How many stutterers do you know? Most of us may be able to think of one or two, if any. But if you ask Yair Shapira, he’ll tell you that you know many more, you’re simply not aware of it. “One percent of the adult population stutters, and that’s a figure that usually surprises people. The reason is that most stutterers are in the closet,” he says.
Dr. Shapira, a biomedical engineer and himself the father of a stutterer, has been trying in recent years to develop a mobile app to help treat stuttering. He works with Prof. Yoav Medan, a doctor of medical bioengineering, and Dr. Ofer Amir, head of the depart of communication disabilities at Tel Aviv University. Their app, NiNispeech, which is now being launched, is one of two Israeli apps designed to help stutterers.
Shapira explained all the difficulties involved in coping with stuttering, and also revealed part of his own personal problem. First of all he spoke of the difficulty in turning the progress many achieve in therapy into a permanent situation.
“After several meetings with a speech therapist they learn techniques and how to speak fluently,” he says. “They’ll probably continue to speak fluently in the clinic, but not with you. They’ll continue to stutter – 84 percent of stutterers are unable to implement it in their lives.”
The same was true of his son. “During therapy he speaks well, but shortly afterwards he’s in bad shape again,” he says.
A minority of patients are able to continue using these techniques, but studies have shown that those who do so for about half a year manage to overcome their stuttering. “All the others regress after a few weeks or months, and of course after that they won’t go back for more therapy. It drives a parent crazy, but it’s super-difficult for a teen. You have to rewire your speech, and that requires an external stimulus,” he explains.
“Just like when you learn to drive at first you can’t turn on the lights without getting confused, after a month or two it enters your hard drive and you can drive. The same thing happens with speech. At first it sounds mechanical but if you’re stubborn you succeed. At that point you actually have two languages in your head: the natural, stuttering one and the one they taught you, which requires a lot of attention and energy. Speech is very spontaneous and you naturally speak with a stutter until you assimilate the new language. If you give up, that’s it.”
One type of therapy is to exploit the chorus effect – stutterers who speak along with others manage to speak fluently. Decades ago therapists tried to use this effect and cause the stutterer to think he’s talking in a chorus. There are now several apps based on this effect. The problem is that eventually you get used to it and the effect is lost, and even when it works success is limited and speech is slow and clumsy.
“There was a stage when my son decided not to speak,” says Shapira. “That’s common among stutterers – elective muteness. We forced him to go back to the communications therapist. She started reading with him, and he read beautifully. At some point she stopped reading and only muttered, and he continued to read beautifully. The second he realized that she was muttering he started stuttering again.”
NiNispeech is based on algorithms that identify the stutter and measure it in real time. The system also works on elements of the quality of speech, such as fluency and naturalness. The inventors hope to provide something that didn’t really exist until now: a measurable objective scale of the severity of the problem, the improvement, and so on.
Using the basic technology they constructed an environment, a combination of a video chat room and a social network with games and activities, designed to enable long-term practice. Activities include reading the news, word games or telling jokes, to encourage speaking. This is done not only alone in front of the screen but with other stutterers, volunteers or people the user invites.
One of the serious problems is, of course, the damage to confidence and self-worth. Shapira says they are planning to enable others to benefit from reading the news, and to give the users a sense of self-worth by giving the recordings to a library for the blind.
If the user is in therapy, the therapist can also receive all the information about use of the app. The economic model is also based on the plan of combining work with private individuals and work with professional therapists.
Focus on fluency
Moshe Rot, a software engineer who is a stutterer from birth, experienced the same regression after taking a course and founded Novotalk with partners from the Hakol Diburim Institute. They focus on fluency of speech, combining frontal therapy followed by work using a video chat room. It also enables them to teach the principles independently in the patient’s home.
The interface between stuttering and technology has one point that makes the community of stutterers quite unique. Usually the Internet is the ideal platform for forming communities on any subject, from hobbies to medical problems or defects. But the stutterers’ community is mainly in the closet and it’s hard to reach them.
“It’s not easy to find people because there is still a belief that a stutterer is not intelligent and has psychological problems, which is untrue,” says Rot. “That’s why many people won’t reveal their stutter. They simply keep quiet and don’t join groups.
“There’s so much ignorance. Where can a stuttering teen go? To doctors? Who talks to doctors about stuttering? They don’t study that. It’s an illness that apparently doesn’t affect life much, but it affects the choice of profession, life as a couple, so many things.”
The Israel Stuttering Association is holding a week on awareness of stuttering this week, with an emphasis on treatment methods, entitled “From Moses Until Today.” Three events are planned, in Haifa, Jerusalem and Tel Aviv.