1. __About stuttering
Stuttering is a speech disorder that is characterized by
involuntary repetitions and prolongations of syllables and
words, as well as pauses, causing an overall verbal
non-fluency. It affects approximately 2.5 million people in the
United States alone, but occurs across all languages and
cultures throughout the world. It can cause social, academic,
and occupational dysfunction, and also lead to avoidance
behavior and social anxiety.
Traditionally, a patient’s stuttering severity is evaluated using
the Stuttering Severity Instrument (SSI-3), in which factors
such as percentage of stuttered syllables, stuttering duration,
and physical concomitants are measured by the clinician.
The use of the SSI-3 is normally based off of a video and/or
audio recording of an interview with the patient. However,
certain studies (Brinton & Fujiki, 2003; a Tetnowski & Franklin
2003) show that the patient’s stuttering in a taped interview is
not wholly reflective of the patient’s stuttering in a real-life
environment, because the task does not accurately mimic
real-life situations or the feelings associated with them, such
as speaking anxiety.
__About virtual reality
Virtual reality (VR) is defined as an application that allows
users navigate and interact with a three-dimensional,
computer-generated environment in real time. This
computer-generated environment can be easily manipulated by
a clinician. In our application, persons who stutter will
experience a virtual auditorium as an uncomfortable public
speaking scenario. The clinician will be able to modify the
audience’s reactions and emotions with the press of a button.
We want to see if a virtual reality environment can mimic
real-life environments to more accurately assess a patient’s
stuttering. We’ll compare SSI-3 scores assessing two
videotaped recordings: (a) a patient-doctor interview versus (b)
a patient speaking in the virtual environment.
__Method
We’ll recruit about 50 patients to take part in the study, then
administer the aforementioned two exams:
(a) A face-to-face interview with a clinician or trained research
assistant.
(b) Immerse the patient in the virtual reality environment by
taking them to a darkened room, seating them to avoid
exacerbating cybersickness symptoms, and fitting them with
the Vuzix VR920 — an inexpensive head-mounted display with a
built-in tracker. We will allow them to become accustomed to
the environment for 10 minutes, then verbally proceed them
through scripted instructions to speak on a controversial
subject for 5 minutes, dictate a script on their virtual podium,
and explain a series of simple pictures displayed on the
projector in the virtual auditorium.
Questionnaires before and after will gauge their immersive
experience and their qualitative assessment of their speaking
abilities in both situations. This time will allow us to monitor
them for 15 minutes to allow them to re-adjust to reality and
avoid any vestibulo-cochlear symptoms.
Both of these videotaped recordings will be evaluated by the
SSI-3. Data will be compiled and analyzed.
__Pharmacologic assessment
An additional planned component to our experiment is the
assessment of Pagoclone, a medication that treats
stuttering, in clinical trials. Our system may be more sensitive
than a typical SSI-3 face-to-face interview in helping detect the
presence of the medication versus placebo, and could help with
more reliable stuttering assessments for future patients.
VuzixVR920
VuzixVR920demonstration
funded by a grant from
the Kirkup Foundation__
CENTER FOR THE MEDICAL
TREATMENT OF STUTTERING
_Gerald MAGUIRE, M.D., DFAPA
_Jimmy DOAN, M.D. Candidate Class of 2011
_Steven CHAN, M.D. Candidate Class of 2011
_David FRANKLIN, Psy.D., MHA
Assessing stuttering with
virtual reality environments.