Stuttering Intervention in Three Service Delivery Models (Direct, Hybrid, and Telepractice): Two Case Studies

PubMed Central

VALENTINE, DANIEL T.

2015-01-01

This study assessed outcomes in stuttering intervention across three service delivery models: direct, hybrid, and telepractice for two 11-year old children who stutter. The goal of the study was to investigate whether short-term goals were maintained through the telepractice sessions. The Stuttering Severity Instrument, Fourth Edition (SSI-4) was administered to each child before and after each intervention period and weekly fluency samples (percentage of stuttered syllables in a monologue) were obtained in each of the 10-week intervention periods. In addition, the Communication Attitudes Test-Revised was used to assess the children’s attitudes toward speaking. Following the telepractice period, parents and children completed a questionnaire concerning the therapy experience via telepractice. Both children continued to improve fluency as measured by the weekly fluency samples. SSI-4 severity ratings improved for one child and remained consistent for the other. These outcomes appear to demonstrate that telepractice is viable for improving and maintaining fluency. PMID:25945229

The Effects of Parent-Focused Slow Relaxed Speech Intervention on Articulation Rate, Response Time Latency, and Fluency in Preschool Children Who Stutter

ERIC Educational Resources Information Center

Sawyer, Jean; Matteson, Colleen; Ou, Hua; Nagase, Takahisa

2017-01-01

Purpose: This study investigated the effects of an intervention to reduce caregivers' articulation rates with children who stutter on (a) disfluency, (b) caregiver and child's articulation rates, and (c) caregiver and child's response time latency (RTL). Method: Seventeen caregivers and their preschool children who stuttered participated in a…

Language ability of children with and without a history of stuttering: a longitudinal cohort study.

PubMed

Watts, Amy; Eadie, Patricia; Block, Susan; Mensah, Fiona; Reilly, Sheena

2015-02-01

This study aims to determine whether the communication and language skills of children who have a history of stuttering are different from children who do not have a history of stuttering at ages 2-5 years. This study utilizes data from the Early Language in Victoria Study (ELVS), a longitudinal study with a community sample of 1910 children recruited in Melbourne, Australia, as well as a concurrent study examining the onset and progression of stuttering. Participants with a history of stuttering (n = 181) and a control group without a history of stuttering (n = 1438) were identified according to the established protocol of these two existing studies. The stuttering group scored higher than the non-stuttering group on all of the communication and language outcomes measured. The group differences were statistically significant on four of the seven measures and these findings were maintained when potentially confounding factors were controlled for. Importantly, the children with a history of stuttering, as a group, and the control group without a history of stuttering demonstrated developmentally-appropriate early communication and language skills.

Sentence Position and Syntactic Complexity of Stuttering in Early Childhood: A Longitudinal Study

ERIC Educational Resources Information Center

Buhr, Anthony; Zebrowski, Patricia

2009-01-01

The purpose of the present investigation was to assess longitudinal word- and sentence-level measures of stuttering in young children. Participants included 12 stuttering and non-stuttering children between 36 and 71 months of age at an initial visit who exhibited a range of stuttering rates. Parent-child spontaneous speech samples were obtained…

Transcranial direct current stimulation over left inferior frontal cortex improves speech fluency in adults who stutter.

PubMed

Chesters, Jennifer; Möttönen, Riikka; Watkins, Kate E

2018-04-01

See Crinion (doi:10.1093/brain/awy075) for a scientific commentary on this article.Stuttering is a neurodevelopmental condition affecting 5% of children, and persisting in 1% of adults. Promoting lasting fluency improvement in adults who stutter is a particular challenge. Novel interventions to improve outcomes are of value, therefore. Previous work in patients with acquired motor and language disorders reported enhanced benefits of behavioural therapies when paired with transcranial direct current stimulation. Here, we report the results of the first trial investigating whether transcranial direct current stimulation can improve speech fluency in adults who stutter. We predicted that applying anodal stimulation to the left inferior frontal cortex during speech production with temporary fluency inducers would result in longer-lasting fluency improvements. Thirty male adults who stutter completed a randomized, double-blind, controlled trial of anodal transcranial direct current stimulation over left inferior frontal cortex. Fifteen participants received 20 min of 1-mA stimulation on five consecutive days while speech fluency was temporarily induced using choral and metronome-timed speech. The other 15 participants received the same speech fluency intervention with sham stimulation. Speech fluency during reading and conversation was assessed at baseline, before and after the stimulation on each day of the 5-day intervention, and at 1 and 6 weeks after the end of the intervention. Anodal stimulation combined with speech fluency training significantly reduced the percentage of disfluent speech measured 1 week after the intervention compared with fluency intervention alone. At 6 weeks after the intervention, this improvement was maintained during reading but not during conversation. Outcome scores at both post-intervention time points on a clinical assessment tool (the Stuttering Severity Instrument, version 4) also showed significant improvement in the group receiving transcranial direct current stimulation compared with the sham group, in whom fluency was unchanged from baseline. We conclude that transcranial direct current stimulation combined with behavioural fluency intervention can improve fluency in adults who stutter. Transcranial direct current stimulation thereby offers a potentially useful adjunct to future speech therapy interventions for this population, for whom fluency therapy outcomes are currently limited.

Childhood Stuttering – Where are we and Where are we going?

PubMed Central

Smith, Anne; Weber, Christine

2017-01-01

Remarkable progress has been made over the past two decades in expanding our understanding of the behavioral, peripheral physiological, and central neurophysiological bases of stuttering in early childhood. It is clear that stuttering is a neurodevelopmental disorder characterized by atypical development of speech motor planning and execution networks. The speech motor system must interact in complex ways with neural systems mediating language, other cognitive, and emotional processes. During the time window when stuttering typically appears and follows its path to either recovery or persistence, all of these neurobehavioral systems are undergoing rapid and dramatic developmental changes. We summarize our current understanding of the various developmental trajectories relevant for the understanding of stuttering in early childhood. We also present theoretical and experimental approaches that we believe will be optimal for even more rapid progress toward developing better and more targeted treatment for stuttering in the preschool children who are more likely to persist in stuttering. PMID:27701705

Long-Term Outcome of the Lidcombe Program for Early Stuttering Intervention

ERIC Educational Resources Information Center

Miller, Barbara; Guitar, Barry

2009-01-01

Purpose: To report long-term outcomes of the first 15 preschool children treated with the Lidcombe Program by speech-language pathologists (SLPs) who were inexperienced with the program and independent of the program developers. Research questions were: Would the treatment have a similar outcome with inexperienced SLPs compared to outcomes when…

The Peer Attitudes toward Children Who Stutter (PATCS) Scale: An Evaluation of Validity, Reliability and the Negativity of Attitudes

ERIC Educational Resources Information Center

Langevin, Marilyn; Kleitman, Sabina; Packman, Ann; Onslow, Mark

2009-01-01

Background: Persistent calls for school-based education about stuttering necessitate a better understanding of peer attitudes toward children who stutter and a means to measure outcomes of such educational interventions. Langevin and Hagler in 2004 developed the Peer Attitudes Toward Children who Stutter scale (PATCS) to address these needs and…

Classroom intervention to change peers' attitudes towards children who stutter: A feasibility study.

PubMed

Kathard, Harsha; Walters, Freda; Frieslaar, Kareemah; Mhlongo, Thembeka; Rhoode, Melissa; Shaboodien, Raeesa; Weidmann, Julia; Zimmerman, Nicole; Zoetmulder, Amy; Camroodien-Surve, Fatemah

2014-12-03

Before interventions are implemented, the potential treatment benefit must be determined. The primary objective of this feasibility study was to assess if peers' attitudes towards children who stutter (CWS) change one month after the administration of the Classroom Communication Resource (CCR). The secondary objectives of the study were to determine if differences in peer attitudes were related to gender and to previous exposure to a person who stutters. The study used a cluster randomised control trial design. The study included 211 Grade 7 participants from schools in the Cape Town Metropole. The CCR intervention was administered to 97 participants in the experimental group, whilst 114 participants in the control group did not receive the intervention. The Stuttering Resource Outcome Measure(SROM) used as the outcome measure during pre- and post-test period. STATISTICA was used for in-depth data analysis. An overall positive direction of change in scores was observed for the experimental group compared with the control group. However, the magnitude of change in the experimental group was not statistically significant (p = 0.2683). Male and female participants did not differ significantly in their scores on the SROM across pre-test and post-test periods. Participants who had exposure to individuals who stutter had significantly more positive scores on the SROM in the pre-test and post-test periods compared to those who had no direct exposure to stuttering. This result indicated the beginning of positive attitude change which may be attributed to the intervention. Further investigation is warranted.

The state of the art in non‐pharmacological interventions for developmental stuttering. Part 1: a systematic review of effectiveness

PubMed Central

Johnson, Maxine; Blank, Lindsay; Cantrell, Anna; Brumfitt, Shelagh; Enderby, Pam; Goyder, Elizabeth

2015-01-01

Abstract Background The growing range of available treatment options for people who stutter presents a challenge for clinicians, service managers and commissioners, who need to have access to the best available treatment evidence to guide them in providing the most appropriate interventions. While a number of reviews of interventions for specific populations or a specific type of intervention have been carried out, a broad‐based systematic review across all forms of intervention for adults and children was needed to provide evidence to underpin future guidelines, inform the implementation of effective treatments and identify future research priorities. Aims To identify and synthesize the published research evidence on the clinical effectiveness of the broad range of non‐pharmacological interventions for the management of developmental stuttering. Methods & Procedures A systematic review of the literature reporting interventions for developmental stuttering was carried out between August 2013 and April 2014. Searches were not limited by language or location, but were restricted by date to studies published from 1990 onwards. Methods for the identification of relevant studies included electronic database searching, reference list checking, citation searching and hand searching of key journals. Appraisal of study quality was performed using a tool based on established criteria for considering risk of bias. Due to heterogeneity in intervention content and outcomes, a narrative synthesis was completed. Main Contribution The review included all available types of intervention and found that most may be of benefit to at least some people who stutter. There was evidence, however, of considerable individual variation in response to these interventions. The review indicated that effects could be maintained following all types of interventions (although this was weakest with regard to feedback and technology interventions). Conclusions This review highlights a need for greater consensus with regard to the key outcomes used to evaluate stuttering interventions, and also a need for enhanced understanding of the process whereby interventions effect change. Further analysis of the variation in effectiveness for different individuals or groups is needed in order to identify who may benefit most from which intervention. PMID:26123259

Genetic etiology in cases of recovered and persistent stuttering in an unselected, longitudinal sample of young twins.

PubMed

Dworzynski, Katharina; Remington, Anna; Rijsdijk, Frühling; Howell, Peter; Plomin, Robert

2007-05-01

The contribution of genetic factors in the persistence of and early recovery from stuttering was assessed. Data from the Twins Early Development Study were employed. Parental reports regarding stuttering were collected at ages 2, 3, 4, and 7 years, and were used to classify speakers into recovered and persistent groups. Of 12,892 children with at least 2 ratings, 950 children had recovered and 135 persisted in their stutter. Logistic regressions showed that the rating at age 2 was not predictive of later stuttering, whereas ratings at ages 3 and 4 were. Concordance rates were consistently higher for monozygotic than for dizygotic twin pairs (with the exception of girls at age 3). At 3, 4, and 7 years, the liability to stuttering was highly heritable (h2 estimates of between .58 and .66). Heritability for the recovered and persistent groups was also high but did not differ from each other. Stuttering appears to be a disorder that has high heritability and little shared environment effect in early childhood and for recovered and persistent groups of children, by age 7. The clinical implications of the findings are discussed.

Genetic etiology in cases of recovered and persistent stuttering in an unselected, longitudinal sample of young twins

PubMed Central

Dworzynski, Katharina; Remington, Anna; Rijsdijk, Frühling; Howell, Peter; Plomin, Robert

2007-01-01

Purpose The contribution of genetic factors in persistence and early recovery from stuttering was assessed.. Method Data from the Twins Early Development Study were employed. Parental reports regarding stuttering were collected at ages 2, 3, 4 and 7 years and were used to classify speakers into recovered and persistent groups. Of 12,892 children with at least two ratings, 950 children had recovered and 135 persisted in their stutter. Results Logistic regressions showed that the rating at age 2 was not predictive of later stuttering, whereas ratings at ages 3 and 4 were. Concordance rates were consistently higher for monozygotic than for dizygotic twin pairs (with the exception of girls at age 3). At 3, 4 and 7 years, the liability to stuttering was highly heritable (h2 estimates of between .58 and .66). Heritability for the recovered and persistent groups was also high, but did not differ from each other. Conclusion Stuttering appears to be a disorder that has high heritability and little shared environment effect in early childhood and for recovered and persistent groups of children, by age 7. The clinical implications of the findings are discussed. PMID:17456895

Stuttering

MedlinePlus

... but treatments can help. They include stuttering therapy, electronic devices, and self-help groups. Starting stuttering therapy early for young children can keep it from becoming a lifelong problem. NIH: National Institute on Deafness and Other Communication Disorders

Cognitive bias modification for social anxiety in adults who stutter: a feasibility study of a randomised controlled trial

PubMed Central

Gascoine, Sally; Carroll, Amy; Humby, Kate; Kingston, Mary; Shepstone, Lee; Risebro, Helen; Mackintosh, Bundy; Thompson, Tammy Davidson; Hodgekins, Jo

2017-01-01

Objective To determine the feasibility and acceptability of a computerised treatment for social anxiety disorder for adults who stutter including identification of recruitment, retention and completion rates, large cost drivers and selection of most appropriate outcome measure(s) to inform the design of a future definitive trial. Design Two-group parallel design (treatment vs placebo), double-blinded feasibility study. Participants: 31 adults who stutter. Intervention Attention training via an online probe detection task in which the stimuli were images of faces displaying neutral and disgusted expressions. Main outcome measures Psychological measures: Structured Clinical Interview Global Assessment of Functioning score; Liebowitz Social Anxiety Scale; Social Phobia and Anxiety Inventory; State-Trait Anxiety Inventory; Unhelpful Thoughts and Beliefs about Stuttering. Speech fluency: percent syllables stuttered. Economic evaluation: resource use questionnaire; EuroQol three-dimension questionnaire. Acceptability: Likert Scale questionnaire of experience of trial, acceptability of the intervention and randomisation procedure. Results Feasibility of recruitment strategy was demonstrated. Participant feedback indicated that the intervention and definitive trial, including randomisation, would be acceptable to adults who stutter. Of the 31 participants who were randomised, 25 provided data at all three data collection points. Conclusions The feasibility study informed components of the intervention. Modifications to the design are needed before a definitive trial can be undertaken. Trial registration number I SRCTN55065978; Post-results. PMID:29061602

Cortical activity during cued picture naming predicts individual differences in stuttering frequency

PubMed Central

Mock, Jeffrey R.; Foundas, Anne L.; Golob, Edward J.

2016-01-01

Objective Developmental stuttering is characterized by fluent speech punctuated by stuttering events, the frequency of which varies among individuals and contexts. Most stuttering events occur at the beginning of an utterance, suggesting neural dynamics associated with stuttering may be evident during speech preparation. Methods This study used EEG to measure cortical activity during speech preparation in men who stutter, and compared the EEG measures to individual differences in stuttering rate as well as to a fluent control group. Each trial contained a cue followed by an acoustic probe at one of two onset times (early or late), and then a picture. There were two conditions: a speech condition where cues induced speech preparation of the picture’s name and a control condition that minimized speech preparation. Results Across conditions stuttering frequency correlated to cue-related EEG beta power and auditory ERP slow waves from early onset acoustic probes. Conclusions The findings reveal two new cortical markers of stuttering frequency that were present in both conditions, manifest at different times, are elicited by different stimuli (visual cue, auditory probe), and have different EEG responses (beta power, ERP slow wave). Significance The cue-target paradigm evoked brain responses that correlated to pre-experimental stuttering rate. PMID:27472545

Cortical activity during cued picture naming predicts individual differences in stuttering frequency.

PubMed

Mock, Jeffrey R; Foundas, Anne L; Golob, Edward J

2016-09-01

Developmental stuttering is characterized by fluent speech punctuated by stuttering events, the frequency of which varies among individuals and contexts. Most stuttering events occur at the beginning of an utterance, suggesting neural dynamics associated with stuttering may be evident during speech preparation. This study used EEG to measure cortical activity during speech preparation in men who stutter, and compared the EEG measures to individual differences in stuttering rate as well as to a fluent control group. Each trial contained a cue followed by an acoustic probe at one of two onset times (early or late), and then a picture. There were two conditions: a speech condition where cues induced speech preparation of the picture's name and a control condition that minimized speech preparation. Across conditions stuttering frequency correlated to cue-related EEG beta power and auditory ERP slow waves from early onset acoustic probes. The findings reveal two new cortical markers of stuttering frequency that were present in both conditions, manifest at different times, are elicited by different stimuli (visual cue, auditory probe), and have different EEG responses (beta power, ERP slow wave). The cue-target paradigm evoked brain responses that correlated to pre-experimental stuttering rate. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

An investigation of language and phonological development and the responsiveness of preschool age children to the Lidcombe Program.

PubMed

Rousseau, Isabelle; Packman, Ann; Onslow, Mark; Harrison, Elisabeth; Jones, Mark

2007-01-01

Knowledge of variables that predict treatment time is of benefit in deciding when to start treatment for early stuttering. To date, the only variable clearly related to treatment time with the Lidcombe Program is pre-treatment stuttering frequency. Previous studies have shown that children whose stuttering is more severe take longer to complete Stage 1 of the program. However, studies to date have not investigated phonology and language as predictors of treatment time. In the context of a Phase II clinical trial, the present prospective study showed that phonological development does not predict treatment time but that, together, stuttering severity, MLU and CELF Receptive Score predict 35-45% of the variance for time taken to complete Stage 1. The reader should be able to (1) understand guidelines developed for the timing of intervention with the Lidcombe Program based on previous retrospective studies, (2) determine whether pre-treatment language and phonological development play a role in treatment-led recovery with the Lidcombe Program and (3) understand recent empirical evidence on time taken by preschool children to complete Stage 1 of the Lidcombe Program.

Childhood Stuttering: Where Are We and Where Are We Going?

PubMed

Smith, Anne; Weber, Christine

2016-11-01

Remarkable progress has been made over the past two decades in expanding our understanding of the behavioral, peripheral physiologic, and central neurophysiologic bases of stuttering in early childhood. It is clear that stuttering is a neurodevelopmental disorder characterized by atypical development of speech motor planning and execution networks. The speech motor system must interact in complex ways with neural systems mediating language and other cognitive and emotional processes. During the time when stuttering typically appears and follows its path to either recovery or persistence, all of these neurobehavioral systems are undergoing rapid and dramatic developmental changes. We summarize our current understanding of the various developmental trajectories relevant for the understanding of stuttering in early childhood. We also present theoretical and experimental approaches that we believe will be optimal for even more rapid progress toward developing better and more targeted treatment for stuttering in the preschool children who are more likely to persist in stuttering. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Bullying in children who stutter: speech-language pathologists' perceptions and intervention strategies.

PubMed

Blood, Gordon W; Boyle, Michael P; Blood, Ingrid M; Nalesnik, Gina R

2010-06-01

Bullying in school-age children is a global epidemic. School personnel play a critical role in eliminating this problem. The goals of this study were to examine speech-language pathologists' (SLPs) perceptions of bullying, endorsement of potential strategies for dealing with bullying, and associations among SLPs' responses and specific demographic and practice-oriented variables. A survey was developed and mailed to 1000 school-based SLPs. Six vignettes describing episodes of physical, verbal, and relational bullying of hypothetical 10-year students who stutter were developed. Three vignettes described bullying specifically mentioning stuttering behaviors, while three described bullying without mentioning stuttering behavior. The data from 475 SLPs were analyzed. SLPs rated physical bullying as most serious and in need of intervention, followed by verbal bullying. Relational bullying was rated as not serious or in need of intervention. SLPs also responded to the likelihood of using strategies for dealing with bullying. Physical and verbal bullying elicited the use of "talking with the teacher", "working with school personnel", and "reassuring the child of his safety" strategies. Relational bullying elicited "ignore the problem" and "be more assertive" strategies. Correlations among variables are reported. The seriousness of physical and verbal bullying, likelihood of intervention, and the lack of knowledge about relational bullying is discussed. Readers should be able to: (1) summarize the research describing the negative effects of three major types of bullying, (2) summarize the research describing bullying and children with communication disorders, especially stuttering, (3) report results of a survey of speech-language pathologists' (SLPs) perceptions of bullying in school-age children, (4) explain the perceived seriousness of the problem by SLPs and likelihood of intervention, and (5) describe the need for continued prevention and intervention activities for children who stutter. Copyright 2010 Elsevier Inc. All rights reserved.

Stuttering at school: the effect of a teacher training program on stuttering.

PubMed

Silva, Lorene Karoline; Martins-Reis, Vanessa de Oliveira; Maciel, Thamiris Moreira; Ribeiro, Jessyca Kelly Barbosa Carneiro; Souza, Marina Alves de; Chaves, Flávia Gonçalves

2016-07-04

Verify the knowledge of teachers from public and private schools about stuttering and attest the effectiveness of the Teacher Training Program on Stuttering in the expansion of this knowledge. The study sample comprised 137 early-childhood teachers. Initially, the teachers responded to a questionnaire on stuttering. After that, 75 teachers attended a 4-hour Teacher Training Program on Stuttering. One month later, the teachers responded to the same questionnaire again. The following points were observed after the training program: increased percentage of teachers who consider as low the prevalence of stuttering in the population; beginning of reports stating that stuttering is more frequent in males; increased number of teachers who consider stuttering hereditary; decreased incidence of teachers who believe stuttering is psychological; prevalence of those who believe stuttering is a consequence of multiple causes; decreased rate of teachers who believe stuttering is emotional; a better understanding of how educators should behave to help stutterers. Before the course, the teachers had some knowledge regarding stuttering, but it was insufficient to differentiate from other language disorders. The Program expanded their knowledge on stuttering. However, it proved to be more effective with respect to the characteristics of stuttering than to the attitudes of the teachers.

A standalone Internet cognitive behavior therapy treatment for social anxiety in adults who stutter: CBTpsych.

PubMed

Helgadóttir, Fjóla Dögg; Menzies, Ross G; Onslow, Mark; Packman, Ann; O'Brian, Sue

2014-09-01

Social anxiety is common for those who stutter and efficacious cognitive behavior therapy (CBT) for them appears viable. However, there are difficulties with provision of CBT services for anxiety among those who stutter. Standalone Internet CBT treatment is a potential solution to those problems. CBTpsych is a fully automated, online social anxiety intervention for those who stutter. This report is a Phase I trial of CBTpsych. Fourteen participants were allowed 5 months to complete seven sections of CBTpsych. Pre-treatment and post-treatment assessments tested for social anxiety, common unhelpful thoughts related to stuttering, quality of life and stuttering frequency. Significant post-treatment improvements in social anxiety, unhelpful thoughts, and quality of life were reported. Five of seven participants diagnosed with social anxiety lost those diagnoses at post-treatment. The two participants who did not lose social anxiety diagnoses did not complete all the CBTpsych modules. CBTpsych did not improve stuttering frequency. Eleven of the fourteen participants who began treatment completed Section 4 or more of the CBTpsych intervention. CBTpsych provides a potential means to provide CBT treatment for social anxiety associated with stuttering, to any client without cost, regardless of location. Further clinical trials are warranted. At the end of this activity the reader will be able to: (a) describe that social anxiety is common in those who stutter; (b) discuss the origin of social anxiety and the associated link with bullying; (c) summarize the problems in provision of effective evidence based cognitive behavior therapy for adults who stutter; (d) describe a scalable computerized treatment designed to tackle the service provision gap; (e) describe the unhelpful thoughts associated with stuttering that this fully automated computer program was able to tackle; (f) list the positive outcomes for individuals who stuttered that participated in this trial such as the reduction of social anxiety symptoms and improvement in the quality of life for individuals who stuttered and participated in this trial. Copyright © 2014 Elsevier Inc. All rights reserved.

Theory and Therapy in Stuttering: A Complex Relationship

ERIC Educational Resources Information Center

Packman, Ann

2012-01-01

There are many treatments currently available for stuttering, for both children and adults. These range from direct interventions intended to reduce the severity and/or frequency of the speech behaviors of stuttering, to those intended to alleviate the anxiety and other mental health issues that can accompany the disorder. However, as there are…

The History of Stuttering by 7 Years of Age: Follow-Up of a Prospective Community Cohort

ERIC Educational Resources Information Center

Kefalianos, Elaina; Onslow, Mark; Packman, Ann; Vogel, Adam; Pezic, Angela; Mensah, Fiona; Conway, Laura; Bavin, Edith; Block, Susan; Reilly, Sheena

2017-01-01

Purpose: For a community cohort of children confirmed to have stuttered by the age of 4 years, we report (a) the recovery rate from stuttering, (b) predictors of recovery, and (c) comorbidities at the age of 7 years. Method: This study was nested in the Early Language in Victoria Study. Predictors of stuttering recovery included child, family, and…

A clinician survey of speech and non-speech characteristics of neurogenic stuttering.

PubMed

Theys, Catherine; van Wieringen, Astrid; De Nil, Luc F

2008-03-01

This study presents survey data on 58 Dutch-speaking patients with neurogenic stuttering following various neurological injuries. Stroke was the most prevalent cause of stuttering in our patients, followed by traumatic brain injury, neurodegenerative diseases, and other causes. Speech and non-speech characteristics were analyzed separately for these four etiology groups. Results suggested possible group differences, including site of lesion and influence of speech conditions on stuttering. Other characteristics, such as within-word localization of disfluencies and presence of secondary behaviors were comparable across the etiology groups. The implications of our results for the diagnosis of neurogenic stuttering will be discussed. After reading this article, the reader will be able to: (1) provide a concise overview of the main literature on neurogenic stuttering; (2) discuss the speech and non-speech characteristics of neurogenic stuttering; (3) provide an overview of current clinical practices for intervention with neurogenic stuttering patients and their perceived outcome.

Phonological Words and Stuttering on Function Words

PubMed Central

Au-Yeung, James; Howell, Peter; Pilgrim, Lesley

2007-01-01

Stuttering on function words was examined in 51 people who stutter. The people who stutter were subdivided into young (2 to 6 years), middle (6 to 9 years), and older (9 to 12 years) child groups; teenagers (13 to 18 years); and adults (20 to 40 years). As reported by previous researchers, children up to about age 9 stuttered more on function words (pronouns, articles, prepositions, conjunctions, auxiliary verbs), whereas older people tended to stutter more on content words (nouns, main verbs, adverbs, adjectives). Function words in early positions in utterances, again as reported elsewhere, were more likely to be stuttered than function words at later positions in an utterance. This was most apparent for the younger groups of speakers. For the remaining analyses, utterances were segmented into phonological words on the basis of Selkirk’s work (1984). Stuttering rate was higher when function words occurred in early phonological word positions than other phonological word positions whether the phonological word appeared in initial position in an utterance or not. Stuttering rate was highly dependent on whether the function word occurred before or after the single content word allowed in Selkirk’s (1984) phonological words. This applied, once again, whether the phonological word was utterance-initial or not. It is argued that stuttering of function words before their content word in phonological words in young speakers is used as a delaying tactic when the forthcoming content word is not prepared for articulation. PMID:9771625

Evidence for the treatment of co-occurring stuttering and speech sound disorder: A clinical case series.

PubMed

Unicomb, Rachael; Hewat, Sally; Spencer, Elizabeth; Harrison, Elisabeth

2017-06-01

There is a paucity of evidence to guide treatment for children with co-occurring stuttering and speech sound disorder. Some guidelines suggest treating the two disorders simultaneously using indirect treatment approaches; however, the research supporting these recommendations is over 20 years old. In this clinical case series, we investigate whether these co-occurring disorders could be treated concurrently using direct treatment approaches supported by up-to-date, high-level evidence, and whether this could be done in an efficacious, safe and efficient manner. Five pre-school-aged participants received individual concurrent, direct intervention for both stuttering and speech sound disorder. All participants used the Lidcombe Program, as manualised. Direct treatment for speech sound disorder was individualised based on analysis of each child's sound system. At 12 months post commencement of treatment, all except one participant had completed the Lidcombe Program, and were less than 1.0% syllables stuttered on samples gathered within and beyond the clinic. These four participants completed Stage 1 of the Lidcombe Program in between 14 and 22 clinic visits, consistent with current benchmark data for this programme. At the same assessment point, all five participants exhibited significant increases in percentage of consonants correct and were in alignment with age-expected estimates of this measure. Further, they were treated in an average number of clinic visits that compares favourably with other research on treatment for speech sound disorder. These preliminary results indicate that young children with co-occurring stuttering and speech sound disorder may be treated concurrently using direct treatment approaches. This method of service delivery may have implications for cost and time efficiency and may also address the crucial need for early intervention in both disorders. These positive findings highlight the need for further research in the area and contribute to the limited evidence base.

Reprint of: Technology and the Evolution of Clinical Methods for Stuttering

ERIC Educational Resources Information Center

Packman, Ann; Meredith, Grant

2011-01-01

The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide…

Experimental Treatment of Early Stuttering: A Preliminary Study

ERIC Educational Resources Information Center

Franken, Marie-Christine J.; Kielstra-Van der Schalk, Carine J.; Boelens, Harrie

2005-01-01

This pilot study compared two treatments for stuttering in preschool-age children. Thirty children were randomly assigned to either a Lidcombe Program (LP) treatment or a Demands and Capacities Model (DCM) treatment. Stuttering frequencies and severity ratings were obtained immediately before and after treatment (12 weeks). The stuttering…

Research and Development on a Public Attitude Instrument for Stuttering

ERIC Educational Resources Information Center

St. Louis, Kenneth O.

2012-01-01

This paper summarizes research associated with the development of the "Public Opinion Survey of Human Attributes-Stuttering" ("POSHA-S"), a survey instrument designed to provide a worldwide standard measure of public attitudes toward stuttering. Pilot studies with early experimental prototypes of the "POSHA-S" are summarized that relate to…

Genetic Bases of Stuttering: The State of the Art, 2011

PubMed Central

Kraft, Shelly Jo; Yairi, Ehud

2011-01-01

Objective The literature on the genetics of stuttering is reviewed with special reference to the historical development from psychosocial explanations leading up to current biological research of gene identification. Summary A gradual progression has been made from the early crude methods of counting percentages of stuttering probands who have relatives who stutter to recent studies using entire genomes of DNA collected from each participant. Despite the shortcomings of some early studies, investigators have accumulated a substantial body of data showing a large presence of familial stuttering. This encouraged more refined research in the form of twin studies. Concordance rates among twins were sufficiently high to lend additional support to the genetic perspective of stuttering. More sophisticated aggregation studies and segregation analyses followed, producing data that matched recognized genetic models, providing the final ‘go ahead’ to proceed from the behavior/statistical genetics into the sphere of biological genetics. Recent linkage and association studies have begun to reveal contributing genes to the disorder. Conclusion No definitive findings have been made regarding which transmission model, chromosomes, genes, or sex factors are involved in the expression of stuttering in the population at large. Future research and clinical implications are discussed. PMID:22067705

White matter neuroanatomical differences in young children who stutter

PubMed Central

Zhu, David C.; Choo, Ai Leen; Angstadt, Mike

2015-01-01

The ability to express thoughts through fluent speech production is a most human faculty, one that is often taken for granted. Stuttering, which disrupts the smooth flow of speech, affects 5% of preschool-age children and 1% of the general population, and can lead to significant communication difficulties and negative psychosocial consequences throughout one’s lifetime. Despite the fact that symptom onset typically occurs during early childhood, few studies have yet examined the possible neural bases of developmental stuttering during childhood. Here we present a diffusion tensor imaging study that examined white matter measures reflecting neuroanatomical connectivity (fractional anisotropy) in 77 children [40 controls (20 females), 37 who stutter (16 females)] between 3 and 10 years of age. We asked whether previously reported anomalous white matter measures in adults and older children who stutter that were found primarily in major left hemisphere tracts (e.g. superior longitudinal fasciculus) are also present in younger children who stutter. All children exhibited normal speech, language, and cognitive development as assessed through a battery of assessments. The two groups were matched in chronological age and socioeconomic status. Voxel-wise whole brain comparisons using tract-based spatial statistics and region of interest analyses of fractional anisotropy were conducted to examine white matter changes associated with stuttering status, age, sex, and stuttering severity. Children who stutter exhibited significantly reduced fractional anisotropy relative to controls in white matter tracts that interconnect auditory and motor structures, corpus callosum, and in tracts interconnecting cortical and subcortical areas. In contrast to control subjects, fractional anisotropy changes with age were either stagnant or showed dissociated development among major perisylvian brain areas in children who stutter. These results provide first glimpses into the neuroanatomical bases of early childhood stuttering, and possible white matter developmental changes that may lead to recovery versus persistent stuttering. The white matter changes point to possible structural connectivity deficits in children who stutter, in interrelated neural circuits that enable skilled movement control through efficient sensorimotor integration and timing of movements. PMID:25619509

Early Childhood Stuttering

ERIC Educational Resources Information Center

Yairi, Ehud; Ambrose, Nicoline Grinager

2004-01-01

This is one of few professional books that addresses the subject of stuttering in young children. This is surprising considering that most cases of stuttering begin in the preschool years and that the prevalence of the disorder in very young children is higher than in any other age group. This excellent and informative text is written for…

Temperament and Early Stuttering Development: Cross-Sectional Findings from a Community Cohort

ERIC Educational Resources Information Center

Kefalianos, Elaina; Onslow, Mark; Ukoumunne, Obioha C.; Block, Susan; Reilly, Sheena

2017-01-01

Purpose: The purpose of this study was to ascertain if there is an association between stuttering severity and behaviors and the expression of temperament characteristics, including precursors of anxiety. Method: We studied temperament characteristics of a prospectively recruited community cohort of children who stutter (N = 173) at ages 3, 4, and…

Managing Stuttering beyond the Preschool Years

ERIC Educational Resources Information Center

Nippold, Marilyn A.; Packman, Ann

2012-01-01

Purpose: This prologue serves to introduce a research forum composed of studies that address the topic of stuttering in school-age children and adolescents. Researchers are encouraged to continue to build the knowledge base that sustains evidence-based practice in this area. Method: The nature of stuttering as it evolves from early childhood into…

Toward a Theory of Stuttering.

PubMed

Mawson, Anthony R; Radford, Nola T; Jacob, Binu

2016-01-01

Stuttering affects about 1% of the general population and from 8 to 11% of children. The onset of persistent developmental stuttering (PDS) typically occurs between 2 and 4 years of age. The etiology of stuttering is unknown and a unifying hypothesis is lacking. Clues to the pathogenesis of stuttering include the following observations: PDS is associated with adverse perinatal outcomes and birth-associated trauma; stuttering can recur or develop in adulthood following traumatic events such as brain injury and stroke; PDS is associated with structural and functional abnormalities in the brain associated with speech and language; and stuttering resolves spontaneously in a high percentage of affected children. Evidence marshaled from the literature on stuttering and from related sources suggests the hypothesis that stuttering is a neuro-motor disorder resulting from perinatal or later-onset hypoxic-ischemic injury (HII), and that chronic stuttering and its behavioral correlates are manifestations of recurrent transient ischemic episodes affecting speech-motor pathways. The hypothesis could be tested by comparing children who stutter and nonstutterers (controls) in terms of the occurrence of perinatal trauma, based on birth records, and by determining rates of stuttering in children exposed to HII during the perinatal period. Subject to testing, the hypothesis suggests that interventions to increase brain perfusion directly could be effective both in the treatment of stuttering and its prevention at the time of birth or later trauma. © 2016 S. Karger AG, Basel.

Development of an operant treatment for content word dysfluencies in persistent stuttering children: Initial experimental data

PubMed Central

Reed, Phil; Howell, Peter C.; Davis, Steve; Osborne, Lisa A.

2009-01-01

A novel behavioral treatment for persistent stuttering is described. Analysis of the dysfluent speech shows that children who emit high rates of stuttering on content words in sentences have a poor prognosis for recovery, compared to those who emit high rates of stuttering on function words. This novel technique aimed to reverse the pattern of dysfluencies noted in such children, and reduce stuttering in the short-term. To this end, dysfluent content words only were subject to an over-correction procedure. In contrast, dysfluent function words were subject to social approval. The results of two studies indicated that these procedures reduced rates of content word stuttering, even at a post-treatment follow-up assessment, for those with severe, and previously intractable, stuttering. These data suggest the efficacy of behavioral interventions for persistent stuttering, and point to the importance of careful delineation between the parts of speech to be subject to various contingencies. However, it remains to be seen whether the treatment efficacy was specifically due to targeting the parts of speech of the stutter-contingent time-outs PMID:19920870

Development of an operant treatment for content word dysfluencies in persistent stuttering children: Initial experimental data.

PubMed

Reed, Phil; Howell, Peter C; Davis, Steve; Osborne, Lisa A

2007-01-01

A novel behavioral treatment for persistent stuttering is described. Analysis of the dysfluent speech shows that children who emit high rates of stuttering on content words in sentences have a poor prognosis for recovery, compared to those who emit high rates of stuttering on function words. This novel technique aimed to reverse the pattern of dysfluencies noted in such children, and reduce stuttering in the short-term. To this end, dysfluent content words only were subject to an over-correction procedure. In contrast, dysfluent function words were subject to social approval. The results of two studies indicated that these procedures reduced rates of content word stuttering, even at a post-treatment follow-up assessment, for those with severe, and previously intractable, stuttering. These data suggest the efficacy of behavioral interventions for persistent stuttering, and point to the importance of careful delineation between the parts of speech to be subject to various contingencies. However, it remains to be seen whether the treatment efficacy was specifically due to targeting the parts of speech of the stutter-contingent time-outs.

Temperament and Early Stuttering Development: Cross-Sectional Findings From a Community Cohort.

PubMed

Kefalianos, Elaina; Onslow, Mark; Ukoumunne, Obioha C; Block, Susan; Reilly, Sheena

2017-04-14

The purpose of this study was to ascertain if there is an association between stuttering severity and behaviors and the expression of temperament characteristics, including precursors of anxiety. We studied temperament characteristics of a prospectively recruited community cohort of children who stutter (N = 173) at ages 3, 4, and 6 years using the Short Temperament Scale STS (Prior, Sanson, Smart & Oberklaid, 2000). Six of 131 statistical tests of association between stuttering severity and behaviors and temperament traits were statistically significant at the 5% level, which was no more than expected by chance alone. On the basis of parent responses to the STS, preschoolers who exhibited different levels of stuttering severity and behaviors did not generally express temperament traits differently from one another. Stuttering severity and stuttering behaviors were not associated with the precursors of anxiety. Overall, taking multiple tests into consideration, results show little evidence of association between stuttering severity and temperament up to 4 years of age or between stuttering behaviors and temperament up to 6 years of age.

Attitudes toward stuttering of nonstuttering preschool and kindergarten children: A comparison using a standard instrument prototype.

