In experimental settings altered auditory feedback (AAF) has been shown to decrease the number of disfluencies in people who stutter (PWS). AAF refers to one or both of the following types of auditory feedback: delayed auditory feedback (DAF) in which the persons vocal output is fed back into their ear at a slight delay similar to hearing an echo, and frequency altered feedback (FAF) where the persons vocal output is fed back into their ear with a change in pitch, either higher (sounding like a chipmunk) or lower (sounding like Darth Vader). The knowledge that AAF can have a positive effect on the speech of PWS has been around for many years but until fairly recently the technology to provide the AAF has been limited to speech clinics and research institutions. However, within the last few years AAF devices have reached the "mainstream" and have allowed PWS to use AAF on their own.

There are two potential problems that I can see with the current stage in the technological advancement of AAF devices. The first is that the technology is just far enough along that these devices are small and portable but the technology is not quite far enough advanced to make the devices reasonably priced. Although most of the companies provide a money back guarantee during a specified trial period, there is still a risk of not getting your money's worth out of the device when you consider the fact that these devices are thousands of dollars. The second problem, that I believe is the most important, is the lack of information that is currently out there about AAF in the "real world". Below is a list of things that I believe are potential gaps in the information about AAF:

1. There has been very little scientific evidence that shows that AAF is effective in day to day conversational speech.
2. There is very little, if any, training at the graduate school level to inform clinicians on how to inform or incorporate AAF in therapy.
3. The media attention that AAF has received may sometimes mislead the general public that AAF is a cure to stuttering.
4. PWS will use AAF as a mono-therapy, without using it in concert with traditional speech therapy.

Having voiced some of my concerns, I do believe that AAF can be a very useful tool for both PWS and clinicians. In order to help resolve some of the aforementioned concerns I have written an AAF software program that people can download on a PC for free. (A Macintosh version is not available). Having the ability to try out AAF for free will hopefully provide PWS an extended feel for how well AAF works for them in all types of situations before they go out and spend thousands of dollars on a portable device. There is also a Yahoo Group that is for both SLPšs and PWS and it is all about AAF. This will hopefully provide a central location and searchable database that will help do the following things:

1. Provide PWS with realistic "real world" knowledge about how AAF has worked for other people in day to day conversations.
2. Help SLP's share with each other how to incorporate AAF into therapy. For example, how to use DAF to encourage speech production awareness and a slow and prolonged speech.
3. Give tips on how to use the software with technologies like Blue Tooth to use the software in real world situations with the freedom of no wires.

The software can be downloaded from http://myweb.uiowa.edu/rarenas/index.htm for free. [2023 editor: this website is no longer available.] There is also a link on the website to join the DAF_FAF yahoo group (DAF_FAF@groups.yahoo.com). I hope that the software and online group will provide both clinicians and PWS with greater access to AAF with no financial risk.

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