Editorial Board

Persons who stutter speak very fluently in some situations, and in some situations, their stuttering becomes very severe. In general, stuttering tends to increase when communication pressure is felt or in situations where stuttering is expected (Bloodstein, 1995). Conversely, stuttering tends to decrease when a person speaks slowly or softly, speaks with others simultaneously, speaks to the beat, or speaks while whispering. Furthermore, stuttering may increase or decrease depending on the contingent stimulation given after the stuttering event. There are reinforcement factors that increase stuttering, and there are punishment factors that reduce stuttering. Stuttering treatments are sometimes performed using stuttering reduction upon presenting a contingent stimulus.

When punishments such as loud noise, electric shock, blame, time-out, and response cost were presented as stuttering consequences, stuttering was reduced. Stuttering decreased even when verbal punishment, such as verbal “stop,” was provided whenever stuttering appeared. It was found that stuttering was reduced even when a neutral or compensatory stimulus was presented instead of a stuttering punishment (Cooper & Cooper, 1993; Prins & Hubbard, 1988).

In addition to feedback from others concerning stuttering, stuttering decreased even when the people who stutter (PWS) were asked to count, record, or use the time-out by themselves whenever they stuttered (James, 1981, 1983). Prins and Hubbard (1988) reported that the stuttering decreased significantly at the time-out, and that this reduction was transferred to an unmediated speech situation, and that the effect persisted.

As a preliminary study on self-monitoring conditions, La Croix (1973) made the stutterer count with his fingers whenever he stuttered, Mowrer (1978) gave himself the colloquial punishment of "stop" whenever he stuttered, Hanson (1978) and James (1981b) recorded stuttering by themselves, and Martin and Haroldson (1982) and James (1983) reported that stuttering was reduced when a time-out was carried out by themselves. James (1981b) reported that 25 subjects experienced reduced levels of disfluency when self-monitoring, whereas eight subjects showed an increase in disfluency. It appears, then, that stuttering may represent a special case and that caution must be exercised when generalizing about the effects of self-monitoring of stuttering.

More studies have been conducted on the reduction of disfluency due to second-party monitoring, and these were the types of studies on response contingent stimuli or response contingent time-out (Bloodstein, 1995; Ingham, 1984; Onslow et al., 1997; Prins & Hubbard, 1988). These studies showed that stuttering was significantly reduced or eliminated by presenting a contingent stimulus for stuttering. However, James (1981a) suggested that the responsiveness to time-out varies from person to person. In particular, time-out was said to have little effect on severe stuttering. Therefore, James et al. (1989) divided the group with a high response to time-out due to stuttering and inadequate response among PWS. It was concluded that it was not universally useful for all PWS. In addition, a minority of adults and adolescents who stutter showed a less or inconsistent reduction in stuttering under response consequence (Ingham, 1984; Onslow et al., 1997; Onslow et al., 2001).

The effect of the contingent stimuli given to a stuttering event was to be explained through operational conditioning. However, it is challenging to explain the stuttering reduction in the aversive stimulus and the ‘neutral’ or ‘compensatory’ stimulus. Other researchers have tried to explain this phenomenon through the speaker's awareness. There have been many studies on the effect of self-awareness in verbal learning. It was explained that when monitoring for disfluency is performed, awareness is increased, and, as a result, the verbal output is improved.

There is monitoring by others, which is performed by others’ contingent stimuli, and there is also self-monitoring that monitors one's own disfluency.

Another explanation is that when the consequence is presented, it is attributed to the change in the speech production (Ingham, 1990; Martin & Ingham, 1973; Onslow, 1992). Martin and Ingham (1973) also suggested that specific speech production changes would accompany the effect of response-consequence to stuttering. In other words, during the timeout, the speaker uses some unusual spoken patterns and, as a result, stuttering is reduced. In the case of one PWS speaking under the time-out condition, it was confirmed that the speech rate and sentence length were slightly reduced. In a study by Onslow et al. (1997), the vowel duration variability during a child's time-out was reduced.