PubMed

Weidner, Mary E; St Louis, Kenneth O; Burgess, Megan E; LeMasters, Staci N

2015-06-01

This study investigated attitudes of nonstuttering preschool and kindergarten children toward peers who stutter in order to identify differences by age groups and better understand the genesis of stuttering attitudes. The study also examined the use of a new stuttering attitudes instrument designed for use with young children. The newly developed Public Opinion Survey on Human Attributes-Stuttering/Child was verbally administered to 27 preschool and 24 kindergarten children who do not stutter in the mid-Atlantic region of the USA. Overall, preschoolers held more negative stuttering attitudes than kindergarteners, but results were not uniformly in that direction. In both groups, the attribute of stuttering was viewed more negatively than individuals who stutter. Children viewed the potential of peers who stutter as quite positive, whereas their knowledge about and experience with stuttering were generally limited and some of their beliefs quite negative. Negative or uninformed stuttering attitudes among nonstuttering children begin as early as the preschool years. This study provides empirical evidence for the need to educate young children about the nature of stuttering and how to respond appropriately to peers who stutter. Readers should be able to: (a) describe attitudinal differences between kindergarteners and preschoolers toward peers who stutter; (b) describe the parameters of the POSHA-S/Child; (c) describe the nature of stuttering attitudes in young children relative to their beliefs and self reactions; and (d) describe the implications and future direction of stuttering attitude research in young children. Copyright © 2015 Elsevier Inc. All rights reserved.

Evidence That Bimanual Motor Timing Performance Is Not a Significant Factor in Developmental Stuttering.

PubMed

Hilger, Allison I; Zelaznik, Howard; Smith, Anne

2016-08-01

Stuttering involves a breakdown in the speech motor system. We address whether stuttering in its early stage is specific to the speech motor system or whether its impact is observable across motor systems. As an extension of Olander, Smith, and Zelaznik (2010), we measured bimanual motor timing performance in 115 children: 70 children who stutter (CWS) and 45 children who do not stutter (CWNS). The children repeated the clapping task yearly for up to 5 years. We used a synchronization-continuation rhythmic timing paradigm. Two analyses were completed: a cross-sectional analysis of data from the children in the initial year of the study (ages 4;0 [years;months] to 5;11) compared clapping performance between CWS and CWNS. A second, multiyear analysis assessed clapping behavior across the ages 3;5-9;5 to examine any potential relationship between clapping performance and eventual persistence or recovery of stuttering. Preschool CWS were not different from CWNS on rates of clapping or variability in interclap interval. In addition, no relationship was found between bimanual motor timing performance and eventual persistence in or recovery from stuttering. The disparity between the present findings for preschoolers and those of Olander et al. (2010) most likely arises from the smaller sample size used in the earlier study. From the current findings, on the basis of data from relatively large samples of stuttering and nonstuttering children tested over multiple years, we conclude that a bimanual motor timing deficit is not a core feature of early developmental stuttering.

Anticipation in stuttering: A theoretical model of the nature of stutter prediction.

PubMed

Garcia-Barrera, Mauricio A; Davidow, Jason H

2015-06-01

The fact that some people who stutter have the ability to anticipate a stuttering moment is essential for several theories of stuttering and important for maximum effectiveness of many currently used treatment techniques. The "anticipation effect," however, is poorly understood despite much investigation into this phenomenon. In the present paper, we combine (1) behavioral evidence from the stuttering-anticipation literature, (2) speech production models, and (3) models of error detection to propose a theoretical model of anticipation. Integrating evidence from theories such as Damasio's Somatic Marker Hypothesis, Levelt's Perceptual Monitoring Theory, Guenther's The Directions Into Velocities of Articulators (DIVA) model, Postma's Covert Repair Hypothesis, among others, our central thesis is that the anticipation of a stuttering moment occurs as an outcome of the interactions between previous learning experiences (i.e., learnt associations between stuttered utterances and any self-experienced or environmental consequence) and error monitoring. Possible neurological mechanisms involved in generating conscious anticipation are also discussed, along with directions for future research. The reader will be able to: (a) describe historical theories that explain how PWS may learn to anticipate stuttering; (b) state some traditional sources of evidence of anticipation in stuttering; (c) describe how PWS may be sensitive to the detection of a stuttering; (d) state some of the neural correlates that may underlie anticipation in stuttering; and (e) describe some of the possible utilities of incorporating anticipation into stuttering interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

Evidence That Bimanual Motor Timing Performance Is Not a Significant Factor in Developmental Stuttering

ERIC Educational Resources Information Center

Hilger, Allison I.; Zelaznik, Howard; Smith, Anne

2016-01-01

Purpose: Stuttering involves a breakdown in the speech motor system. We address whether stuttering in its early stage is specific to the speech motor system or whether its impact is observable across motor systems. Method: As an extension of Olander, Smith, and Zelaznik (2010), we measured bimanual motor timing performance in 115 children: 70…

An Investigation of Language and Phonological Development and the Responsiveness of Preschool Age Children to the Lidcombe Program

ERIC Educational Resources Information Center

Rousseau, Isabelle; Packman, Ann; Onslow, Mark; Harrison, Elisabeth; Jones, Mark

2007-01-01

Knowledge of variables that predict treatment time is of benefit in deciding when to start treatment for early stuttering. To date, the only variable clearly related to treatment time with the Lidcombe Program is pre-treatment stuttering frequency. Previous studies have shown that children whose stuttering is more severe take longer to complete…

Using syllable-timed speech to treat preschool children who stutter: a multiple baseline experiment.

PubMed

Trajkovski, Natasha; Andrews, Cheryl; Onslow, Mark; Packman, Ann; O'Brian, Sue; Menzies, Ross

2009-03-01

This report presents the results of an experimental investigation of the effects of a syllable-timed speech treatment on three stuttering preschool children. Syllable-timed speech involves speaking with minimal differentiation in linguistic stress across syllables. Three children were studied in a multiple baseline across participants design, with percent syllables stuttered (%SS) as the dependent variable. In the week following the initial clinic visit, each child decreased their beyond-clinic stuttering by 40%, 49% and 32%, respectively. These reductions are only evident in the time series after the introduction of the syllable-timed speech treatment procedure. Participants required a mean of six clinic visits, of approximately 30-60 min in duration, to reach and sustain a beyond-clinic %SS below 1.0. The results suggest that clinical trials of the treatment are warranted. The reader will be able to summarize, discuss and evaluate: (1) The nature, impact and treatment options available for early stuttering. (2) The syllable-timed speech treatment protocol administered. (3) The advantages of syllable-timed speech treatment for early stuttering. (4) The questions that further research needs to answer about the syllable-timed speech treatment.

Stuttering and Tourette's Syndrome

MedlinePlus

... this research, however, was not based on systematic observations on larger groups of children or adults. Recent ... struggled with stuttering early in her life. A teacher encouraged her to act in a school play ...

Speech motor correlates of treatment-related changes in stuttering severity and speech naturalness.

PubMed

Tasko, Stephen M; McClean, Michael D; Runyan, Charles M

2007-01-01

Participants of stuttering treatment programs provide an opportunity to evaluate persons who stutter as they demonstrate varying levels of fluency. Identifying physiologic correlates of altered fluency levels may lead to insights about mechanisms of speech disfluency. This study examined respiratory, orofacial kinematic and acoustic measures in 35 persons who stutter prior to and as they were completing a 1-month intensive stuttering treatment program. Participants showed a marked reduction in stuttering severity as they completed the treatment program. Coincident with reduced stuttering severity, participants increased the amplitude and duration of speech breaths, reduced the rate of lung volume change during inspiration, reduced the amplitude and speed of lip movements early in the test utterance, increased lip and jaw movement durations, and reduced syllable rate. A multiple regression model that included two respiratory measures and one orofacial kinematic measure accounted for 62% of the variance in changes in stuttering severity. Finally, there was a weak but significant tendency for speech of participants with the largest reductions in stuttering severity to be rated as more unnatural as they completed the treatment program.

University students' perceptions of pre-school and kindergarten children who stutter.

PubMed

Betz, Ilana Roth; Blood, Gordon W; Blood, Ingrid M

2008-01-01

To determine how early "the stuttering stereotype" is assigned, 160 university students rated a hypothetical vignette depicting either a 3-, 4-, 5-, or 6-year-old with or without the statement "He stutters". A factor analysis of the semantic differential scale showed a three-factor solution comprised of 17 of the 25 bi-polar adjective pairs. The factor labeled personality showed significantly more negative ratings for 2-, 4-, 5-, or 6-year-old children based on the inclusion of the "He stutters" sentence. There were no differences between male and female raters. A significant difference was found between raters who were knew someone who stuttered and raters who did not know someone who stuttered on the personality factor. Raters who were knew someone who stuttered were significantly more likely to assign more positive ratings to the children. Readers should be able to learn and understand: (1) the research describing the negative stereotypes associated with stuttering; (2) the vignette method used to evaluate stereotypes in children and youth; (3) the negative perceptions of the sentence "He stutters" on raters' perception of personality, sociability and speech for children as young as 3-, 4-, 5-, or 6-year-olds; and (4) the familiarity with a person who stutters and raters' perceptions of children who stutter.

Early-Stage Chunking of Finger Tapping Sequences by Persons Who Stutter and Fluent Speakers

ERIC Educational Resources Information Center

Smits-Bandstra, Sarah; De Nil, Luc F.

2013-01-01

This research note explored the hypothesis that chunking differences underlie the slow finger-tap sequencing performance reported in the literature for persons who stutter (PWS) relative to fluent speakers (PNS). Early-stage chunking was defined as an immediate and spontaneous tendency to organize a long sequence into pauses, for motor planning,…

Lidcombe Program Webcam Treatment for Early Stuttering: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Bridgman, Kate; Onslow, Mark; O'Brian, Susan; Jones, Mark; Block, Susan

2016-01-01

Purpose: Webcam treatment is potentially useful for health care in cases of early stuttering in which clients are isolated from specialized treatment services for geographic and other reasons. The purpose of the present trial was to compare outcomes of clinic and webcam deliveries of the Lidcombe Program treatment (Packman et al., 2015) for early…

"Not Unless It's a Life or Death Thing": A Qualitative Study of the Health Care Experiences of Adults Who Stutter.

PubMed

Perez, Hector R; Doig-Acuña, Camilo; Starrels, Joanna L

2015-11-01

For adults who stutter, communication difficulties can impact many spheres of life. Previous studies have not examined how stuttering might impact patient's experiences with the medical system. Our objective was to understand the range and depth of experiences with the medical system among adults who stutter. This was a qualitative study using age-stratified focus groups. Sixteen adults who stutter were recruited at a national conference about stuttering. We conducted three focus groups. Participants also completed a written questionnaire about sociodemographic characteristics, health status, and the impact of stuttering on their life [using the St. Louis Inventory of Life Perspectives Scale (SL-ILP-S) Total Effect Score]. We analyzed data using an iterative, thematic analysis, with an inductive approach, at a semantic level. Participants were mostly (75 %) male and resided throughout the United States. The mean SL-ILP-S Total Effect Score was 27.3, indicating that stuttering caused minimal concern in participants' lives. Despite this, we identified five themes that characterize ways in which stuttering affects interactions with the medical system. Participants described (1) discomfort speaking with office staff and physicians, which resulted in (2) avoiding health care interactions because of stuttering, and (3) relying on a third party to navigate the medical system. During visits with physicians, participants felt that (4) discussing stuttering with physicians required trust and rapport, and (5) speaking assertively with physicians required self-acceptance of their stuttering. We identified ways in which stuttering affects medical interactions. These results highlight the need for increased awareness and training for medical staff and physicians when caring for persons who stutter. Future studies among diverse samples of stutterers can determine the effects of stuttering on medical interactions, and inform the development of interventions to provide high quality health care for adults who stutter.

Webcam Delivery of the Lidcombe Program for Early Stuttering: A Phase I Clinical Trial

ERIC Educational Resources Information Center

O'Brian, Sue; Smith, Kylie; Onslow, Mark

2014-01-01

Purpose: The Lidcombe Program is an operant treatment for early stuttering shown with meta-analysis to have a favorable odds ratio. However, many clients are unable to access the treatment because of distance and lifestyle factors. In this Phase I trial, we explored the potential efficacy, practicality, and viability of an Internet webcam Lidcombe…

Sentence Position and Syntactic Complexity of Stuttering in Early Childhood: A Longitudinal Study

PubMed Central

Buhr, Anthony P.; Zebrowski, Patricia M.

2009-01-01

The purpose of the present investigation was to assess longitudinal word- and sentence-level measures of stuttering in young children. Participants included 12 stuttering and non-stuttering children between 36 and 71 months of age at an initial who exhibited a range of stuttering rates. Parent-child spontaneous speech samples were obtained over a period of two years at six-month intervals. Each speech sample was transcribed, and both stuttering-like disfluencies (SLDs) and other disfluencies (ODs) were coded. Word and sentence-level measures of SLDs were used to assess linguistic characteristics of stuttering. Results of the word-level analysis indicated that stuttering was most likely to occur at the sentence-initial position, but that a tendency to stutter on function words was present only at the sentence-initial position. Results of the sentence-level analyses indicated that sentences containing ODs and those containing SLDs were both significantly longer and more complex than fluent sentences, but did not differ from each other. Word- and sentence-level measures also did not change across visits. Results were taken to suggest that both SLDs and ODs originate during the same stage of sentence planning. PMID:19948270

ACTH has beneficial effects on stuttering in ADHD and ASD patients with ESES: A retrospective study.

PubMed

Altunel, Attila; Sever, Ali; Altunel, Emine Özlem

2017-02-01

Etiology of stuttering remains unknown and no pharmacologic intervention has been approved for treatment. We aimed to evaluate EEG parameters and the effect of adrenocorticotropic hormone (ACTH) therapy in stuttering. In this retrospective study, 25 patients with attention deficit and hyperactivity (ADHD) or autism spectrum disorder (ASD), and comorbid stuttering were followed and treated with ACTH for electrical status epilepticus in sleep (ESES). Sleep EEGs were recorded at referral and follow-up visits and short courses of ACTH were administered when spike-wave index (SWI) was ⩾15%. The assessment of treatment effectiveness was based on reduction in SWI, and the clinician-reported improvement in stuttering, and ADHD or ASD. Statistical analyses were conducted in order to investigate the relationship between the clinical and EEG parameters. Following treatment with ACTH, a reduction in SWI in all the patients was accompanied by a 72% improvement in ADHD or ASD, and 83.8% improvement in stuttering. Twelve of the 25 patients with stuttering showed complete treatment response. Linear regressions established that SWI at final visit significantly predicted improvement in ADHD or ASD, and in stuttering. If symptoms had recurred, improvement was once again achieved with repeated ACTH therapies. Stuttering always improved prior to, and recurred following ADHD or ASD. The underlying etiology leading to ESES may play a significant role in the pathophysiology of stuttering and connect stuttering to other developmental disorders. ACTH therapy has beneficial effects on stuttering and improves EEG parameters. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Effectiveness of the Lidcombe Program for early stuttering in Australian community clinics.

PubMed

O'Brian, Sue; Iverach, Lisa; Jones, Mark; Onslow, Mark; Packman, Ann; Menzies, Ross

2013-12-01

This study explored the effectiveness of the Lidcombe Program for early stuttering in community clinics. Participants were 31 speech-language pathologists (SLPs) using the Lidcombe Program in clinics across Australia, and 57 of their young stuttering clients. Percentage of syllables stuttered (%SS) was collected 9 months after beginning treatment along with information about variables likely to influence outcomes. The mean %SS for the 57 children 9 months after starting treatment was 1.7. The most significant predictor of outcome was Lidcombe Program Trainers Consortium (LPTC) training. The children of trained SLPs (n = 19), compared to the children of untrained SLPs, took 76% more sessions to complete stage 1, but achieved 54% lower %SS scores, 9 months after starting treatment. Results suggest that outcomes for the Lidcombe Program in the general community may be comparable to those obtained in clinical trials when SLPs receive formal training and support.

Recovery of brain abscess-induced stuttering after neurosurgical intervention.

PubMed

Sudo, Daisuke; Doutake, Youichi; Yokota, Hidenori; Watanabe, Eiju

2018-05-12

Stuttering occurs in approximately 5% of all children and 1% of adults. One type, neurogenic stuttering, is usually attributable to strokes or other structural damages to the brain areas that are responsible for language fluency. Here, we present the first case of neurogenic stuttering caused by a brain abscess. The patient was a 60-year-old man admitted for a seizure and administered an anticonvulsant, after which he began stuttering. MRI revealed a brain abscess in the left frontal lobe that extended to the dorsolateral prefrontal cortex (BA (Brodmann's area) 9 and 46), frontal eye field (BA 8) and premotor cortex and supplementary motor area (BA 6). After neurosurgical drainage and antibiotic treatment, the symptoms had resolved. This case is unique in that the therapeutic effects and localisation of the cause of stuttering were rapidly identified, allowing for a more accurate description of the neural circuitry related to stuttering. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Stuttering in adults: the acoustic startle response, temperamental traits, and biological factors.

PubMed

Alm, Per A; Risberg, Jarl

2007-01-01

The purpose of this study was to investigate the relation between stuttering and a range of variables of possible relevance, with the main focus on neuromuscular reactivity, and anxiety. The explorative analysis also included temperament, biochemical variables, heredity, preonset lesions, and altered auditory feedback (AAF). An increased level of neuromuscular reactivity in stuttering adults has previously been reported by [Guitar, B. (2003). Acoustic startle responses and temperament in individuals who stutter. Journal of Speech Language and Hearing Research, 46, 233-240], also indicating a link to anxiety and temperament. The present study included a large number of variables in order to enable analysis of subgroups and relations between variables. Totally 32 stuttering adults were compared with nonstuttering controls. The acoustic startle eyeblink response was used as a measure of neuromuscular reactivity. No significant group difference was found regarding startle, and startle was not significantly correlated with trait anxiety, stuttering severity, or AAF. Startle was mainly related to calcium and prolactin. The stuttering group had significantly higher scores for anxiety and childhood ADHD. Two subgroups of stuttering were found, with high versus low traits of childhood ADHD, characterized by indications of preonset lesions versus heredity for stuttering. The study does not support the view that excessive reactivity is a typical characteristic of stuttering. The increased anxiety is suggested to mainly be an effect of experiences of stuttering. As a result of reading this article, the reader will be able to: (a) critically discuss the literature regarding stuttering in relation to acoustic startle, anxiety, and temperament; (b) describe the effect of calcium on neuromuscular reactivity; (c) discuss findings supporting the importance of early neurological incidents in some cases of stuttering, and the relation between such incidents and traits of ADHD or ADD; and (d) discuss the role of genetics in stuttering.

Reorganization of brain function after a short-term behavioral intervention for stuttering.

PubMed

Lu, Chunming; Zheng, Lifen; Long, Yuhang; Yan, Qian; Ding, Guosheng; Liu, Li; Peng, Danling; Howell, Peter

2017-05-01

This study investigated changes in brain function that occurred over a 7-day behavioral intervention for adults who stutter (AWS). Thirteen AWS received the intervention (AWS+), and 13 AWS did not receive the intervention (AWS-). There were 13 fluent controls (FC-). All participants were scanned before and after the intervention. Whole-brain analysis pre-intervention showed significant differences in task-related brain activation between AWS and FC- in the right inferior frontal cortex (IFC) and left middle temporal cortex, but there were no differences between the two AWS groups. Across the 7-day period of the intervention, AWS+ alone showed a significant increase of brain activation in the left ventral IFC/insula. There were no changes in brain function for the other two groups. Further analysis revealed that the change did not correlate with resting-state functional connectivity (RSFC) that AWS showed in the cerebellum (Lu et al., 2012). However, both changes in task-related brain function and RSFC correlated with changes in speech fluency level. Together, these findings suggest that functional reorganization in a brain region close to the left IFC that shows anomalous function in AWS, occurs after a short-term behavioral intervention for stuttering. Copyright © 2017 Elsevier Inc. All rights reserved.

Stuttering treatment and brain research in adults: A still unfolding relationship.

PubMed

Ingham, Roger J; Ingham, Janis C; Euler, Harald A; Neumann, Katrin

2018-03-01

Brain imaging and brain stimulation procedures have now been used for more than two decades to investigate the neural systems that contribute to the occurrence of stuttering in adults, and to identify processes that might enhance recovery from stuttering. The purpose of this paper is to review the extent to which these dual lines of research with adults who stutter have intersected and whether they are contributing towards the alleviation of this impairment. Several areas of research are reviewed in order to determine whether research on the neurology of stuttering is showing any potential for advancing the treatment of this communication disorder: (a) attempts to discover the neurology of stuttering, (b) neural changes associated with treated recovery, and (c) direct neural intervention. Although much has been learned about the neural underpinnings of stuttering, little research in any of the reviewed areas has thus far contributed to the advancement of stuttering treatment. Much of the research on the neurology of stuttering that does have therapy potential has been largely driven by a speech-motor model that is designed to account for the efficacy of fluency-inducing strategies and strategies that have been shown to yield therapy benefits. Investigations on methods that will induce neuroplasticity are overdue. Strategies profitable with other disorders have only occasionally been employed. However, there are signs that investigations on the neurology of adults who have recovered from stuttering are slowly being recognized for their potential in this regard. Copyright © 2017 Elsevier Inc. All rights reserved.

Technology and the evolution of clinical methods for stuttering.

PubMed

Packman, Ann; Meredith, Grant

2011-06-01

The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide opportunities for people who stutter to share their experiences from a distance and to support one another. New technologies are also being adopted into speech-language pathology practice and service delivery. Telehealth is an exciting development as it means that treatment can now be made available to many rural and remotely located people who previously did not have access to it. Possible future technological developments for speech-language pathology practice include Internet based treatments and the use of Virtual Reality. Having speech and CBT treatments for stuttering available on the Internet would greatly increase their accessibility. Second Life also has exciting possibilities for people who stutter. The reader will (1) explain how people who stutter and their families can get information about stuttering from the World Wide Web, (2) discuss how new technologies have been applied in speech-language pathology practice, and (3) summarize the principles and practice of telehealth delivery of services for people who stutter and their families. Copyright © 2011. Published by Elsevier Inc.

Reprint of: technology and the evolution of clinical methods for stuttering.

PubMed

Packman, Ann; Meredith, Grant

2011-09-01

The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide opportunities for people who stutter to share their experiences from a distance and to support one another. New technologies are also being adopted into speech-language pathology practice and service delivery. Telehealth is an exciting development as it means that treatment can now be made available to many rural and remotely located people who previously did not have access to it. Possible future technological developments for speech-language pathology practice include Internet based treatments and the use of Virtual Reality. Having speech and CBT treatments for stuttering available on the Internet would greatly increase their accessibility. Second Life also has exciting possibilities for people who stutter. The reader will (1) explain how people who stutter and their families can get information about stuttering from the World Wide Web, (2) discuss how new technologies have been applied in speech-language pathology practice, and (3) summarize the principles and practice of telehealth delivery of services for people who stutter and their families. Copyright © 2011. Published by Elsevier Inc.

Neural network connectivity differences in children who stutter

PubMed Central

Zhu, David C.

2013-01-01

Affecting 1% of the general population, stuttering impairs the normally effortless process of speech production, which requires precise coordination of sequential movement occurring among the articulatory, respiratory, and resonance systems, all within millisecond time scales. Those afflicted experience frequent disfluencies during ongoing speech, often leading to negative psychosocial consequences. The aetiology of stuttering remains unclear; compared to other neurodevelopmental disorders, few studies to date have examined the neural bases of childhood stuttering. Here we report, for the first time, results from functional (resting state functional magnetic resonance imaging) and structural connectivity analyses (probabilistic tractography) of multimodal neuroimaging data examining neural networks in children who stutter. We examined how synchronized brain activity occurring among brain areas associated with speech production, and white matter tracts that interconnect them, differ in young children who stutter (aged 3–9 years) compared with age-matched peers. Results showed that children who stutter have attenuated connectivity in neural networks that support timing of self-paced movement control. The results suggest that auditory-motor and basal ganglia-thalamocortical networks develop differently in stuttering children, which may in turn affect speech planning and execution processes needed to achieve fluent speech motor control. These results provide important initial evidence of neurological differences in the early phases of symptom onset in children who stutter. PMID:24131593

A case of multiple system atrophy-parkinsonian type with stuttering- and palilalia-like dysfluencies and putaminal atrophy.

PubMed

Kikuchi, Yoshikazu; Umezaki, Toshiro; Uehara, Taira; Yamaguchi, Hiroo; Yamashita, Koji; Hiwatashi, Akio; Sawatsubashi, Motohiro; Adachi, Kazuo; Yamaguchi, Yumi; Murakami, Daisuke; Kira, Jun-Ichi; Nakagawa, Takashi

2017-11-14

Both developmental and acquired stuttering are related to the function of the basal ganglia-thalamocortical loop, which includes the putamen. Here, we present a case of stuttering- and palilalia-like dysfluencies that manifested as an early symptom of multiple system atrophy-parkinsonian type (MSA-P) and bilateral atrophy of the putamen. The patient was a 72-year-old man with no history of developmental stuttering who presented with a stutter for consultation with our otorhinolaryngology department. The patient was diagnosed with MSA-P based on parkinsonism, autonomic dysfunction, and bilateral putaminal atrophy revealed by T2-weighted magnetic resonance imaging. Treatment with levodopa improved both the motor functional deficits related to MSA-P and stuttering-like dysfluencies while reading; however, the palilalia-like dysfluencies were much less responsive to levodopa therapy. The patient died of aspiration pneumonia two years after his first consultation at our hospital. In conclusion, adult-onset stuttering- and palilalia-like dysfluencies warrant careful examination of the basal ganglia-thalamocortical loop, and especially the putamen, using neuroimaging techniques. Acquired stuttering may be related to deficits in dopaminergic function. Copyright © 2017 Elsevier Inc. All rights reserved.

Spectral Coefficient Analyses of Word-Initial Stop Consonant Productions Suggest Similar Anticipatory Coarticulation for Stuttering and Nonstuttering Adults.

PubMed

Maruthy, Santosh; Feng, Yongqiang; Max, Ludo

2018-03-01

A longstanding hypothesis about the sensorimotor mechanisms underlying stuttering suggests that stuttered speech dysfluencies result from a lack of coarticulation. Formant-based measures of either the stuttered or fluent speech of children and adults who stutter have generally failed to obtain compelling evidence in support of the hypothesis that these individuals differ in the timing or degree of coarticulation. Here, we used a sensitive acoustic technique-spectral coefficient analyses-that allowed us to compare stuttering and nonstuttering speakers with regard to vowel-dependent anticipatory influences as early as the onset burst of a preceding voiceless stop consonant. Eight adults who stutter and eight matched adults who do not stutter produced C 1 VC 2 words, and the first four spectral coefficients were calculated for one analysis window centered on the burst of C 1 and two subsequent windows covering the beginning of the aspiration phase. Findings confirmed that the combined use of four spectral coefficients is an effective method for detecting the anticipatory influence of a vowel on the initial burst of a preceding voiceless stop consonant. However, the observed patterns of anticipatory coarticulation showed no statistically significant differences, or trends toward such differences, between the stuttering and nonstuttering groups. Combining the present results for fluent speech in one given phonetic context with prior findings from both stuttered and fluent speech in a variety of other contexts, we conclude that there is currently no support for the hypothesis that the fluent speech of individuals who stutter is characterized by limited coarticulation.

Workplace in fluency management: factoring the workplace into fluency management.

PubMed

Cassar, M C; Neilson, M D

1997-01-01

This article addresses competency-based standards and guidelines for the involvement of speech-language pathologists in the workplace of clients who stutter. It advocates broadening customary practices in stuttering treatment and suggests that speech-language pathologists should extend their scope of service delivery to the workplace. It presents a sequence for the collaborative involvement of the employer and other workplace members and proposes strategies for evaluating workplace based fluency programs. Issues of fluency management, transfer, maintenance, and efficacy are discussed in the workplace context. Also addressed is workplace communication as well as such factors as stereotypes, discrimination, and resistance to change which may impinge on workplace intervention. It is argued that structured intervention, transfer, and generalization within a collaborative workplace framework facilitates best practice for the fluency clinician and more appropriate outcomes for the diversity of clients who stutter.

Examination of validity in spoken language evaluations: Adult onset stuttering following mild traumatic brain injury.

PubMed

Roth, Carole R; Cornis-Pop, Micaela; Beach, Woodford A

2015-01-01

Reports of increased incidence of adult onset stuttering in veterans and service members with mild traumatic brain injury (mTBI) from combat operations in Iraq and Afghanistan lead to a reexamination of the neurogenic vs. psychogenic etiology of stuttering. This article proposes to examine the merit of the dichotomy between neurogenic and psychogenic bases of stuttering, including symptom exaggeration, for the evaluation and treatment of the disorder. Two case studies of adult onset stuttering in service members with mTBI from improvised explosive device blasts are presented in detail. Speech fluency was disrupted by abnormal pauses and speech hesitations, brief blocks, rapid repetitions, and occasional prolongations. There was also wide variability in the frequency of stuttering across topics and conversational situations. Treatment focused on reducing the frequency and severity of dysfluencies and included educational, psychological, environmental, and behavioral interventions. Stuttering characteristics as well as the absence of objective neurological findings ruled out neurogenic basis of stuttering in these two cases and pointed to psychogenic causes. However, the differential diagnosis had only limited value for developing the plan of care. The successful outcomes of the treatment serve to illustrate the complex interaction of neurological, psychological, emotional, and environmental factors of post-concussive symptoms and to underscore the notion that there are many facets to symptom presentation in post-combat health.

The History of Stuttering by 7 Years of Age: Follow-Up of a Prospective Community Cohort.

PubMed

Kefalianos, Elaina; Onslow, Mark; Packman, Ann; Vogel, Adam; Pezic, Angela; Mensah, Fiona; Conway, Laura; Bavin, Edith; Block, Susan; Reilly, Sheena

2017-10-17

For a community cohort of children confirmed to have stuttered by the age of 4 years, we report (a) the recovery rate from stuttering, (b) predictors of recovery, and (c) comorbidities at the age of 7 years. This study was nested in the Early Language in Victoria Study. Predictors of stuttering recovery included child, family, and environmental measures and first-degree relative history of stuttering. Comorbidities examined at 7 years included temperament, language, nonverbal cognition, and health-related quality of life. The recovery rate by the age of 7 years was 65%. Girls with stronger communication skills at the age of 2 years had higher odds of recovery (adjusted OR = 7.1, 95% CI [1.3, 37.9], p = .02), but similar effects were not evident for boys (adjusted OR = 0.5, 95% CI [0.3, 1.1], p = .10). At the age of 7 years, children who had recovered from stuttering were more likely to have stronger language skills than children whose stuttering persisted (p = .05). No evident differences were identified on other outcomes including nonverbal cognition, temperament, and parent-reported quality of life. Overall, findings suggested that there may be associations between language ability and recovery from stuttering. Subsequent research is needed to explore the directionality of this relationship.

Acceptance and Commitment Therapy for Adults Who Stutter: Psychosocial Adjustment and Speech Fluency

ERIC Educational Resources Information Center

Beilby, Janet M.; Byrnes, Michelle L.; Yaruss, J. Scott

2012-01-01

The aim of the present study was to assess the effectiveness of an Acceptance and Commitment Therapy group intervention program for adults who stutter (N = 20). The program consisted of 2-h therapeutic sessions conducted weekly for eight consecutive weeks. It was an integrated program designed to improve: (a) psychosocial functioning, (b)…

Parenting Styles and Attachment in School-Aged Children Who Stutter

ERIC Educational Resources Information Center

Lau, Su Re; Beilby, Janet M.; Byrnes, Michelle L.; Hennessey, Neville W.

2012-01-01

Parental input has been described as influential in early childhood stuttering yet the exact nature of this influence remains equivocal. The present study aimed to examine whether quantitative measures of parenting styles, parent and peer attachment patterns, and parent- and self-reported child behaviour could differentiate between school-aged…

Non-Linguistic Auditory Processing and Working Memory Update in Pre-School Children Who Stutter: An Electrophysiological Study

PubMed Central

Kaganovich, Natalya; Wray, Amanda Hampton; Weber-Fox, Christine

2010-01-01

Non-linguistic auditory processing and working memory update were examined with event-related potentials (ERPs) in 18 children who stutter (CWS) and 18 children who do not stutter (CWNS). Children heard frequent 1kHz tones interspersed with rare 2kHz tones. The two groups did not differ on any measure of the P1 and N1 components, strongly suggesting that early auditory processing of pure tones is unimpaired in CWS. However, as a group, only CWNS exhibited a P3 component to rare tones suggesting that developmental stuttering may be associated with a less efficient attentional allocation and working memory update in response to auditory change. PMID:21038162

Dysfluencies in the speech of adults with intellectual disabilities and reported speech difficulties.

PubMed

Coppens-Hofman, Marjolein C; Terband, Hayo R; Maassen, Ben A M; van Schrojenstein Lantman-De Valk, Henny M J; van Zaalen-op't Hof, Yvonne; Snik, Ad F M

2013-01-01

In individuals with an intellectual disability, speech dysfluencies are more common than in the general population. In clinical practice, these fluency disorders are generally diagnosed and treated as stuttering rather than cluttering. To characterise the type of dysfluencies in adults with intellectual disabilities and reported speech difficulties with an emphasis on manifestations of stuttering and cluttering, which distinction is to help optimise treatment aimed at improving fluency and intelligibility. The dysfluencies in the spontaneous speech of 28 adults (18-40 years; 16 men) with mild and moderate intellectual disabilities (IQs 40-70), who were characterised as poorly intelligible by their caregivers, were analysed using the speech norms for typically developing adults and children. The speakers were subsequently assigned to different diagnostic categories by relating their resulting dysfluency profiles to mean articulatory rate and articulatory rate variability. Twenty-two (75%) of the participants showed clinically significant dysfluencies, of which 21% were classified as cluttering, 29% as cluttering-stuttering and 25% as clear cluttering at normal articulatory rate. The characteristic pattern of stuttering did not occur. The dysfluencies in the speech of adults with intellectual disabilities and poor intelligibility show patterns that are specific for this population. Together, the results suggest that in this specific group of dysfluent speakers interventions should be aimed at cluttering rather than stuttering. The reader will be able to (1) describe patterns of dysfluencies in the speech of adults with intellectual disabilities that are specific for this group of people, (2) explain that a high rate of dysfluencies in speech is potentially a major determiner of poor intelligibility in adults with ID and (3) describe suggestions for intervention focusing on cluttering rather than stuttering in dysfluent speakers with ID. Copyright © 2013 Elsevier Inc. All rights reserved.

Early Childhood Stuttering and Electrophysiological Indices of Language Processing

PubMed Central

Weber-Fox, Christine; Wray, Amanda Hampton; Arnold, Hayley

2013-01-01

We examined neural activity mediating semantic and syntactic processing in 27 preschool-age children who stutter (CWS) and 27 preschool-age children who do not stutter (CWNS) matched for age, nonverbal IQ and language abilities. All participants displayed language abilities and nonverbal IQ within the normal range. Event-related brain potentials (ERPs) were elicited while participants watched a cartoon video and heard naturally spoken sentences that were either correct or contained semantic or syntactic (phrase structure) violations. ERPs in CWS, compared to CWNS, were characterized by longer N400 peak latencies elicited by semantic processing. In the CWS, syntactic violations elicited greater negative amplitudes for the early time window (150–350 ms) over medial sites compared to CWNS. Additionally, the amplitude of the P600 elicited by syntactic violations relative to control words was significant over the left hemisphere for the CWNS but showed the reverse pattern in CWS, a robust effect only over the right hemisphere. Both groups of preschoolage children demonstrated marked and differential effects for neural processes elicited by semantic and phrase structure violations; however, a significant proportion of young CWS exhibit differences in the neural functions mediating language processing compared to CWNS despite normal language abilities. These results are the first to show that differences in event-related brain potentials reflecting language processing occur as early as the preschool years in CWS and provide the first evidence that atypical lateralization of hemispheric speech/language functions previously observed in the brains of adults who stutter begin to emerge near the onset of developmental stuttering. PMID:23773672

Caregiver-Child Interactions and Their Impact on Children's Fluency: Implications for Treatment

ERIC Educational Resources Information Center

Ratner, Nan Bernstein

2004-01-01

There is a relatively strong focus in the stuttering literature on the desirability of selected alterations in parental speech and language style in the management of early stuttering. In this article, the existing research support for such recommendations is evaluated, together with relevant research from the normal language acquisition…

Neural Indices of Semantic Processing in Early Childhood Distinguish Eventual Stuttering Persistence and Recovery

ERIC Educational Resources Information Center

Kreidler, Kathryn; Wray, Amanda Hampton; Usler, Evan; Weber, Christine

2017-01-01

Purpose: Maturation of neural processes for language may lag in some children who stutter (CWS), and event-related potentials (ERPs) distinguish CWS who have recovered from those who have persisted. The current study explores whether ERPs indexing semantic processing may distinguish children who will eventually persist in stuttering…

Temperament, Emotion and Childhood Stuttering

PubMed Central

Jones, Robin; Choi, Dahye; Conture, Edward; Walden, Tedra

2015-01-01

The purpose of this article is to provide a brief description of temperament and emotion, review empirical evidence pertaining to their possible association with childhood stuttering, and discuss possible clinical implications. In general, temperament is typically thought of as an individual's constitutionally (biologically) based behavioral proclivities. These proclivities often include emotional reactivity and self-regulation. Reactivity refers to arousal of emotions, motor activity, and attention, and self-regulation refers to the ability to moderate those tendencies. The trait-like nature of temperament makes it potentially salient to our understanding of the onset and development of stuttering because temperamental tendencies may result in greater reactivity or difficulty in coping. Emotions, which are more state-like and variable, may influence the variation of stuttering commonly observed both within and between speaking situations. Temperament and emotion may serve as a causal contributor to developmental stuttering, with empirical findings indicating that preschool-aged children who stutter (CWS) exhibit differences in temperament and emotion when compared with children who do not stutter (CWNS). Given that empirical study of temperament in preschool-aged CWS is nascent, extensive discussion of clinical implications is challenging. With that caution, we present some early possibilities, including matching treatment approaches with the child's temperamental profile and using temperament as a predictor of treatment outcome. PMID:24782274

EEG Mu (µ) rhythm spectra and oscillatory activity differentiate stuttering from non-stuttering adults.

PubMed

Saltuklaroglu, Tim; Harkrider, Ashley W; Thornton, David; Jenson, David; Kittilstved, Tiffani

2017-06-01

Stuttering is linked to sensorimotor deficits related to internal modeling mechanisms. This study compared spectral power and oscillatory activity of EEG mu (μ) rhythms between persons who stutter (PWS) and controls in listening and auditory discrimination tasks. EEG data were analyzed from passive listening in noise and accurate (same/different) discrimination of tones or syllables in quiet and noisy backgrounds. Independent component analysis identified left and/or right μ rhythms with characteristic alpha (α) and beta (β) peaks localized to premotor/motor regions in 23 of 27 people who stutter (PWS) and 24 of 27 controls. PWS produced μ spectra with reduced β amplitudes across conditions, suggesting reduced forward modeling capacity. Group time-frequency differences were associated with noisy conditions only. PWS showed increased μ-β desynchronization when listening to noise and early in discrimination events, suggesting evidence of heightened motor activity that might be related to forward modeling deficits. PWS also showed reduced μ-α synchronization in discrimination conditions, indicating reduced sensory gating. Together these findings indicate spectral and oscillatory analyses of μ rhythms are sensitive to stuttering. More specifically, they can reveal stuttering-related sensorimotor processing differences in listening and auditory discrimination that also may be influenced by basal ganglia deficits. Copyright © 2017 Elsevier Inc. All rights reserved.

