[13 May 2018, The STAR]

An android mobile app is helping stutterers to speak better and communicate confidently

FAZWA Mohd Fadzillah was nine years old when she started stuttering. As she entered secondary school the struggles with her speech worsened. Friends and classmates noticed and inevitably, there were unkind remarks that affected the young girl.

"I was hurt by the teasing, so to avoid it I would just stay silent and not speak at all," she recalls.

The 25-year-old from Manjung, Perak, says in the beginning she did not seek any treatment for the stuttering.

"Later, I looked for doctors who could help me overcome the problem but the cost of treatment was high so I ended up not doing anything about it," she adds.

Today, the Masters in Information Technology student at Universiti Teknologi PETRONAS (UTP) has come a long way from those years of struggling with her speech. Fazwa is now able to speak more smoothly and can carry out a phone conversation with ease.

"Previously it would take me a long time to resume a conversation after I began stuttering; now it's more smooth. But I am not completely cured…maybe about 80-90% cured," she says.

Her improvements are attributed to an app developed at UTP, called the Stutter Manager. This mobile app features five types of vocal learning exercises and games to address stuttering problems. These are Metronome, Delay Auditory Feedback, Mirroring, Stutter Rate and Add Word Game.

A research team led by principal investigator Dr Noreen Izza Arshad, a senior lecturer at the Department of Computer and Information Sciences, Faculty of Science and Information Technology, first began developing the android mobile app in 2013. The team collaborated with KPerak Inc, a state-linked company that promotes the development of ICT and knowledge-driven activities in the state.

Armed with seed funding of RM10,000 from UTP and a RM68,200 grant from the Ministry of Higher Education, the team began by conducting interviews with the Ministry of Education – seeking feedback on issues and solutions for those with special education needs. The team also collaborated with speech pathologists before introducing a preliminary version of the app to rural schools near UTP as well as an orphanage in Ipoh.

The app was finally made available on the Google Play Store sometime in 2014. To date the app has notched 5,000 downloads, with 80% of these being from users in Malaysia.

"With the app, stutterers can carry out vocal learning exercises at any time and from anywhere. Through the app, the speech pathologists are able to monitor and track your progress, and provide comments and feedback," she says, adding that although the goal is not to replace speech pathologists, the app can reduce costs of travelling and meeting speech pathologists for face-to-face therapy sessions.

Next generation therapy

The exercises within the Stutter Manager have been developed from face-to-face speech therapy techniques. Elaborating on the different exercises, Noreen explains that the metronome technique allows a stutterer to practice words and sentences to a tempo or beat (per minute) that can be adjusted. The speech pathologist for instance, will advise a severe stutterer to follow a slow tempo – increasing it as his/her condition improves.

Mirroring and delayed auditory feedback, which are used in combination, allow the stutterers to not only see themselves when they speak but also listen to their speech. Through these techniques, stutterers are able to find out the words that require more practice and at the same time build their confidence when speaking to others and in public.

Targeted at children who have stuttering problems, stutter rate involves the use of flash cards. "This technique requires the help of a parent or teacher. A word will flash on the screen and you are required to repeat that word. Marks will then be recorded automatically and saved, and at the end of the session the results revealed. The results are also tracked over a period, whether it's a week, month or year, allowing parents and teachers to follow the child's progress," says Noreen.

A fun twist to the exercises is the add word game, created by UTP. Here, words are generated randomly, and the stutterer selects the words that they can pronounce correctly. Results at the end of the session will show the percentage of words that the stutterer can pronounce without difficulty.

"The speech pathologist is also able to analyse the words that cause stuttering, for example six-syllable words, and from there, advise and suggest other types of exercises," explains Noreen.

Practice makes perfect

Fazwa, who is one of the members of the research team and one of the app's earliest users, credits the app for the improvements to her speech.

"I use the delayed auditory feedback and stutter rate, and practice daily for about 30 minutes," she says, adding that after two years she's noticed an improvement to both her speech and confidence. "Other people around me have also noticed that I don't stutter as much anymore."

She also likes being able to monitor her progress. "With the graphs I am able to track my progress, and if I am not doing well then I practice more," she adds.

To date, the Stutter Manager has won several awards including Silver at the 25th International Invention, Innovation and Technology Exhibition (ITEX2014) and Gold at the Malaysia Technology Expo (MTE2015).

Noreen has also, since February 2017, received mentoring from Oxford Innovation through the Newton-Ungku Omar Fund. She is especially excited about working with Oxford Innovation, which has a 30-year track record of specialist coaching services and support of entrepreneurs.

"Through the mentoring we are looking at how to make the app profitable, and the different business models we can use," she says.

In the meantime, feedback from users is also being considered to refine and improve the app. The potential for the app is significant, says Noreen, adding that greater awareness of the app, especially among parents, is needed to encourage its use.

Stutter 101

STUTTERING is a communication disorder involving disruptions, or disfluencies, in a person's speech. Stuttering can be referred to as either the specific speech disfluencies that are commonly produced by people who stutter or to the overall communication difficulty that people who stutter may experience. It has been estimated that about 1% of the general population stutters.

In addition to producing disfluencies, people who stutter often experience physical tension and struggle in their speech muscles, as well as embarrassment, anxiety, and fear about speaking. Together, these symptoms can make it very difficult for people who stutter to speak, and this makes it difficult for them to communicate effectively with others.

Most treatment programmes for people who stutter are behavioural – designed to teach the person specific skills or behaviours that lead to improved oral communication. For instance, many speech language pathologists teach people who stutter to control and/or monitor the rate at which they speak.

When learning to control speech rate, people often begin by practicing smooth, fluent speech at rates that are much slower than typical speech, using short phrases and sentences. Over time, people learn to produce smooth speech at faster rates, in longer sentences, and in more challenging situations until speech sounds both fluent and natural.

Source: National Stuttering Association, US & American Speech-Language-Hearing Association

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