your voice back to you through an earpiece with a delay and/or at a different pitch.

I took the opportunity and jumped in with both feet, using it the next day when chairing a large meeting. It was great as I could suddenly speak much more fluently, which made a great difference (I felt) to the way I chaired the meeting and made it an easier experience for everyone else. Indeed I felt people were paying more attention to what I said. I went on using the device for a week and had a variety of speech experiences, some positive some not.

When I had to give the device back, it was the spur for me to get some DAF/FAF software for my mobile phone (which runs Windows Mobile), so that I could carry on using AAF. I got the 'Pocket' Windows Mobile software from Artefactsoft - they offer a free trial and it cost under £50. I have been using it on and off ever since. I have also had their PC software loaded on to my computer at work.

Ease of use

I found the VoiceAmp device very convenient. As long I remembered to charge it each night it worked all day with very little adjustment. In a work situation I would just switch it on and go.

Regarding Artefactsoft software on my phone (not necessarily a fair way to judge the software), I am pleased to have it but had some difficulty installing it and find it fiddly to start up. I need to switch off the phone, plug in the earpiece before opening the software to avoid a discordant noise, uncheck the box which would otherwise turn the software off after two minutes, and adjust the volume. (I still get confused if my phone rings in a meeting while I'm using the software.) Battery life is an issue - in some cases my phone will only last about 3 hours if the software is running. I cannot use the software for calls actually on the mobile phone - I use it for talking face-to-face, or calls on a landline. My experience is limited to my own device, an HTC phone running Windows Mobile. People can use the free trial of the software to test it on their own device. Also, despite these points, I have been extremely glad to have the software available for many conversations and meetings.

"...despite these points, I have been extremely glad to have the software available for many conversations and meetings."

Effect on my stammer

What is my experience of using AAF? I am talking here mainly about the software on my phone as I only used the VoiceAmp device a few days.

AAF's effect on my speech is good when I have a reasonable length of talking, e.g. chairing a meeting or in 1 to 1 situations at work. I find it much harder for short conversations and when I answer the phone. I do find AAF helpful on the phone if I use it on some easier calls before moving on to more difficult ones.

Another instance where my stammer was severe even with AAF was a meeting where I had been expecting to answer questions on one topic, for which I had prepared, but the questions were on something quite different.

My advice would be not to follow my example and just use the device. You need the support of a speech therapist. See Jan Logan's article below for the support she gave me which was invaluable. I found that using AAF could make my levels of fluency fluctuate, and this can be worrying and challenging. It is much better and less stressful to use it in a planned way.

Lastly, I have found it best to let everyone know I'm using my phone for AAF (people can see the wire and earpiece). The title for this article came from a colleague asking me if I was listening to music. It can look like you have your iPod on while you are talking to them, and this can be alienating.

Information on AAF, including free and paid software:

AAF - a therapist's view

by Jan Logan, City Lit

Christine (see article above) and I had been working together for some weeks revising stammering management strategies and desensitisation. One week she announced that during the week she had been experimenting with altered auditory feedback (AAF) software on her mobile phone. I was mindful of Mary Kingston and Heidi Kings advice that "therapy before and after getting the device is essential". Having known Christine for a number of years, I realised her more impulsive side had come to fore and led her (in her words) to "jump in with both feet"! I wanted to support my client's choice so decided to follow the therapeutic principle of 'starting where your client is', and so asked Christine how she felt I might support her.

Christine was clear she wanted AAF to sit alongside her other stammering management strategies, and be one of a range of tools she might use to support her speech - a useful tool but not the main one. Christine's experience of using the software had been generally positive but she recognised it was not a 'cure all'. She wanted some of our sessions to focus on the question of how much to use AAF, as she did not want to become dependent. She also had some concerns about the extent to which AAF may be less effective if over-used. She had other questions she hoped we might answer together such as: what kind of situations might it be most practical to use AAF in - high challenge or low challenge? Christine also wanted feedback about how she sounded when using AAF. She wondered, did she sound odd? How was the speech rate? Was it too slow?

She reported that the AAF had been very helpful in a number of work situations, but found that in higher stress situations such as particular phone calls or challenging meetings it had not helped. Together we came to the conclusion that she needed to use a hierarchy of situations in which to start using AAF, starting with the easier situations. It was also important for her to be open with people about it, in order to clarify what she was using and challenge any expectations they might have of her speech being totally fluent. Whilst she had a great deal more fluency when using the AAF she still sometimes stammered - but found managing these moments easier.

Christine was keen to know how her speech sounded when using AAF. I gave her some feedback but also we used the video camera so Christine could observe and hear herself speaking when using AAF and when not. This proved to be invaluable as it not only raised her awareness of her rate of speech but allowed her to evaluate how her speech sounded and so satisfy herself that it was within 'normal' limits.

Mix of skills

Prior to one of our meetings, Christine's phone 'seized up' and she was unable to use the AAF. She initially felt anxious and wondered whether she had started to become reliant on it. This led us to reflect more on how much she had been using AAF. We felt it was important for her to get back in touch with some of her skills that were not dependent on an external device. Christine set some aims to work on avoidance reduction and stammering management strategies alongside use of the software.

What did I learn, and what had been my role? Firstly, I believe it was important to support my client's choice. I would also endorse Mary and Heidi's advice: for people using external speech aids, therapy support supplements rather than replaces more general speech therapy. Furthermore, planning and preparation before and whilst using the device in the early stages is key. My role included offering support, giving feedback, helping to clarify difficulties, collaborative problem solving, as well as jointly planning and evaluating my client's experiences. I found this a real learning experience and welcomed the challenge to explore a different therapy focus.

Why pay more?

Speaking Out asked VoiceAmp and SpeechEasy how they felt their products were preferable to software on a portable device.

Both suppliers said their devices incorporate features that seek to reduce background noise (e.g. conversations, music) heard through the device, making the device more comfortable to wear in a variety of situations.

VoiceAmp said its dedicated device devoted all its processing power to delivering a high fidelity programmable AAF sound, leading to greater fluency and user control. It offered discreet wireless 'in-ear' options not available on Pocket PCs, good battery life, robustness and more customisable settings. VoiceAmp's 'Dynamic Pitch' (aimed at improving fluency and reducing the 'wearing off effect') was another plus. Prices of entry level devices had come down, and options could be added with no performance compromises, reducing obsolescence.

SpeechEasy said a feature of its device was its size (everything is contained in an in-the-ear or round-the-ear device). They found people did not want to wear bulky devices or headsets, and did not want to explain to others why they are wearing a device. Further, each device was custom programmed and manufactured for the specific client. Devices were programmed only after an evaluation in which the delay and pitch for the client was prescribed, and then produced using a mould of their ear.
The software on my PC at work (also from Artefactsoft) is much easier. Once it had been installed on the PC, I can open it up and it is on all the time. When I wish to use it I just put on the headphones. It isn't portable of course, but I use it for phone calls at work.

These are extended versions of articles on pages 8 and 9 of the Spring 2009 issue of Speaking Out.