Group Lidcombe Program Treatment for Early Stuttering: A Randomized Controlled Trial

ERIC Educational Resources Information Center

Arnott, Simone; Onslow, Mark; O'Brian, Sue; Packman, Ann; Jones, Mark; Block, Susan

2014-01-01

Purpose: This study adds to the Lidcombe Program evidence base by comparing individual and group treatment of preschoolers who stutter. Method: A randomized controlled trial of 54 preschoolers was designed to establish whether group delivery outcomes were not inferior to the individual model. The group arm used a rolling group model, in which a…

A Dialogue among Various Cultures and Its Manifestation in Stuttering Therapy

ERIC Educational Resources Information Center

Ezrati-Vinacour, Ruth; Weinstein, Nitza

2011-01-01

This paper presents a historical retrospective of the evolution of the clinical aspects of stuttering, and refers to social, cultural, political, and economic variables that might have exerted an influence on this evolution, particularly in relation to the authors' experience in Israel. The retrospective commences in the early decades of the 20th…

Expressive Language Intratest Scatter of Preschool-Age Children Who Stutter.

PubMed

Millager, Ryan A; Conture, Edward G; Walden, Tedra A; Kelly, Ellen M

2014-01-01

The purpose of this study was to assess intratest scatter (variability) on standardized tests of expressive language by preschool-age children who do (CWS) and do not stutter (CWNS). Participants were 40 preschool-age CWS and 46 CWNS. Between-group comparisons of intratest scatter were made based on participant responses to the Expressive subtest of the Test of Early Language Development - 3 (TELD-Exp; Hresko, Reid, & Hamill, 1999) and the Expressive Vocabulary Test 2 (EVT-2; Williams, 2007). Within-group correlational analyses between intratest scatter and stuttering frequency and severity were also conducted for CWS. Findings indicated that, for CWS, categorical scatter on the EVT-2 was positively correlated with their stuttering frequency. No significant between-group differences in intratest scatter were found on the TELD-Exp or the EVT-2. Consistent with earlier findings, variability in speech-language performance appears to be related to CWS' stuttering, a finding taken to suggest an underlying cognitive-linguistic variable (e.g., cognitive load) may be common to both variables.

Self-perceived competence and social acceptance of young children who stutter: Initial findings.

PubMed

Hertsberg, Naomi; Zebrowski, Patricia M

The goals of this study were to determine whether young children who stutter (CWS) perceive their own competence and social acceptance differently than young children who do not stutter (CWNS), and to identify the predictors of perceived competence and social acceptance in young speakers. We administered the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PSPCSA; Harter & Pike, 1984) to 13 CWS and 14 CWNS and examined group differences. We also collected information on the children's genders, temperaments, stuttering frequencies, language abilities, and phonological skills to identify which of these factors predicted PSPCSA scores. CWS, as a group, did not differ from CWNS in their perceived general competence or social acceptance. Gender predicted scores of perceived general competence, and stuttering frequency predicted perceived social acceptance. Temperament, language abilities, and phonological skills were not significant predictors of perceived competence or social acceptance in our sample. While CWS did not significantly differ from CWNS in terms of perceived competence and social acceptance, when both talker groups were considered together, girls self-reported greater perceived competence than boys. Further, lower stuttering frequency was associated with greater perceived social acceptance. These preliminary findings provide motivation for further empirical study of the psychosocial components of childhood stuttering. Readers will be able to describe the constructs of perceived competence and social acceptance in young children, and whether early stuttering plays a role in the development of these constructs. Copyright © 2016 Elsevier Inc. All rights reserved.

Cognitive flexibility in preschool children with and without stuttering disorders.

PubMed

Eichorn, Naomi; Marton, Klara; Pirutinsky, Steven

2017-11-13

Multifactorial explanations of developmental stuttering suggest that difficulties in self-regulation and weak attentional flexibility contribute to persisting stuttering. We tested this prediction by examining whether preschool-age children who stutter (CWS) shift their attention less flexibly than children who do not stutter (CWNS) during a modified version of the Dimension Card Change Sort (DCCS), a reliable measure of attention switching for young children. Sixteen CWS (12 males) and 30 children CWNS (11 males) participated in the study. Groups were matched on age (CWS: M=49.63, SD=10.34, range=38-80months; CWNS: M=50.63, SD=9.82, range=37-74months), cognitive ability, and language skills. All children completed a computer-based variation of the DCCS, in which they matched on-screen bivalent stimuli to response buttons based on rules that switched mid-task. Results showed increased slowing for CWS compared to controls during the postswitch phase, as well as contrasting patterns of speed-accuracy tradeoff for CWS and CWNS as they moved from the preswitch to postswitch phase of the task. Group differences in performance suggest that early stuttering may be associated with difficulty shifting attention efficiently and greater concern about errors. Findings are consistent with a growing literature indicating links between weak attentional control and persisting developmental stuttering. Copyright © 2017 Elsevier Inc. All rights reserved.

Neural Indices of Semantic Processing in Early Childhood Distinguish Eventual Stuttering Persistence and Recovery.

PubMed

Kreidler, Kathryn; Hampton Wray, Amanda; Usler, Evan; Weber, Christine

2017-11-09

Maturation of neural processes for language may lag in some children who stutter (CWS), and event-related potentials (ERPs) distinguish CWS who have recovered from those who have persisted. The current study explores whether ERPs indexing semantic processing may distinguish children who will eventually persist in stuttering (CWS-ePersisted) from those who will recover from stuttering (CWS-eRecovered). Fifty-six 5-year-old children with normal receptive language listened to naturally spoken sentences in a story context. ERP components elicited for semantic processing (N400, late positive component [LPC]) were compared for CWS-ePersisted, CWS-eRecovered, and children who do not stutter (CWNS). The N400 elicited by semantic violations had a more focal scalp distribution (left lateralized and less anterior) in the CWS-eRecovered compared with CWS-ePersisted. Although the LPC elicited in CWS-eRecovered and CWNS did not differ, the LPC elicited in the CWS-ePersisted was smaller in amplitude compared with that in CWNS. ERPs elicited in 5-year-old CWS-eRecovered compared with CWS-ePersisted suggest that future recovery from stuttering may be associated with earlier maturation of semantic processes in the preschool years. Subtle differences in ERP indices offer a window into neural maturation processes for language and may help distinguish the course of stuttering development.

An exploration of the mechanisms of change following an integrated group intervention for stuttering, as perceived by school-aged children who stutter (CWS).

PubMed

Caughter, Sarah; Dunsmuir, Sandra

2017-03-01

To explore the process of change and role of resilience following an integrated group intervention for children who stutter (CWS). Using an exploratory multiple case study design, this research sought to identify the most significant changes perceived by seven participants following therapy, the mechanisms of change, and the role of resilience in the process of change. Quantitative measurements of resilience were combined with qualitative analysis of semi-structured interviews. Thematic analysis of qualitative data showed that cognitive and emotional change was a key driver for therapeutic change, enabled by the shared experience of the group and a positive therapeutic environment. These changes were generalised into clients' real-world experiences, facilitated by their support network. Quantitative data demonstrated a statistically reliable positive change in overall Resiliency scores for four participants and reduced impact of stuttering scores on OASES-S for all participants, maintained at 12 month follow-up. This study demonstrates the importance of adopting an integrated approach in therapy for CWS, which incorporates Cognitive Behavioural Therapy (CBT) as a key component, to facilitate change and build resilience. These results are unique to this cohort of CWS and further investigation into the use of CBT and the process of change may be warranted. The reader will be able to (1) describe the integrated intervention used in this study (2) define the most significant change following therapy for the participants involved (3) summarise the key factors that facilitated change during the therapy process (as perceived by the participants). Copyright © 2016 Elsevier Inc. All rights reserved.

Parenting styles and attachment in school-aged children who stutter.

PubMed

Lau, Su Re; Beilby, Janet M; Byrnes, Michelle L; Hennessey, Neville W

2012-01-01

Parental input has been described as influential in early childhood stuttering yet the exact nature of this influence remains equivocal. The present study aimed to examine whether quantitative measures of parenting styles, parent and peer attachment patterns, and parent- and self-reported child behaviour could differentiate between school-aged children who stutter (CWS) (n=10) and their fluent peers (n=10). In addition, qualitative individual semi-structured interviews with all CWS were conducted to gain insight into their life experiences and reflections in relation to stuttering. The interviews were classified into ancillary themes of school, peers and parents. Quantitative findings revealed that CWS perceived their parents with significantly lower attachment, particularly in relation to trust, and parents of CWS perceived their children with significantly higher maladjustments than fluent counterparts. Qualitative themes emerged pertaining to attitudes, perceptions and relationships with teachers, peers and parents, with consistent experiences of teasing and bullying reported as a consequence of the stutter. The majority of participants recounted frustration with the nature in which their parents attempted to remediate their stuttering. Collectively, these findings highlight imperative management considerations for school-aged CWS and their parents. The usefulness of quantitative and qualitative research paradigms is also emphasised. The reader will be able to: (1) identify themes associated with the impact a childhood stutter has on parent and peer relationships; (2) identify how the quality of the parent child relationship is influenced by parenting styles and attachment; and (3) discuss the clinical implications of the results for children who stutter and their families. © 2011 Elsevier Inc. All rights reserved.

Expressive Language Intratest Scatter of Preschool-Age Children Who Stutter

PubMed Central

Millager, Ryan A.; Conture, Edward G.; Walden, Tedra A.; Kelly, Ellen M.

2014-01-01

Purpose The purpose of this study was to assess intratest scatter (variability) on standardized tests of expressive language by preschool-age children who do (CWS) and do not stutter (CWNS). Method Participants were 40 preschool-age CWS and 46 CWNS. Between-group comparisons of intratest scatter were made based on participant responses to the Expressive subtest of the Test of Early Language Development – 3 (TELD-Exp; Hresko, Reid, & Hamill, 1999) and the Expressive Vocabulary Test 2 (EVT-2; Williams, 2007). Within-group correlational analyses between intratest scatter and stuttering frequency and severity were also conducted for CWS. Results Findings indicated that, for CWS, categorical scatter on the EVT-2 was positively correlated with their stuttering frequency. No significant between-group differences in intratest scatter were found on the TELD-Exp or the EVT-2. Conclusions Consistent with earlier findings, variability in speech-language performance appears to be related to CWS’ stuttering, a finding taken to suggest an underlying cognitive-linguistic variable (e.g., cognitive load) may be common to both variables. PMID:25520550

Logistic regression for risk factor modelling in stuttering research.

PubMed

Reed, Phil; Wu, Yaqionq

2013-06-01

To outline the uses of logistic regression and other statistical methods for risk factor analysis in the context of research on stuttering. The principles underlying the application of a logistic regression are illustrated, and the types of questions to which such a technique has been applied in the stuttering field are outlined. The assumptions and limitations of the technique are discussed with respect to existing stuttering research, and with respect to formulating appropriate research strategies to accommodate these considerations. Finally, some alternatives to the approach are briefly discussed. The way the statistical procedures are employed are demonstrated with some hypothetical data. Research into several practical issues concerning stuttering could benefit if risk factor modelling were used. Important examples are early diagnosis, prognosis (whether a child will recover or persist) and assessment of treatment outcome. After reading this article you will: (a) Summarize the situations in which logistic regression can be applied to a range of issues about stuttering; (b) Follow the steps in performing a logistic regression analysis; (c) Describe the assumptions of the logistic regression technique and the precautions that need to be checked when it is employed; (d) Be able to summarize its advantages over other techniques like estimation of group differences and simple regression. Copyright © 2012 Elsevier Inc. All rights reserved.

Preliminary Evidence That Growth in Productive Language Differentiates Childhood Stuttering Persistence and Recovery

PubMed Central

Bernstein Ratner, Nan; Brown, Barbara; Weber, Christine M.

2017-01-01

Purpose Childhood stuttering is common but is often outgrown. Children whose stuttering persists experience significant life impacts, calling for a better understanding of what factors may underlie eventual recovery. In previous research, language ability has been shown to differentiate children who stutter (CWS) from children who do not stutter, yet there is an active debate in the field regarding what, if any, language measures may mark eventual recovery versus persistence. In this study, we examined whether growth in productive language performance may better predict the probability of recovery compared to static profiles taken from a single time point. Method Productive syntax and vocabulary diversity growth rates were calculated for 50 CWS using random coefficient models. Logistic regression models were then used to determine whether growth rates uniquely predict likelihood of recovery, as well as if these rates were predictive over and above currently identified correlates of stuttering onset and recovery. Results Different linguistic profiles emerged between children who went on to recover versus those who persisted. Children who had steeper productive syntactic growth, but not vocabulary diversity growth, were more likely to recover by study end. Moreover, this effect held after controlling for initial language ability at study onset as well as demographic covariates. Conclusions Results are discussed in terms of how growth estimates can be incorporated in recommendations for fostering productive language skills among CWS. The need for additional research on language in early stuttering and recovery is suggested. PMID:29049493

Preliminary Evidence That Growth in Productive Language Differentiates Childhood Stuttering Persistence and Recovery.

PubMed

Leech, Kathryn A; Bernstein Ratner, Nan; Brown, Barbara; Weber, Christine M

2017-11-09

Childhood stuttering is common but is often outgrown. Children whose stuttering persists experience significant life impacts, calling for a better understanding of what factors may underlie eventual recovery. In previous research, language ability has been shown to differentiate children who stutter (CWS) from children who do not stutter, yet there is an active debate in the field regarding what, if any, language measures may mark eventual recovery versus persistence. In this study, we examined whether growth in productive language performance may better predict the probability of recovery compared to static profiles taken from a single time point. Productive syntax and vocabulary diversity growth rates were calculated for 50 CWS using random coefficient models. Logistic regression models were then used to determine whether growth rates uniquely predict likelihood of recovery, as well as if these rates were predictive over and above currently identified correlates of stuttering onset and recovery. Different linguistic profiles emerged between children who went on to recover versus those who persisted. Children who had steeper productive syntactic growth, but not vocabulary diversity growth, were more likely to recover by study end. Moreover, this effect held after controlling for initial language ability at study onset as well as demographic covariates. Results are discussed in terms of how growth estimates can be incorporated in recommendations for fostering productive language skills among CWS. The need for additional research on language in early stuttering and recovery is suggested.

A dialogue among various cultures and its manifestation in stuttering therapy.

PubMed

Ezrati-Vinacour, Ruth; Weinstein, Nitza

2011-09-01

This paper presents a historical retrospective of the evolution of the clinical aspects of stuttering, and refers to social, cultural, political, and economic variables that might have exerted an influence on this evolution, particularly in relation to the authors' experience in Israel. The retrospective commences in the early decades of the 20th century, when speech and language pathology did not exist as a profession, and presents the major approaches to therapy in children and adults employed by clinicians throughout the century. We focused on the impact of the change that occurred in religious society vis-à-vis stuttering on the various aspects of stuttering therapy and research. The Israeli Stuttering Organization - AMBI - is discussed in order to explore the possible influence of social, cultural, and political variables. In addition, we devoted special attention to the changes that occurred in the therapist-client relationship since they are indicative of the change in the nature of the treatment. We elaborated on the need for dialogue as a major component in the therapy and as an important contributor to a successful outcome. The dialogue is also discussed in terms of Eastern philosophy. Future developments in the understanding of stuttering and its implications for therapy are presented and discussed. The reader will be able to: (1) summarize the history of the clinical development of stuttering and explore the possible influence of social, cultural, political, and economic variables particularly in relation to Israel; (2) provide a new definition of stuttering; and (3) contrast the model of a dialogue as opposed to a monologue and explain its use in the therapist-client relationship. Copyright © 2011 Elsevier Inc. All rights reserved.

Health and human services for persons who stutter and education of logopedists in East-European countries.

PubMed

Fibiger, Steen; Peters, Herman F M; Euler, Harald A; Neumann, Katrin

2008-03-01

The International Association of Logopedics and Phoniatrics (IALP) assessed the therapy status of fluency disorders, service opportunities, and education of logopedists (speech-language pathologists) with a mail survey in Eastern Europe. Information was collected on the following aspects: incidence, prevalence, availability of information, non-therapeutic support for persons who stutter (PWS), providers of diagnostics and therapy, cooperating professionals, therapy approaches, forms, goals, financing, early detection and prevention, training of professionals, specialization in stuttering therapy, needs for improving the situation of PWS, and problems which hinder better care. Stuttering therapy for children is available in many countries and is frequently provided by the educational system. Therapy for adults is provided best by the health services but is not satisfactorily available everywhere. Modern therapeutic approaches coexist with obsolete ones. Lack of resources, awareness, entitlement, and assessment of therapy effectiveness are pervasive problems. Readers will be able to describe and evaluate: (1) the therapy status of fluency disorders and service opportunities in various East-European countries; (2) the training of logopedists (speech-language pathologists); (3) specialization in stuttering therapy; and (4) the organizational services for PWS within the health and human service systems.

[Family characteristics of stuttering children].

PubMed

Simić-Ruzić, Budimirka; Jovanović, Aleksandar A

2008-01-01

Stuttering is a functional impairment of speech, which is manifested by conscious, but nonintentionally interrupted, disharmonic and disrhythmic fluctuation of sound varying in frequency and intensity. Aetiology of this disorder has been conceived within the frame of theoretical models, which tend to connect genetic and epigenetic factors. The goal of the paper was to study the characteristics of the family functioning of stuttering children in comparison to the family functioning of children without speech disorder, which confirmed the justification of the introduction of family orientated therapeutic interventions into the therapy spectrum of child stuttering. Seventy-nine nucleus families of 3 to 6-year-old children were examined; of these, 39 families had stuttering children and 40 had children without speech disorder. The assessment of family characteristics was made using the Family Health Scale, an observer-rating scale which according to semistructured interview and operational criteria, measures 6 basic dimensions of family functioning: Emotional State, Communication, Borders, Alliances, Adaptability & Stability, Family Skills. A total score calculated from the basic dimensions, is considered as a global index of family health. Families with stuttering children compared to families with children without speech disorder showed significantly lower scores in all the basic dimension of family functioning, as well as in the total score on the Family Health Scale. Our research results have shown that stuttering children in comparison with children without speech disorder live in families with unfavourable emotional atmosphere, impaired communication and worse control over situational and developmental difficulties, which affect children's development and well-being. In the light of previous research, the application of family therapy modified according to the child's needs is now considered indispensable in the therapeutic approach to stuttering children. The assessment of family characteristics with special reference to the ability of parents to recognize specific needs of children with speech disorder and adequate interaction, as well as readiness of parents for therapeutic collaboration are the necessary elements in legal custody evaluations.

Randomized controlled trial of video self-modeling following speech restructuring treatment for stuttering.

PubMed

Cream, Angela; O'Brian, Sue; Jones, Mark; Block, Susan; Harrison, Elisabeth; Lincoln, Michelle; Hewat, Sally; Packman, Ann; Menzies, Ross; Onslow, Mark

2010-08-01

In this study, the authors investigated the efficacy of video self-modeling (VSM) following speech restructuring treatment to improve the maintenance of treatment effects. The design was an open-plan, parallel-group, randomized controlled trial. Participants were 89 adults and adolescents who undertook intensive speech restructuring treatment. Post treatment, participants were randomly assigned to 2 trial arms: standard maintenance and standard maintenance plus VSM. Participants in the latter arm viewed stutter-free videos of themselves each day for 1 month. The addition of VSM did not improve speech outcomes, as measured by percent syllables stuttered, at either 1 or 6 months postrandomization. However, at the latter assessment, self-rating of worst stuttering severity by the VSM group was 10% better than that of the control group, and satisfaction with speech fluency was 20% better. Quality of life was also better for the VSM group, which was mildly to moderately impaired compared with moderate impairment in the control group. VSM intervention after treatment was associated with improvements in self-reported outcomes. The clinical implications of this finding are discussed.

Phonetic difficulty and stuttering in English

PubMed Central

Howell, Peter; Au-Yeung, James; Yaruss, Scott; Eldridge, Kevin

2007-01-01

Previous work has shown that phonetic difficulty affects older, but not younger, speakers who stutter and that older speakers experience more difficulty on content words than function words. The relationship between stuttering rate and a recently-developed index of phonetic complexity (IPC, Jakielski, 1998) was examined in this study separately for function and content words for speakers in 6-11, 11 plus-18 and 18 plus age groups. The hypothesis that stuttering rate on the content words of older speakers, but not younger speakers, would be related to the IPC score was supported. It is argued that the similarity between results using the IPC scores with a previous analysis that looked at late emerging consonants, consonant strings and multiple syllables (also conducted on function and content words separately), validates the former instrument. In further analyses, the factors that are most likely to lead to stuttering in English and their order of importance were established. The order found was consonant by manner, consonant by place, word length and contiguous consonant clusters. As the effects of phonetic difficulty are evident in teenage and adulthood, at least some of the factors may have an acquired influence on stuttering (rather than an innate universal basis, as the theory behind Jakielski's work suggests). This may be established in future work by doing cross-linguistic comparisons to see which factors operate universally. Disfluency on function words in early childhood appears to be responsive to factors other than phonetic complexity. PMID:17342878

Factitious Disorder Presenting with Stuttering in Two Adolescents: The Importance of Psychoeducation.

PubMed

Bolat, Nurullah; Yalçin, Özhan

2017-03-01

A factitious disorder (FD) is a diagnostic entity in which patients intentionally act physically or mentally ill without obvious benefits and without being consciously aware of a clear underlying motive. Most pediatric FD cases have been reported as Munchausen syndrome by Proxy; however, pediatric disease symptoms can also be intentionally falsified by child and adolescent patients. To our knowledge, in the medical literature, an FD patient presenting with stuttering has not been previously reported. In this case report, we aimed to discuss the diagnosis and treatment process of FDs in children and adolescents by reporting the cases of two FD patients presenting with stuttering according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition. Both patients improved with psychoeducation and early confrontation.

Priapism and sickle-cell anemia: diagnosis and nonsurgical therapy.

PubMed

Broderick, Gregory A

2012-01-01

Priapism describes a persistent erection lasting longer than 4 hours. Ischemic priapism and stuttering priapism are phenotypic manifestations of sickle-cell disease (SCD). To define the types of priapism associated with SCD, to address pathogenesis, and to recommend best practices. Literature review and published clinical guidelines. Priapism is a full or partial erection that persists more than 4 hours. There are three kinds of priapism: ischemic priapism (veno-occlusive, low flow), stuttering priapism (recurrent ischemic priapism), and nonischemic priapism (arterial, high flow). Ischemic priapism is a pathologic phenotype of SCD. Ischemic priapism is a urologic emergency when untreated priapism results in corporal fibrosis and erectile dysfunction. The recommended treatment for ischemic priapism is decompression of the penis by needle aspiration and if needed, injection (or irrigation) with dilute sympathomimetic drugs. Stuttering priapism describes a pattern of recurring unwanted painful erections in men with SCD. Patients typically awaken with an erection that persists for several hours and becomes painful. The goals of managing stuttering ischemic priapism are: prevention of future episodes, preservation of erectile function, and balancing the risks vs. benefits of various treatment options. The current molecular hypothesis for stuttering priapism in SCD proposes that insufficient basal levels of phosphodiesterase type-5 are available in the corpora to degrade cyclic guanosine monophosphate (cGMP). Nocturnal erections result from normal neuronal production and surges of cGMP. In the context of SCD stuttering priapism, these nocturnal surges in cGMP go unchecked, resulting in stuttering priapism. Considering the embarrassing nature of the problem and the dire consequences to erectile function, it is important to inform patients, parents, and providers about the relationship of SCD to prolonged painful erections. Prompt diagnosis and appropriate medical management of priapism are necessary to spare patients surgical interventions and preserve erectile function. © 2011 International Society for Sexual Medicine.

Prevalence of stuttering.

PubMed Central

Porfert, A R; Rosenfield, D B

1978-01-01

The prevalence of stuttering in a university population was 2.1%; 3.4% were former stutterers. More men than women stuttered. Right handed female stutterers were less likely to have "lost" their stutter than were right handed males. Stutterers, past stutterers, and questionable stutterers all had a family history of stuttering. The significant prevalence of stuttering, the increased prevalence among males, the lack of a decline of this disorder over the past few decades despite the increased number of speech clinicians and data concerning handedness, emphasise the need to investigate organic causes of stuttering. PMID:731247

Verbal implicit sequence learning in persons who stutter and persons with Parkinson's disease.

PubMed

Smits-Bandstra, Sarah; Gracco, Vincent

2013-01-01

The authors investigated the integrity of implicit learning systems in 14 persons with Parkinson's disease (PPD), 14 persons who stutter (PWS), and 14 control participants. In a 120-min session participants completed a verbal serial reaction time task, naming aloud 4 syllables in response to 4 visual stimuli. Unbeknownst to participants, the syllables formed a repeating 8-item sequence. PWS and PPD demonstrated slower reaction times for early but not late learning trials relative to controls reflecting delays but not deficiencies in general learning. PPD also demonstrated less accuracy in general learning relative to controls. All groups demonstrated similar limited explicit sequence knowledge. Both PWS and PPD demonstrated significantly less implicit sequence learning relative to controls, suggesting that stuttering may be associated with compromised functional integrity of the cortico-striato-thalamo-cortical loop.

Segments and Stutters: Early Years Teachers and Becoming-Professional

ERIC Educational Resources Information Center

Fairchild, Nikki

2017-01-01

There has been extensive research and analysis of the professionalization of early childhood educators/teachers. The recent promotion of a teacher-led workforce in England has further focused discussions on the modelling of early years teachers as professionals. In this article, the author develops an alternative analysis using the concepts of…

General vulnerability to stuttering: The experience of stuttering and conditions bringing about invulnerability.

PubMed

Briley, P M; Kalinowski, J S

2016-08-01

General vulnerability to stuttering is the broad awareness of stuttering and the ever-present, experiential sense of a person who stutters (PWS). It is defined by stuttering in all its forms and the awareness of its presence, both in moments of stuttering and moments of perceivably fluent speech. Under the heading of general vulnerability to stuttering is specific vulnerability to stuttering, which includes the actual events of stuttering (i.e., overt symptoms, covert symptoms, subperceptual stuttering, and anticipation of stuttering). The differentiation between the two is that specific vulnerability requires a specific moment of stuttering where general vulnerability does not. Copyright © 2016 Elsevier Ltd. All rights reserved.

Stuttering Frequency, Speech Rate, Speech Naturalness, and Speech Effort During the Production of Voluntary Stuttering.

PubMed

Davidow, Jason H; Grossman, Heather L; Edge, Robin L

2018-05-01

Voluntary stuttering techniques involve persons who stutter purposefully interjecting disfluencies into their speech. Little research has been conducted on the impact of these techniques on the speech pattern of persons who stutter. The present study examined whether changes in the frequency of voluntary stuttering accompanied changes in stuttering frequency, articulation rate, speech naturalness, and speech effort. In total, 12 persons who stutter aged 16-34 years participated. Participants read four 300-syllable passages during a control condition, and three voluntary stuttering conditions that involved attempting to produce purposeful, tension-free repetitions of initial sounds or syllables of a word for two or more repetitions (i.e., bouncing). The three voluntary stuttering conditions included bouncing on 5%, 10%, and 15% of syllables read. Friedman tests and follow-up Wilcoxon signed ranks tests were conducted for the statistical analyses. Stuttering frequency, articulation rate, and speech naturalness were significantly different between the voluntary stuttering conditions. Speech effort did not differ between the voluntary stuttering conditions. Stuttering frequency was significantly lower during the three voluntary stuttering conditions compared to the control condition, and speech effort was significantly lower during two of the three voluntary stuttering conditions compared to the control condition. Due to changes in articulation rate across the voluntary stuttering conditions, it is difficult to conclude, as has been suggested previously, that voluntary stuttering is the reason for stuttering reductions found when using voluntary stuttering techniques. Additionally, future investigations should examine different types of voluntary stuttering over an extended period of time to determine their impact on stuttering frequency, speech rate, speech naturalness, and speech effort.

Does Working Memory Enhance or Interfere With Speech Fluency in Adults Who Do and Do Not Stutter? Evidence From a Dual-Task Paradigm.

PubMed

Eichorn, Naomi; Marton, Klara; Schwartz, Richard G; Melara, Robert D; Pirutinsky, Steven

2016-06-01

The present study examined whether engaging working memory in a secondary task benefits speech fluency. Effects of dual-task conditions on speech fluency, rate, and errors were examined with respect to predictions derived from three related theoretical accounts of disfluencies. Nineteen adults who stutter and twenty adults who do not stutter participated in the study. All participants completed 2 baseline tasks: a continuous-speaking task and a working-memory (WM) task involving manipulations of domain, load, and interstimulus interval. In the dual-task portion of the experiment, participants simultaneously performed the speaking task with each unique combination of WM conditions. All speakers showed similar fluency benefits and decrements in WM accuracy as a result of dual-task conditions. Fluency effects were specific to atypical forms of disfluency and were comparable across WM-task manipulations. Changes in fluency were accompanied by reductions in speaking rate but not by corresponding changes in overt errors. Findings suggest that WM contributes to disfluencies regardless of stuttering status and that engaging WM resources while speaking enhances fluency. Further research is needed to verify the cognitive mechanism involved in this effect and to determine how these findings can best inform clinical intervention.

Perceptions of university instructors toward students who stutter: a quantitative and qualitative approach.

PubMed

Daniels, Derek E; Panico, James; Sudholt, Jennifer

2011-01-01

Many research studies have focused on perceptions of stuttering by various groups of people. However, there is limited research on the perceptions of university instructors toward stuttering and people who stutter. Therefore, this study explored the perceptions of university instructors toward stuttering and students who stutter, and their beliefs about classroom participation. Participants included 328 university instructors across a variety of disciplines at two Midwestern universities. Each participant completed a 12-item questionnaire regarding perceptions related to stuttering, students who stutter, and classroom participation. Of the 328 participants, 212 completed an open-ended question about their experiences and concerns of working with students who stutter. Results indicated that increased knowledge of stuttering is associated with positive attitudes toward students who stutter. Moreover, the participants in this study expressed a need for more information about stuttering and ways to accommodate students who stutter in the classroom. After reading this article, the reader will be able to: (1) discuss the challenges that university instructors face when working with students with disabilities; (2) provide a rationale for the need to explore the perceptions of university instructors toward students who stutter; (3) describe the major themes of university instructors' knowledge of stuttering, and beliefs about classroom participation for students who stutter; and (4) discuss the need for disseminating more knowledge about stuttering to university instructors. Copyright © 2011 Elsevier Inc. All rights reserved.

A speech and psychological profile of treatment-seeking adolescents who stutter.

PubMed

Iverach, Lisa; Lowe, Robyn; Jones, Mark; O'Brian, Susan; Menzies, Ross G; Packman, Ann; Onslow, Mark

2017-03-01

The purpose of this study was to evaluate the relationship between stuttering severity, psychological functioning, and overall impact of stuttering, in a large sample of adolescents who stutter. Participants were 102 adolescents (11-17 years) seeking speech treatment for stuttering, including 86 boys and 16 girls, classified into younger (11-14 years, n=57) and older (15-17 years, n=45) adolescents. Linear regression models were used to evaluate the relationship between speech and psychological variables and overall impact of stuttering. The impact of stuttering during adolescence is influenced by a complex interplay of speech and psychological variables. Anxiety and depression scores fell within normal limits. However, higher self-reported stuttering severity predicted higher anxiety and internalizing problems. Boys reported externalizing problems-aggression, rule-breaking-in the clinical range, and girls reported total problems in the borderline-clinical range. Overall, higher scores on measures of anxiety, stuttering severity, and speech dissatisfaction predicted a more negative overall impact of stuttering. To our knowledge, this is the largest cohort study of adolescents who stutter. Higher stuttering severity, speech dissatisfaction, and anxiety predicted a more negative overall impact of stuttering, indicating the importance of carefully managing the speech and psychological needs of adolescents who stutter. Further research is needed to understand the relationship between stuttering and externalizing problems for adolescent boys who stutter. Copyright © 2016. Published by Elsevier Inc.

Secondary School Teachers' Beliefs, Attitudes, and Reactions to Stuttering.

PubMed

Adriaensens, Stefanie; Struyf, Elke

2016-04-01

The study identifies teachers' beliefs about and attitudes toward stuttering and explores to what extent these beliefs and attitudes prompt specific teachers' reactions to the stuttering of a student. Participants were teachers in secondary education in Flanders (Belgium), currently teaching an adolescent who stutters. They were the student's class teacher or instructed a course in which communication is important. Ten semistructured interviews were conducted and analyzed thematically. Teachers believed that (a) when peers do not react to the stuttering, the lesson is not disrupted by it, and the student who stutters participates in the lesson, stuttering is not necessarily a problem; (b) when attention is paid to it, stuttering can become a problem; (c) they try to react as little as possible to the stuttering; and (d) they seldom talk about the stuttering. Although teachers reported that they feel confident in how to deal with stuttering, and although it is possible that students who stutter do not feel the need to talk about their stuttering, teachers could consult their students on this matter. This way, they would acknowledge the stuttering and likely encourage the students to approach them when they feel the need.

DISFLUENCY PATTERNS AND PHONOLOGICAL SKILLS NEAR STUTTERING ONSET

PubMed Central

Gregg, Brent Andrew; Yairi, Ehud

2012-01-01

There is a substantial amount of literature reporting the incidence of phonological difficulties to be higher for children who stutter when compared to normally fluent children, suggesting a link between stuttering and phonology. In view of this, the purpose of the investigation was to determine whether, among children who stutter, there are relationships between phonological skills and the initial characteristics of stuttering. That is, close to the onset of stuttering, are there differences in specific stuttering patterns between children who exhibit minimal and moderate phonological deviations in terms of frequency of stuttering and length of stuttering events? Twenty-nine preschool children near the onset of stuttering, ranging in age from 29 to 49 months, with a mean of 39.17 months, were divided into two groups based on the level of phonological ability: minimal phonological deviations and moderate phonological deviations. The children’s level of stuttering-like disfluencies was examined. Results revealed no statistically significant differences in the stuttering characteristics of the two groups near onset, calling into the question the nature of the stuttering-phonology link. PMID:22939524

Effect(s) of Language Tasks on Severity of Disfluencies in Preschool Children with Stuttering.

PubMed

Zamani, Peyman; Ravanbakhsh, Majid; Weisi, Farzad; Rashedi, Vahid; Naderi, Sara; Hosseinzadeh, Ayub; Rezaei, Mohammad

2017-04-01

Speech disfluency in children can be increased or decreased depending on the type of linguistic task presented to them. In this study, the effect of sentence imitation and sentence modeling on severity of speech disfluencies in preschool children with stuttering is investigated. In this cross-sectional descriptive analytical study, 58 children with stuttering (29 with mild stuttering and 29 with moderate stuttering) and 58 typical children aged between 4 and 6 years old participated. The severity of speech disfluencies was assessed by SSI-3 and TOCS before and after offering each task. In boys with mild stuttering, The mean stuttering severity scores in two tasks of sentence imitation and sentence modeling were [Formula: see text] and [Formula: see text] respectively ([Formula: see text]). But, in boys with moderate stuttering the stuttering severity in the both tasks were [Formula: see text] and [Formula: see text] respectively ([Formula: see text]). In girls with mild stuttering, the stuttering severity in two tasks of sentence imitation and sentence modeling were [Formula: see text] and [Formula: see text] respectively ([Formula: see text]). But, in girls with moderate stuttering the mean stuttering severity in the both tasks were [Formula: see text] and [Formula: see text] respectively ([Formula: see text]). In both gender of typical children, the score of speech disfluencies had no significant difference between two tasks ([Formula: see text]). In preschool children with mild stuttering and peer non-stutters, performing the tasks of sentence imitation and sentence modeling could not increase the severity of stuttering. But, in preschool children with moderate stuttering, doing the task of sentence modeling increased the stuttering severity score.

Retention of Implicit Sequence Learning in Persons who Stutter and Persons with Parkinson's Disease

PubMed Central

Smits-Bandstra, Sarah; Gracco, Vincent

2014-01-01

This study investigated the retention of implicit sequence learning in 14 persons with Parkinson's disease (PPD), 14 persons who stutter (PWS) and 14 control participants. Participants completed a nonsense syllable serial reaction time task in a 120-minute session. Participants named aloud four syllables in response to four visual stimuli. The syllables formed a repeating 8-item sequence not made known to participants. After one week, participants completed a 60-minute retention session that included an explicit learning questionnaire and a sequence generation task. PPD showed retention of general learning equivalent to controls but PWS's reaction times were significantly slower on early trials of the retention test relative to other groups. Controls showed implicit learning during the initial session that was retained on the retention test. In contrast, PPD and PWS did not demonstrate significant implicit learning until the retention test suggesting intact, but delayed, learning and retention of implicit sequencing skills. All groups demonstrated similar limited explicit sequence knowledge. Performance differences between PWS and PPD relative to controls during the initial session and on early retention trials indicated possible dysfunction of the cortico-striato-thalamo-cortical loop. The etiological implications for stuttering, and clinical implications for both populations, of this dysfunction are discussed. PMID:23844763

The effects of self-disclosure and non self-disclosure of stuttering on listeners' perceptions of a person who stutters.

PubMed

Healey, E Charles; Gabel, Rodney M; Daniels, Derek E; Kawai, Nori

2007-01-01

The aim of this study was to examine listener perceptions of an adult male person who stutters (PWS) who did or did not disclose his stuttering. Ninety adults who do not stutter individually viewed one of three videotaped monologues produced by a male speaker with severe stuttering. In one monologue, 30 listeners heard the speaker disclose stuttering at the beginning and in another monologue, 30 listeners heard the speaker disclose stuttering at the end. A third group of 30 listeners viewed a monologue where no disclosure of stuttering occurred. After listeners viewed a monologue, they were asked to rate a set of six Likert scale statements and answer three open-ended questions. The results showed that only one of six Likert statements was significantly different across the three conditions. The only statement that was different was that the speaker was perceived to be significantly more friendly when disclosing stuttering at the end of the monologue than when not disclosing stuttering. There were no significant differences between the percentage of positive and negative comments made by listeners across the three conditions. Listeners' comments to each open-ended question showed they were comfortable listening to stuttering with or without disclosure and slightly more than half of the listeners believed their perceptions of the speaker did not change when he disclosed stuttering. The results also showed that the speaker who disclosed stuttering at the beginning of the monologue received significantly more positive listener comments than when he disclosed stuttering at the end of the monologue. Results are discussed relative to comparisons with the study, the clinical relevance of acknowledging stuttering as a component of treatment, and future research on the self-disclosure of stuttering. The reader will be able to: (1) describe how different groups of listeners perceive and respond to two conditions of self-disclosure of stuttering and one condition involving non self-disclosure of stuttering; (2) summarize the range of listener responses to and benefits of self-disclosure of stuttering; and (3) describe the value of self-disclosure of stuttering for the listener and the speaker.

Characteristics of stuttering-like disfluencies in Dutch-speaking children.

