Exploring the potential of biofeedback for stammering

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Nigel

Nigel Wilson wonders if technology to track and measure bodily reactions can help with stammering therapy. He'd love to hear your thoughts — and from any researchers who want to explore it.

I've been thinking a lot lately about 'biofeedback' and how it might help with stammering. If you've never heard of biofeedback, it's basically a way to measure what your body is doing — like heart rate, breathing or muscle tension — and show it to you in real-time and/or recorded for playback on a computer. By seeing these patterns, you can learn to control your body's reactions. 

It's not a new idea — it was actually explored as a stammering therapy option back in the 1970s and 80s. Back then, though, the equipment was bulky, clinic-based and not really practical for everyday use. But now? With today's technology, biofeedback devices are smaller, portable and even concealable. That's what got me wondering: could now be the right time to revisit this approach? 

Let me share a bit about what I've learned, why I think it could be helpful, and how it might work in practice. 

My journey with stammering 

Like many people who stammer, I've had my ups and downs with speaking. Therapy has helped in some ways, but one thing that's always fascinated me is how much stammering seems tied to what's going on in my body. 

For example, I used to dread certain speaking situations like asking for a ticket or talking to authority figures. Even before I opened my mouth my heart would race, my muscles would tense and I'd feel myself sweating. These physical reactions often made me stammer more. 

One thing that's always fascinated me is how much stammering seems tied to what's going on in my body. 

Over time, I started wondering: what if I could understand and manage those bodily responses better? Could it make speaking feel less overwhelming? That's what led me to explore biofeedback.

Previous research

In the 1970s and 80s, researchers looked at how biofeedback might help people who stammer¹. They used bulky and/or mains-powered equipment in clinical settings to measure things like muscle tension and stress. While the results were interesting, the size and cost of the equipment made it impractical for regular use and difficult to combine/synchronise with recorded speech. 

Fast-forward to today, and the story is completely different. Technology has come so far that biofeedback devices can now fit in a small pack or even be worn discreetly. This opens up new possibilities for using biofeedback in real-world speaking situations — not just in a clinic. 

How Could Biofeedback Work for Stammering? 

Here's what I imagine: a small device that measures things like your heart rate, muscle tension, breathing and stress levels while you speak. It could sync with a recording of your voice, so you'd get a detailed picture of how your body reacts when you stammer - or even before you stammer. 

For example: 

• Muscle tension: Does the tension in your face, neck or shoulders increase when you're about to stammer?
• Heart rate: Does your heart race before speaking in certain situations?
• Breathing: Is your breathing shallow or irregular during speech?
• Stress levels: Are you more physically stressed in specific speaking contexts? 

By spotting these patterns, you could work on managing your body's responses. For me, just having that awareness could make me feel more in control. 

Why I think this could help 

Here's how I think biofeedback could make a difference: 

1. Spot triggers: You might notice certain situations or thoughts that make your body react more. That could give you insights into what's making fluency harder.
2. Develop strategies: By experimenting with ways to calm your body — like breathing modification or relaxation techniques - you could see what works best for you.
3. Track progress: With data over time, you could see how your body's reactions change as you practise managing them. That kind of progress could be really motivating and also evidence as an outcome measure following therapy.
4. Support therapy: If you're working with a speech & language therapist, they could use the data to tailor therapy to your needs, focusing on both the physical and emotional sides of stammering. 

Why now? 

Back in the 70s and 80s, biofeedback for stammering was explored with some published research. The idea was promising, but the technology wasn't there yet. Now, with today's advances, we have devices that are smaller, more affordable and much easier to use. 

Imagine having a biofeedback tool that you could carry in a small pack and wear discreetly during a conversation. Or in an app maybe. It could collect data in real-world situations like at work, in social settings or during a presentation, so you'd get insights that actually apply to your daily life.

Where do we go from here? 

This is still just an idea, but I'd love to see someone explore it further. If you're an MSc student or a professional in speech & language therapy, maybe this could be your next research project! I'm not in a position to develop it myself, but I wanted to share it in case it sparks interest. 

A pilot study could test whether this kind of tool is effective and how it fits into existing therapies. I'd love to see a collaboration between speech therapists, researchers and biofeedback experts to bring this idea to life. 

What do you think? 

If you stammer, does this sound like something that might help you? Or if you're a therapist, could you see this fitting into the work you do? 

For me, just sharing this idea feels like a step toward making it happen. Even if it doesn't, I hope it starts a conversation about new ways to support each other in this journey. 

Remember, you're not alone. We're all figuring out what works for us, and tools like biofeedback could be one more option to explore. Let's keep the conversation going! 

If you're interested in discussing this I'd love to hear from you. Email STAMMA at hello@stamma.org and they'll put us in contact with one another.

¹ Eg, Richmond Hanna, Franz Wilfling & Brent McNeil (1975), 'A Biofeedback Treatment for Stuttering', Journal of Speech and Hearing Disorders, Vol 4, No. 20.