Token reinforcement during the instatement and shaping of fluency in the treatment of stuttering

Revisiting speech rate and utterance length manipulations in stuttering speakers

The goal of this study was to evaluate stuttering frequency across a multidimensional (2x2) hierarchy of speech performance tasks. Specifically, this study examined the interaction between changes in length of utterance and levels of speech rate stability. Forty-four adult male speakers participated in the study (22 stuttering speakers and 22 non-stuttering speakers). Participants were audio and video recorded while producing a spontaneous speech task and four different experimental speaking tasks. The four experimental speaking tasks involved reading a list of 45 words and a list 45 phrases two times each. One reading of each list involved speaking at a steady habitual rate (habitual rate tasks) and another reading involved producing each list at a variable speaking rate (variable rate tasks). For the variable rate tasks, participants were directed to produce words or phrases at randomly ordered slow, habitual, and fast rates. The stuttering speakers exhibited significantly more stuttering on the variable rate tasks than on the habitual rate tasks. In addition, the stuttering speakers exhibited significantly more stuttering on the first word of the phrase length tasks compared to the single word tasks. Overall, the results indicated that varying levels of both utterance length and temporal complexity function to modulate stuttering frequency in adult stuttering speakers. Discussion focuses on issues of speech performance according to stuttering severity and possible clinical implications.

LEARNING OUTCOMES

The reader will learn about and be able to: (1) describe the mediating effects of length of utterance and speech rate on the frequency of stuttering in stuttering speakers; (2) understand the rationale behind multidimensional skill performance matrices; and (3) describe possible applications of motor skill performance matrices to stuttering therapy.

Does behavior therapy still work when the experimenters depart? An analysis of a behavioral treatment program for stuttering

The power of behavior therapy to change maladaptive behavior in the short run is well documented. Although successful medical treatments soon become incorporated into service programs, similar transitions are not so evident in the behavioral literature. A successful behavioral treatment program for adult stutterers is described. This program had been developed from a series of empirical investigations. However, for the last five years it has been operating as a service program. It therefore presented a unique opportunity to document the transition to the service phase of a behavior therapy program. Outcome results in the empirical phase were comparable in the short run and superior in the long run to those derived from the experimental phase. Implications for clinical research in the behavioral therapies are discussed.

On token reinforcement and stuttering therapy: another view on findings reported by Howie and Woods (1982)

Howie and Woods (1982) have provided data that, they claim, indicate that a token reinforcement system is redundant in instating and shaping fluent speech within a stuttering treatment program developed by Ingham and Andrews (1973a, b). However, there were substantial procedural differences between the treatment programs referred to in both studies, as well as methodological weaknesses in Howie and Woods' study. These factors provide ample sources of explanation for Howie and Woods' failure to demonstrate benefits from their token reinforcement system.

A response to "On token reinforcement and stuttering therapy: Another view on findings reported by Howie and Woods (1982)"

Ingham's (1983) critique of our research is based on the unwarranted assumption that it claimed to be a replication of Ingham and Andrews' (1973a) study. Our report did not claim to be a replication. Procedural differences between treatments do not preclude the possibility of drawing general conclusions that may apply to related treatments, or suggesting possible confounding variables that might be operating in another study. We have nevertheless dealt with each of Ingham's methodological objections. In general, we believe that we struck an acceptable compromise between the needs of clients and theoretical and research demands. We stand by our original conclusions, and note with satisfaction that Ingham concurs with our emphasis on systematic structure rather than the presence or absence of rewards as the crucial component of this type of stuttering treatment.