PubMed

Boey, Ronny A; Wuyts, Floris L; Van de Heyning, Paul H; De Bodt, Marc S; Heylen, Louis

2007-01-01

The purpose of this study was to compare the characteristics of stuttering-like disfluencies in a group of native Dutch-speaking children who stutter (n=693), with a group of normally fluent children (n=79). Methods involved the observation of stuttering-like disfluencies in participants' conversational speech samples (total 77,200 words), particularly the frequency, duration and physical tension of instances of stuttering. Findings indicate that stuttering-like disfluencies exhibited by children who stutter are significantly more frequent, longer in duration and involve more physical tension when compared to those of normally fluent children. Furthermore, applying a criterion of 3% stuttering-like disfluencies to distinguish stuttering from normally fluent children resulted in a high degree of sensitivity (0.9452) and specificity (0.9747). Results were taken to suggest that characteristics of stuttering-like disfluencies of Dutch-speaking children are similar to those of English-speaking children and that talker group membership criteria for childhood stuttering can reasonably be extrapolated from the Dutch to the English language and vice versa. The reader will be able to: (1) describe characteristics of stuttering-like disfluencies, (2) define properties such as frequency, duration and physical tension for stuttering children and normally fluent children, and (3) make use of data on sensitivity and specificity of the criterion of 3% stuttering-like disfluencies to distinguish stuttering and normally fluent children.

Implementation and validation of an improved allele specific stutter filtering method for electropherogram interpretation.

PubMed

Kalafut, Tim; Schuerman, Curt; Sutton, Joel; Faris, Tom; Armogida, Luigi; Bright, Jo-Anne; Buckleton, John; Taylor, Duncan

2018-03-31

Modern probabilistic genotyping (PG) software is capable of modeling stutter as part of the profile weighting statistic. This allows for peaks in stutter positions to be considered as allelic or stutter or both. However, prior to running any sample through a PG calculator, the examiner must first interpret the sample, considering such things as artifacts and number of contributors (NOC or N). Stutter can play a major role both during the assignment of the number of contributors, and the assessment of inclusion and exclusion. If stutter peaks are not filtered when they should be, it can lead to the assignment of an additional contributor, causing N contributors to be assigned as N + 1. If peaks in the stutter position of a major contributor are filtered using a threshold that is too high, true alleles of minor contributors can be lost. Until now, the software used to view the electropherogram stutter filters are based on a locus specific model. Combined stutter peaks occur when a peak could be the result of both back stutter (stutter one repeat shorter than the allele) and forward stutter (stutter one repeat unit larger than the allele). This can challenge existing filters. We present here a novel stutter filter model in the ArmedXpert™ software package that uses a linear model based on allele for back stutter and applies an additive filter for combined stutter. We term this the allele specific stutter model (AM). We compared AM with a traditional model based on locus specific stutter filters (termed LM). This improved stutter model has the benefit of: Instances of over filtering were reduced 78% from 101 for a traditional model (LM) to 22 for the allele specific model (AM) when scored against each other. Instances of under filtering were reduced 80% from 85 (LM) to 17 (AM) when scored against ground truth mixtures. Published by Elsevier B.V.

Stuttering and Labor Market Outcomes in the United States.

PubMed

Gerlach, Hope; Totty, Evan; Subramanian, Anu; Zebrowski, Patricia

2018-06-22

The purpose of this study was to quantify relationships between stuttering and labor market outcomes, determine if outcomes differ by gender, and explain the earnings difference between people who stutter and people who do not stutter. Survey and interview data were obtained from the National Longitudinal Study of Adolescent to Adult Health. Of the 13,564 respondents who completed 4 waves of surveys over 14 years and answered questions about stuttering, 261 people indicated that they stutter. Regression analysis, propensity score matching, and Blinder-Oaxaca decomposition were used. After controlling for numerous variables related to demographics and comorbidity, the deficit in earnings associated with stuttering exceeded $7,000. Differences in observable characteristics between people who stutter and people who do not stutter (e.g., education, occupation, self-perception, hours worked) accounted for most of the earnings gap for males but relatively little for females. Females who stutter were also 23% more likely to be underemployed than females who do not stutter. Stuttering was associated with reduced earnings and other gender-specific disadvantages in the labor market. Preliminary evidence indicates that discrimination may have contributed to the earnings gap associated with stuttering, particularly for females.

The Effect of Frequency Altered Feedback on Stuttering Duration and Type

ERIC Educational Resources Information Center

Stuart, Andrew; Frazier, Carmen L.; Kalinowski, Joseph; Vos, Paul W.

2008-01-01

Purpose: The effect of frequency altered feedback (FAF) on stuttering type (i.e., prolongation, repetition, or silent block) and stuttering duration (i.e., average duration of stuttering event and total stuttering time) was examined. Method: Retrospective analyses of previously collected data from 12 adult persons who stutter who participated in…

Perceptions of University Instructors toward Students Who Stutter: A Quantitative and Qualitative Approach

ERIC Educational Resources Information Center

Daniels, Derek E.; Panico, James; Sudholt, Jennifer

2011-01-01

Many research studies have focused on perceptions of stuttering by various groups of people. However, there is limited research on the perceptions of university instructors toward stuttering and people who stutter. Therefore, this study explored the perceptions of university instructors toward stuttering and students who stutter, and their beliefs…

Social anxiety and the severity and typography of stuttering in adolescents.

PubMed

Mulcahy, Kylie; Hennessey, Neville; Beilby, Janet; Byrnes, Michelle

2008-12-01

The present study examined the relationship between anxiety, attitude toward daily communication, and stuttering symptomatology in adolescent stuttering. Adolescents who stuttered (n=19) showed significantly higher levels of trait, state and social anxiety than fluent speaking controls (n=18). Trait and state anxiety was significantly associated with difficulty with communication in daily situations for adolescents who stutter, but not for controls. No statistically significant associations were found between anxiety and measures of communication difficulty, and the severity or typography of stuttering surface behaviours. These results highlight some of the psychosocial concomitants of chronic stuttering in adolescence, but challenge the notion that anxiety plays a direct mediating role in stuttering surface behaviours. Rather, the results suggest stuttering is a disorder that features psychosocial conflict regardless of its surface features. The reader will be able to: (1) summarise findings from previous studies with regards to stuttering and anxiety; (2) identify the sub-types of anxiety that may impact on the individual who stutters; and (3) discuss the clinical implications of the results with regards to working with adolescents who stutter.

A comparison of attitudes towards stuttering of non-stuttering preschoolers in the United States and Turkey

PubMed Central

Nakisci, Egemen; Ozdemir, Ramazan S.

2017-01-01

Background and objectives Extensive research documents ubiquitous negative attitudes towards stuttering, but when and how they develop is unclear. This non-experimental, comparative study examined US and Turkish preschoolers to explore the origin of stuttering attitudes cross-culturally. Method The authors compared stuttering attitudes of 28 US and 31 Turkish non-stuttering preschoolers on English and Turkish versions of experimental prototypes of the newly developed Public Opinion Survey on Human Attributes–Stuttering/Child (POSHA–S/Child). Children first watched a short video of two stuttering avatar characters and then answered oral questions about stuttering. Parents completed a demographic questionnaire. Differences in the US and Turkish POSHA–S/Child means were calculated using the Mann–Whitney U test. Results Attitudes of the US and Turkish children were remarkably similar. Children rated most of the items negatively but also rated some items as neutral or positive. They held relatively more negative attitudes towards traits and personalities of children who stutter yet relatively more positive attitudes towards stuttering children’s potential. Conclusion Stuttering attitudes in children appear to be partly independent of culture. PMID:28470081

A comparison of attitudes towards stuttering of non-stuttering preschoolers in the United States and Turkey.

PubMed

Weidner, Mary E; St Louis, Kenneth O; Nakisci, Egemen; Ozdemir, Ramazan S

2017-04-21

Extensive research documents ubiquitous negative attitudes towards stuttering, but when and how they develop is unclear. This non-experimental, comparative study examined US and Turkish preschoolers to explore the origin of stuttering attitudes cross-culturally. The authors compared stuttering attitudes of 28 US and 31 Turkish non-stuttering preschoolers on English and Turkish versions of experimental prototypes of the newly developed Public Opinion Survey on Human Attributes-Stuttering/Child (POSHA-S/Child). Children first watched a short video of two stuttering avatar characters and then answered oral questions about stuttering. Parents completed a demographic questionnaire. Differences in the US and Turkish POSHA-S/Child means were calculated using the Mann-Whitney U test. Attitudes of the US and Turkish children were remarkably similar. Children rated most of the items negatively but also rated some items as neutral or positive. They held relatively more negative attitudes towards traits and personalities of children who stutter yet relatively more positive attitudes towards stuttering children's potential. Stuttering attitudes in children appear to be partly independent of culture.

The role of psychological processes in estimates of stuttering severity.

PubMed

Manning, Walter; Gayle Beck, J

2013-12-01

To examine the associations of trait anxiety (STAI), social anxiety (SIAS), depression (BDI-II), and personality features (ADP-IV) with three measures of stuttering severity: %SS, Stuttering Severity, Instrument, and the Overall Assessment of the Speaker's Experience of Stuttering. Fifty adults with a history of stuttering served as participants. Participant scores on trait, anxiety, social anxiety, depression, and personality features were entered into a regression analysis, with the criterion variables (DVs) being: %SS, SSI-3, OASES total score. In order to explore the OASES, further, each of the four OASES subscales were also examined. A separate regression was conducted for, each dependent variable. The OASES total score model was significant (p<.0001) and revealed that social anxiety and, trait anxiety were the only significant predictors, with medium effect sizes noted for both variables. In contrast, percent syllables stuttered and the SSI were not significantly associated with psychological, variables, suggesting that anxiety may not always be related to overt indicators of stuttering. Depression and personality dysfunction were not significantly associated with any measure of, stuttering severity. Anxiety in the form of social and trait anxiety are significantly associated with stuttering, severity as indicated by the OASES. Traditional procedures for assigning severity ratings to individuals, who stutter based on percent syllables stuttered and the Stuttering Severity Instrument are not, significantly related to psychological processes central to the stuttering experience. Depression and, personality characteristics do not meaningfully account for stuttering. The reader will be able to: (a) differentiate forms of anxiety that are likely to be associated with stuttering (b) understand the importance of determining features of stuttering that go beyond the obvious, surface characteristics of stuttering frequency, and (c) discuss the important clinical and theoretical implications for understanding the degree of psychological dysfunction that is likely to be characteristic of those who stutter. Copyright © 2013 Elsevier Inc. All rights reserved.

University Students' Perceptions of the Life Effects of Stuttering

ERIC Educational Resources Information Center

Hughes, Stephanie; Gabel, Rodney; Irani, Farzan; Schlagheck, Adam

2010-01-01

An open-ended, written survey was administered to 146 university students who did not stutter to obtain their impressions of the effects of stuttering on the lives of people who stutter (PWS). Participants first wrote about the general effects of stuttering and then considered how their lives would be different if they stuttered. Both types of…

Public attitudes toward-and identification of-cluttering and stuttering in Norway and Puerto Rico.

PubMed

St Louis, Kenneth O; Sønsterud, Hilda; Carlo, Edna J; Heitmann, Ragnhild R; Kvenseth, Helene

2014-12-01

The study sought to compare public attitudes toward cluttering versus stuttering in Norway and Puerto Rico and to compare respondents' identification of persons known with these fluency disorders. After reading lay definitions of cluttering and stuttering, three samples of adults from Norway and three from Puerto Rico rated their attitudes toward cluttering and/or stuttering on modified versions of the POSHA-Cl (for cluttering) and POSHA-S (for stuttering). They also identified children and adults whom they knew who either or both manifested cluttering or stuttering. Attitudes toward cluttering were essentially unaffected by rating either cluttering only or combined cluttering and stuttering on the same questionnaire in both countries. The same was also true of stuttering. Attitudes were very similar toward both disorders although slightly less positive for cluttering. Norwegian attitudes toward both disorders were generally more positive than Puerto Rican attitudes. The average respondent identified slightly more than one fluency disorder, a higher percentage for stuttering than cluttering and higher for adults than children. Cluttering-stuttering was rarely identified. Given a lay definition, this study confirmed that adults from diverse cultures hold attitudes toward cluttering that are similar to-but somewhat less positive than-their attitudes toward stuttering. It also confirmed that adults can identify cluttering among people they know, although less commonly than stuttering. Design controls in this study assured that consideration of stuttering did not affect either the attitudes or identification results for cluttering. The reader will be able to: (a) describe the effects-or lack thereof-of considerations of stuttering on attitudes toward cluttering; (b) describe differences in public identification of children and adults who either clutter or stutter; (c) describe differences between attitudes toward cluttering and stuttering in Norway and Puerto Rico. Copyright © 2014 Elsevier Inc. All rights reserved.

Early-stage chunking of finger tapping sequences by persons who stutter and fluent speakers.

PubMed

Smits-Bandstra, Sarah; De Nil, Luc F

2013-01-01

This research note explored the hypothesis that chunking differences underlie the slow finger-tap sequencing performance reported in the literature for persons who stutter (PWS) relative to fluent speakers (PNS). Early-stage chunking was defined as an immediate and spontaneous tendency to organize a long sequence into pauses, for motor planning, and chunks of fluent motor performance. A previously published study in which 12 PWS and 12 matched PNS practised a 10-item finger tapping sequence 30 times was examined. Both groups significantly decreased the duration of between-chunk intervals (BCIs) and within-chunk intervals (WCIs) over practice. PNS had significantly shorter WCIs relative to PWS, but minimal differences between groups were found for the number of, or duration of, BCI. Results imply that sequencing differences found between PNS and PWS may be due to differences in automatizing movements within chunks or retrieving chunks from memory rather than chunking per se.

Self-efficacy and quality of life in adults who stutter.

PubMed

Carter, Alice; Breen, Lauren; Yaruss, J Scott; Beilby, Janet

2017-12-01

Self-efficacy has emerged as a potential predictor of quality of life for adults who stutter. Research has focused primarily on the positive relationship self-efficacy has to treatment outcomes, but little is known about the relationship between self-efficacy and quality of life for adults who stutter. The purpose of this mixed- methods study is to determine the predictive value of self-efficacy and its relationship to quality of life for adults who stutter. The Self-Efficacy Scale for Adult Stutterers and the Overall Assessment of the Speaker's Experience with Stuttering were administered to 39 adults who stutter, aged 18- 77. Percentage of syllables stuttered was calculated from a conversational speech sample as a measure of stuttered speech frequency. Qualitative interviews with semi-structured probes were conducted with 10 adults and analyzed using thematic analysis to explore the lived experience of adults who stutter. Self-efficacy emerged as a strong positive predictor of quality of life for adults living with a stuttered speech disorder. Stuttered speech frequency was a moderate negative predictor of self-efficacy. Major qualitative themes identified from the interviews with the participants were: encumbrance, self-concept, confidence, acceptance, life-long journey, treatment, and support. Results provide clarity on the predictive value of self-efficacy and its relationship to quality of life and stuttered speech frequency. Findings highlight that the unique life experiences of adults who stutter require a multidimensional approach to the assessment and treatment of stuttered speech disorders. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

An investigation into the personal financial costs associated with stuttering.

PubMed

Blumgart, Elaine; Tran, Yvonne; Craig, Ashley

2010-09-01

Stuttering has been found to deteriorate quality of life in psychological, emotional and social functioning domains. It is reasonable to assume then that stuttering would also be associated with economic consequences that may also challenge quality of life. Remarkably, the personal financial costs associated with stuttering in adults has rarely if ever been explored or investigated in the fluency disorders field. This study involved an assessment of the personal costs of stuttering and an investigation into determinants that may influence spending. Two hundred adults who stutter participated in this study. Findings indicated that the average total cost was around $5,500 (median cost $4,165) in 2007/08 Australian dollars over a 5-year period. Major financial items included costs of direct and indirect treatments for stuttering, self-help, stuttering related conferences, and technology. Financial costs were not significantly influenced by the sex of the person, annual income, or by how severe the person stuttered. However, those individuals younger than 60 years old spent significantly more on treatment related costs, while those with elevated levels of social anxiety spent significantly less than those with lower levels of social anxiety. Quality of life implications associated with stuttering are discussed. The reader will be able to: (a) describe the method for assessing the direct financial costs of stuttering over a 5-year period; (b) describe the financial personal cost of stuttering for adults who stutter; (c) describe the relationship between factors like sex, age, severity of stuttering and financial costs; and (d) describe the relationship between social anxiety and the financial cost of stuttering.

Stuttering as a trait or state - an ALE meta-analysis of neuroimaging studies.

PubMed

Belyk, Michel; Kraft, Shelly Jo; Brown, Steven

2015-01-01

Stuttering is a speech disorder characterised by repetitions, prolongations and blocks that disrupt the forward movement of speech. An earlier meta-analysis of brain imaging studies of stuttering (Brown et al., 2005) revealed a general trend towards rightward lateralization of brain activations and hyperactivity in the larynx motor cortex bilaterally. The present study sought not only to update that meta-analysis with recent work but to introduce an important distinction not present in the first study, namely the difference between 'trait' and 'state' stuttering. The analysis of trait stuttering compares people who stutter (PWS) with people who do not stutter when behaviour is controlled for, i.e., when speech is fluent in both groups. In contrast, the analysis of state stuttering examines PWS during episodes of stuttered speech compared with episodes of fluent speech. Seventeen studies were analysed using activation likelihood estimation. Trait stuttering was characterised by the well-known rightward shift in lateralization for language and speech areas. State stuttering revealed a more diverse pattern. Abnormal activation of larynx and lip motor cortex was common to the two analyses. State stuttering was associated with overactivation in the right hemisphere larynx and lip motor cortex. Trait stuttering was associated with overactivation of lip motor cortex in the right hemisphere but underactivation of larynx motor cortex in the left hemisphere. These results support a large literature highlighting laryngeal and lip involvement in the symptomatology of stuttering, and disambiguate two possible sources of activation in neuroimaging studies of persistent developmental stuttering. © 2014 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Exploring risk factors for stuttering development in Parkinson disease after deep brain stimulation.

PubMed

Picillo, Marina; Vincos, Gustavo B; Sammartino, Francesco; Lozano, Andres M; Fasano, Alfonso

2017-05-01

Stuttering is a speech disorder with disruption of verbal fluency, occasionally present in Parkinson's disease (PD). PD co-incident stuttering may either worsen or improve after Deep Brain Stimulation (DBS). Sixteen out of 453 PD patients (3.5%) exhibited stuttering after DBS (PD-S) and were compared with a group of patients without stuttering (PD-NS) using non-parametric statistics. After DBS, stuttering worsened in 3 out of 4 patients with co-incidental stuttering. Most PD-S underwent subthalamic (STN) DBS, but 4 were implanted in the globus pallidus (GPi). Nine out of 16 PD-S (56.3%) reported a positive familial history for stuttering compared to none of the PD-NS. PD-S were mainly male (81.3%) with slight worse motor features compared to PD-NS. Herein, we describe a group of PD patients developing stuttering after DBS and report the presence of a positive familial history for stuttering as the most relevant risk factor, suggesting a possible underlying genetic cause. The fact that stuttering occurred after either STN or GPi DBS is an argument against the impact of medication reduction on stuttering. Copyright © 2017 Elsevier Ltd. All rights reserved.

Impact of stuttering severity on adolescents' domain-specific and general self-esteem through cognitive and emotional mediating processes.

PubMed

Adriaensens, Stefanie; Beyers, Wim; Struyf, Elke

2015-01-01

The theory that self-esteem is substantially constructed based on social interactions implies that having a stutter could have a negative impact on self-esteem. Specifically, self-esteem during adolescence, a period of life characterized by increased self-consciousness, could be at risk. In addition to studying mean differences between stuttering and non-stuttering adolescents, this article concentrates on the influence of stuttering severity on domain-specific and general self-esteem. Subsequently, we investigate if covert processes on negative communication attitudes, experienced stigma, non-disclosure of stuttering, and (mal)adaptive perfectionism mediate the relationship between stuttering severity and self-esteem. Our sample comprised 55 stuttering and 76 non-stuttering adolescents. They were asked to fill in a battery of questionnaires, consisting of: Subjective Screening of Stuttering, Self-Perception Profile for Adolescents, Erickson S-24, Multidimensional Perfectionism Scale, and the Stigmatization and Disclosure in Adolescents Who Stutter Scale. SEM (structural equation modeling) analyses showed that stuttering severity negatively influences adolescents' evaluations of social acceptance, school competence, the competence to experience a close friendship, and global self-esteem. Maladaptive perfectionism and especially negative communication attitudes fully mediate the negative influence of stuttering severity on self-esteem. Group comparison showed that the mediation model applies to both stuttering and non-stuttering adolescents. We acknowledge the impact of having a stutter on those domains of the self in which social interactions and communication matter most. We then accentuate that negative attitudes about communication situations and excessive worries about saying things in ways they perceive as wrong are important processes to consider with regard to the self-esteem of adolescents who stutter. Moreover, we provide evidence that these covert processes also need to be addressed when helping adolescents who are insecure about their fluency in general. Copyright © 2015 Elsevier Inc. All rights reserved.

Preliminary study of self-reported experience of physical aggression and bullying of boys who stutter: relation to increased anxiety.

PubMed

Blood, Gordon W; Blood, Ingrid M

2007-06-01

This study examined the relationship of self-reported anxiety and vulnerability to bullying for 18 children who stuttered and 18 children who did not stutter. More children who stuttered were at significantly higher risk of experiencing bullying behavior (61%) than children who did not stutter (22%); 39% of children who stuttered scored at least one standard deviation above the mean on the Revised Children's Manifest Anxiety Scale, suggestive of higher anxiety. In contrast, only 6% of children who did not stutter scored at least one standard deviation above the mean. The correlation was .82 for children who stuttered between greater vulnerability to bullying and self-reported anxiety. A bidirectional relationship is hypothesized between high anxiety and bullying of children who stutter.

Brain anatomy differences in childhood stuttering.

PubMed

Chang, Soo-Eun; Erickson, Kirk I; Ambrose, Nicoline G; Hasegawa-Johnson, Mark A; Ludlow, Christy L

2008-02-01

Stuttering is a developmental speech disorder that occurs in 5% of children with spontaneous remission in approximately 70% of cases. Previous imaging studies in adults with persistent stuttering found left white matter deficiencies and reversed right-left asymmetries compared to fluent controls. We hypothesized that similar differences might be present indicating brain development differences in children at risk of stuttering. Optimized voxel-based morphometry compared gray matter volume (GMV) and diffusion tensor imaging measured fractional anisotropy (FA) in white matter tracts in 3 groups: children with persistent stuttering, children recovered from stuttering, and fluent peers. Both the persistent stuttering and recovered groups had reduced GMV from normal in speech-relevant regions: the left inferior frontal gyrus and bilateral temporal regions. Reduced FA was found in the left white matter tracts underlying the motor regions for face and larynx in the persistent stuttering group. Contrary to previous findings in adults who stutter, no increases were found in the right hemisphere speech regions in stuttering or recovered children and no differences in right-left asymmetries. Instead, a risk for childhood stuttering was associated with deficiencies in left gray matter volume while reduced white matter integrity in the left hemisphere speech system was associated with persistent stuttering. Anatomical increases in right hemisphere structures previously found in adults who stutter may have resulted from a lifetime of stuttering. These findings point to the importance of considering the role of neuroplasticity during development when studying persistent forms of developmental disorders in adults.

Brain Anatomy Differences in Childhood Stuttering

PubMed Central

Chang, Soo-Eun; Erickson, Kirk I.; Ambrose, Nicoline G.; Hasegawa-Johnson, Mark A.; Ludlow, Christy L.

2009-01-01

Stuttering is a developmental speech disorder that occurs in 5% of children with spontaneous remission in approximately 70% of cases. Previous imaging studies in adults with persistent stuttering found left white matter deficiencies and reversed right-left asymmetries compared to fluent controls. We hypothesized that similar differences might be present indicating brain development differences in children at risk of stuttering. Optimized voxel-based morphometry compared gray matter volume (GMV) and diffusion tensor imaging measured fractional anisotropy (FA) in white matter tracts in 3 groups: children with persistent stuttering, children recovered from stuttering, and fluent peers. Both the persistent stuttering and recovered groups had reduced GMV from normal in speech-relevant regions: the left inferior frontal gyrus, and bilateral temporal regions. Reduced FA was found in the left white matter tracts underlying the motor regions for face and larynx in the persistent stuttering group. Contrary to previous findings in adults who stutter, no increases were found in the right hemisphere speech regions in stuttering or recovered children and no differences in right-left asymmetries. Instead, a risk for childhood stuttering was associated with deficiencies in left gray matter volume while reduced white matter integrity in the left hemisphere speech system was associated with persistent stuttering. Anatomical increases in right hemisphere structures previously found in adults who stutter may have resulted from a life-time of stuttering. These findings point to the importance of considering the role of neuroplasticity during development when studying persistent forms of developmental disorders in adults. PMID:18023366

CNV amplitude as a neural correlate for stuttering frequency: A case report of acquired stuttering.

PubMed

Vanhoutte, Sarah; Van Borsel, John; Cosyns, Marjan; Batens, Katja; van Mierlo, Pieter; Hemelsoet, Dimitri; Van Roost, Dirk; Corthals, Paul; De Letter, Miet; Santens, Patrick

2014-11-01

A neural hallmark of developmental stuttering is abnormal articulatory programming. One of the neurophysiological substrates of articulatory preparation is the contingent negative variation (CNV). Unfortunately, CNV tasks are rarely performed in persons who stutter and mainly focus on the effect of task variation rather than on interindividual variation in stutter related variables. However, variations in motor programming seem to be related to variation in stuttering frequency. The current study presents a case report of acquired stuttering following stroke and stroke related surgery in the left superior temporal gyrus. A speech related CNV task was administered at four points in time with differences in stuttering severity and frequency. Unexpectedly, CNV amplitudes at electrode sites approximating bilateral motor and left inferior frontal gyrus appeared to be inversely proportional to stuttering frequency. The higher the stuttering frequency, the lower the activity for articulatory preparation. Thus, the amount of disturbance in motor programming seems to determine stuttering frequency. At right frontal electrodes, a relative increase in CNV amplitude was seen at the test session with most severe stuttering. Right frontal overactivation is cautiously suggested to be a compensation strategy. In conclusion, late CNV amplitude elicited by a relatively simple speech task seems to be able to provide an objective, neural correlate of stuttering frequency. The present case report supports the hypothesis that motor preparation has an important role in stuttering. Copyright © 2014 Elsevier Ltd. All rights reserved.

Emotional and physiological responses of fluent listeners while watching the speech of adults who stutter.

PubMed

Guntupalli, Vijaya K; Everhart, D Erik; Kalinowski, Joseph; Nanjundeswaran, Chayadevie; Saltuklaroglu, Tim

2007-01-01

People who stutter produce speech that is characterized by intermittent, involuntary part-word repetitions and prolongations. In addition to these signature acoustic manifestations, those who stutter often display repetitive and fixated behaviours outside the speech producing mechanism (e.g. in the head, arm, fingers, nares, etc.). Previous research has examined the attitudes and perceptions of those who stutter and people who frequently interact with them (e.g. relatives, parents, employers). Results have shown an unequivocal, powerful and robust negative stereotype despite a lack of defined differences in personality structure between people who stutter and normally fluent individuals. However, physiological investigations of listener responses during moments of stuttering are limited. There is a need for data that simultaneously examine physiological responses (e.g. heart rate and galvanic skin conductance) and subjective behavioural responses to stuttering. The pairing of these objective and subjective data may provide information that casts light on the genesis of negative stereotypes associated with stuttering, the development of compensatory mechanisms in those who stutter, and the true impact of stuttering on senders and receivers alike. To compare the emotional and physiological responses of fluent speakers while listening and observing fluent and severe stuttered speech samples. Twenty adult participants (mean age = 24.15 years, standard deviation = 3.40) observed speech samples of two fluent speakers and two speakers who stutter reading aloud. Participants' skin conductance and heart rate changes were measured as physiological responses to stuttered or fluent speech samples. Participants' subjective responses on arousal (excited-calm) and valence (happy-unhappy) dimensions were assessed via the Self-Assessment Manikin (SAM) rating scale with an additional questionnaire comprised of a set of nine bipolar adjectives. Results showed significantly increased skin conductance and lower mean heart rate during the presentation of stuttered speech relative to the presentation of fluent speech samples (p<0.05). Listeners also self-rated themselves as being more aroused, unhappy, nervous, uncomfortable, sad, tensed, unpleasant, avoiding, embarrassed, and annoyed while viewing stuttered speech relative to the fluent speech. These data support the notion that stutter-filled speech can elicit physiological and emotional responses in listeners. Clinicians who treat stuttering should be aware that listeners show involuntary physiological responses to moderate-severe stuttering that probably remain salient over time and contribute to the evolution of negative stereotypes of people who stutter. With this in mind, it is hoped that clinicians can work with people who stutter to develop appropriate coping strategies. The role of amygdala and mirror neural mechanism in physiological and subjective responses to stuttering is discussed.

Effect of extended exposure to frequency-altered feedback on stuttering during reading and monologue.

PubMed

Armson, J; Stuart, A

1998-06-01

An ABA time series design was used to examine the effect of extended, continuous exposure to frequency-altered auditory feedback (FAF) during an oral reading and monologue task on stuttering frequency and speech rate. Twelve adults who stutter participated. A statistically significant decrease in number of stuttering events, an increase in number of syllables produced, and a decrease in percent stuttering was observed during the experimental segment relative to baseline segments for the oral reading task. In the monologue task, there were no statistically significant differences for the number of stuttering events, number of syllables produced, or percent stuttering between the experimental and baseline segments. Varying individual patterns of response to FAF were evident during the experimental segment of the reading task: a large consistent reduction in stuttering, an initial reduction followed by fluctuations in amount of stuttering, and essentially no change in stuttering frequency. Ten of 12 participants showed no reduction in stuttering frequency during the experimental segment of the monologue task. These findings have ramifications both for the clinical utilization of FAF and for theoretical explanations of fluency-enhancement.

Language skills of children during the first 12 months after stuttering onset.

PubMed

Watts, Amy; Eadie, Patricia; Block, Susan; Mensah, Fiona; Reilly, Sheena

2017-03-01

To describe the language development in a sample of young children who stutter during the first 12 months after stuttering onset was reported. Language production was analysed in a sample of 66 children who stuttered (aged 2-4 years). The sample were identified from a pre-existing prospective, community based longitudinal cohort. Data were collected at three time points within the first year after stuttering onset. Stuttering severity was measured, and global indicators of expressive language proficiency (length of utterances and grammatical complexity) were derived from the samples and summarised. Language production abilities of the children who stutter were contrasted with normative data. The majority of children's stuttering was rated as mild in severity, with more than 83% of participants demonstrating very mild or mild stuttering at each of the time points studied. The participants demonstrated developmentally appropriate spoken language skills comparable with available normative data. In the first year following the report of stuttering onset, the language skills of the children who were stuttering progressed in a manner that is consistent with developmental expectations. Copyright © 2016 Elsevier Inc. All rights reserved.

Cognitive processing load as a determinant of stuttering: summary of a research programme.

PubMed

Bosshardt, Hans-Georg

2006-07-01

The present paper integrates the results of experimental studies in which cognitive differences between stuttering and nonstuttering adults were investigated. In a monitoring experiment it was found that persons who stutter encode semantic information more slowly than nonstuttering persons. In dual-task experiments the two groups were compared in overt word-repetition and sentence-production experiments. The results of the two word-repetition experiments indicate that the speech of stuttering persons is sensitive to interference from concurrent attention-demanding cognitive processing-particularly when phonological coding is involved. In two sentence-generation and -production experiments it was found that under dual-task conditions stuttering persons produced sentences containing a smaller number of content units whereas persons who do not stutter did not show a significant single- vs. dual-task contrast. These results suggest that sentence generation and production required greater sustained attentional processing in stuttering than in nonstuttering persons and that persons who stutter reduce the amount of "conceptual work" in order to keep their stuttering rates low. Data from an fMRI-study indicate that in persons who stutter the neural systems activated during sentence generation and production overlap to a greater extent than those of persons who do not stutter. It is suggested that in persons who stutter neural subsystems involved in speech planning are "modularized" to a lesser extent than in persons who do not stutter.

Elementary school students' perceptions of stuttering: A mixed model approach.

PubMed

Panico, James; Healey, E Charles; Knopik, Jennifer

2015-09-01

Past research studies have focused on perceptions of stuttering by various age groups and only a few have examined how children react to a peer who stutters. All of these studies used a quantitative analysis but only one included a qualitative analysis of elementary school age children's responses to stuttering. The aim of this study was to further explore the perceptions of elementary school students toward a peer who stutters using both quantitative and qualitative analyses of three levels of stuttering. Participants included 88 elementary school children between 8 and 12 years of age. Each participant viewed one of four audiovisual samples of a peer producing fluent speech and mild, moderate, and severe simulated stuttering. Each participant then rated five Likert statements and answered three open-ended questions. Quantitative and qualitative results indicated that negative ratings and the percentage of negative comments increased as the frequency of stuttering increased. However, the children in this study indicated that they were comfortable listening to stuttering and would be comfortable making friends with the peer who stutters. The findings of this study together with past research in this area should help clinicians and their clients appreciate the range of social and emotional reactions peers have of a child who stutters. After reading this article, the reader will be able to: (a) discuss past research regarding children's perceptions of stuttering; (b) summarize the need to explore the perceptions of elementary-aged children toward a peer who stutters; (c) describe the major quantitative and qualitative findings of children's perceptions of stuttering; and (d) discuss the need for disseminating more information about stuttering to children and teachers. Copyright © 2015 Elsevier Inc. All rights reserved.

Self-acceptance of stuttering: A preliminary study.

PubMed

De Nardo, Thales; Gabel, Rodney M; Tetnowski, John A; Swartz, Eric R

2016-01-01

This study explored the relationship between self-acceptance of stuttering and (1) psychosocial factors (self-esteem, hostility towards others, emotional support, and perceived discrimination); (2) treatment history (support group participation, therapy duration, and perceived therapy success); and (3) previously reported variables in self-acceptance of stuttering, which include age and stuttering severity. Participants were 80 adults who stutter who were recruited with assistance from the National Stuttering Association and Board Certified Specialists in Fluency Disorders. Participants completed an electronic survey composed of an acceptance of stuttering scale, psychosocial scales, and a participant information questionnaire. Statistical analysis identified significant correlations between participants' reports of self-acceptance of stuttering and self-esteem, perceived discrimination, hostility towards others, and perceived therapy outcome. Self-esteem was positively correlated with self-acceptance, while hostility towards others and perceived discrimination was negatively correlated with self-acceptance. Participants who perceived their therapy outcome to be successful were significantly more likely to report higher levels of self-acceptance. No significant relationships were found between self-acceptance of stuttering and support group participation, emotional support, stuttering severity, and participant age. This exploratory investigation has provided a foundation for future studies on the self-acceptance of stuttering. The findings indicate common psychosocial variables in self-acceptance of stuttering and of other disabilities. The significant relationships between self-acceptance of stuttering and psychosocial and therapeutic variables found need to be further explored to identify its causalities and clinical implications. The reader will be able to (1) discuss the importance of assessing self-acceptance of stuttering, (2) summarize the literature on self-acceptance of disability, and (3) describe the significant findings related to self-acceptance of stuttering and psychosocial, therapeutic variables. Copyright © 2016 Elsevier Inc. All rights reserved.

[Comorbidity of tics and stuttering].

PubMed

Surushkina, S Yu; Chutko, L S; Aitbekov, K A; Nikishena, I S; Bondarchuk, Yu I

2014-01-01

To determine the clinical presentations of stuttering in children with tics treated with noofen. Authors examined 181 children with tics, aged 7-13. Stuttering was identified in 23.2% of cases. Thirty children with tics and comorbid stuttering received noofen. RESULTS AND СONCLUSION: The prevalence of stuttering in children with tics was significantly higher than in the population. Stuttering was significantly more frequent in children with transient tics than chronic tics. Neurotic stuttering was recorded more frequently. The high efficacy of noofen was shown; the decrease in ticks was obtained in 80% of cases, the reduction of stuttering in 66.7% of cases. The data of clinical, psychological and neurophysiological studies, confirming the improvement of patients after treatment, are presented.

Anxiety levels in adolescents who stutter.

PubMed

Blood, Gordon W; Blood, Ingrid M; Maloney, Kristy; Meyer, Crystal; Qualls, Constance Dean

2007-01-01

High levels of anxiety can negatively affect the lives of children and adolescents. Thirty-six adolescents who stutter and 36 adolescents who do not stutter were administered standardized scales for anxiety and self-esteem. Significant differences were found for the total T-scores for Revised Children's Manifest Anxiety Scale for the two groups, although both groups mean T-scores were within normal range. Eighty-three percent of adolescents who stutter and 95% of adolescents who do not stutter earned scores in the normal range. No significant differences were found on the self-esteem scale, with 86% of adolescents who stutter and 97% of adolescents who do not stutter earning scores in the normal/positive range. Adolescents who stutter with co-occurring disorders displayed significantly higher levels of anxiety than adolescents who stutter with no co-occurring disorders. No significant differences were found between groups on ethnicity, socioeconomic class, gender and anxiety levels. A positive, significant correlation between anxiety scores and self-esteem scores was found for both groups. Readers will learn about and understand (a) the role of anxiety and self-esteem in stuttering; (b) the methods used to evaluate anxiety and self-esteem in adolescents; and (c) the similarities between adolescents who stutter and adolescents who do not stutter on anxiety and self-esteem scales.

Relations between causal attributions for stuttering and psychological well-being in adults who stutter.

PubMed

Boyle, Michael

2016-02-01

This study attempted to understand the relationship between causal attributions for stuttering and psychological well-being in adults who stutter. The study employed a cross-sectional design using a web survey distribution mode to gain information related to causal attributions and psychological well-being of 348 adults who stutter. Correlation analyses were conducted to determine relationships between participants' causal attributions (i.e. locus of causality, external control, personal control, stability, biological attributions, non-biological attributions) for stuttering and various measures of psychological well-being including self-stigma, self-esteem/self-efficacy, hope, anxiety and depression. Results indicated that higher perceptions of external control of stuttering were related to significantly lower ratings of hope and self-esteem/self-efficacy and higher ratings of anxiety and depression. Higher perceptions of personal control of stuttering were related to significantly lower ratings of self-stigma and higher ratings of hope and self-esteem/self-efficacy. Increased biological attributions were significantly related to higher ratings of permanency and unchangeableness of stuttering and lower ratings of personal control of stuttering. The findings demonstrate the importance of instilling a sense of control in PWS regarding their ability to manage their stuttering. Findings also raise questions regarding the benefits of educating PWS about the biological underpinnings of stuttering.

The effects of bilingualism on stuttering during late childhood.