The following research questions were set up to determine the effect of the monitoring conditions for a speech on the disfluency of PWS.

First, are there any differences in the frequency of disfluency and speech rate under self-monitoring?

Second, are there any differences in the frequency of disfluency and speech rate under second-party monitoring?

Third, are there any differences in the frequency of disfluency and speech rate according to the group’s monitoring conditions based on the severity of stuttering?

Fourth, is there a correlation between the change in the frequency of disfluency and the change in the speech rate under the monitoring conditions?

This study attempted to find out how disfluency changes under monitoring conditions. Under the self-monitoring condition, ND, AD, TD, and speech rate all decreased, but were not statistically significant. This is consistent with the results in previous studies in which the change of disfluency was inconsistent concerning self-monitoring conditions. Depending on the person who stuttered, some people had good responsiveness to self-monitoring, while others did not respond, or the stuttering worsened (Goldiamond, 1965; La Croix, 1973). This study also analyzed the correlation between the frequency of disfluency at baseline level (non-monitoring condition) and the amount of change in self-monitoring condition to explain this individual difference. Except for AD, ND, TD, and speech rate changes, all showed a negative correlation. Among them, ND and TD showed a statistically significant correlation. In other words, the ND and TD were found to be more responsive to self-monitoring as the disfluency was severe at the baseline level. On the other hand, AD was found to coexist in self-monitoring conditions with more severe AD and those with weakening fluency. It can be seen as consistent with the individual differences in responsiveness to self-monitoring in previous studies (James, 1981b).

Second, ND, AD, and TD all decreased under the second-party monitoring condition, and, in particular, AD decreased statistically significantly. This result is consistent with previous studies showing that disfluency decreases in the subsequent stimulus of monitoring others. Speech rate increased, which can be explained in association with a decrease in ND, AD, and TD. Depending on the level of disfluency at the baseline status (non-monitoring condition), the responsiveness to second-party monitoring conditions was also significantly negatively correlated with the self-monitoring conditions. On the other hand, AD was not statistically significant, but when looking at the visually presented graph, it was found that the greater the disfluency, the greater the extent of the decrease (James, 1981).

Third, there was a statistically significant difference in the amount of change in AD, whether there was a difference in the change in disfluency and speech rate in the self-monitoring condition and second-party monitoring condition. In the self-monitoring condition, the disfluency increased on average, but it decreased under the second-party monitoring condition. In addition to the monitoring effect, in self-monitoring conditions, an exercise process of pressing a button by monitoring one's disfluency is added, resulting in high reaction complexity. On the other hand, in the second-party monitoring condition, it can be inferred that the inflexibility is improved by paying more attention to spoken language according to others' feedback. However, there is a tendency among these groups to respond otherwise, but because individual differences in responsiveness to self-monitoring conditions and second-party monitoring conditions are enormous, care should be taken to generalize the monitoring effect suggested in previous studies.

Fourth, a correlation analysis between disfluency and changes in speech rate was conducted to determine whether improved disfluency under self-monitoring conditions and second-party monitoring conditions is related to simplifying spoken language (e.g., a decrease in speech rate). As a result, no correlation was found in the self-monitoring condition, and there was a significant negative correlation between the TD and the speech rate change in the second-party monitoring condition. Even under such condition, it is difficult to explain the change in normal disfluency or stuttering related to the change in speech rate. Among the effects of consequent stimuli claimed by researchers in previous studies, it is difficult to see that stuttering is improved by simplifying spoken language output.

Based on this study's results, it was confirmed that the effects of self-monitoring or second-party monitoring on stuttering did not appear consistently in all stuttering adults. Follow-up studies are needed to determine why stuttering and disfluency are more severe under monitoring conditions. Moreover, in the intervention of adult stuttering, monitoring can be selectively used to treat stuttering by dividing the cases with and without responses to the monitoring conditions.