ISTAR researchers, clients turn to video to treat stuttering

Institute for Stuttering Treatment and Research investigates using self-modelling videos to help clients maintain fluency after treatment.

BY BRYAN ALARY

ISTAR client Tim Sesink talks about his positive experience using video self-modelling to improve his fluency.

(Edmonton) Fly fishing isn't just a hobby for Tim Sesink, it's a passion. And it comes through in his voice when talking about the complex set of variables-water speed, temperature and wind-that come into play when letting a cast fly.

The words flow fast and smooth, which is no small feat for someone who has stuttered since the age of four and endured teasing and bullying most of his life.

"For a long time, it brought a deep sense of shame into my life that I had this speech struggle that I couldn't get over," he says.

Getting over it was important, especially given Sesink's calling as a full-time pastor, a role that requires extensive communication skills. He took action by undergoing intensive treatment at the University of Alberta's Institute for Stuttering Treatment and Research (ISTAR), and now that he's achieved remarkable results he is working hard to maintain his fluency.

That's where fly fishing comes in. Sesink is one of ISTAR's first clients to undergo video self-modelling, or VSM, a form of treatment that involves watching videos of oneself speaking fluently. Athletes use VSM all the time to practise skills and acquire behaviour, and the technique has been used clinically to treat Tourette syndrome and depression, and improve communication skills in children with autism.

For the first time in North America, researchers at ISTAR are using VSM as another treatment approach for stuttering with adults. Results from a recent pilot study showed VSM helped reduce stuttering frequency in clients who had experienced relapse after therapy.

Just like any behaviour change, such as exercising or starting a new diet regime, relapse can be a concern with stuttering, said study co-author Marilyn Langevin, ISTAR's director of research. VSM is a tool that can help manage those relapses and build confidence along the way.

"It's hard to keep the motivation going, and video self-modelling helps clients see themselves perform the behaviour in a very confident, successful way," said Langevin. "It builds their belief and their ability to do it and helps with motivation."

The pilot study was conducted by Jessica Harasym, a speech-language pathologist with ISTAR who holds the Elks and Royal Purple Clinical Chair, in collaboration with Langevin and former ISTAR executive director Deborah Kully. Their findings were published in the Journal of Fluency Disorders.

For the study, participant videos were recorded post-treatment when their fluency skills-breathing techniques, how to start their voice, or move forward in speech-were at their peak, explained Harasym.

Participants were required to watch their videos at least twice a week. And the more they viewed, the better the results were, with a decrease in syllables stuttered and participants reporting their own perceptions that VSM helps in personal and professional situations, she said.

"This gave us some really useful information that we are now applying to our clinical practice and will help with designing followup studies as well."

"ISTAR is world-renowned for our innovative evidence-to-care approach to stuttering treatment," added ISTAR executive director Deryk Beal. "Video self-modelling is an exciting opportunity to further improve the long-term support of our clients' fluency outside the confines of the clinic."

Though his fluency has greatly improved since coming to ISTAR, Sesink says he has bumpy moments when tired, stressed or surrounded by lots of people. He sees VSM as an important tool to maintain his forward momentum.

"My speech isn't perfect. There are still many times when I stutter, but I've become okay with it and have realized that it's part of my experience," he said. "Thanks to ISTAR, I've learned to manage it much better and communicate my thoughts in a clear way."