PubMed

Howell, P; Davis, S; Williams, R

2009-01-01

To examine stuttering by children speaking an alternative language exclusively (LE) or with English (BIL) and to study onset of stuttering, school performance and recovery rate relative to monolingual speakers who stutter (MONO). Clinical referral sample with supplementary data obtained from speech recordings and interviews. South-East England, 1999-2007. Children aged 8-12 plus who stuttered (monolingual and bilingual) and fluent bilingual controls (FB). Participants' stuttering history, SATS scores, measures of recovery or persistence of stuttering. 69 (21.8%) of 317 children were bilingual. Of 38 children who used a language other than English at home, 36 (94.7%) stuttered in both languages. Fewer LE (15/38, 39.5%) than BIL (23/38, 60.5%) children stuttered at first referral to clinic, but more children in the fluent control sample were LE (28/38, 73.7%) than BIL (10/38, 26.3%). The association between stuttering and bilingual group (LE/BIL) was significant by chi(2) test; BIL speakers have more chance of stuttering than LE speakers. Age at stuttering onset and male/female ratio for LE, BIL and MONO speakers were similar (4 years 9 months, 4 years 10 months and 4 years 3 months, and 4.1:1, 4.75:1 and 4.43:1, respectively). Educational achievement was not affected by bilingualism relative to the MONO and FB groups. The recovery rate for the LE and MONO controls together (55%) was significantly higher by chi(2) test than for the BIL group (25%). BIL children had an increased risk of stuttering and a lower chance of recovery from stuttering than LE and MONO speakers.

Responses of adults who stutter to the anticipation of stuttering.

PubMed

Jackson, Eric S; Yaruss, J Scott; Quesal, Robert W; Terranova, Valerie; Whalen, D H

2015-09-01

Many people who stutter experience the phenomenon of anticipation-the sense that stuttering will occur before it is physically and overtly realized. A systematic investigation of how people who stutter respond to anticipation has not been previously reported. The purposes of this study were to provide self-report evidence of what people do in response to anticipation of stuttering and to determine the extent to which this anticipation occurs. Thirty adults who stutter indicated on a Likert rating scale the extent to which they anticipate stuttering and answered three open-ended (written) questions regarding how they respond to anticipation. All participants reported experiencing anticipation at least "sometimes," and 77% of the participants reported experiencing anticipation "often" or "always." The extent to which participants reported experiencing anticipation was not related to stuttering severity, impact, or treatment history. Analysis of written responses revealed 24 major categories, which were heuristically divided into action or non-action responses. Categories representing avoidance and self-management strategies were further divided into 14 and 19 subcategories, respectively. Participants were just as likely to view anticipation as helpful as they were to view it as harmful. Findings demonstrate that most, if not all, adults who stutter experience anticipation, and the majority of adults who stutter report doing so at least often. Adults who stutter respond to this anticipation by altering the speech production process in various ways. Results highlight the importance of the role that anticipation plays in how stuttering behaviors manifest themselves. The reader will be able to: (a) summarize existing literature on the anticipation of stuttering; (b) describe the role and extent of anticipation of stuttering in adults; (c) describe the various ways that adults who stutter respond to anticipation; (d) describe the importance of measuring anticipation in clinical and research domains. Copyright © 2015 Elsevier Inc. All rights reserved.

The experiences of living with a sibling who stutters: a preliminary study.

PubMed

Beilby, Janet M; Byrnes, Michelle L; Young, Kate N

2012-06-01

Stuttering impacts on the child in a variety of ways, notably in terms of communicative impairment and psychosocial impact. In addition, the stuttering disorder has a holistic impact, affecting those with whom the child who stutters lives. Within the family constellation, the closest person to the individual who stutters is often their sibling. This study investigated the experiences of fluent siblings of children who stutter to examine the impact that stuttering may have on their lives. A mixed methods research design incorporated qualitative semi-structured interviews and quantitative questionnaires. The results of the qualitative investigation revealed four aspects of children's lives that were affected by having a sibling who stuttered: the relationship between siblings, the impact on the fluent sibling, the impact on the parent relationship with both children, and the impact on the sibling's relationship with others. Findings revealed that siblings of children who stutter exhibited strongly negative emotions, and differing levels of responsibility associated with their involvement in the actual stuttering management programme. Furthermore, for the fluent sibling, secondary to having a brother or sister who stuttered, communication with and attention from their parents was variable. The results of the quantitative component of the study revealed children who stutter and their siblings demonstrated significantly greater closeness, and concurrently, increased conflict and status disparity than did the control fluent sibling dyads. The parents of the experimental sibling dyads also demonstrated significantly greater partiality towards a child, namely the child who stuttered, than did the parents of the control sibling dyads. The reader will be able to: (1) identify the themes associated with having a sibling who stutters; (2) identify how the quality of the sibling relationship differs between sibling dyads that do and do not consist of a sibling who stutters; and (3) discuss the clinical implications of the results with regards to working with children who stutter and their families. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

Teaching Students Who Stutter

ERIC Educational Resources Information Center

Education Digest: Essential Readings Condensed for Quick Review, 2011

2011-01-01

Stutterer's incident in class draws national attention; Stuttering Foundation responds with tips for educators. In response to the articles in the "New York Times," Jane Fraser, president of the nonprofit Stuttering Foundation, wrote in a press release eight tips for educators regarding working with students who stutter. This article presents…

Characteristics of Stuttering in Dutch-Speaking Individuals

ERIC Educational Resources Information Center

Boey, Ronny A.; Wuyts, Floris L.; van de Heyning, Paul H.; Heylen, Louis; de Bodt, Marc S.

2009-01-01

Clinical diagnostic procedures to distinguish stuttering from non-stuttering individuals partially rely on the observation of characteristics of stuttered words or syllables. The purpose of this study was to examine the sensitivity and specificity of such a procedure, and to describe the observed characteristics of stuttered words. Methods…

The Influence of Stuttering Severity on Acoustic Startle Responses

ERIC Educational Resources Information Center

Ellis, John B.; Finan, Donald S.; Ramig, Peter R.

2008-01-01

Purpose: This study examined the potential impact of stuttering severity, as measured by the Perceptions of Stuttering Inventory (Woolf, 1967) on acoustic startle responses. Method: Three groups, consisting of 10 nonstuttering adults, 9 mild stutterering adults, and 11 moderate/severe stutterering adults, were presented with identical 95-dB…

Stuttering: What It Is and What to Do About It.

ERIC Educational Resources Information Center

Ainsworth, Stanley

Written for parents, teachers, students in training, school administrators, and stutterers themselves, the book discusses the causes, development, and treatment of stuttering. Presented are a definition, incidence figures, and overview of the impact of stuttering on an individual. Traced are the beginnings and development of stuttering in four…

Differential Diagnosis of Stuttering for Forensic Purposes

ERIC Educational Resources Information Center

Seery, Carol Hubbard

2005-01-01

Purpose: This case study demonstrates the application of an assessment protocol for differential diagnosis of psychogenic stuttering, neurogenic stuttering, developmental stuttering, and malingering. Method: A male in his late 30s, accused of armed robbery, was evaluated for stuttering at the request of his defense attorney. The speech assessment…

Comparison of different speech tasks among adults who stutter and adults who do not stutter

PubMed Central

Ritto, Ana Paula; Costa, Julia Biancalana; Juste, Fabiola Staróbole; de Andrade, Claudia Regina Furquim

2016-01-01

OBJECTIVES: In this study, we compared the performance of both fluent speakers and people who stutter in three different speaking situations: monologue speech, oral reading and choral reading. This study follows the assumption that the neuromotor control of speech can be influenced by external auditory stimuli in both speakers who stutter and speakers who do not stutter. METHOD: Seventeen adults who stutter and seventeen adults who do not stutter were assessed in three speaking tasks: monologue, oral reading (solo reading aloud) and choral reading (reading in unison with the evaluator). Speech fluency and rate were measured for each task. RESULTS: The participants who stuttered had a lower frequency of stuttering during choral reading than during monologue and oral reading. CONCLUSIONS: According to the dual premotor system model, choral speech enhanced fluency by providing external cues for the timing of each syllable compensating for deficient internal cues. PMID:27074176

Effects of stuttering severity and therapy involvement on attitudes towards people who stutter.

PubMed

Gabel, Rodney M

2006-01-01

The purpose of this study was to explore whether stuttering severity or therapy involvement had an effect on the attitudes that individuals who do not stutter reported towards people who stutter (PWS). Two hundred and sixty (260) university students participated in this study. Direct survey procedures consisting of a 25-item semantic differential scale were utilized. Comparisons of the effects of stuttering severity, level of therapy involvement, and the interaction of these variables were completed. Results suggested that both stuttering severity and therapy involvement had significant effects on participants' attitudes towards PWS. Findings of this study support past research studies that has found that individuals who stutter mildly are perceived more positively than those who are severe. Similarly, the data supported past research that has found that PWS that attend therapy are perceived more positively than those who do not attend therapy. Surprisingly, the interaction of these variables was not significant. The reader will be able to: (1) explain the possible effects of listeners' attitudes toward stuttering on the lives of PWS; (2) discuss how different factors might alter listeners' attitudes towards stuttering; (3) delineate how stuttering severity and involvement in therapy might impact listeners' attitudes towards PWS.

Public awareness and knowledge of stuttering in Japan.

PubMed

Iimura, Daichi; Yada, Yasuto; Imaizumi, Kazuya; Takeuchi, Toshimitsu; Miyawaki, Manami; Van Borsel, John

To determine laypeople's knowledge and awareness of stuttering in Japan. A total of 303 respondents, recruited by street sampling, completed a questionnaire assessing the prevalence, onset, gender distribution, occurrence in different races, cause, treatment, association with intelligence, and hereditariness of stuttering. The questionnaire used was a Japanese version of that devised by Van Borsel, Verniers, and Bouvry (1999) for use in Belgium. Although around half of the respondents had heard or met a stutterer, they tended to misunderstand the stuttering; e.g., respondents estimated the prevalence of stuttering as high. Knowledge also differed according to age, gender, and education level. Specifically, older individuals, females, and individuals with higher levels of education tended to have greater knowledge of stuttering. In comparing the results of the present study with similar studies conducted in Belgium, China, and Brazil, we observed several similarities and differences. Although most respondents were to some extent familiar with stuttering, their overall knowledge of the condition was limited. Certain factors could be involved in having knowledge of stuttering, such as one's life experience, cultural background, and social attitudes toward stuttering. The findings suggest the need for growing knowledge and awareness of stuttering. Copyright © 2018 Elsevier Inc. All rights reserved.

Stuttering: A novel bullfrog vocalization

NASA Astrophysics Data System (ADS)

Simmons, Andrea; Suggs, Dianne

2004-05-01

The advertisement call of male bullfrogs (Rana catesbeiana) consists of a series of individual croaks, each of which contains multiple harmonics with a missing or attenuated fundamental frequency of approximately 100 Hz. The envelope of individual croaks has typically been represented in the literature as smooth and unmodulated. From an analysis of 5251 advertisement calls from 17 different choruses over two mating seasons, we show that males add an extra modulation (around 4 Hz) to the envelope of individual croaks, following specific rules. We term these extra modulations stutters. Neither single croak calls nor the first croak in multiple croak calls contains stutters. When stuttering begins, it does so with a croak containing a single stutter, and the number of stutters increases linearly (plus or minus 1 stutter, up to 4 stutters) with the number of croaks. This pattern is stable across individual males (N=10). Playback experiments reveal that vocal responses to stuttered and nonstuttered calls vary with proximity to the stimulus. Close males respond with nonstuttered calls, while far males respond with stuttered calls. The data suggest that nonstuttered calls are used for aggressive or territorial purposes, while stuttered calls are used to attract females.

Auditory abilities of speakers who persisted, or recovered, from stuttering

PubMed Central

Howell, Peter; Davis, Stephen; Williams, Sheila M.

2006-01-01

Objective The purpose of this study was to see whether participants who persist in their stutter have poorer sensitivity in a backward masking task compared to those participants who recover from their stutter. Design The auditory sensitivity of 30 children who stutter was tested on absolute threshold, simultaneous masking, backward masking with a broadband and with a notched noise masker. The participants had been seen and diagnosed as stuttering at least 1 year before their 12th birthday. The participants were assessed again at age 12 plus to establish whether their stutter had persisted or recovered. Persistence or recovery was based on participant's, parent's and researcher's assessment and Riley's [Riley, G. D. (1994). Stuttering severity instrument for children and adults (3rd ed.). Austin, TX: Pro-Ed.] Stuttering Severity Instrument-3. Based on this assessment, 12 speakers had persisted and 18 had recovered from stuttering. Results Thresholds differed significantly between persistent and recovered groups for the broadband backward-masked stimulus (thresholds being higher for the persistent group). Conclusions Backward masking performance at teenage is one factor that distinguishes speakers who persist in their stutter from those who recover.

 Education objectives: Readers of this article should: (1) explain why auditory factors have been implicated in stuttering; (2) summarise the work that has examined whether peripheral, and/or central, hearing are problems in stuttering; (3) explain how the hearing ability of persistent and recovered stutterers may differ; (4) discuss how hearing disorders have been implicated in other language disorders. PMID:16920188

Long- and short-term results of children's and adolescents' therapy courses for stuttering.

PubMed

Laiho, Auli; Klippi, Anu

2007-01-01

It is widely known that most young children recover from stuttering. Evaluations of this spontaneous recovery vary from 40 to 80% of stuttering children. However, if the child is already older than 6 years of age, the spontaneous recovery will be less likely. The effectiveness of stuttering treatment, and especially fluency shaping methods, has been frequently studied. Good results in the treatment of stuttering for school-aged children have been accomplished by several treatment methods. However, stuttering modification treatments have not been studied so intensively. This study addresses the effects of intensive therapy courses on the stuttering behaviour of children and adolescents. The courses included speech therapy, where stuttering modification treatment was used, and also parental guidance. Taking part in the study were 21 children/adolescents who stutter, and 29 of their mothers/fathers took part in the study. The children were between the ages of 6.8 and 14.0 years. The effectiveness of therapy was evaluated in three ways. First, the speech of the children who stutter was videotaped at both the beginning and the end of the course and the samples were transcribed and analysed. Second, the parents and adolescents completed a feedback questionnaire at the end of the course. And third, the parents and adolescents completed a follow-up questionnaire 9 months after the course. The aim was to evaluate the changes in stuttering behaviour after the therapy course. The results indicate that stuttering severity became milder or did not change during the course. The percentage of syllables stuttered dropped with two-thirds of the participants. This result was replicated with avoidance behaviour and struggle behaviour. The quality of stuttering became milder, and by the end many children had shorter moments of stuttering and more repetitions and prolongation instead of blocks. Two participants did not complete the questionnaire. Of those who did, all but one adolescent, and all except one parent, reported that the positive changes in stuttering behaviour had continued during the follow-up period. The implication is that intensive therapy courses can be helpful to some participants who stutter.

Gestural recovery and the role of forward and reversed syllabic repetitions as stuttering inhibitors in adults.

PubMed

Kalinowski, Joseph; Saltuklaroglu, Tim; Guntupalli, Vijaya; Stuart, Andrew

2004-06-10

Instead of being the core stuttering 'problem', syllabic repetitions may be a biological mechanism, or 'solution', to the central involuntary stuttering block. Simply put, stuttering is an endogenous transitory state of 'shadowed speech', a choral speech derivative that allows for a neural release of the central block. To investigate this possibility, 14 adults who stutter read while listening to forward fluent speech, reversed fluent speech, forward stuttered speech, and reversed stuttered speech. All conditions induced significant degrees of stuttering inhibition when compared to a control condition. However, the reversed fluent condition was less powerful than the other three conditions ( approximately 42% vs. approximately 65%) for inhibiting stuttering. Stuttering inhibition appears to proceed by 'gestural recovery', made possible by the presence of an exogenous or 'second' set of speech gestures and engagement of mirror neurons. When reversed fluent speech was used, violations in normal gesture-time relationships (i.e., normal speech entropy) resulted in gestural configurations that apparently were inadequately recovered, and therefore, were not as conducive to high levels of stuttering inhibition. In contrast, high levels of encoding found in the simple syllabic structures of stuttered speech allowed its forward and reversed forms to be equally effective for gestural recovery and stuttering inhibition. The reversal of repeated syllables did not appear to significantly degrade the natural gesture-time relationships (i.e., they were perceptually recognizable). Thus, exogenous speech gestures that displayed near normal gestural relationships allowed for easy recovery and fluent productions via mirror systems, suggesting a more choral-like nature. The importance of syllabic repetitions is highlighted: both their perceived (exogenous) and produced (endogenous) forms appear to be fundamental, surface acoustic manifestations for central stuttering inhibition via the engagement of mirror neurons.

The effects of bilingualism on stuttering during late childhood

PubMed Central

Howell, P; Davis, S; Williams, R

2009-01-01

Objectives: To examine stuttering by children speaking an alternative language exclusively (LE) or with English (BIL) and to study onset of stuttering, school performance and recovery rate relative to monolingual speakers who stutter (MONO). Design: Clinical referral sample with supplementary data obtained from speech recordings and interviews. Setting: South-East England, 1999–2007. Participants: Children aged 8–12 plus who stuttered (monolingual and bilingual) and fluent bilingual controls (FB). Main outcome measures: Participants’ stuttering history, SATS scores, measures of recovery or persistence of stuttering. Results: 69 (21.8%) of 317 children were bilingual. Of 38 children who used a language other than English at home, 36 (94.7%) stuttered in both languages. Fewer LE (15/38, 39.5%) than BIL (23/38, 60.5%) children stuttered at first referral to clinic, but more children in the fluent control sample were LE (28/38, 73.7%) than BIL (10/38, 26.3%). The association between stuttering and bilingual group (LE/BIL) was significant by χ2 test; BIL speakers have more chance of stuttering than LE speakers. Age at stuttering onset and male/female ratio for LE, BIL and MONO speakers were similar (4 years 9 months, 4 years 10 months and 4 years 3 months, and 4.1:1, 4.75:1 and 4.43:1, respectively). Educational achievement was not affected by bilingualism relative to the MONO and FB groups. The recovery rate for the LE and MONO controls together (55%) was significantly higher by χ2 test than for the BIL group (25%). Conclusions: BIL children had an increased risk of stuttering and a lower chance of recovery from stuttering than LE and MONO speakers. PMID:18782846

Revisiting speech rate and utterance length manipulations in stuttering speakers.

PubMed

Blomgren, Michael; Goberman, Alexander M

2008-01-01

The goal of this study was to evaluate stuttering frequency across a multidimensional (2x2) hierarchy of speech performance tasks. Specifically, this study examined the interaction between changes in length of utterance and levels of speech rate stability. Forty-four adult male speakers participated in the study (22 stuttering speakers and 22 non-stuttering speakers). Participants were audio and video recorded while producing a spontaneous speech task and four different experimental speaking tasks. The four experimental speaking tasks involved reading a list of 45 words and a list 45 phrases two times each. One reading of each list involved speaking at a steady habitual rate (habitual rate tasks) and another reading involved producing each list at a variable speaking rate (variable rate tasks). For the variable rate tasks, participants were directed to produce words or phrases at randomly ordered slow, habitual, and fast rates. The stuttering speakers exhibited significantly more stuttering on the variable rate tasks than on the habitual rate tasks. In addition, the stuttering speakers exhibited significantly more stuttering on the first word of the phrase length tasks compared to the single word tasks. Overall, the results indicated that varying levels of both utterance length and temporal complexity function to modulate stuttering frequency in adult stuttering speakers. Discussion focuses on issues of speech performance according to stuttering severity and possible clinical implications. The reader will learn about and be able to: (1) describe the mediating effects of length of utterance and speech rate on the frequency of stuttering in stuttering speakers; (2) understand the rationale behind multidimensional skill performance matrices; and (3) describe possible applications of motor skill performance matrices to stuttering therapy.

Speech Timing Deficit of Stuttering: Evidence from Contingent Negative Variations

PubMed Central

Ning, Ning; Peng, Danling; Liu, Xiangping; Yang, Shuang

2017-01-01

The aim of the present study was to investigate the speech preparation processes of adults who stutter (AWS). Fifteen AWS and fifteen adults with fluent speech (AFS) participated in the experiment. The event-related potentials (ERPs) were recorded in a foreperiod paradigm. The warning signal (S1) was a color square, and the following imperative stimulus (S2) was either a white square (the Go signal that required participants to name the color of S1) or a white dot (the NoGo signal that prevents participants from speaking). Three differences were found between AWS and AFS. First, the mean amplitude of the ERP component parietal positivity elicited by S1 (S1-P3) was smaller in AWS than in AFS, which implies that AWS may have deficits in investing working memory on phonological programming. Second, the topographic shift from the early phase to the late phase of contingent negative variation occurred earlier for AWS than for AFS, thus suggesting that the motor preparation process is promoted in AWS. Third, the NoGo effect in the ERP component parietal positivity elicited by S2 (S2-P3) was larger for AFS than for AWS, indicating that AWS have difficulties in inhibiting a planned speech response. These results provide a full picture of the speech preparation and response inhibition processes of AWS. The relationship among these three findings is discussed. However, as stuttering was not manipulated in this study, it is still unclear whether the effects are the causes or the results of stuttering. Further studies are suggested to explore the relationship between stuttering and the effects found in the present study. PMID:28068353

Korean speech-language pathologists' attitudes toward stuttering according to clinical experiences.

PubMed

Lee, Kyungjae

2014-11-01

Negative attitudes toward stuttering and people who stutter (PWS) are found in various groups of people in many regions. However the results of previous studies examining the influence of fluency coursework and clinical certification on the attitudes of speech-language pathologists (SLPs) toward PWS are equivocal. Furthermore, there have been few empirical studies on the attitudes of Korean SLPs toward stuttering. To determine whether the attitudes of Korean SLPs and speech-language pathology students toward stuttering would be different according to the status of clinical certification, stuttering coursework completion and clinical practicum in stuttering. Survey data from 37 certified Korean SLPs and 70 undergraduate students majoring in speech-language pathology were analysed. All the participants completed the modified Clinician Attitudes Toward Stuttering (CATS) Inventory. Results showed that the diagnosogenic view was still accepted by many participants. Significant differences were found in seven out of 46 CATS Inventory items according to the certification status. In addition significant differences were also found in three items and one item according to stuttering coursework completion and clinical practicum experience in stuttering, respectively. Clinical and educational experience appears to have mixed influences on SLPs' and students' attitudes toward stuttering. While SLPs and students may demonstrate more appropriate understanding and knowledge in certain areas of stuttering, they may feel difficulty in their clinical experience, possibly resulting in low self-efficacy. © 2014 Royal College of Speech and Language Therapists.

Beliefs and behavioural intentions towards pharmacotherapy for stuttering: A survey of adults who stutter.

PubMed

McGroarty, Allan; McCartan, Rebecca

Although considerable efforts have been made to investigate the effectiveness of pharmacological treatments for stuttering, little is known about how the stuttering community perceives these treatments. This study aimed to assess and quantify beliefs regarding pharmacotherapy for adults who stutter and to establish whether behavioural intentions to undertake treatment were related to these beliefs. An adapted version of the Beliefs about Medicine Questionnaire was completed by adults who stutter. Participants also reported perceptions of their stuttering including its overall impact, ratings of previous speech therapy, and behavioural intentions to initiate pharmacotherapy and speech therapy in future. Necessity and concern beliefs were distributed widely across the sample and in a pattern indicating a relatively balanced perception of the benefits and costs of medication prescribed specifically for stuttering. Of the study's measures, the necessity-concerns differential most strongly predicted the behavioural intention to initiate pharmacotherapy. The overall impact of stuttering predicted intentions to seek both pharmacotherapy and speech therapy. Participants reported the likelihood of pursuing pharmacotherapy and speech therapy in equal measure. The theoretical model of medication representations appears to be a useful framework for understanding the beliefs of adults who stutter towards the medical treatment of their disorder. The findings of this study may be of interest to clinicians and researchers working in the field of stuttering treatment and to people who stutter considering pharmacotherapy. Copyright © 2018 Elsevier Inc. All rights reserved.

Does Language Influence the Accuracy of Judgments of Stuttering in Children?

ERIC Educational Resources Information Center

Einarsdottir, Johanna; Ingham, Roger J.

2009-01-01

Purpose: To determine whether stuttering judgment accuracy is influenced by familiarity with the stuttering speaker's language. Method: Audiovisual 7-min speech samples from nine 3- to 5-year-olds were used. Icelandic children who stutter (CWS), preselected for different levels of stuttering, were subdivided into 5-s intervals. Ten experienced…

Using Statistical Process Control Charts to Study Stuttering Frequency Variability during a Single Day

ERIC Educational Resources Information Center

Karimi, Hamid; O'Brian, Sue; Onslow, Mark; Jones, Mark; Menzies, Ross; Packman, Ann

2013-01-01

Purpose: Stuttering varies between and within speaking situations. In this study, the authors used statistical process control charts with 10 case studies to investigate variability of stuttering frequency. Method: Participants were 10 adults who stutter. The authors counted the percentage of syllables stuttered (%SS) for segments of their speech…

Stuttering, Emotions, and Heart Rate during Anticipatory Anxiety: A Critical Review

ERIC Educational Resources Information Center

Alm, Per A.

2004-01-01

Persons who stutter often report their stuttering is influenced by emotional reactions, yet the nature of such relation is still unclear. Psychophysiological studies of stuttering have failed to find any major association between stuttering and the activity of the sympathetic nervous system. A review of published studies of heart rate in relation…

Preliminary Evidence That Growth in Productive Language Differentiates Childhood Stuttering Persistence and Recovery

ERIC Educational Resources Information Center

Leech, Kathryn A.; Ratner, Nan Bernstein; Brown, Barbara; Weber, Christine M.

2017-01-01

Purpose: Childhood stuttering is common but is often outgrown. Children whose stuttering persists experience significant life impacts, calling for a better understanding of what factors may underlie eventual recovery. In previous research, language ability has been shown to differentiate children who stutter (CWS) from children who do not stutter,…

Comparisons of Audio and Audiovisual Measures of Stuttering Frequency and Severity in Preschool-Age Children

ERIC Educational Resources Information Center

Rousseau, Isabelle; Onslow, Mark; Packman, Ann; Jones, Mark

2008-01-01

Purpose: To determine whether measures of stuttering frequency and measures of overall stuttering severity in preschoolers differ when made from audio-only recordings compared with audiovisual recordings. Method: Four blinded speech-language pathologists who had extensive experience with preschoolers who stutter measured stuttering frequency and…

The Client's Perspective on Voluntary Stuttering.

PubMed

Byrd, Courtney T; Gkalitsiou, Zoi; Donaher, Joe; Stergiou, Erin

2016-08-01

Voluntary stuttering is a strategy that has been suggested for use in the clinical literature but has minimal empirical data regarding treatment outcomes. The purpose of the present study is to explore client perspectives regarding the impact of the use of this strategy on the affective, behavioral, and cognitive components of stuttering. The present study used an original survey designed to explore the intended purpose. A total of 206 adults who stutter were included in the final data corpus. Responses were considered with respect to the type of voluntary stuttering the participants reportedly produced and the location of use. A client perceives significantly greater affective, behavioral, and cognitive benefits from voluntary stuttering when the production is closely matched to the client's actual stutter and when it is used outside the clinical environment. To enhance client perception of associated benefits, clinicians should encourage use of voluntary stuttering that closely matches the client's own stuttering. Clinicians should also facilitate practice of voluntary stuttering outside of the therapy room. Finally, clinicians should be aware that clients, at least initially, may not perceive any benefits from the use of this strategy.

The accuracy with which adults who do not stutter predict stuttering-related communication attitudes.

PubMed

Logan, Kenneth J; Willis, Julie R

2011-12-01

The purpose of this study was to examine the extent to which adults who do not stutter can predict communication-related attitudes of adults who do stutter. 40 participants (mean age of 22.5 years) evaluated speech samples from an adult with mild stuttering and an adult with severe stuttering via audio-only (n=20) or audio-visual (n=20) modes to predict how the adults had responded on the S24 scale of communication attitudes. Participants correctly predicted which speaker had the more favorable S24 score, and the predicted scores were significantly different between the severity conditions. Across the four subgroups, predicted S24 scores differed from actual scores by 4-9 points. Predicted values were greater than the actual values for 3 of 4 subgroups, but still relatively positive in relation to the S24 norm sample. Stimulus presentation mode interacted with stuttering severity to affect prediction accuracy. The participants predicted the speakers' negative self-attributions more accurately than their positive self-attributions. Findings suggest that adults who do not stutter estimate the communication-related attitudes of specific adults who stutter in a manner that is generally accurate, though, in some conditions, somewhat less favorable than the speaker's actual ratings. At a group level, adults who do not stutter demonstrate the ability to discern minimal versus average levels of attitudinal impact for speakers who stutter. The participants' complex prediction patterns are discussed in relation to stereotype accuracy and classic views of negative stereotyping. The reader will be able to (a) summarize main findings on research related to listeners' attitudes toward people who stutter, (b) describe the extent to which people who do not stutter can predict the communication attitudes of people who do stutter; and (c) discuss how findings from the present study relate to previous findings on stereotypes about people who stutter. Copyright © 2011 Elsevier Inc. All rights reserved.

A life-time of stuttering: how emotional reactions to stuttering impact activities and participation in older people.

PubMed

Bricker-Katz, Geraldine; Lincoln, Michelle; McCabe, Patricia

2009-01-01

The International Classification of Functioning, Disability and Health (ICF) framework has a pragmatic focus on how impairment impacts the individual's activities and participation. Stuttering is known to impact communication in younger adults but this has not been established in older people who stutter. In this study, emotional reactions to stuttering were investigated in a group 55 years and older who self-reported stuttering since childhood. This was a cross-sectional descriptive design. Twelve participants who self-reported that they still stuttered and in whom stuttering was confirmed, and 14 controls completed the Fear of Negative Evaluation Scale (FNES), The Endler Multi-dimensional Anxiety Scales-Trait (EMAS-T) and The Australian Personal Wellbeing Index (PWA-I). Participants whose stuttering persisted also completed the Overall Assessment of Speakers Experience of Stuttering (OASES). The group who stuttered scored significantly higher on the FNES, with scores in the social phobia range. Responses on the OASES showed that stuttering continues to be a negative experience for this older group. Results for the EMAS-T and PWA-I were within the average range across both participant groups however significant differences existed between the groups in the social evaluative and physical danger domains of the EMAS-T, and the satisfaction with health domain of the PWA-I. Significant fear of negative evaluation, which is the key feature for social anxiety, was found in the group of older people who stuttered with a higher level of trait anxiety in social evaluative domains. The OASES showed that they also reacted to stuttering and communication in daily situations with moderate to severe impact scores which showed that stuttering impacted on speaking activities and by those negative experiences limited communication. Limited communication and restricted participation in the lives of older people have implications for healthy productive ageing and this is discussed.

Responses of adults who stutter to the anticipation of stuttering

PubMed Central

Jackson, Eric S.; Yaruss, J. Scott; Quesal, Robert W.; Terranova, Valerie; Whalen, D. H.

2016-01-01

Purpose Many people who stutter experience the phenomenon of anticipation—the sense that stuttering will occur before it is physically and overtly realized. A systematic investigation of how people who stutter respond to anticipation has not been previously reported. The purposes of this study were to provide self-report evidence of what people do in response to anticipation of stuttering and to determine the extent to which this anticipation occurs. Methods Thirty adults who stutter indicated on a Likert rating scale the extent to which they anticipate stuttering and answered three open-ended (written) questions regarding how they respond to anticipation. Results All participants reported experiencing anticipation at least “sometimes,” and 77% of the participants reported experiencing anticipation “often” or “always.” The extent to which participants reported experiencing anticipation was not related to stuttering severity, impact, or treatment history. Analysis of written responses revealed 24 major categories, which were heuristically divided into action or non-action responses. Categories representing avoidance and self-management strategies were further divided into 14 and 19 subcategories, respectively. Participants were just as likely to view anticipation as helpful as they were to view it as harmful. Conclusion Findings demonstrate that most, if not all, adults who stutter experience anticipation, and the majority of adults who stutter report doing so at least often. Adults who stutter respond to this anticipation by altering the speech production process in various ways. Results highlight the importance of the role that anticipation plays in how stuttering behaviors manifest themselves. PMID:26065618

A comparison of three strategies for reducing the public stigma associated with stuttering.

PubMed

Boyle, Michael P; Dioguardi, Lauren; Pate, Julie E

2016-12-01

The effects of three anti-stigma strategies for stuttering-contact (hearing personal stories from an individual who stutters), education (replacing myths about stuttering with facts), and protest (condemning negative attitudes toward people who stutter)-were examined on attitudes, emotions, and behavioral intentions toward people who stutter. Two hundred and twelve adults recruited from a nationwide survey in the United States were randomly assigned to one of the three anti-stigma conditions or a control condition. Participants completed questionnaires about stereotypes, negative emotional reactions, social distance, discriminatory intentions, and empowerment regarding people who stutter prior to and after watching a video for the assigned condition, and reported their attitude changes about people who stutter. Some participants completed follow-up questionnaires on the same measures one week later. All three anti-stigma strategies were more effective than the control condition for reducing stereotypes, negative emotions, and discriminatory intentions from pretest to posttest. Education and protest effects for reducing negative stereotypes were maintained at one-week follow-up. Contact had the most positive effect for increasing affirming attitudes about people who stutter from pretest to posttest and pretest to follow-up. Participants in the contact and education groups, but not protest, self-reported significantly more positive attitude change about people who stutter as a result of watching the video compared to the control group. Advocates in the field of stuttering can use education and protest strategies to reduce negative attitudes about people who stutter, and people who stutter can increase affirming attitudes through interpersonal contact with others. Copyright © 2016 Elsevier Inc. All rights reserved.

Autonomic arousal in adults who stutter prior to various reading tasks intended to elicit changes in stuttering frequency.

PubMed

Bowers, Andrew; Saltuklaroglu, Tim; Kalinowski, Joseph

2012-01-01

This study examined relationships between anticipatory autonomic arousal and stuttering in four reading tasks. 13 adult persons who stutter (PWS) reported their 'feared' (expected to elicit more stuttering) sounds. They read phrases initiated by feared (F) and neutral (N) phonemes. Both stimuli sets were read solo (S) and with choral accompaniment (C), creating FS, FC, NS, and NC conditions. Skin conductance (SC) and heart rate (HR) measures were made during a 9s window that followed stimulus presentation and preceded speaking. Only SC measures produced significant differences across conditions. Choral conditions produced decreases in SC measures and stuttered trials. Feared conditions produced increases in SC but not stuttering. HR measures were variable, undifferentiated by condition, but produced a gradually increasing triphasic response pattern. No differences in anticipatory SC or HR measures were found in stuttered versus fluent trial comparisons. However, the NC condition, which eliminated stuttering, produced significantly lower SC measures than the fluent utterances in the other conditions (FS, FC, NS). Furthermore, SC measures from the fluent and stuttered trials were similar in these three conditions. These findings suggest that anticipatory autonomic arousal is better differentiated by the possibility of stuttering than by a fluent/stuttered speech outcome. Trials that produced anticipatory SC responses showed greater final HR deceleration, suggesting autonomic coactivation, a response pattern that is associated with aversive stimuli and herein, likely indicative of speech-related state anxiety. However, these physiological markers of anxiety appear to be neither necessary nor sufficient to induce observable stuttering. Copyright © 2011 Elsevier B.V. All rights reserved.

Phonological skills and disfluency levels in preschool children who stutter.

PubMed

Gregg, Brent Andrew; Yairi, Ehud

2007-01-01

The relation between stuttering and aspects of language, including phonology, has been investigated for many years. Whereas past literature reported that the incidence of phonological difficulties is higher for children who stutter when compared to normally fluent children, the suggestion of association between the two disorders also drew several critical evaluations. Nevertheless, only a limited amount of information exists concerning the manner and extent to which the speech sound errors exhibited by young children who stutter, close to stuttering onset, is related to the characteristics of their stuttering, such as its severity. Conversely, information is limited regarding the effects a child's phonological skills may have on his/her stuttering severity. The current study investigated the mutual relations between these two factors in 28 carefully selected preschool children near the onset of their stuttering. The children, 20 boys and 8 girls, ranged in age from 25 to 38 months, with a mean of 32.2 months. The phonological skills of two groups with different ratings of stuttering were compared. Similarly, the stuttering severities of two groups with different levels of phonological skills (minimal deviations-moderate deviations) were compared. No statistically significant differences were found for either of the two factors. Inspection of the data revealed interesting individual differences. The reader will be able to list: (1) differences in the phonological skills of preschool children whose stuttering is severe as compared to children whose stuttering is mild and (2) differences in stuttering severity in preschool children with minimal phonological deviations as compared to children with moderate phonological deviations.

The experience of stuttering among Ultra-Orthodox and Secular/Traditional Jews.

PubMed

Freud, Debora; Ezrati-Vinacour, Ruth; Katz-Bernstein, Nitza; Fostick, Leah

2017-12-01

This groundbreaking research compares the experience of stuttering among adult male People Who Stutter (PWS) from the ultra-Orthodox (UO) Jewish community in Israel to those from Secular/Traditional (ST) backgrounds. Participants were 32 UO and 31 ST PWS, aged 18-67 years. Self-report questionnaires utilized: Perceived Stuttering Severity (PSS); Overall Assessment of the Speaker's Experience of Stuttering (OASES-A); Students' Life Satisfaction Scale (SLSS); Situation Avoidance Behavior Checklist (SABC). Demographic, religious, and stuttering information was collected. Groups were compared on scales, and correlations between scales and the PSS. Subjective stuttering severity ratings were significantly higher among the UO. A significant group effect was found for the OASES-A quality of life subscale, but not other subscales. Significant positive correlations were found between: 1) PSS and OASES-A Total Impact; 2) PSS and 3 OASES subscales; and 3) PSS and SABC (indicating increased avoidance with increased stuttering severity rating). A significant negative correlation was found between the PSS and SLSS, indicating lower life satisfaction with higher rates of stuttering severity among the ST. Interestingly, when tested by group, significant correlations between the PSS and all other study measures were observed only among the ST. UO participants showed higher subjective stuttering severity ratings, yet less impact on quality of life, and no correlation between subjective stuttering and other measures of stuttering experience. These novel findings may result from the combined protective effect of religiosity and socio-cultural characteristics on UO PWS' well-being, despite heightened concern about social consequences of stuttering within UO society. Copyright © 2017 Elsevier Inc. All rights reserved.

Phonological neighborhood and word frequency effects in the stuttered disfluencies of children who stutter.

PubMed

Anderson, Julie D

2007-02-01

The purpose of this study was to examine (a) the role of neighborhood density (number of words that are phonologically similar to a target word) and frequency variables on the stuttering-like disfluencies of preschool children who stutter, and (b) whether these variables have an effect on the type of stuttering-like disfluency produced. A 500+ word speech sample was obtained from each participant (N = 15). Each stuttered word was randomly paired with the firstly produced word that closely matched it in grammatical class, familiarity, and number of syllables/phonemes. Frequency, neighborhood density, and neighborhood frequency values were obtained for the stuttered and fluent words from an online database. Findings revealed that stuttered words were lower in frequency and neighborhood frequency than fluent words. Words containing part-word repetitions and sound prolongations were also lower in frequency and/or neighborhood frequency than fluent words, but these frequency variables did not have an effect on single-syllable word repetitions. Neighborhood density failed to influence the susceptibility of words to stuttering, as well as the type of stuttering-like disfluency produced. In general, findings suggest that neighborhood and frequency variables not only influence the fluency with which words are produced in speech, but also have an impact on the type of stuttering-like disfluency produced.

Stuttering in English-Mandarin bilingual speakers: the influence of language dominance on stuttering severity.

