Tom, I have noticed (and have had this confirmed by the comments of others) problems with volume, with stuttering and a sort of running-away with my speech (I guess you'd call it speed!). The stuttering is somewhat, but not entirely, stress related, and everything is worse when I'm tired. I haven't worked with a speech patholgoist at all -- as yet I haven't felt it was too bad, and, as someone else on the list mentioned, I am also trying to avoid being consumed by my identity as a PWP to the extent that I can. Hope this helps. Norma Messer 46/2+