PubMed

Lim, Valerie P C; Lincoln, Michelle; Chan, Yiong Huak; Onslow, Mark

2008-12-01

English and Mandarin are the 2 most spoken languages in the world, yet it is not known how stuttering manifests in English-Mandarin bilinguals. In this research, the authors investigated whether the severity and type of stuttering is different in English and Mandarin in English-Mandarin bilinguals, and whether this difference was influenced by language dominance. Thirty English-Mandarin bilinguals who stutter (BWS), ages 12-44 years, were categorized into 3 groups (15 English-dominant, 4 Mandarin-dominant, and 11 balanced bilinguals) using a self-report classification tool. Three 10-min conversations in English and Mandarin were assessed by 2 English-Mandarin bilingual clinicians for percent syllables stuttered (%SS), perceived stuttering severity (SEV), and types of stuttering behaviors using the Lidcombe Behavioral Data Language (LBDL; Packman & Onslow, 1998; Teesson, Packman, & Onslow, 2003). English-dominant and Mandarin-dominant BWS exhibited higher %SS and SEV scores in their less dominant language, whereas the scores for the balanced bilinguals were similar for both languages. The difference in the percentage of stutters per LBDL category between English and Mandarin was not markedly different for any bilingual group. Language dominance appeared to influence the severity but not the types of stuttering behaviors in BWS. Clinicians working with BWS need to assess language dominance when diagnosing stuttering severity in bilingual clients.

Stuttering in relation to anxiety, temperament, and personality: review and analysis with focus on causality.

PubMed

Alm, Per A

2014-06-01

Anxiety and emotional reactions have a central role in many theories of stuttering, for example that persons who stutter would tend to have an emotionally sensitive temperament. The possible relation between stuttering and certain traits of temperament or personality were reviewed and analyzed, with focus on temporal relations (i.e., what comes first). It was consistently found that preschool children who stutter (as a group) do not show any tendencies toward elevated temperamental traits of shyness or social anxiety compared with children who do not stutter. Significant group differences were, however, repeatedly reported for traits associated with inattention and hyperactivity/impulsivity, which is likely to reflect a subgroup of children who stutter. Available data is not consistent with the proposal that the risk for persistent stuttering is increased by an emotionally reactive temperament in children who stutter. Speech-related social anxiety develops in many cases of stuttering, before adulthood. Reduction of social anxiety in adults who stutter does not in itself appear to result in significant improvement of speech fluency. Studies have not revealed any relation between the severity of the motor symptoms of stuttering and temperamental traits. It is proposed that situational variability of stuttering, related to social complexity, is an effect of interference from social cognition and not directly from the emotions of social anxiety. In summary, the studies in this review provide strong evidence that persons who stutter are not characterized by constitutional traits of anxiety or similar constructs. This paper provides a review and analysis of studies of anxiety, temperament, and personality, organized with the objective to clarify cause and effect relations. Readers will be able to (a) understand the importance of effect size and distribution of data for interpretation of group differences; (b) understand the role of temporal relations for interpretation of cause and effect; (c) discuss the results of studies of anxiety, temperament and personality in relation to stuttering; and (d) discuss situational variations of stuttering and the possible role of social cognition. Copyright © 2014 Elsevier Inc. All rights reserved.

The Experiences of Living with a Sibling Who Stutters: A Preliminary Study

ERIC Educational Resources Information Center

Beilby, Janet M.; Byrnes, Michelle L.; Young, Kate N.

2012-01-01

Stuttering impacts on the child in a variety of ways, notably in terms of communicative impairment and psychosocial impact. In addition, the stuttering disorder has a holistic impact, affecting those with whom the child who stutters lives. Within the family constellation, the closest person to the individual who stutters is often their sibling.…

Anxiety in 11-Year-Old Children Who Stutter: Findings from a Prospective Longitudinal Community Sample

ERIC Educational Resources Information Center

Smith, Kylie A.; Iverach, Lisa; O'Brian, Susan; Mensah, Fiona; Kefalianos, Elaina; Hearne, Anna; Reilly, Sheena

2017-01-01

Purpose: To examine if a community sample of 11-year-old children with persistent stuttering have higher anxiety than children who have recovered from stuttering and nonstuttering controls. Method: Participants in a community cohort study were categorized into 3 groups: (a) those with persistent stuttering, (b) those with recovered stuttering, and…

Turkish Language Teachers' and Primary School Teachers' Attitudes toward Their Stuttering Students

ERIC Educational Resources Information Center

Educational Research and Reviews, 2013

2013-01-01

Stuttering is a speech defect which is seen in all countries. Stuttering affects fluency of speech due to some physiological, psychological and neurological causes. Protractions, clogs and repeats are seen in stuttering. Since it will probably result in social handicaps, stuttering should be considered as more important than other speech defects.…

The SpeechEasy device in stuttering and nonstuttering adults: fluency effects while speaking and reading.

PubMed

Foundas, Anne L; Mock, Jeffrey R; Corey, David M; Golob, Edward J; Conture, Edward G

2013-08-01

The SpeechEasy is an electronic device designed to alleviate stuttering by manipulating auditory feedback via time delays and frequency shifts. Device settings (control, default, custom), ear-placement (left, right), speaking task, and cognitive variables were examined in people who stutter (PWS) (n=14) compared to controls (n=10). Among the PWS there was a significantly greater reduction in stuttering (compared to baseline) with custom device settings compared to the non-altered feedback (control) condition. Stuttering was reduced the most during reading, followed by narrative and conversation. For the conversation task, stuttering was reduced more when the device was worn in the left ear. Those individuals with a more severe stuttering rate at baseline had a greater benefit from the use of the device compared to individuals with less severe stuttering. Our results support the view that overt stuttering is associated with defective speech-language monitoring that can be influenced by manipulating auditory feedback. Copyright © 2013 Elsevier Inc. All rights reserved.

Stuttering Min oscillations within E. coli bacteria: a stochastic polymerization model

NASA Astrophysics Data System (ADS)

Sengupta, Supratim; Derr, Julien; Sain, Anirban; Rutenberg, Andrew D.

2012-10-01

We have developed a 3D off-lattice stochastic polymerization model to study the subcellular oscillation of Min proteins in the bacteria Escherichia coli, and used it to investigate the experimental phenomenon of Min oscillation stuttering. Stuttering was affected by the rate of immediate rebinding of MinE released from depolymerizing filament tips (processivity), protection of depolymerizing filament tips from MinD binding and fragmentation of MinD filaments due to MinE. Processivity, protection and fragmentation each reduce stuttering, speed oscillations and MinD filament lengths. Neither processivity nor tip protection were, on their own, sufficient to produce fast stutter-free oscillations. While filament fragmentation could, on its own, lead to fast oscillations with infrequent stuttering; high levels of fragmentation degraded oscillations. The infrequent stuttering observed in standard Min oscillations is consistent with short filaments of MinD, while we expect that mutants that exhibit higher stuttering frequencies will exhibit longer MinD filaments. Increased stuttering rate may be a useful diagnostic to find observable MinD polymerization under experimental conditions.

Speech Evoked Auditory Brainstem Response in Stuttering

PubMed Central

Tahaei, Ali Akbar; Ashayeri, Hassan; Pourbakht, Akram; Kamali, Mohammad

2014-01-01

Auditory processing deficits have been hypothesized as an underlying mechanism for stuttering. Previous studies have demonstrated abnormal responses in subjects with persistent developmental stuttering (PDS) at the higher level of the central auditory system using speech stimuli. Recently, the potential usefulness of speech evoked auditory brainstem responses in central auditory processing disorders has been emphasized. The current study used the speech evoked ABR to investigate the hypothesis that subjects with PDS have specific auditory perceptual dysfunction. Objectives. To determine whether brainstem responses to speech stimuli differ between PDS subjects and normal fluent speakers. Methods. Twenty-five subjects with PDS participated in this study. The speech-ABRs were elicited by the 5-formant synthesized syllable/da/, with duration of 40 ms. Results. There were significant group differences for the onset and offset transient peaks. Subjects with PDS had longer latencies for the onset and offset peaks relative to the control group. Conclusions. Subjects with PDS showed a deficient neural timing in the early stages of the auditory pathway consistent with temporal processing deficits and their abnormal timing may underlie to their disfluency. PMID:25215262

A One Year Prospective Study of Neurogenic Stuttering Following Stroke: Incidence and Co-Occurring Disorders

ERIC Educational Resources Information Center

Theys, C.; van Wieringen, A.; Sunaert, S.; Thijs, V.; De Nil, L. F.

2011-01-01

In this prospective study, data on incidence, stuttering characteristics, co-occurring speech disorders, and recovery of neurogenic stuttering in a large sample of stroke participants were assessed. Following stroke onset, 17 of 319 participants (5.3%; 95% CI, 3.2-8.3) met the criteria for neurogenic stuttering. Stuttering persisted in at least…

The Impact of Adolescent Stuttering on Educational and Employment Outcomes: Evidence from a Birth Cohort Study

ERIC Educational Resources Information Center

McAllister, Jan; Collier, Jacqueline; Shepstone, Lee

2012-01-01

Purpose: In interview and survey studies, people who stutter report the belief that stuttering has had a negative impact on their own education and employment. This population study sought objective evidence of such disadvantage for people who stutter as a group, compared with people who do not stutter. Method: A secondary analysis of a British…

Measurement of trained speech patterns in stuttering: interjudge and intrajudge agreement of experts by means of modified time-interval analysis.

PubMed

Alpermann, Anke; Huber, Walter; Natke, Ulrich; Willmes, Klaus

2010-09-01

Improved fluency after stuttering therapy is usually measured by the percentage of stuttered syllables. However, outcome studies rarely evaluate the use of trained speech patterns that speakers use to manage stuttering. This study investigated whether the modified time interval analysis can distinguish between trained speech patterns, fluent speech, and stuttered speech. Seventeen German experts on stuttering judged a speech sample on two occasions. Speakers of the sample were stuttering adults, who were not undergoing therapy, as well as participants in a fluency shaping and a stuttering modification therapy. Results showed satisfactory inter-judge and intra-judge agreement above 80%. Intervals with trained speech patterns were identified as consistently as stuttered and fluent intervals. We discuss limitations of the study, as well as implications of our findings for the development of training for identification of trained speech patterns and future outcome studies. The reader will be able to (a) explain different methods to measure the use of trained speech patterns, (b) evaluate whether German experts are able to discriminate intervals with trained speech patterns reliably from fluent and stuttered intervals and (c) describe how the measurement of trained speech patterns can contribute to outcome studies.

Decreased Cerebellar-Orbitofrontal Connectivity Correlates with Stuttering Severity: Whole-Brain Functional and Structural Connectivity Associations with Persistent Developmental Stuttering.

PubMed

Sitek, Kevin R; Cai, Shanqing; Beal, Deryk S; Perkell, Joseph S; Guenther, Frank H; Ghosh, Satrajit S

2016-01-01

Persistent developmental stuttering is characterized by speech production disfluency and affects 1% of adults. The degree of impairment varies widely across individuals and the neural mechanisms underlying the disorder and this variability remain poorly understood. Here we elucidate compensatory mechanisms related to this variability in impairment using whole-brain functional and white matter connectivity analyses in persistent developmental stuttering. We found that people who stutter had stronger functional connectivity between cerebellum and thalamus than people with fluent speech, while stutterers with the least severe symptoms had greater functional connectivity between left cerebellum and left orbitofrontal cortex (OFC). Additionally, people who stutter had decreased functional and white matter connectivity among the perisylvian auditory, motor, and speech planning regions compared to typical speakers, but greater functional connectivity between the right basal ganglia and bilateral temporal auditory regions. Structurally, disfluency ratings were negatively correlated with white matter connections to left perisylvian regions and to the brain stem. Overall, we found increased connectivity among subcortical and reward network structures in people who stutter compared to controls. These connections were negatively correlated with stuttering severity, suggesting the involvement of cerebellum and OFC may underlie successful compensatory mechanisms by more fluent stutterers.

The Efficacy of Stuttering Measurement Training: Evaluating Two Training Programs

PubMed Central

Bainbridge, Lauren A.; Stavros, Candace; Ebrahimian, Mineh; Wang, Yuedong

2015-01-01

Purpose Two stuttering measurement training programs currently used for training clinicians were evaluated for their efficacy in improving the accuracy of total stuttering event counting. Method Four groups, each with 12 randomly allocated participants, completed a pretest–posttest design training study. They were evaluated by their counts of stuttering events on eight 3-min audiovisual speech samples from adults and children who stutter. Stuttering judgment training involved use of either the Stuttering Measurement System (SMS), Stuttering Measurement Assessment and Training (SMAAT) programs, or no training. To test for the reliability of any training effect, SMS training was repeated with the 4th group. Results Both SMS-trained groups produced approximately 34% improvement, significantly better than no training or the SMAAT program. The SMAAT program produced a mixed result. Conclusions The SMS program was shown to produce a “medium” effect size improvement in the accuracy of stuttering event counts, and this improvement was almost perfectly replicated in a 2nd group. Half of the SMAAT judges produced a 36% improvement in accuracy, but the other half showed no improvement. Additional studies are needed to demonstrate the durability of the reported improvements, but these positive effects justify the importance of stuttering measurement training. PMID:25629956

The efficacy of stuttering measurement training: evaluating two training programs.

PubMed

Bainbridge, Lauren A; Stavros, Candace; Ebrahimian, Mineh; Wang, Yuedong; Ingham, Roger J

2015-04-01

Two stuttering measurement training programs currently used for training clinicians were evaluated for their efficacy in improving the accuracy of total stuttering event counting. Four groups, each with 12 randomly allocated participants, completed a pretest-posttest design training study. They were evaluated by their counts of stuttering events on eight 3-min audiovisual speech samples from adults and children who stutter. Stuttering judgment training involved use of either the Stuttering Measurement System (SMS), Stuttering Measurement Assessment and Training (SMAAT) programs, or no training. To test for the reliability of any training effect, SMS training was repeated with the 4th group. Both SMS-trained groups produced approximately 34% improvement, significantly better than no training or the SMAAT program. The SMAAT program produced a mixed result. The SMS program was shown to produce a "medium" effect size improvement in the accuracy of stuttering event counts, and this improvement was almost perfectly replicated in a 2nd group. Half of the SMAAT judges produced a 36% improvement in accuracy, but the other half showed no improvement. Additional studies are needed to demonstrate the durability of the reported improvements, but these positive effects justify the importance of stuttering measurement training.

Shifted dynamic interactions between subcortical nuclei and inferior frontal gyri during response preparation in persistent developmental stuttering.

PubMed

Metzger, F Luise; Auer, Tibor; Helms, Gunther; Paulus, Walter; Frahm, Jens; Sommer, Martin; Neef, Nicole E

2018-01-01

Persistent developmental stuttering is associated with basal ganglia dysfunction or dopamine dysregulation. Here, we studied whole-brain functional connectivity to test how basal ganglia structures coordinate and reorganize sensorimotor brain networks in stuttering. To this end, adults who stutter and fluent speakers (control participants) performed a response anticipation paradigm in the MRI scanner. The preparation of a manual Go/No-Go response reliably produced activity in the basal ganglia and thalamus and particularly in the substantia nigra. Strikingly, in adults who stutter, substantia nigra activity correlated positively with stuttering severity. Furthermore, functional connectivity analyses yielded altered task-related network formations in adults who stutter compared to fluent speakers. Specifically, in adults who stutter, the globus pallidus and the thalamus showed increased network synchronization with the inferior frontal gyrus. This implies dynamic shifts in the response preparation-related network organization through the basal ganglia in the context of a non-speech motor task in stuttering. Here we discuss current findings in the traditional framework of how D1 and D2 receptor activity shapes focused movement selection, thereby suggesting a disproportional involvement of the direct and the indirect pathway in stuttering.

A voxel-based morphometry (VBM) analysis of regional grey and white matter volume abnormalities within the speech production network of children who stutter.

PubMed

Beal, Deryk S; Gracco, Vincent L; Brettschneider, Jane; Kroll, Robert M; De Nil, Luc F

2013-09-01

It is well documented that neuroanatomical differences exist between adults who stutter and their fluently speaking peers. Specifically, adults who stutter have been found to have more grey matter volume (GMV) in speech relevant regions including inferior frontal gyrus, insula and superior temporal gyrus (Beal et al., 2007; Song et al., 2007). Despite stuttering having its onset in childhood only one study has investigated the neuroanatomical differences between children who do and do not stutter. Chang et al. (2008) reported children who stutter had less GMV in the bilateral inferior frontal gyri and middle temporal gyrus relative to fluently speaking children. Thus it appears that children who stutter present with unique neuroanatomical abnormalities as compared to those of adults who stutter. In order to better understand the neuroanatomical correlates of stuttering earlier in its development, near the time of onset, we used voxel-based morphometry to examine volumetric differences between 11 children who stutter and 11 fluent children. Children who stutter had less GMV in the bilateral inferior frontal gyri and left putamen but more GMV in right Rolandic operculum and superior temporal gyrus relative to fluent children. Children who stutter also had less white matter volume bilaterally in the forceps minor of the corpus callosum. We discuss our findings of widespread anatomic abnormalities throughout the cortical network for speech motor control within the context of the speech motor skill limitations identified in people who stutter (Namasivayam and van Lieshout, 2008; Smits-Bandstra et al., 2006). Copyright © 2012 Elsevier Ltd. All rights reserved.

Origins of the stuttering stereotype: stereotype formation through anchoring-adjustment.

PubMed

MacKinnon, Sean P; Hall, Shera; Macintyre, Peter D

2007-01-01

The stereotype of people who stutter is predominantly negative, holding that stutterers are excessively nervous, anxious, and reserved. The anchoring-adjustment hypothesis suggests that the stereotype of stuttering arises from a process of first anchoring the stereotype in personal feelings during times of normal speech disfluency, and then adjusting based on a rapid heuristic judgment. The current research sought to test this hypothesis, elaborating on previous research by [White, P. A., & Collins, S. R. (1984). Stereotype formation by inference: A possible explanation for the "stutterer" stereotype. Journal of Speech and Hearing Research, 27, 567-570]. Participants provided ratings of a hypothetical typical person who stutters, a person suffering from normal speech disfluency and a typical male on a 25-item semantic differential scale. Results showed a stereotype of people who stutter similar to that found in previous research. The pattern of results is consistent with the anchoring-adjustment hypothesis. Ratings of a male stutterer are very similar to a male experiencing temporary disfluency, both of which differ from ratings of a typical male. As expected, ratings of a stutterer show a small but statistically significant adjustment on several traits that makes the stereotype of stutterers less negative and less emotionally extreme than the temporarily disfluent male. Based on the results of this research, it appears that stereotype formation is a result of generalization and adjustment from personal experience during normal speech disfluency. The reader will be able to: (1) explain how the negative stereotype of people who stutter arises; (2) discuss the negative implications of stereotypes in the lives of people who stutter; and (3) summarize why the stereotype of people who stutter is so consistent and resistant to change.

Corpus callosum demyelination associated with acquired stuttering.

PubMed

Decker, Barbara McElwee; Guitar, Barry; Solomon, Andrew

2018-04-21

Compared with developmental stuttering, adult onset acquired stuttering is rare. However, several case reports describe acquired stuttering and an association with callosal pathology. Interestingly, these cases share a neuroanatomical localisation also demonstrated in developmental stuttering. We present a case of adult onset acquired stuttering associated with inflammatory demyelination within the corpus callosum. This patient's disfluency improved after the initiation of immunomodulatory therapy. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The speech naturalness of people who stutter speaking under delayed auditory feedback as perceived by different groups of listeners.

PubMed

Van Borsel, John; Eeckhout, Hannelore

2008-09-01

This study investigated listeners' perception of the speech naturalness of people who stutter (PWS) speaking under delayed auditory feedback (DAF) with particular attention for possible listener differences. Three panels of judges consisting of 14 stuttering individuals, 14 speech language pathologists, and 14 naive listeners rated the naturalness of speech samples of stuttering and non-stuttering individuals using a 9-point interval scale. Results clearly indicate that these three groups evaluate naturalness differently. Naive listeners appear to be more severe in their judgements than speech language pathologists and stuttering listeners, and speech language pathologists are apparently more severe than PWS. The three listener groups showed similar trends with respect to the relationship between speech naturalness and speech rate. Results of all three indicated that for PWS, the slower a speaker's rate was, the less natural speech was judged to sound. The three listener groups also showed similar trends with regard to naturalness of the stuttering versus the non-stuttering individuals. All three panels considered the speech of the non-stuttering participants more natural. The reader will be able to: (1) discuss the speech naturalness of people who stutter speaking under delayed auditory feedback, (2) discuss listener differences about the naturalness of people who stutter speaking under delayed auditory feedback, and (3) discuss the importance of speech rate for the naturalness of speech.

Phonological Neighborhood and Word Frequency Effects in the Stuttered Disfluencies of Children Who Stutter

PubMed Central

Anderson, Julie D.

2008-01-01

Purpose The purpose of this study was to examine (a) the role of neighborhood density (number of words that are phonologically similar to a target word) and frequency variables on the stuttering-like disfluencies of preschool children who stutter, and (b) whether these variables have an effect on the type of stuttering-like disfluency produced. Method A 500+ word speech sample was obtained from each participant (N = 15). Each stuttered word was randomly paired with the firstly produced word that closely matched it in grammatical class, familiarity, and number of syllables/phonemes. Frequency, neighborhood density, and neighborhood frequency values were obtained for the stuttered and fluent words from an online database. Results Findings revealed that stuttered words were lower in frequency and neighborhood frequency than fluent words. Words containing part-word repetitions and sound prolongations were also lower in frequency and/or neighborhood frequency than fluent words, but these frequency variables did not have an effect on single-syllable word repetitions. Neighborhood density failed to influence the susceptibility of words to stuttering, as well as the type of stuttering-like disfluency produced. Conclusions In general, findings suggest that neighborhood and frequency variables not only influence the fluency with which words are produced in speech, but also have an impact on the type of stuttering-like disfluency produced. PMID:17344561

Sociodynamic relationships between children who stutter and their non-stuttering classmates

PubMed Central

Davis, Stephen; Howell, Peter; Cooke, Frances

2007-01-01

Background: Previous research has indicated that children who stutter are more likely to be bullied and to hold a lower social position than their peers who do not stutter. However, the majority of this research has used data from respondents who were in the educational system more than 20 years ago. The current policy on integration of children with severe disabilities into mainstream education and the increased awareness of bullying in schools would indicate that attitudes toward children who stutter might have changed in the intervening period. Method: The study uses a sociometric scale (adapted from Coie, Dodge, & Coppotelli, 1982) to assess children who stutter in classroom groups with fluent peers. The peer relationships between 16 children who stutter and their classmates (403 children in total) were examined. Results: Children who stutter were rejected significantly more often than were their peers and were significantly less likely to be popular. When compared to children who do not stutter, the children who stutter were less likely to be nominated as ‘leaders’ and were more likely to be nominated to the ‘bullied’ and ‘seeks help’ categories. Conclusions: The changes in integration policy and the implementation of anti-bullying policies in many schools appear to have made little impact on the social status of children who stutter. The incidence of bullying and rejection reported in this study has implications for schools and clinicians. PMID:12405481

Effect of delayed auditory feedback on stuttering with and without central auditory processing disorders.

PubMed

Picoloto, Luana Altran; Cardoso, Ana Cláudia Vieira; Cerqueira, Amanda Venuti; Oliveira, Cristiane Moço Canhetti de

2017-12-07

To verify the effect of delayed auditory feedback on speech fluency of individuals who stutter with and without central auditory processing disorders. The participants were twenty individuals with stuttering from 7 to 17 years old and were divided into two groups: Stuttering Group with Auditory Processing Disorders (SGAPD): 10 individuals with central auditory processing disorders, and Stuttering Group (SG): 10 individuals without central auditory processing disorders. Procedures were: fluency assessment with non-altered auditory feedback (NAF) and delayed auditory feedback (DAF), assessment of the stuttering severity and central auditory processing (CAP). Phono Tools software was used to cause a delay of 100 milliseconds in the auditory feedback. The "Wilcoxon Signal Post" test was used in the intragroup analysis and "Mann-Whitney" test in the intergroup analysis. The DAF caused a statistically significant reduction in SG: in the frequency score of stuttering-like disfluencies in the analysis of the Stuttering Severity Instrument, in the amount of blocks and repetitions of monosyllabic words, and in the frequency of stuttering-like disfluencies of duration. Delayed auditory feedback did not cause statistically significant effects on SGAPD fluency, individuals with stuttering with auditory processing disorders. The effect of delayed auditory feedback in speech fluency of individuals who stutter was different in individuals of both groups, because there was an improvement in fluency only in individuals without auditory processing disorder.

Working memory involvement in stuttering: exploring the evidence and research implications.

PubMed

Bajaj, Amit

2007-01-01

Several studies of utterance planning and attention processes in stuttering have raised the prospect of working memory involvement in the disorder. In this paper, potential connections between stuttering and two elements of Baddeley's [Baddeley, A. D. (2003). Working memory: Looking back and looking forward. Neuroscience, 4, 829-839] working memory model, phonological memory and central executive, are posited. Empirical evidence is drawn from studies on phonological memory and dual-task performance among children and adults who stutter to examine support for the posited connections. Implications for research to examine working memory as one of the psycholinguistic bases of stuttering are presented. The reader will learn about and be able to: (1) appraise potential relationships between working memory and stuttering; (2) evaluate empirical evidence that suggests the possibility of working memory involvement in stuttering; and (3) identify research directions to explore the role of working memory in stuttering.

A review of brain circuitries involved in stuttering

PubMed Central

Craig-McQuaide, Anna; Akram, Harith; Zrinzo, Ludvic; Tripoliti, Elina

2014-01-01

Stuttering has been the subject of much research, nevertheless its etiology remains incompletely understood. This article presents a critical review of the literature on stuttering, with particular reference to the role of the basal ganglia (BG). Neuroimaging and lesion studies of developmental and acquired stuttering, as well as pharmacological and genetic studies are discussed. Evidence of structural and functional changes in the BG in those who stutter indicates that this motor speech disorder is due, at least in part, to abnormal BG cues for the initiation and termination of articulatory movements. Studies discussed provide evidence of a dysfunctional hyperdopaminergic state of the thalamocortical pathways underlying speech motor control in stuttering. Evidence that stuttering can improve, worsen or recur following deep brain stimulation for other indications is presented in order to emphasize the role of BG in stuttering. Further research is needed to fully elucidate the pathophysiology of this speech disorder, which is associated with significant social isolation. PMID:25452719

The Transition from the Core Vowels to the Following Segments in Japanese Children Who Stutter: The Second, Third and Fourth Syllables

ERIC Educational Resources Information Center

Matsumoto-Shimamori, Sachiyo; Ito, Tomohiko; Fukuda, Suzy E.; Fukuda, Shinji

2011-01-01

Shimamori and Ito (2007, Syllable weight and phonological encoding in Japanese children who stutter. "Japanese Journal of Special Education", 44, 451-462; 2008, Syllable weight and frequency of stuttering: Comparison between children who stutter with and without a family history of stuttering. "Japanese Journal of Special Education", 45, 437-445;…

Brain correlates of stuttering and syllable production. A PET performance-correlation analysis.

PubMed

Fox, P T; Ingham, R J; Ingham, J C; Zamarripa, F; Xiong, J H; Lancaster, J L

2000-10-01

To distinguish the neural systems of normal speech from those of stuttering, PET images of brain blood flow were probed (correlated voxel-wise) with per-trial speech-behaviour scores obtained during PET imaging. Two cohorts were studied: 10 right-handed men who stuttered and 10 right-handed, age- and sex-matched non-stuttering controls. Ninety PET blood flow images were obtained in each cohort (nine per subject as three trials of each of three conditions) from which r-value statistical parametric images (SPI¿r¿) were computed. Brain correlates of stutter rate and syllable rate showed striking differences in both laterality and sign (i.e. positive or negative correlations). Stutter-rate correlates, both positive and negative, were strongly lateralized to the right cerebral and left cerebellar hemispheres. Syllable correlates in both cohorts were bilateral, with a bias towards the left cerebral and right cerebellar hemispheres, in keeping with the left-cerebral dominance for language and motor skills typical of right-handed subjects. For both stutters and syllables, the brain regions that were correlated positively were those of speech production: the mouth representation in the primary motor cortex; the supplementary motor area; the inferior lateral premotor cortex (Broca's area); the anterior insula; and the cerebellum. The principal difference between syllable-rate and stutter-rate positive correlates was hemispheric laterality. A notable exception to this rule was that cerebellar positive correlates for syllable rate were far more extensive in the stuttering cohort than in the control cohort, which suggests a specific role for the cerebellum in enabling fluent utterances in persons who stutter. Stutters were negatively correlated with right-cerebral regions (superior and middle temporal gyrus) associated with auditory perception and processing, regions which were positively correlated with syllables in both the stuttering and control cohorts. These findings support long-held theories that the brain correlates of stuttering are the speech-motor regions of the non-dominant (right) cerebral hemisphere, and extend this theory to include the non-dominant (left) cerebellar hemisphere. The present findings also indicate a specific role of the cerebellum in the fluent utterances of persons who stutter. Support is also offered for theories that implicate auditory processing problems in stuttering.

Social anxiety disorder and stuttering: current status and future directions.

PubMed

Iverach, Lisa; Rapee, Ronald M

2014-06-01

Anxiety is one of the most widely observed and extensively studied psychological concomitants of stuttering. Research conducted prior to the turn of the century produced evidence of heightened anxiety in people who stutter, yet findings were inconsistent and ambiguous. Failure to detect a clear and systematic relationship between anxiety and stuttering was attributed to methodological flaws, including use of small sample sizes and unidimensional measures of anxiety. More recent research, however, has generated far less equivocal findings when using social anxiety questionnaires and psychiatric diagnostic assessments in larger samples of people who stutter. In particular, a growing body of research has demonstrated an alarmingly high rate of social anxiety disorder among adults who stutter. Social anxiety disorder is a prevalent and chronic anxiety disorder characterised by significant fear of humiliation, embarrassment, and negative evaluation in social or performance-based situations. In light of the debilitating nature of social anxiety disorder, and the impact of stuttering on quality of life and personal functioning, collaboration between speech pathologists and psychologists is required to develop and implement comprehensive assessment and treatment programmes for social anxiety among people who stutter. This comprehensive approach has the potential to improve quality of life and engagement in everyday activities for people who stutter. Determining the prevalence of social anxiety disorder among children and adolescents who stutter is a critical line of future research. Further studies are also required to confirm the efficacy of Cognitive Behaviour Therapy in treating social anxiety disorder in stuttering. The reader will be able to: (a) describe the nature and course of social anxiety disorder; (b) outline previous research regarding anxiety and stuttering, including features of social anxiety disorder; (c) summarise research findings regarding the diagnostic assessment of social anxiety disorder among people who stutter; (d) describe approaches for the assessment and treatment of social anxiety in stuttering, including the efficacy of Cognitive Behaviour Therapy; and (e) outline clinical implications and future directions associated with heightened social anxiety in stuttering. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

Comparison of adults who stutter with and without social anxiety disorder.

PubMed

Iverach, Lisa; Jones, Mark; Lowe, Robyn; O'Brian, Susan; Menzies, Ross G; Packman, Ann; Onslow, Mark

2018-06-01

Social anxiety disorder is a debilitating anxiety disorder associated with significant life impairment. The purpose of the present study is to evaluate overall functioning for adults who stutter with and without a diagnosis of social anxiety disorder. Participants were 275 adults who stuttered (18-80 years), including 219 males (79.6%) and 56 females (20.4%), who were enrolled to commence speech treatment for stuttering. Comparisons were made between participants diagnosed with social anxiety disorder (n = 82, 29.8%) and those without that diagnosis (n = 193, 70.2%). Although the socially anxious group was significantly younger than the non-socially anxious group, no other demographic differences were found. When compared to the non-socially anxious group, the socially anxious group did not demonstrate significantly higher self-reported stuttering severity or percentage of syllables stuttered. Yet the socially anxious group reported more speech dissatisfaction and avoidance of speaking situations, significantly more psychological problems, and a greater negative impact of stuttering. Significant differences in speech and psychological variables between groups suggest that, despite not demonstrating more severe stuttering, socially anxious adults who stutter demonstrate more psychological difficulties and have a more negative view of their speech. The present findings suggest that the demographic status of adults who stutter is not worse for those with social anxiety disorder. These findings pertain to a clinical sample, and cannot be generalized to the wider population of adults who stutter from the general community. Further research is needed to understand the longer-term impact of social anxiety disorder for those who stutter. Copyright © 2018. Published by Elsevier Inc.

Prenatal testosterone and stuttering.

PubMed

Montag, Christian; Bleek, Benjamin; Breuer, Svenja; Prüss, Holger; Richardt, Kirsten; Cook, Susanne; Yaruss, J Scott; Reuter, Martin

2015-01-01

The prevalence of stuttering is much higher in males compared to females. The biological underpinnings of this skewed sex-ratio is poorly understood, but it has often been speculated that sex hormones could play an important role. The present study investigated a potential link between prenatal testosterone and stuttering. Here, an indirect indicator of prenatal testosterone levels, the Digit Ratio (2D:4D) of the hand, was used. As numerous studies have shown, hands with more "male" characteristics (putatively representing greater prenatal testosterone levels) are characterized by a longer ring finger compared to the index finger (represented as a lower 2D:4D ratio) in the general population. We searched for differences in the 2D:4D ratios between 38 persons who stutter and 36 persons who do not stutter. In a second step, we investigated potential links between the 2D:4D ratio and the multifaceted symptomatology of stuttering, as measured by the Overall Assessment of the Speaker's Experience of Stuttering (OASES), in a larger sample of 44 adults who stutter. In the first step, no significant differences in the 2D:4D were observed between individuals who stutter and individuals who do not stutter. In the second step, 2D:4D correlated negatively with higher scores of the OASES (representing higher negative experiences due to stuttering), and this effect was more pronounced for female persons who stutter. The findings indicate for the first time that prenatal testosterone may influence individual differences in psychosocial impact of this speech disorder. Copyright © 2014 Elsevier Ltd. All rights reserved.

Stuttering Due To Ischemic Stroke

PubMed Central

Sahin, Huseyin Alparslan; Krespi, Yakup; Yilmaz, Ahmet; Coban, Oguzhan

2005-01-01

Acquired stuttering is a disorder of the fluency of speech. The mechanism underlying stuttering is unknown. It may occur after bilateral and unilateral cortical or subcortical brain damage. We report two cases who had stuttering resulting from left parietal infarction. PMID:16082078

Subtyping Stuttering II

PubMed Central

Seery, Carol Hubbard; Watkins, Ruth V.; Mangelsdorf, Sarah C.; Shigeto, Aya

2007-01-01

This paper is the second in a series of two articles exploring subtypes of stuttering, and it addresses the question of whether and how language ability and temperament variables may be relevant to the study of subtypes within the larger population of children who stutter. Despite observations of varied profiles among young children who stutter, efforts to identify and characterize subtypes of stuttering have had limited influence on theoretical or clinical understanding of the disorder. This manuscript briefly highlights research on language and temperament in young children who stutter, and considers whether the results can provide guidance for efforts to more effectively investigate and elucidate subtypes in childhood stuttering. Issues from the literature that appear relevant to research on stuttering subtypes include: (a) the question of whether stuttering is best characterized as categorical or continuous; (b) interpretation of individual differences in skills and profiles; and (c) the fact that, during the preschool years, the interaction among domains such as language and temperament are changing very rapidly, resulting in large differences in developmental profiles within relatively brief chronological age periods. PMID:17825669

The role of language familiarity in bilingual stuttering assessment.

PubMed

Lee, Amanda Savio; Robb, Michael P; Ormond, Tika; Blomgren, Michael

2014-10-01

The aim of this study was to evaluate the ability of English-speaking speech-language pathologists (SLPs) to evaluate stuttering behaviour in two Spanish-English bilingual adults who stutter (AWS1 and AWS2). The English-speaking SLPs were asked to judge the frequency, severity, type, duration, and physical concomitants of stuttering in both languages of the two AWS. The combined results from the English-speaking SLPs were then compared to the judgements of three Spanish-English bilingual SLPs. Results indicated that English-speaking SLPs (1) judged stuttering frequency to be greater in Spanish than English for AWS1, and equal in Spanish and English for AWS2, (2) were more accurate at evaluating individual moments of stuttering for the English samples compared to the Spanish samples, (3) identified fewer and less severe stuttering behaviours than the bilingual SLPs in both languages, and (4) were accurate judges of overall stuttering severity in both languages. The results correspond to past research examining the accuracy of stuttering evaluations in unfamiliar languages. Possible explanations for the findings, clinical implications, and future research directions are discussed.

Temporal processing and long-latency auditory evoked potential in stutterers.

PubMed

Prestes, Raquel; de Andrade, Adriana Neves; Santos, Renata Beatriz Fernandes; Marangoni, Andrea Tortosa; Schiefer, Ana Maria; Gil, Daniela

Stuttering is a speech fluency disorder, and may be associated with neuroaudiological factors linked to central auditory processing, including changes in auditory processing skills and temporal resolution. To characterize the temporal processing and long-latency auditory evoked potential in stutterers and to compare them with non-stutterers. The study included 41 right-handed subjects, aged 18-46 years, divided into two groups: stutterers (n=20) and non-stutters (n=21), compared according to age, education, and sex. All subjects were submitted to the duration pattern tests, random gap detection test, and long-latency auditory evoked potential. Individuals who stutter showed poorer performance on Duration Pattern and Random Gap Detection tests when compared with fluent individuals. In the long-latency auditory evoked potential, there was a difference in the latency of N2 and P3 components; stutterers had higher latency values. Stutterers have poor performance in temporal processing and higher latency values for N2 and P3 components. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

A case series on the effectiveness of lurasidone in patients with stuttering.

PubMed

Charoensook, Janet; Maguire, Gerald A

2017-08-01

The prevalence of stuttering is approximately 1% of the population, affecting an estimated 3 million individuals in the United States. The dopamine hypothesis of stuttering explains that abnormally increased cerebral dopamine affects the balanced levels that maintain the basal ganglia circuits, which helps with timing cues in initiating speech. This is especially significant when considering treatment strategies. We report a reduction in stuttering with lurasidone, a potent D2 receptor antagonist with a relatively favorable adverse effects profile. We conducted a non-randomized, open-label study of lurasidone in patients with stuttering (N = 7). Patients self-reported stuttering severity, locus of control, and avoidance using the Subjective Screening of Stuttering (SSS) scale and were assessed with the Clinical Global Impression (CGI) Scale. We observed a notable, statistically significant improvement in all areas of stuttering, as rated by the SSS scale. According to the CGI-Improvement Scale, 2 patients were scored as "very much improved" and 5 were scored as "much improved." This open-label study of lurasidone in patients with stuttering showed improvement in subjective symptoms, in CGI scores, and on the SSS scale.

Comparisons of stuttering frequency during and after speech initiation in unaltered feedback, altered auditory feedback and choral speech conditions.

PubMed

Saltuklaroglu, Tim; Kalinowski, Joseph; Robbins, Mary; Crawcour, Stephen; Bowers, Andrew

2009-01-01

Stuttering is prone to strike during speech initiation more so than at any other point in an utterance. The use of auditory feedback (AAF) has been found to produce robust decreases in the stuttering frequency by creating an electronic rendition of choral speech (i.e., speaking in unison). However, AAF requires users to self-initiate speech before it can go into effect and, therefore, it might not be as helpful as true choral speech during speech initiation. To examine how AAF and choral speech differentially enhance fluency during speech initiation and in subsequent portions of utterances. Ten participants who stuttered read passages without altered feedback (NAF), under four AAF conditions and under a true choral speech condition. Each condition was blocked into ten 10 s trials separated by 5 s intervals so each trial required 'cold' speech initiation. In the first analysis, comparisons of stuttering frequencies were made across conditions. A second, finer grain analysis involved examining stuttering frequencies on the initial syllable, the subsequent four syllables produced and the five syllables produced immediately after the midpoint of each trial. On average, AAF reduced stuttering by approximately 68% relative to the NAF condition. Stuttering frequencies on the initial syllables were considerably higher than on the other syllables analysed (0.45 and 0.34 for NAF and AAF conditions, respectively). After the first syllable was produced, stuttering frequencies dropped precipitously and remained stable. However, this drop in stuttering frequency was significantly greater (approximately 84%) in the AAF conditions than in the NAF condition (approximately 66%) with frequencies on the last nine syllables analysed averaging 0.15 and 0.05 for NAF and AAF conditions, respectively. In the true choral speech condition, stuttering was virtually (approximately 98%) eliminated across all utterances and all syllable positions. Altered auditory feedback effectively inhibits stuttering immediately after speech has been initiated. However, unlike a true choral signal, which is exogenously initiated and offers the most complete fluency enhancement, AAF requires speech to be initiated by the user and 'fed back' before it can directly inhibit stuttering. It is suggested that AAF can be a viable clinical option for those who stutter and should often be used in combination with therapeutic techniques, particularly those that aid speech initiation. The substantially higher rate of stuttering occurring on initiation supports a hypothesis that overt stuttering events help 'release' and 'inhibit' central stuttering blocks. This perspective is examined in the context of internal models and mirror neurons.

Webcam delivery of the Camperdown Program for adolescents who stutter: a phase II trial.

PubMed

Carey, Brenda; O'Brian, Sue; Lowe, Robyn; Onslow, Mark

2014-10-01

This Phase II clinical trial examined stuttering adolescents' responsiveness to the Webcam-delivered Camperdown Program. Sixteen adolescents were treated by Webcam with no clinic attendance. Primary outcome was percentage of syllables stuttered (%SS). Secondary outcomes were number of sessions, weeks and hours to maintenance, self-reported stuttering severity, speech satisfaction, speech naturalness, self-reported anxiety, self-reported situation avoidance, self-reported impact of stuttering, and satisfaction with Webcam treatment delivery. Data were collected before treatment and up to 12 months after entry into maintenance. Fourteen participants completed the treatment. Group mean stuttering frequency was 6.1 %SS (range, 0.7-14.7) pretreatment and 2.8 %SS (range, 0-12.2) 12 months after entry into maintenance, with half the participants stuttering at 1.2 %SS or lower at this time. Treatment was completed in a mean of 25 sessions (15.5 hr). Self-reported stuttering severity ratings, self-reported stuttering impact, and speech satisfaction scores supported %SS outcomes. Minimal anxiety was evident either pre- or post-treatment. Individual responsiveness to the treatment varied, with half the participants showing little reduction in avoidance of speech situations. The Webcam service delivery model was appealing to participants, although it was efficacious and efficient for only half. Suggestions for future stuttering treatment development for adolescents are discussed.

Enhancing treatment for school-age children who stutter I. Reducing negative reactions through desensitization and cognitive restructuring.

PubMed

Murphy, William P; Yaruss, J Scott; Quesal, Robert W

2007-01-01

This paper describes several treatment strategies that clinicians can use to address negative affective, behavioral, and cognitive reactions that school-age children who stutter may experience as part of their disorder. Specific strategies include desensitization to stuttering, cognitive restructuring, self-acceptance, purposeful self-disclosure, and a combination of both fluency enhancing and stuttering modification approaches. To facilitate clinicians' application of these techniques, the strategies are presented in the context of a case study involving a 9-year-old boy who participated in a comprehensive treatment program for stuttering. Following treatment, the child exhibited improved communication attitudes and a reduced frequency and severity of stuttering, combined with reduced concern about stuttering, as indicated through formal and informal assessments. Findings suggest that clinicians can help children overcome the negative reactions associated with stuttering through a number of treatment strategies that can be applied in a variety of clinical settings. After reading this article, participants will be able to: (1) define desensitization and cognitive restructuring and provide two arguments in favor of using these strategies in treatment for school-age children who stutter; (2) describe two treatment strategies for helping school-age children achieve desensitization through stuttering therapy; (3) describe two treatment strategies for helping school-age children engage in cognitive restructuring in the context of therapy.

Decreased Cerebellar-Orbitofrontal Connectivity Correlates with Stuttering Severity: Whole-Brain Functional and Structural Connectivity Associations with Persistent Developmental Stuttering

PubMed Central

Sitek, Kevin R.; Cai, Shanqing; Beal, Deryk S.; Perkell, Joseph S.; Guenther, Frank H.; Ghosh, Satrajit S.

2016-01-01

Persistent developmental stuttering is characterized by speech production disfluency and affects 1% of adults. The degree of impairment varies widely across individuals and the neural mechanisms underlying the disorder and this variability remain poorly understood. Here we elucidate compensatory mechanisms related to this variability in impairment using whole-brain functional and white matter connectivity analyses in persistent developmental stuttering. We found that people who stutter had stronger functional connectivity between cerebellum and thalamus than people with fluent speech, while stutterers with the least severe symptoms had greater functional connectivity between left cerebellum and left orbitofrontal cortex (OFC). Additionally, people who stutter had decreased functional and white matter connectivity among the perisylvian auditory, motor, and speech planning regions compared to typical speakers, but greater functional connectivity between the right basal ganglia and bilateral temporal auditory regions. Structurally, disfluency ratings were negatively correlated with white matter connections to left perisylvian regions and to the brain stem. Overall, we found increased connectivity among subcortical and reward network structures in people who stutter compared to controls. These connections were negatively correlated with stuttering severity, suggesting the involvement of cerebellum and OFC may underlie successful compensatory mechanisms by more fluent stutterers. PMID:27199712

The Use of Behavior Therapy Techniques in Crisis-Intervention: A Case Report

ERIC Educational Resources Information Center

Balson, Paul M.

1971-01-01

In the case of a man with an acute onset of stuttering and massive free floating anxiety following an automobile accident, a variety of behavioral techniques, including relaxation training, assertive training, graded rehearsal and modification of behavioral operants were employed, with the complete eradication of the symptoms in five sessions. The…

Bullying in Children Who Stutter: Speech-Language Pathologists' Perceptions and Intervention Strategies

ERIC Educational Resources Information Center

Blood, Gordon W.; Boyle, Michael P.; Blood, Ingrid M.; Nalesnik, Gina R.

2010-01-01

Bullying in school-age children is a global epidemic. School personnel play a critical role in eliminating this problem. The goals of this study were to examine speech-language pathologists' (SLPs) perceptions of bullying, endorsement of potential strategies for dealing with bullying, and associations among SLPs' responses and specific demographic…

Subtyping stuttering II: contributions from language and temperament.

PubMed

Seery, Carol Hubbard; Watkins, Ruth V; Mangelsdorf, Sarah C; Shigeto, Aya

2007-01-01

This paper is the second in a series of two articles exploring subtypes of stuttering, and it addresses the question of whether and how language ability and temperament variables may be relevant to the study of subtypes within the larger population of children who stutter. Despite observations of varied profiles among young children who stutter, efforts to identify and characterize subtypes of stuttering have had limited influence on theoretical or clinical understanding of the disorder. This manuscript briefly highlights research on language and temperament in young children who stutter, and considers whether the results can provide guidance for efforts to more effectively investigate and elucidate subtypes in childhood stuttering. Issues from the literature that appear relevant to research on stuttering subtypes include: (a) the question of whether stuttering is best characterized as categorical or continuous; (b) interpretation of individual differences in skills and profiles; and (c) the fact that, during the preschool years, the interaction among domains such as language and temperament are changing very rapidly, resulting in large differences in developmental profiles within relatively brief chronological age periods. The reader will be able to: (1) discuss possible associations of language ability and temperament to the development of stuttering in young children; (2) summarize the subtyping research from the literature on language ability and temperament in young children; (3) generate directions for future research of stuttering subtypes drawn from the literature related to language ability and temperament in young children.

Reduced Perfusion in Broca’s Area in Developmental Stuttering

PubMed Central

Desai, Jay; Huo, Yuankai; Wang, Zhishun; Bansal, Ravi; Williams, Steven C. R.; Lythgoe, David; Zelaya, Fernando O.; Peterson, Bradley S.

2016-01-01

Objective To study resting cerebral blood flow in children and adults with developmental stuttering. Methods We acquired pulsed arterial spin labeling magnetic resonance imaging data in 26 participants with stuttering and 36 healthy, fluent controls. While covarying for age, sex, and IQ, we compared perfusion values voxel-wise across diagnostic groups and assessed correlations of perfusion with stuttering severity within the stuttering group and with measures of motor speed in both groups. Results We detected lower regional Cerebral Blood Flow (rCBF) at rest in the stuttering group compared to healthy controls in Broca’s area bilaterally and the superior frontal gyrus. rCBF values in Broca’s area bilaterally correlated inversely with the severity of stuttering and extended posteriorly into other portions of the language loop. We also found increased rCBF in cerebellar nuclei and parietal cortex in the stuttering group compared to healthy controls. Findings were unchanged in child-only analyses and when excluding participants with comorbid illnesses or those taking medication. Conclusions rCBF is reduced in Broca’s region in persons who stutter. More severe stuttering is associated with even greater reductions in rCBF to Broca’s region, additive to the underlying putative trait reduction in rCBF relative to control values. Moreover, a greater abnormality in rCBF in the posterior language loop is associated with more severe symptoms, suggesting that a common pathophysiology throughout the language loop likely contributes to stuttering severity. PMID:28035724

Reduced perfusion in Broca's area in developmental stuttering.

PubMed

Desai, Jay; Huo, Yuankai; Wang, Zhishun; Bansal, Ravi; Williams, Steven C R; Lythgoe, David; Zelaya, Fernando O; Peterson, Bradley S

2017-04-01

To study resting cerebral blood flow in children and adults with developmental stuttering. We acquired pulsed arterial spin labeling magnetic resonance imaging data in 26 participants with stuttering and 36 healthy, fluent controls. While covarying for age, sex, and IQ, we compared perfusion values voxel-wise across diagnostic groups and assessed correlations of perfusion with stuttering severity within the stuttering group and with measures of motor speed in both groups. We detected lower regional Cerebral Blood Flow (rCBF) at rest in the stuttering group compared with healthy controls in Broca's area bilaterally and the superior frontal gyrus. rCBF values in Broca's area bilaterally correlated inversely with the severity of stuttering and extended posteriorly into other portions of the language loop. We also found increased rCBF in cerebellar nuclei and parietal cortex in the stuttering group compared with healthy controls. Findings were unchanged in child-only analyses and when excluding participants with comorbid illnesses or those taking medication. rCBF is reduced in Broca's region in persons who stutter. More severe stuttering is associated with even greater reductions in rCBF to Broca's region, additive to the underlying putative trait reduction in rCBF relative to control values. Moreover, a greater abnormality in rCBF in the posterior language loop is associated with more severe symptoms, suggesting that a common pathophysiology throughout the language loop likely contributes to stuttering severity. Hum Brain Mapp 38:1865-1874, 2017. © 2017 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Altered morphology of the nucleus accumbens in persistent developmental stuttering.

PubMed

Neef, Nicole E; Bütfering, Christoph; Auer, Tibor; Metzger, F Luise; Euler, Harald A; Frahm, Jens; Paulus, Walter; Sommer, Martin

2018-03-01

Neuroimaging studies in persistent developmental stuttering repeatedly report altered basal ganglia functions. Together with thalamus and cerebellum, these structures mediate sensorimotor functions and thus represent a plausible link between stuttering and neuroanatomy. However, stuttering is a complex, multifactorial disorder. Besides sensorimotor functions, emotional and social-motivational factors constitute major aspects of the disorder. Here, we investigated cortical and subcortical gray matter regions to study whether persistent developmental stuttering is also linked to alterations of limbic structures. The study included 33 right-handed participants who stutter and 34 right-handed control participants matched for sex, age, and education. Structural images were acquired using magnetic resonance imaging to estimate volumetric characteristics of the nucleus accumbens, hippocampus, amygdala, pallidum, putamen, caudate nucleus, and thalamus. Volumetric comparisons and vertex-based shape comparisons revealed structural differences. The right nucleus accumbens was larger in participants who stutter compared to controls. Recent theories of basal ganglia functions suggest that the nucleus accumbens is a motivation-to-movement interface. A speaker intends to reach communicative goals, but stuttering can derail these efforts. It is therefore highly plausible to find alterations in the motivation-to-movement interface in stuttering. While behavioral studies of stuttering sought to find links between the limbic and sensorimotor system, we provide the first neuroimaging evidence of alterations in the limbic system. Thus, our findings might initialize a unified neurobiological framework of persistent developmental stuttering that integrates sensorimotor and social-motivational neuroanatomical circuitries. Copyright © 2017 Elsevier Inc. All rights reserved.

The perceived impact of stuttering on personality as measured by the NEO-FFI-3.

PubMed

Banerjee, Shivangi; Casenhiser, Devin; Hedinger, Tricia; Kittilstved, Tiffani; Saltuklaroglu, Tim

2017-04-01

The NEO-FFI has been widely used to demonstrate personality differences between people who stutter (PWS) and those who do not. These differences can be interpreted as indicators of internal sources of disability that contribute to handicaps associated with stuttering. The aim of the current study was to use this same tool to determine the perceived impact of stuttering on personality in order to provide a similar indicator of how external factors may contribute to the stuttering disability. A total of 49 non-stuttering young adults were given the NEO-FFI-3 after watching a video of someone stuttering (moderately to severely) and after watching a video of someone speaking fluently. Participants were asked to answer test items while imagining that they had spoken like the persons in the videos for their entire lives. When asked to assume the stuttering perspective, participants reported themselves to be significantly more neurotic (P < 0.01) and less extraverted (P < 0.01) than when they assumed the perspective of the fluent speaker. The large differences (∼10 points; greater than one standard deviation) in these domains between the fluent and stuttered perspectives are consistent with existing stereotypes about PWS. These differences are greater than and only partially consistent with differences in personality found between PWS and non-stuttering individuals. The findings support the notion that external factors (e.g. listener reactions and stereotypes about PWS) contribute strongly to the manner in which stuttering restricts function and results in handicaps.

Stuttering in Parkinson's disease after deep brain stimulation: A note on dystonia and low-frequency stimulation.

PubMed

Mendonça, Marcelo D; Barbosa, Raquel; Seromenho-Santos, Alexandra; Reizinho, Carla; Bugalho, Paulo

2018-04-01

Stuttering, a speech fluency disorder, is a rare complication of Deep Brain Stimulation (DBS) in Parkinson's Disease (PD). We report a 61 years-old patient with PD, afflicted by severe On and Off dystonia, treated with Subthalamic Nucleus DBS that developed post-DBS stuttering while on 130 Hz stimulation. Stuttering reduction was noted when frequency was changed to 80 Hz, but the previously observed dystonia improvement was lost. There are no reports in literature on patients developing stuttering with low-frequency stimulation. We question if low-frequency stimulation could have a role for managing PD's post-DBS stuttering, and notice that stuttering improvement was associated with dystonia worsening suggesting that they are distinct phenomena. Copyright © 2018 Elsevier Ltd. All rights reserved.

Arab school teachers' knowledge, beliefs and reactions regarding stuttering.

PubMed

Abdalla, Fauzia A; St Louis, Kenneth O

2012-03-01

Stereotypes toward stuttering and people who stutter (PWS) are widespread in the general public irrespective of age, level of education, culture, geographic location and profession. Negative attitudes held by persons of authority like teachers can lead to social, economic and educational obstacles in the lives of PWS. The current study used an Arabic translation of an adapted version of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) to explore Arab teachers' knowledge and attitudes toward stuttering as well as strategies they adopt to cope with the problem in class. The participants were 262 in-service and 209 pre-service public school teachers in Kuwait. The results are contrasted to those of Arab parents in Kuwait reported earlier. Although many of the teachers knew a person who stutters well and were sensitive in their interactions with PWS, major findings of this study suggest that many were misinformed about the causes of stuttering and held stereotypical views about PWS, comparable to those reported in the literature. Very few differences were noted between opinions of teachers who were still in training and those who were practicing for an average of 11 years. The study underscores the need for awareness campaigns that target not only teachers who are currently working but also those still in training to dispel misconceptions about stuttering and ensure a better educational environment for PWS. At the end of this activity the reader will be able to: (1) describe knowledge of stuttering and attitudes toward students who stutter and classroom strategies perceived to be helpful by pre-service and in-service teachers in Kuwait; (2) identify stereotypes toward stuttering across cultures, professions and geographic locations; and (3) list similarities and differences in attitude and knowledge of stuttering between parents and teachers. Copyright © 2011 Elsevier Inc. All rights reserved.

The effectiveness of stuttering treatments in Germany.

PubMed

Euler, Harald A; Lange, Benjamin P; Schroeder, Sascha; Neumann, Katrin

2014-03-01

Persons who stutter (PWS) should be referred to the most effective treatments available, locally or regionally. A prospective comparison of the effects of the most common stuttering treatments in Germany is not available. Therefore, a retrospective evaluation by clients of stuttering treatments was carried out. The five most common German stuttering treatments (231 single treatment cases) were rated as to their perceived effectiveness, using a structured questionnaire, by 88 PWS recruited through various sources. The participants had received between 1 and 7 treatments for stuttering. Two stuttering treatments (stuttering modification, fluency shaping) showed favorable and three treatments (breathing therapy, hypnosis, unspecified logopedic treatment) showed unsatisfactory effectiveness ratings. The effectiveness ratings of stuttering modification and fluency shaping did not differ significantly. The three other treatments were equally ineffective. The differences between the effective and ineffective treatments were of large effect sizes. The typical therapy biography begins in childhood with an unspecified logopedic treatment administered extensively in single and individual sessions. Available comparisons showed intensive or interval treatments to be superior to extensive treatments, and group treatments to be superior to single client treatments. The stuttering treatment most often prescribed in Germany, namely a weekly session of individual treatment by a speech-language pathologist, usually with an assorted package of mostly unknown components, is of limited effectiveness. Better effectiveness can be expected from fluency shaping or stuttering modification approaches, preferably with an intensive time schedule and with group sessions. Readers will be able to: (a) discuss the five most prevalent stuttering treatments in Germany; (b) summarize the effectiveness of these treatments; and (c) describe structural treatment components that seem to be preferable across different kinds of treatments. Copyright © 2014 Elsevier Inc. All rights reserved.

Utterance complexity and stuttering on function words in preschool-age children who stutter.

PubMed

Richels, Corrin; Buhr, Anthony; Conture, Edward; Ntourou, Katerina

2010-09-01

The purpose of the present investigation was to examine the relation between utterance complexity and utterance position and the tendency to stutter on function words in preschool-age children who stutter (CWS). Two separate studies involving two different groups of participants (Study 1, n=30; Study 2, n=30) were conducted. Participants were preschool-age CWS between the age of 3, 0 and 5, 11 who engaged in 15-20min parent-child conversational interactions. From audio-video recordings of each interaction, every child utterance of each parent-child sample was transcribed. From these transcripts, for each participant, measures of language (e.g., length and complexity) and measures of stuttering (e.g., word type and utterance position) were obtained. Results of Study 1 indicated that children stuttered more frequently on function words, but that this tendency was not greater for complex than simple utterances. Results of Study 2, involving the assessment of utterance position and MLU quartile, indicated that that stuttering was more likely to occur with increasing sentence length, and that stuttering tended to occur at the utterance-initial position, the position where function words were also more likely to occur. Findings were taken to suggest that, although word-level influences cannot be discounted, utterance-level influences contribute to the loci of stuttering in preschool-age children, and may help account for developmental changes in the loci of stuttering. The reader will learn about and be able to: (a) describe the influence of word type (function versus content words), and grammatical complexity, on disfluent speech; (b) compare the effect of stuttering frequency based on the position of the word in the utterance; (c) discuss the contribution of utterance position on the frequency of stuttering on function words; and (d) explain possible reasons why preschoolers stutter more frequently on function words than content words.

Stuttering and work life: an interpretative phenomenological analysis.

PubMed

Bricker-Katz, Geraldine; Lincoln, Michelle; Cumming, Steven

2013-12-01

The experiential claims of nine people who stuttered were examined with the purpose of determining the impact of stuttering on their work lives and to further examine what meaning they derive from these experiences. Six male and three female participants aged 29-61 years (mean age, 41.4) who stuttered were interviewed and verbatim interview transcripts were analyzed using interpretative phenomenological analysis. Credibility was established by way of member checking, researcher comparison with only consensual themes and interpretations presented in the final analysis. Four Superordinate themes, "stuttering is always there; stuttering at work reveals a problem; stuttering limits communication; and stuttering limits occupational progression" were distilled by descriptive and interpretative treatment of the interview transcripts. The interpretative level of analysis identified self-stigma as central to the meaning derived from these experiences. Participants' expectation of stigmatizing public attitudes, together with their own self-validation of such attitudes perpetuated diminished feelings about self-esteem and self-efficacy. Fear of negative evaluation may be heightened in the work context and might mediate feelings of self-stigma in this context. Superordinate themes and their subthemes indicate that stuttering is problematic at work by way of perpetuating in the PWS an expectation of negative evaluation by others. Findings implicate issues of self-stigma as generating feelings of self-doubt and self-reproach in PWS in the workplace. The development and effects of self-stigma in PWS have broader implications than the workplace context alone and further examination of the issues of self-stigma in stuttering is recommended. At the end of this activity the reader will be able to: (a) describe how stuttering might affect workplace experiences; (b) describe the impact of stuttering on communication in the work context; (c) describe how qualitative methods can provide insights into the impact of stuttering in the work context; (d) describe the impact of self and public stigma on wellbeing in the work context. Copyright © 2013 Elsevier Inc. All rights reserved.

Severe stuttering and motor tics responsive to cocaine.

PubMed

Linazasoro, G; Van Blercom, N

2007-02-01

Developmental stuttering and tics share many clinical and therapeutical aspects. Dopaminergic neurotransmission seems to be involved in the pathophysiology of both, tics and stuttering. We report on a patient with severe stuttering and mild facial tics which were dramatically improved by cocaine, challenging previous reports.

Listener Responses According to Stuttering Self-Acknowledgment and Modification

ERIC Educational Resources Information Center

Lee, Kyungjae; Manning, Walter H.

2010-01-01

Given the well-documented understanding that stuttering behavior elicits stereotypically negative responses from listeners, two experiments explored the equivocal results of earlier investigations concerning the potential for self-acknowledgment and modification of stuttering to elicit positive responses from naive (unfamiliar with stuttering)…

A simple and effective treatment for stuttering: speech practice without audience.

PubMed

Yamada, Jun; Homma, Takanobu

2007-01-01

On the assumption that stuttering is essentially acquired behavior, it has been concluded that speech-related anticipatory anxiety as a major cause of stuttering accounts for virtually all apparently-different aspects of stuttering on the behavioral level. Stutterers' linguistic competence is unimpaired, although their speech production is characterized as "disfluent". Yet, such disfluency is dramatically reduced when such people speak in anxiety-free no-audience conditions. Furthermore, our pilot study of oral reading in Japanese indicates that a stutterer can easily replace stuttering events with a common interjection, "eh", and make oral reading sound natural and fluent. Given these facts, we propose the Overlearning Fluency when Alone (OFA) treatment, consisting of two distinct but overlapping steps: (1) Overlearning of fluency in a no-audience condition, and (2) Use of an interjection, "eh", as a starter when a stuttering event is anticipated. It remains to be demonstrated that this is a truly simple and effective treatment for "one of mankind's most baffling afflictions".

Factors involved in the identification of stuttering severity in a foreign language.

PubMed

Cosyns, Marjan; Einarsdóttir, Jóhanna T; Van Borsel, John

2015-01-01

Speech-language pathologists nowadays are more and more confronted with clients who speak a language different from their own mother tongue. The assessment of persons who speak a foreign language poses particular challenges. The present study investigated the possible role and interplay of factors involved in the identification of stuttering severity in a foreign language. Nineteen speech-language pathologists from five different countries (i.e. Iceland, Sweden, Norway, Finland, and Belgium) rated stuttering severity of speech samples featuring persons who stutter speaking Icelandic, Swedish, Norwegian, or Dutch. Additionally, they were asked to score how easy they found it to rate the samples. Accuracy of rating stuttering severity in another language appeared to be foremost determined by the client's stuttering severity, while experienced ease of rating stuttering severity was essentially related to closeness of the language of the clinician to that of the client and familiarity of the clinician with the client's language. Stuttering measurement training programmes in different languages are needed.

Language and motor abilities of preschool children who stutter: Evidence from behavioral and kinematic indices of nonword repetition performance

PubMed Central

Smith, Anne; Goffman, Lisa; Sasisekaran, Jayanthi; Weber-Fox, Christine

2012-01-01

Stuttering is a disorder of speech production that typically arises in the preschool years, and many accounts of its onset and development implicate language and motor processes as critical underlying factors. There have, however, been very few studies of speech motor control processes in preschool children who stutter. Hearing novel nonwords and reproducing them engages multiple neural networks, including those involved in phonological analysis and storage and speech motor programming and execution. We used this task to explore speech motor and language abilities of 31 children aged 4–5 years who were diagnosed as stuttering. We also used sensitive and specific standardized tests of speech and language abilities to determine which of the children who stutter had concomitant language and/or phonological disorders. Approximately half of our sample of stuttering children had language and/or phonological disorders. As previous investigations would suggest, the stuttering children with concomitant language or speech sound disorders produced significantly more errors on the nonword repetition task compared to typically developing children. In contrast, the children who were diagnosed as stuttering, but who had normal speech sound and language abilities, performed the nonword repetition task with equal accuracy compared to their normally fluent peers. Analyses of interarticulator motions during accurate and fluent productions of the nonwords revealed that the children who stutter (without concomitant disorders) showed higher variability in oral motor coordination indices. These results provide new evidence that preschool children diagnosed as stuttering lag their typically developing peers in maturation of speech motor control processes. Educational objectives The reader will be able to: (a) discuss why performance on nonword repetition tasks has been investigated in children who stutter; (b) discuss why children who stutter in the current study had a higher incidence of concomitant language deficits compared to several other studies; (c) describe how performance differed on a nonword repetition test between children who stutter who do and do not have concomitant speech or language deficits; (d) make a general statement about speech motor control for nonword production in children who stutter compared to controls. PMID:23218217

Validation and evaluation of the Dutch translation of the Overall Assessment of the Speaker's Experience of Stuttering for School-age children (OASES-S-D).

PubMed

Lankman, Romy S; Yaruss, J Scott; Franken, Marie-Christine

2015-09-01

Stuttering can have a negative impact on many aspects of a speaker's life. Comprehensive assessment must therefore examine a range of experiences in order to reflect the overall impact of the disorder. This study evaluated the Dutch translation of the Overall Assessment of the Speaker's Experience of Stuttering--School-age (OASES-S; Yaruss & Quesal, 2010), which examines the impact of stuttering on the lives of children ages 7-12. The OASES-S was translated to Dutch (OASES-S-D) using a forward/backward translation process. Participants were 101 Dutch-speaking children who stutter (ages 7-12) who were recruited by speech-language therapists throughout the Netherlands. All participants completed the OASES-S-D, the Children's Attitudes about Talking-Dutch, a self-assessment of severity, a clinical assessment of severity, and a speech satisfaction rating. A control group of 51 children who do not stutter also completed the OASES-S-D to determine whether the tool could differentiate between children who stutter and children who do not stutter. All sections of the OASES-S-D except section I surpassed a Cronbach's alpha of 0.70, indicating good internal consistency and reliability. Comparisons between the OASES-S-D and other tools revealed moderate to high associations. The OASES-S-D was able to discriminate between children who stutter and children who do not stutter and between participants with different levels of stuttering severity. The OASES-S-D appears to be a reliable and valid measure that can be used to assess the impact of stuttering on 7- to 12-year old Dutch-speaking children who stutter. The reader will be able to: (a) describe the purpose of the OASES-S-D measurement tool; (b) summarize the translation process used in creating the OASES-S-D; (c) summarize the aspects of stuttering measured in the different sections of the OASES-S-D; (d) describe with what measurement tools the validity of the OASES-S-D was investigated; and (e) describe the differences between the American-English version and Dutch translation of the OASES-S. Copyright © 2015 Elsevier Inc. All rights reserved.

Atypical Brain Torque in Boys With Developmental Stuttering

PubMed Central

Mock, Jeffrey Ryan; Zadina, Janet N.; Corey, David M.; Cohen, Jeremy D.; Lemen, Lisa C.; Foundas, Anne L.

2017-01-01

The counterclockwise brain torque, defined as a larger right prefrontal and left parietal-occipital lobe, is a consistent brain asymmetry. Reduced or reversed lobar asymmetries are markers of atypical cerebral laterality and have been found in adults who stutter. It was hypothesized that atypical brain torque would be more common in children who stutter. MRI-based morphology measures were completed in boys who stutter (n=14) and controls (n=14), ages 8–13. The controls had the expected brain torque configurations whereas the boys who stutter were atypical. These results support the hypothesis that developmental stuttering is associated with atypical prefrontal and parietal-occipital lobe asymmetries. PMID:22799762

Standalone Internet speech restructuring treatment for adults who stutter: A phase I study.

PubMed

Erickson, Shane; Block, Susan; Menzies, Ross; O'Brian, Sue; Packman, Ann; Onslow, Mark

2016-08-01

This Phase I trial reports the results of a clinician-free Internet speech restructuring treatment for adults who stutter. The program consists of nine phases with concepts loosely based on the Camperdown Program. Twenty adults who stutter were recruited. They were given unlimited access to the program for 6 months. Primary outcome measures were the percentage of syllables stuttered and self-reported severity ratings. Five participants accessed all phases of the program, while another five accessed more than half the phases. The remaining 10 accessed between one and four phases. Four of five participants who accessed all phases reduced their stuttering frequency by more than 50% and an additional two participants who accessed more than half the phases also achieved similar reductions. These results were confirmed by self-reports of stuttering severity. Stuttering reductions were largely commensurate with the amount of the program accessed. As with other clinician-free programs in related health areas, maintaining adherence to the program's procedures was a significant issue. Nonetheless, this novel approach to treating stuttering has the potential to be a viable alternative for some clients and may help to address the significant access and relapse issues that affect treatment provision for adults who stutter.

Anxiety in speakers who persist and recover from stuttering.

PubMed

Davis, Stephen; Shisca, Daniella; Howell, Peter

2007-01-01

The study was designed to see whether young children and adolescents who persist in their stutter (N=18) show differences in trait and/or state anxiety compared with people who recover from their stutter (N=17) and fluent control speakers (N=19). A fluent control group, a group of speakers who have been documented as stuttering in the past but do not stutter now and a group of speakers (also with a documented history of stuttering) who persist in their stuttering participated, all aged 10-17 years. The State-Trait Anxiety Inventory for Children was administered. There were no differences between persistent, recovered and control groups with regard to trait anxiety. The persistent group had higher state anxiety than controls and the recovered group for three out of four speaking situations. The findings are interpreted as showing that anxiety levels in certain affective states appear to be associated with the speaking problem. A reader should be able to appreciate the difference between state and trait anxiety understand views about how the role anxiety has on stuttering has changed over time appreciate different views about how anxiety affects speakers who persist and recover from stuttering see why longitudinal work is needed to study these issues.

Non-verbal sensorimotor timing deficits in children and adolescents who stutter

PubMed Central

Falk, Simone; Müller, Thilo; Dalla Bella, Simone

2015-01-01

There is growing evidence that motor and speech disorders co-occur during development. In the present study, we investigated whether stuttering, a developmental speech disorder, is associated with a predictive timing deficit in childhood and adolescence. By testing sensorimotor synchronization abilities, we aimed to assess whether predictive timing is dysfunctional in young participants who stutter (8–16 years). Twenty German children and adolescents who stutter and 43 non-stuttering participants matched for age and musical training were tested on their ability to synchronize their finger taps with periodic tone sequences and with a musical beat. Forty percent of children and 90% of adolescents who stutter displayed poor synchronization with both metronome and musical stimuli, falling below 2.5% of the estimated population based on the performance of the group without the disorder. Synchronization deficits were characterized by either lower synchronization accuracy or lower consistency or both. Lower accuracy resulted in an over-anticipation of the pacing event in participants who stutter. Moreover, individual profiles revealed that lower consistency was typical of participants that were severely stuttering. These findings support the idea that malfunctioning predictive timing during auditory–motor coupling plays a role in stuttering in children and adolescents. PMID:26217245

Coarticulatory evidence in stuttered disfluencies

NASA Astrophysics Data System (ADS)

Arbisi-Kelm, Timothy

2005-09-01

While the disfluencies produced in stuttered speech surface at a significantly higher rate than those found in normal speech, it is less clear from the previous stuttering literature how exactly these disfluency patterns might differ in kind [Wingate (1988)]. One tendency found in normal speech is for disfluencies to remove acoustic evidence of coarticulation patterns [Shriberg (1999)]. This appears attributable to lexical search errors which prevent a speaker from accessing a word's phonological form; that is, coarticulation between words will fail to occur when segmental material from the following word is not retrieved. Since stuttering is a disorder which displays evidence of phonological but not lexical impairment, it was predicted that stuttered disfluencies would differ from normal errors in that the former would reveal acoustic evidence of word transitions. Eight speakers four stutterers and four control subjects participated in a narrative-production task, spontaneously describing a picture book. Preliminary results suggest that while both stutterers and controls did produce similar rates of disfluencies occurring without coarticulatory evidence, only the stutterers regularly produced disfluencies reflecting this transitional evidence. These results support the argument that disfluencies proper to stuttering result from a phonological deficit, while normal disfluencies are generally lexically based.

Young children's family history of stuttering and their articulation, language and attentional abilities: An exploratory study.

PubMed

Choi, Dahye; Conture, Edward G; Tumanova, Victoria; Clark, Chagit E; Walden, Tedra A; Jones, Robin M

The purpose of this study was to determine whether young children who do (CWS) and do not stutter (CWNS) with a positive versus negative family history of stuttering differ in articulation, language and attentional abilities and family histories of articulation, language and attention related disorders. Participants were 25 young CWS and 50 young CWNS. All 75 participants' caregivers consistently reported a positive or negative family history of stuttering across three consecutive time points that were about 8 months apart for a total of approximately 16 months. Each participant's family history focused on the same, relatively limited number of generations (i.e., participants' parents & siblings). Children's family history of stuttering as well as articulation, language, and attention related disorders was obtained from one or two caregivers during an extensive interview. Children's speech and language abilities were measured using four standardized articulation and language tests and their attentional abilities were measured using caregiver reports of temperament. Findings indicated that (1) most caregivers (81.5% or 75 out 92) were consistent in their reporting of positive or negative history of stuttering; (2) CWNS with a positive family history of stuttering, compared to those with a negative family history of stuttering, were more likely to have reported a positive family history of attention deficit/hyperactivity disorder (ADHD), and (3) CWNS with a positive family history of stuttering had lower language scores than those with a negative family history of stuttering. However, there were no such significant differences in family histories of ADHD and language scores for CWS with a positive versus negative family history of stuttering. In addition, although 24% of CWS versus 12% of CWNS's caregivers reported a positive family history of stuttering, inferential analyses indicated no significant differences between CWS and CWNS in relative proportions of family histories of stuttering. Finding that a relatively high proportion (i.e., 81.5%) of caregivers consistently reported a positive or negative family history of stuttering across three consecutive time points should provide some degree of assurance to those who collect such caregiver reports. Based on such consistent caregiver reports, linguistic as well as attentional vulnerabilities appear associated with a positive family history of stuttering, a finding that must await further empirical study for confirmation or refutation. Published by Elsevier Inc.

Dysphonia in adults with developmental stuttering: A descriptive study.

PubMed

Botha, Anél; Ras, Elizbé; Abdoola, Shabnam; Van der Linde, Jeannie

2017-06-26

Persons with stuttering (PWS) often present with other co-occurring conditions. The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) proposes that it is important to understand the full burden of a health condition. A few studies have explored voice problems among PWS, and the characteristics of voices of PWS are relatively unknown. The importance of conducting future research has been emphasised. This study aimed to describe the vocal characteristics of PWS. Acoustic and perceptual data were collected during a comprehensive voice assessment. The severity of stuttering was also determined. Correlations between the stuttering severity instrument (SSI) and the acoustic measurements were evaluated to determine the significance. Twenty participants were tested for this study. Only two participants (10%) obtained a positive Dysphonia Severity Index (DSI) score of 1.6 or higher, indicating that no dysphonia was present, while 90% of participants (n = 18) scored lower than 1.6, indicating that those participants presented with dysphonia. Some participants presented with weakness (asthenia) of voice (35%), while 65% presented with a slightly strained voice quality. Moderately positive correlations between breathiness and SSI (r = 0.40, p = 0.08) have been reported. In addition, participants with high SSI scores also scored a poor DSI of below 1.6, as observed by a moderate positive correlation between SSI and DSI (r = 0.41). The majority of PWS presented with dysphonia, evident in the perceptual or acoustic parameters of their voices. These results can be used for further investigation to create awareness and to establish intervention strategies for voice disorders among PWS.

Acute management of priapism in men.

PubMed

Tay, Yeng K; Spernat, Daniel; Rzetelski-West, Kathryn; Appu, Sree; Love, Chris

2012-04-01

What's known on the subject? and What does the study add? Priapism is a rare event. However, various medications and medical conditions may increase the risk. Priapism can be ischaemic, non-ischaemic or stuttering. It is paramount to distinguish the type of priapism, as misdiagnosis may lead to significant morbidity. Ischaemic priapism represents a compartment syndrome of the penis and is therefore a medical emergency. A delay in management may significantly affect future erectile function. Stuttering priapism represents recurrent subacute episodes of ischaemic priapism, which may lead to erectile dysfunction. Thus episodes must be minimised. Non-ischaemic priapism is not a medical emergency. However, misdiagnosis and injection with sympathomimetic agents can result in system absorption and toxicity. This review article provides a summary of the evaluation and management of priapism. Furthermore, a step by step flow chart is provided to guide the clinician through the assessment and management of this complex issue. To review the literature regarding ischaemic, non-ischaemic and stuttering priapism. To provide management recommendations. A Medline search was carried out to identify all relevant papers with management guidelines for priapism. Ischaemic priapism represents a compartment syndrome of the penis and urgent intervention is required to decrease the risk of erectile dysfunction. Non-ischaemic priapism is not a medical emergency; however, it can result in erectile dysfunction. The treatment objective for stuttering priapism is to reduce future episodes with systemic treatments, whilst treating each ischaemic episode as an emergency. Priapism is a complex condition that requires expert care to prevent complications and irreversible erectile dysfunction. © 2012 THE AUTHOR. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

Culture and Listeners' Gaze Responses to Stuttering

ERIC Educational Resources Information Center

Zhang, Jianliang; Kalinowski, Joseph

2012-01-01

Background: It is frequently observed that listeners demonstrate gaze aversion to stuttering. This response may have profound social/communicative implications for both fluent and stuttering individuals. However, there is a lack of empirical examination of listeners' eye gaze responses to stuttering, and it is unclear whether cultural background…

Public Attitudes toward Stuttering in Poland

ERIC Educational Resources Information Center

Przepiorka, Aneta M.; Blachnio, Agata; St. Louis, Kenneth O.; Wozniak, Tomasz

2013-01-01

Background: People who stutter often experience negative judgments and reactions to their stuttering from the nonstuttering majority. Many are stigmatized because of their stuttering and threatened with social exclusion, placing them at risk for compromised quality of life. Aims: The purpose of this investigation was to measure public attitudes…

Effects of Cognitive Demand on Word Encoding in Adults Who Stutter

ERIC Educational Resources Information Center

Tsai, Pei-Tzu

2011-01-01

The etiology of persistent stuttering is unknown, but stuttering has been attributed to multiple potential factors, including difficulty in processing language-related information, but findings remain inconclusive regarding any "specific" linguistic deficit potentially causing stuttering. One particular challenge in drawing conclusions is the…

The transition from the core vowels to the following segments in Japanese children who stutter: the second, third and fourth syllables.

PubMed

Matsumoto-Shimamori, Sachiyo; Ito, Tomohiko; Fukuda, Suzy E; Fukuda, Shinji

2011-09-01

Shimamori and Ito (2007 , Syllable weight and phonological encoding in Japanese children who stutter. Japanese Journal of Special Education, 44, 451-462; 2008, Syllable weight and frequency of stuttering: Comparison between children who stutter with and without a family history of stuttering. Japanese Journal of Special Education, 45, 437-445; 2009, Difference in frequency of stuttering between light and heavy syllables in the production of monosyllables: From the viewpoint of phonetic transition. The Japanese Journal of Logopedics and Phoniatrics, 50, 116-122 (in Japanese)) proposed the hypothesis that in Japanese the transition from the core vowels (CVs) to the following segments affected the occurrence of stuttering. However, the transition we investigated was in the first syllables only, and the effect of the transition in second, third and fourth syllables was not addressed. The purpose of this study was to investigate whether the transition from the CVs in the second, third and fourth syllables affected the occurrence of stuttering. The participants were 21 Japanese children. A non-word naming task and a non-word reading task were used. The frequency of stuttering was not significantly different where the number of transitions from the CVs differed on either task. These results suggest that the transition from the CVs in the second, third and fourth syllables does not have a significant effect on the occurrence of stuttering in Japanese.

Emotional Diathesis, Emotional Stress, and Childhood Stuttering

PubMed Central

Conture, Edward G.; Walden, Tedra A.; Jones, Robin M.; Kim, Hanjoe

2016-01-01

Purpose The purpose of this study was to determine (a) whether emotional reactivity and emotional stress of children who stutter (CWS) are associated with their stuttering frequency, (b) when the relationship between emotional reactivity and stuttering frequency is more likely to exist, and (c) how these associations are mediated by a 3rd variable (e.g., sympathetic arousal). Method Participants were 47 young CWS (M age = 50.69 months, SD = 10.34). Measurement of participants' emotional reactivity was based on parental report, and emotional stress was engendered by viewing baseline, positive, and negative emotion-inducing video clips, with stuttered disfluencies and sympathetic arousal (indexed by tonic skin conductance level) measured during a narrative after viewing each of the various video clips. Results CWS's positive emotional reactivity was positively associated with percentage of their stuttered disfluencies regardless of emotional stress condition. CWS's negative emotional reactivity was more positively correlated with percentage of stuttered disfluencies during a narrative after a positive, compared with baseline, emotional stress condition. CWS's sympathetic arousal did not appear to mediate the effect of emotional reactivity, emotional stress condition, and their interaction on percentage of stuttered disfluencies, at least during this experimental narrative task following emotion-inducing video clips. Conclusions Results were taken to suggest an association between young CWS's positive emotional reactivity and stuttering, with negative reactivity seemingly more associated with these children's stuttering during positive emotional stress (a stress condition possibly associated with lesser degrees of emotion regulation). Such findings seem to support the notion that emotional processes warrant inclusion in any truly comprehensive account of childhood stuttering. PMID:27327187

Emotional Diathesis, Emotional Stress, and Childhood Stuttering.

PubMed

Choi, Dahye; Conture, Edward G; Walden, Tedra A; Jones, Robin M; Kim, Hanjoe

2016-08-01

The purpose of this study was to determine (a) whether emotional reactivity and emotional stress of children who stutter (CWS) are associated with their stuttering frequency, (b) when the relationship between emotional reactivity and stuttering frequency is more likely to exist, and (c) how these associations are mediated by a 3rd variable (e.g., sympathetic arousal). Participants were 47 young CWS (M age = 50.69 months, SD = 10.34). Measurement of participants' emotional reactivity was based on parental report, and emotional stress was engendered by viewing baseline, positive, and negative emotion-inducing video clips, with stuttered disfluencies and sympathetic arousal (indexed by tonic skin conductance level) measured during a narrative after viewing each of the various video clips. CWS's positive emotional reactivity was positively associated with percentage of their stuttered disfluencies regardless of emotional stress condition. CWS's negative emotional reactivity was more positively correlated with percentage of stuttered disfluencies during a narrative after a positive, compared with baseline, emotional stress condition. CWS's sympathetic arousal did not appear to mediate the effect of emotional reactivity, emotional stress condition, and their interaction on percentage of stuttered disfluencies, at least during this experimental narrative task following emotion-inducing video clips. Results were taken to suggest an association between young CWS's positive emotional reactivity and stuttering, with negative reactivity seemingly more associated with these children's stuttering during positive emotional stress (a stress condition possibly associated with lesser degrees of emotion regulation). Such findings seem to support the notion that emotional processes warrant inclusion in any truly comprehensive account of childhood stuttering.

Effect of an 8-week practice of externally triggered speech on basal ganglia activity of stuttering and fluent speakers.

PubMed

Toyomura, Akira; Fujii, Tetsunoshin; Kuriki, Shinya

2015-04-01

The neural mechanisms underlying stuttering are not well understood. It is known that stuttering appears when persons who stutter speak in a self-paced manner, but speech fluency is temporarily increased when they speak in unison with external trigger such as a metronome. This phenomenon is very similar to the behavioral improvement by external pacing in patients with Parkinson's disease. Recent imaging studies have also suggested that the basal ganglia are involved in the etiology of stuttering. In addition, previous studies have shown that the basal ganglia are involved in self-paced movement. Then, the present study focused on the basal ganglia and explored whether long-term speech-practice using external triggers can induce modification of the basal ganglia activity of stuttering speakers. Our study of functional magnetic resonance imaging revealed that stuttering speakers possessed significantly lower activity in the basal ganglia than fluent speakers before practice, especially when their speech was self-paced. After an 8-week speech practice of externally triggered speech using a metronome, the significant difference in activity between the two groups disappeared. The cerebellar vermis of stuttering speakers showed significantly decreased activity during the self-paced speech in the second compared to the first experiment. The speech fluency and naturalness of the stuttering speakers were also improved. These results suggest that stuttering is associated with defective motor control during self-paced speech, and that the basal ganglia and the cerebellum are involved in an improvement of speech fluency of stuttering by the use of external trigger. Copyright © 2015 Elsevier Inc. All rights reserved.

Separation of trait and state in stuttering.

PubMed

Connally, Emily L; Ward, David; Pliatsikas, Christos; Finnegan, Sarah; Jenkinson, Mark; Boyles, Rowan; Watkins, Kate E

2018-04-06

Stuttering is a disorder in which the smooth flow of speech is interrupted. People who stutter show structural and functional abnormalities in the speech and motor system. It is unclear whether functional differences reflect general traits of the disorder or are specifically related to the dysfluent speech state. We used a hierarchical approach to separate state and trait effects within stuttering. We collected sparse-sampled functional MRI during two overt speech tasks (sentence reading and picture description) in 17 people who stutter and 16 fluent controls. Separate analyses identified indicators of: (1) general traits of people who stutter; (2) frequency of dysfluent speech states in subgroups of people who stutter; and (3) the differences between fluent and dysfluent states in people who stutter. We found that reduced activation of left auditory cortex, inferior frontal cortex bilaterally, and medial cerebellum were general traits that distinguished fluent speech in people who stutter from that of controls. The stuttering subgroup with higher frequency of dysfluent states during scanning (n = 9) had reduced activation in the right subcortical grey matter, left temporo-occipital cortex, the cingulate cortex, and medial parieto-occipital cortex relative to the subgroup who were more fluent (n = 8). Finally, during dysfluent states relative to fluent ones, there was greater activation of inferior frontal and premotor cortex extending into the frontal operculum, bilaterally. The above differences were seen across both tasks. Subcortical state effects differed according to the task. Overall, our data emphasise the independence of trait and state effects in stuttering. © 2018 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

Effectiveness of Intensive, Group Therapy for Teenagers Who Stutter

ERIC Educational Resources Information Center

Fry, Jane; Millard, Sharon; Botterill, Willie

2014-01-01

Background: Treatment of adolescents who stutter is an under-researched area that would benefit from greater attention. Aims: To investigate whether an intensive treatment programme for older teenagers who stutter, aged over 16 years of age, is effective in reducing overt and covert aspects of stuttering. Methods & Procedures: A…

Social Anxiety and the Severity and Typography of Stuttering in Adolescents

ERIC Educational Resources Information Center

Mulcahy, Kylie; Hennessey, Neville; Beilby, Janet; Byrnes, Michelle

2008-01-01

The present study examined the relationship between anxiety, attitude toward daily communication, and stuttering symptomatology in adolescent stuttering. Adolescents who stuttered (n = 19) showed significantly higher levels of trait, state and social anxiety than fluent speaking controls (n = 18). Trait and state anxiety was significantly…

Orofacial Muscle Activity of Children Who Stutter: A Preliminary Study.

ERIC Educational Resources Information Center

Kelly, Ellen M.; And Others

1995-01-01

This preliminary investigation of stuttering development and maturation of speech motor processes recorded the electromyographic activity of the orofacial muscles of nine children who stuttered. Results suggest that the emergence of tremor-like instabilities in the speech motor processes of stuttering children may coincide with aspects of general…

Modifying Electroglottograph-Identified Intervals of Phonation: The Effect on Stuttering.

ERIC Educational Resources Information Center

Gow, Merrilyn L.; Ingham, Roger J.

1992-01-01

This study, involving an adolescent and adult male with stuttering problems, evaluated modification of the frequency of electroglottograph-measured phonation intervals on stuttering and speech naturalness. Both subjects demonstrated that stuttering could be controlled by modifying the frequency of phonation intervals within short duration ranges,…

Accuracy of Parent Identification of Stuttering Occurrence

ERIC Educational Resources Information Center

Einarsdottir, Johanna; Ingham, Roger

2009-01-01

Background: Clinicians rely on parents to provide information regarding the onset and development of stuttering in their own children. The accuracy and reliability of their judgments of stuttering is therefore important and is not well researched. Aim: To investigate the accuracy of parent judgements of stuttering in their own children's speech…

Stuttering and Language Ability in Children: Questioning the Connection

ERIC Educational Resources Information Center

Nippold, Marilyn A.

2012-01-01

Purpose: This article explains why it is reasonable to question the view that stuttering and language ability in children are linked--the so-called "stuttering-language connection." Method: Studies that focused on syntactic, morphologic, and lexical development in children who stutter (CWS) are examined for evidence to support the following…

Changing Adolescent Attitudes toward Stuttering

ERIC Educational Resources Information Center

Flynn, Timothy W.; St. Louis, Kenneth O.

2011-01-01

Purpose: Live oral or recorded video presentations on stuttering were delivered to high school students in order to determine the extent to which their attitudes toward stuttering could be improved. Methods: A classroom teacher administered the "Public Opinion Survey of Human Attributes-Stuttering" ("POSHA-S") to two health classes before and…

Secondary School Teachers' Beliefs, Attitudes, and Reactions to Stuttering

ERIC Educational Resources Information Center

Adriaensens, Stefanie; Struyf, Elke

2016-01-01

Purpose: The study identifies teachers' beliefs about and attitudes toward stuttering and explores to what extent these beliefs and attitudes prompt specific teachers' reactions to the stuttering of a student. Method: Participants were teachers in secondary education in Flanders (Belgium), currently teaching an adolescent who stutters. They were…

Translation, Assessment and Deployment of Stuttering Instruments into Different Languages: Comments Arising from Bakhtiar et al., "Investigation of the Reliability of the SSI-3 for Preschool Persian-Speaking Children Who Stutter" ["J. Fluency Disord." 35 (2010) 87-91

ERIC Educational Resources Information Center

Karimi, Hamid; Nilipour, Reza; Shafiei, Bijan; Howell, Peter

2011-01-01

Bakhtiar, Seifpanahi, Ansari, Ghanadzade and Packman (2010) reported high inter-, and intra-judge agreement of a translation of the Stuttering Severity Instrument (SSI-3) for preschool Persian-speaking children who stutter. Translation of SSI-3 into Persian is desirable as there is no standardised stuttering severity test for that language.…

Beyond stuttering: Speech disfluencies in normally fluent French-speaking children at age 4.

PubMed

Leclercq, Anne-Lise; Suaire, Pauline; Moyse, Astrid

2018-01-01

The aim of this study was to establish normative data on the speech disfluencies of normally fluent French-speaking children at age 4, an age at which stuttering has begun in 95% of children who stutter (Yairi & Ambrose, 2013). Fifty monolingual French-speaking children who do not stutter participated in the study. Analyses of a conversational speech sample comprising 250-550 words revealed an average of 10% total disfluencies, 2% stuttering-like disfluencies and around 8% non-stuttered disfluencies. Possible explanations for these high speech disfluency frequencies are discussed, including explanations linked to French in particular. The results shed light on the importance of normative data specific to each language.

Relationships between psychosocial factors and quality of life for adults who stutter.

PubMed

Boyle, Michael P

2015-02-01

In this study, the author examined the relationship of social support, empowerment, self-help support group participation, and group identification to quality of life in adults who stutter. Two-hundred forty-nine adults who stutter completed a web-based survey, including measures of social support, empowerment, self-help support group participation, group identification, and quality of life. After controlling for demographic and stuttering parameters, both empowerment in the self-esteem/self-efficacy domain and social support from family significantly predicted quality of life in adults in the sample. Increased self-esteem/self-efficacy and social support from family relates to improved quality of life in adults who stutter, independent of stuttering severity. Treatments that increase feelings of self-esteem/self-efficacy and strengthen social support from the family should be considered for individuals who struggle to cope with stuttering in order to enhance their quality of life.

Behavioral and multimodal neuroimaging evidence for a deficit in brain timing networks in stuttering: a hypothesis and theory

PubMed Central

Etchell, Andrew C.; Johnson, Blake W.; Sowman, Paul F.

2014-01-01

The fluent production of speech requires accurately timed movements. In this article, we propose that a deficit in brain timing networks is one of the core neurophysiological deficits in stuttering. We first discuss the experimental evidence supporting the involvement of the basal ganglia and supplementary motor area (SMA) in stuttering and the involvement of the cerebellum as a possible mechanism for compensating for the neural deficits that underlie stuttering. Next, we outline the involvement of the right inferior frontal gyrus (IFG) as another putative compensatory locus in stuttering and suggest a role for this structure in an expanded core timing-network. Subsequently, we review behavioral studies of timing in people who stutter and examine their behavioral performance as compared to people who do not stutter. Finally, we highlight challenges to existing research and provide avenues for future research with specific hypotheses. PMID:25009487

Stuttering on function words in bilingual children who stutter: A preliminary study.

PubMed

Gkalitsiou, Zoi; Byrd, Courtney T; Bedore, Lisa M; Taliancich-Klinger, Casey L

2017-01-01

Evidence suggests young monolingual children who stutter (CWS) are more disfluent on function than content words, particularly when produced in the initial utterance position. The purpose of the present preliminary study was to investigate whether young bilingual CWS present with this same pattern. The narrative and conversational samples of four bilingual Spanish- and English-speaking CWS were analysed. All four bilingual participants produced significantly more stuttering on function words compared to content words, irrespective of their position in the utterance, in their Spanish narrative and conversational speech samples. Three of the four participants also demonstrated more stuttering on function compared to content words in their narrative speech samples in English, but only one participant produced more stuttering on function than content words in her English conversational sample. These preliminary findings are discussed relative to linguistic planning and language proficiency and their potential contribution to stuttered speech.

Identification of Fluency and Word-Finding Difficulty in Samples of Children with Diverse Language Backgrounds

ERIC Educational Resources Information Center

Howell, Peter; Tang, Kevin; Tuomainen, Outi; Chan, Sin Kan; Beltran, Kirsten; Mirawdeli, Avin; Harris, John

2017-01-01

Background: Stuttering and word-finding difficulty (WFD) are two types of communication difficulty that occur frequently in children who learn English as an additional language (EAL), as well as those who only speak English. The two disorders require different, specific forms of intervention. Prior research has described the symptoms of each type…

Stuttering Inhibition via Altered Auditory Feedback during Scripted Telephone Conversations

ERIC Educational Resources Information Center

Hudock, Daniel; Kalinowski, Joseph

2014-01-01

Background: Overt stuttering is inhibited by approximately 80% when people who stutter read aloud as they hear an altered form of their speech feedback to them. However, levels of stuttering inhibition vary from 60% to 100% depending on speaking situation and signal presentation. For example, binaural presentations of delayed auditory feedback…

Laterality Differences in Child Stutterers: Heterogeneity, Severity Levels, and Statistical Treatments.

ERIC Educational Resources Information Center

Blood, Gordon W.

1985-01-01

Results of a study involving 76 stutterers and 76 nonstutterers (seven to 15 years old) included (1) a right- ear preference for both groups; (2) differences in dichotic stuttering and nonstuttering Ss; and (3) a relationship between stuttering severity and hemispheric dominance dependency on manner of data analysis. (Author/CL)

The Relationship between Pre-Treatment Clinical Profile and Treatment Outcome in an Integrated Stuttering Program

ERIC Educational Resources Information Center

Huinck, Wendy J.; Langevin, Marilyn; Kully, Deborah; Graamans, Kees; Peters, Herman F. M.; Hulstijn, Wouter

2006-01-01

A procedure for subtyping individuals who stutter and its relationship to treatment outcome is explored. Twenty-five adult participants of the Comprehensive Stuttering Program (CSP) were classified according to: (1) stuttering severity and (2) severity of negative emotions and cognitions associated with their speech problem. Speech characteristics…

Phonological Priming in Adults Who Stutter

ERIC Educational Resources Information Center

Vincent, Irena; Grela, Bernard G.; Gilbert, Harvey R.

2012-01-01

The purpose of this study was to compare the speed of phonological encoding between adults who stutter (AWS) and adults who do not stutter (ANS). Fifteen male AWS and 15 age- and gender-matched ANS participated in the study. Speech onset latency was obtained for both groups and stuttering frequency was calculated for AWS during three phonological…

Stuttered and Fluent Speakers' Heart Rate and Skin Conductance in Response to Fluent and Stuttered Speech

ERIC Educational Resources Information Center

Zhang, Jianliang; Kalinowski, Joseph; Saltuklaroglu, Tim; Hudock, Daniel

2010-01-01

Background: Previous studies have found simultaneous increases in skin conductance response and decreases in heart rate when normally fluent speakers watched and listened to stuttered speech compared with fluent speech, suggesting that stuttering induces arousal and emotional unpleasantness in listeners. However, physiological responses of persons…

Relation of Emotional Reactivity and Regulation to Childhood Stuttering

ERIC Educational Resources Information Center

Karrass, Jan; Walden, Tedra A.; Conture, Edward G.; Graham, Corrin G.; Arnold, Hayley S.; Hartfield, Kia N.; Schwenk, Krista A.

2006-01-01

The purpose of the present study was to examine relations between children's emotional reactivity, emotion regulation and stuttering. Participants were 65 preschool children who stutter (CWS) and 56 preschool children who do not stutter (CWNS). Parents completed the Behavior Style Questionnaire (BSQ) [McDevitt S. C., & Carey, W. B. (1978). A…

Stages of Change and Stuttering: A Preliminary View

ERIC Educational Resources Information Center

Floyd, Jennifer; Zebrowski, Patricia M.; Flamme, Gregory A.

2007-01-01

As a way to better understand the process of change that occurs in stuttering, Craig [Craig, A. (1998). "Relapse following treatment for stuttering: a critical review and correlative data." "Journal of Fluency Disorders," 23, 1-30] compared the behavioral changes that people who stutter often experience with and without treatment to those that…

Differences of Articulation Rate and Utterance Length in Fluent and Disfluent Utterances of Preschool Children Who Stutter

ERIC Educational Resources Information Center

Chon, HeeCheong; Sawyer, Jean; Ambrose, Nicoline G.

2012-01-01

Purpose: The purpose of this study was to investigate characteristics of four types of utterances in preschool children who stutter: perceptually fluent, containing normal disfluencies (OD utterance), containing stuttering-like disfluencies (SLD utterance), and containing both normal and stuttering-like disfluencies (SLD+OD utterance).…

College Students' Perspectives on Dating a Person Who Stutters

ERIC Educational Resources Information Center

Mayo, Robert; Mayo, Carolyn M.

2013-01-01

The purpose of this study was to examine college students' perspectives on dating a person who stutters (PWS). One hundred and thirty-two college students responded to a 19-item survey questionnaire. Survey items included questions about participants' familiarity with persons who stutter, family and/or personal history of stuttering, knowledge of…

The Effects of Simulated Stuttering and Prolonged Speech on the Neural Activation Patterns of Stuttering and Nonstuttering Adults

ERIC Educational Resources Information Center

De Nil, Luc F.; Beal, Deryk S.; Lafaille, Sophie J.; Kroll, Robert M.; Crawley, Adrian P.; Gracco, Vincent L.

2008-01-01

Functional magnetic resonance imaging was used to investigate the neural correlates of passive listening, habitual speech and two modified speech patterns (simulated stuttering and prolonged speech) in stuttering and nonstuttering adults. Within-group comparisons revealed increased right hemisphere biased activation of speech-related regions…

"Roadblocks" Revisited: Neural Change, Stuttering Treatment, and Recovery from Stuttering

ERIC Educational Resources Information Center

Ingham, Roger J.; Finn, Patrick; Bothe, Anne K.

2005-01-01

In light of emerging findings concerning untreated recovery and neural plasticity, this paper re-examines the viability of an NIH conference recommendation [Cooper, J. A. (1990). Research directions in stuttering: Consensus and conflict. In Cooper, J. A. (Ed.), "Research needs in stuttering: Roadblocks and future directions" (pp. 98-100).…

Dissecting Choral Speech: Properties of the Accompanist Critical to Stuttering Reduction

ERIC Educational Resources Information Center

Kiefte, Michael; Armson, Joy

2008-01-01

The effects of choral speech and altered auditory feedback (AAF) on stuttering frequency were compared to identify those properties of choral speech that make it a more effective condition for stuttering reduction. Seventeen adults who stutter (AWS) participated in an experiment consisting of special choral speech conditions that were manipulated…

Jaw-Phonatory Coordination in Chronic Developmental Stuttering

ERIC Educational Resources Information Center

Loucks, Torrey M. J.; De Nil, Luc F.; Sasisekaran, Jayanthi

2007-01-01

A deficiency in sensorimotor integration in a person who stutters may be a factor in the pathophysiology of developmental stuttering. To test oral sensorimotor function in adults who stutter, we used a task that requires the coordination of a jaw-opening movement with phonation onset. The task was adapted from previous limb coordination studies,…

Disfluency Patterns and Phonological Skills Near Stuttering Onset

ERIC Educational Resources Information Center

Gregg, Brent Andrew; Yairi, Ehud

2012-01-01

There is a substantial amount of literature reporting the incidence of phonological difficulties to be higher for children who stutter when compared to normally fluent children, suggesting a link between stuttering and phonology. In view of this, the purpose of the investigation was to determine whether, among children who stutter, there are…

Emotional Diathesis, Emotional Stress, and Childhood Stuttering

ERIC Educational Resources Information Center

Choi, Dahye; Conture, Edward G.; Walden, Tedra A.; Jones, Robin M.; Kim, Hanjoe

2016-01-01

Purpose: The purpose of this study was to determine (a) whether emotional reactivity and emotional stress of children who stutter (CWS) are associated with their stuttering frequency, (b) when the relationship between emotional reactivity and stuttering frequency is more likely to exist, and (c) how these associations are mediated by a 3rd…

Stuttering Characteristics of German-English Bilingual Speakers

ERIC Educational Resources Information Center

Schafer, Martina; Robb, Michael P.

2012-01-01

The purpose of this study was to examine stuttering behavior in German-English bilingual people who stutter (PWS), with particular reference to the frequency of stuttering on content and function words. Fifteen bilingual PWS were sampled who spoke German as the first language (L1) and English as a second language (L2). Conversational speech was…

Characteristics of Stuttering-Like Disfluencies in Dutch-Speaking Children

ERIC Educational Resources Information Center

Boey, Ronny A.; Wuyts, Floris L.; Van de Heyning, Paul H.; De Bodt, Marc S.; Heylen, Louis

2007-01-01

The purpose of this study was to compare the characteristics of stuttering-like disfluencies in a group of native Dutch-speaking children who stutter (n = 693), with a group of normally fluent children (n = 79). Methods involved the observation of stuttering-like disfluencies in participants' conversational speech samples (total 77,200 words),…

Observer perspective imagery with stuttering.

PubMed

Lowe, Robyn; Menzies, Ross; Packman, Ann; O'Brian, Sue; Onslow, Mark

2015-01-01

Adults who stutter are at risk of developing a range of psychological conditions. Social anxiety disorder is the most common anxiety disorder associated with stuttering. Observer perspective imagery is one cognitive process involved in the maintenance of some anxiety disorders. This involves viewing images as if looking at the self from the perspective of another. In contrast, the field perspective involves looking out from the self at the surrounding environment. The purpose of this study was to assess the presence of observer perspective imagery with stuttering. The authors administered the Hackmann, Surawy and Clark (1998) semi-structured interview to 30 adults who stutter and 30 controls. Group images and impressions were compared for frequency, perspective recalled and emotional valence. The stuttering group was significantly more likely than controls to recall images and impressions from an observer rather than a field perspective for anxious situations. It is possible the present results could reflect the same attentional processing bias that occurs with anxiety disorders in the non-stuttering population. These preliminary results provide an explanation for the persistence of conditions such as social anxiety disorder with stuttering. Clinical implications are discussed.

Lexical tone and stuttering loci in Mandarin: evidence from preschool children who stutter.

PubMed

Chou, Fang-Chi; Zebrowski, Patricia; Yang, Shu-Lan

2015-02-01

The purpose of this study was to examine the relationship between stuttering loci and lexical tone in Mandarin-speaking preschoolers. Conversational samples from 20 Taiwanese children who stutter (CWS; M = 4:9; range = 3:2-6:4) were analysed for frequency and type of speech disfluency and lexical tone associated with stuttering-like disfluencies (SLDs). Results indicated that SLDs were significantly more likely to be produced on Mandarin syllables carrying Tone 3 and Tone 4 syllables compared to syllables carrying either Tone 1 or Tone 2. Post-hoc analyses revealed: (1) no significant differences in the stuttering frequencies between Tone 1 and Tone 2, or between Tone 3 and Tone 4, and (2) a higher incidence of stuttering on syllables carrying Tone 3 and Tone 4 embedded in conflicting (as opposed to compatible) tonal contexts. Results suggest that the higher incidence of stuttering on Mandarin syllables carrying either Tone 3 or 4 may be attributed to the increased level of speech motor demand underlying rapid F0 change both within and across syllables.

Hemodynamics of speech production: An fNIRS investigation of children who stutter.

PubMed

Walsh, B; Tian, F; Tourville, J A; Yücel, M A; Kuczek, T; Bostian, A J

2017-06-22

Stuttering affects nearly 1% of the population worldwide and often has life-altering negative consequences, including poorer mental health and emotional well-being, and reduced educational and employment achievements. Over two decades of neuroimaging research reveals clear anatomical and physiological differences in the speech neural networks of adults who stutter. However, there have been few neurophysiological investigations of speech production in children who stutter. Using functional near-infrared spectroscopy (fNIRS), we examined hemodynamic responses over neural regions integral to fluent speech production including inferior frontal gyrus, premotor cortex, and superior temporal gyrus during a picture description task. Thirty-two children (16 stuttering and 16 controls) aged 7-11 years participated in the study. We found distinctly different speech-related hemodynamic responses in the group of children who stutter compared to the control group. Whereas controls showed significant activation over left dorsal inferior frontal gyrus and left premotor cortex, children who stutter exhibited deactivation over these left hemisphere regions. This investigation of neural activation during natural, connected speech production in children who stutter demonstrates that in childhood stuttering, atypical functional organization for speech production is present and suggests promise for the use of fNIRS during natural speech production in future research with typical and atypical child populations.

Executive Functions Impact the Relation Between Respiratory Sinus Arrhythmia and Frequency of Stuttering in Young Children Who Do and Do Not Stutter

PubMed Central

Walden, Tedra A.; Conture, Edward G.; Erdemir, Aysu; Lambert, Warren E.; Porges, Stephen W.

2017-01-01

Purpose This study sought to determine whether respiratory sinus arrhythmia (RSA) and executive functions are associated with stuttered speech disfluencies of young children who do (CWS) and do not stutter (CWNS). Method Thirty-six young CWS and 36 CWNS were exposed to neutral, negative, and positive emotion-inducing video clips, followed by their participation in speaking tasks. During the neutral video, we measured baseline RSA, a physiological index of emotion regulation, and during video viewing and speaking, we measured RSA change from baseline, a physiological index of regulatory responses during challenge. Participants' caregivers completed the Children's Behavior Questionnaire from which a composite score of the inhibitory control and attentional focusing subscales served to index executive functioning. Results For both CWS and CWNS, greater decrease of RSA during both video viewing and speaking was associated with more stuttering. During speaking, CWS with lower executive functioning exhibited a negative association between RSA change and stuttering; conversely, CWNS with higher executive functioning exhibited a negative association between RSA change and stuttering. Conclusion Findings suggest that decreased RSA during video viewing and speaking is associated with increased stuttering and young CWS differ from CWNS in terms of how their executive functions moderate the relation between RSA change and stuttered disfluencies. PMID:28763803

Jaw-phonatory coordination in chronic developmental stuttering.

PubMed

Loucks, Torrey M J; De Nil, Luc F; Sasisekaran, Jayanthi

2007-01-01

A deficiency in sensorimotor integration in a person who stutters may be a factor in the pathophysiology of developmental stuttering. To test oral sensorimotor function in adults who stutter, we used a task that requires the coordination of a jaw-opening movement with phonation onset. The task was adapted from previous limb coordination studies, which show that movement coordination depends on intact proprioception. We hypothesized that adult stutterers would show deficient jaw-phonatory coordination relative to control participants. The task required initiation of phonation as a jaw-opening movement passed through a narrow spatial target. Target amplitude and jaw movement speed were varied. The stuttering group showed significantly higher movement error and spatial variability in jaw-phonatory coordination compared to the control group, but group differences in movement velocity or duration were not found. The aberrant jaw-phonatory coordination of the stuttering participants suggests that stuttering is associated with an oral proprioceptive limitation, although, the findings are also consistent with a motor control deficit. As a result of this activity, reader will (1) learn about a hypothesis and evidence supporting the view that a sensorimotor deficit contributes to chronic developmental stuttering and (2) will obtain information about the role of proprioception in multi-articulatory coordination and how it can be tested using an oral-phonatory coordination task.

The validity of a simple outcome measure to assess stuttering therapy.

PubMed

Huinck, Wendy; Rietveld, Toni

2007-01-01

The validity of a simple and not time-consuming self-assessment (SA) Scale was tested to establish progress after or during stuttering therapy. The scores on the SA scale were related to (1) objective measures (percentage of stuttered syllables, and syllables per minute) and (2) (self-)evaluation tests (self-evaluation questionnaires and perceptual evaluations or judgments of disfluency, naturalness and comfort by naïve listeners). Data were collected from two groups of stutterers at four measurement times: pretherapy, posttherapy, 12 months after therapy and 24 months after therapy. The first group attended the Comprehensive Stuttering Program: an integrated program based on fluency shaping techniques, and the second group participated in a Dutch group therapy: the Doetinchem Method that focuses on emotions and cognitions related to stuttering. Results showed similar score patterns on the SA scale, the self-evaluation questionnaires, the objective measures over time, and significant correlations between the SA scale and syllables per minute, percentage of stuttered syllables, Struggle subscale of the Perceptions of Stuttering Inventory and judged fluency on the T1-T2 difference scores. We concluded that the validity of the SA measure was proved and therefore encourage the use of such an instrument when (stuttering) treatment efficacy is studied.

On the importance of scientific rhetoric in stuttering: a reply to Finn, Bothe, and Bramlett (2005).

PubMed

Kalinowski, Joseph; Saltuklaroglu, Tim; Stuart, Andrew; Guntupalli, Vijaya K

2007-02-01

To refute the alleged practice of "pseudoscience" by P. Finn, A. K. Bothe, and R. E. Bramlett (2005) and to illustrate their experimental and systematic bias when evaluating the SpeechEasy, an altered auditory feedback device used in the management of stuttering. We challenged the experimental design that led to the seemingly predetermined outcome of pseudoscience rather than science: Limited preselected literature was submitted to a purposely sampled panel of judges (i.e., their own students). Each criterion deemed pseudoscientific was contested with published peer-reviewed data illustrating the importance of good rhetoric, testability, and logical outcomes from decades of scientific research. Stuttering is an involuntary disorder that is highly resistant to therapy. Altered auditory feedback is a derivation of choral speech (nature's most powerful stuttering "inhibitor") that can be synergistically combined with other methods for optimal stuttering inhibition. This approach is logical considering that in stuttering no single treatment is universally helpful. Also, caution is suggested when attempting to differentiate science from pseudoscience in stuttering treatments using the criteria employed by Finn et al. For example, evaluating behavioral therapy outcomes implements a post hoc or untestable system. Speech outcome (i.e., stuttered or fluent speech) determines success or failure of technique use, placing responsibility for failure on those who stutter.

Prevalence of stuttering in primary school children in Cairo-Egypt.

PubMed

Abou Ella, Mahmoud; Saleh, Marwa; Habil, Ihab; El Sawy, Mohammed; El Assal, Lamia

2015-01-01

To determine the prevalence of stuttering among primary school children in Cairo. A cross-sectional design was employed. Using a multi-stage random sample from 10 schools in Cairo, a total of 8765 primary school students were enrolled in the study. The teacher referring method was initially used to detect stuttering students, which was then confirmed by a Speech Language Pathologist (SLP) using Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV) criteria. Personal data were collected for all students and separate questionnaires were administered to the parents of each stuttering child, inquiring about consanguinity, family history, presence of other disorders and family attitudes towards the child. Prevalence of stuttering among primary school children in Cairo was 1.03%. The prevalence of stuttering showed a declining trend in the older age group. Stuttering was 7-fold more prevalent among left-handed students. Males had a higher prevalence of stuttering, but didn't reach statistical significance. Anxiety was expressed in 25% of the families of affected children. Positive family history was found in 28% of cases, mainly among first-degree relatives. The current study showed a prevalence of stuttering comparable to other areas of the world with some evidence of hereditary background, although lower than that reported by other studies.

Executive Functions Impact the Relation Between Respiratory Sinus Arrhythmia and Frequency of Stuttering in Young Children Who Do and Do Not Stutter.

PubMed

Jones, Robin M; Walden, Tedra A; Conture, Edward G; Erdemir, Aysu; Lambert, Warren E; Porges, Stephen W

2017-08-16

This study sought to determine whether respiratory sinus arrhythmia (RSA) and executive functions are associated with stuttered speech disfluencies of young children who do (CWS) and do not stutter (CWNS). Thirty-six young CWS and 36 CWNS were exposed to neutral, negative, and positive emotion-inducing video clips, followed by their participation in speaking tasks. During the neutral video, we measured baseline RSA, a physiological index of emotion regulation, and during video viewing and speaking, we measured RSA change from baseline, a physiological index of regulatory responses during challenge. Participants' caregivers completed the Children's Behavior Questionnaire from which a composite score of the inhibitory control and attentional focusing subscales served to index executive functioning. For both CWS and CWNS, greater decrease of RSA during both video viewing and speaking was associated with more stuttering. During speaking, CWS with lower executive functioning exhibited a negative association between RSA change and stuttering; conversely, CWNS with higher executive functioning exhibited a negative association between RSA change and stuttering. Findings suggest that decreased RSA during video viewing and speaking is associated with increased stuttering and young CWS differ from CWNS in terms of how their executive functions moderate the relation between RSA change and stuttered disfluencies.

Maintenance of Social Anxiety in Stuttering: A Cognitive-Behavioral Model.

PubMed

Iverach, Lisa; Rapee, Ronald M; Wong, Quincy J J; Lowe, Robyn

2017-05-17

Stuttering is a speech disorder frequently accompanied by anxiety in social-evaluative situations. A growing body of research has confirmed a significant rate of social anxiety disorder among adults who stutter. Social anxiety disorder is a chronic and disabling anxiety disorder associated with substantial life impairment. Several influential models have described cognitive-behavioral factors that contribute to the maintenance of social anxiety in nonstuttering populations. The purpose of the present article is to apply these leading models to the experience of social anxiety for people who stutter. Components from existing models were applied to stuttering in order to determine cognitive-behavioral processes that occur before, during, and after social-evaluative situations, which may increase the likelihood of stuttering-related social fears persisting. Maintenance of social anxiety in stuttering may be influenced by a host of interrelated factors, including fear of negative evaluation, negative social-evaluative cognitions, attentional biases, self-focused attention, safety behaviors, and anticipatory and postevent processing. Given the chronic nature of social anxiety disorder, identifying factors that contribute to the persistence of stuttering-related social fears has the potential to inform clinical practice and the development of psychological treatment programs to address the speech and psychological needs of people who stutter with social anxiety.

Behavioral inhibition and childhood stuttering

PubMed Central

Choi, Dahye; Conture, Edward G.; Walden, Tedra A.; Lambert, Warren E.; Tumanova, Victoria

2013-01-01

Purpose The purpose of this study was to assess the relation of behavioral inhibition to stuttering and speech/language output in preschool-age children who do (CWS) and do not stutter (CWNS). Method Participants were preschool-age (ages 36 to 68 months), including 26 CWS (22 males) and 28 CWNS (13 males). Participants’ behavioral inhibition (BI) was assessed by measuring the latency to their sixth spontaneous comment during conversation with an unfamiliar experimenter, using methodology developed by Kagan, Reznick, and Gibbons (1989). In addition to these measures of BI, each participant’s stuttered and non-stuttered disfluencies and mean length of utterance (in morphemes) were assessed. Results Among the more salient findings, it was found that (1) there was no significant difference in BI between preschool-age CWS and CWNS as a group, (2) when extremely high versus low inhibited children were selected, there were more CWS with higher BI and fewer CWS with lower BI when compared to their CWNS peers, and (3) more behaviorally inhibited CWS, when compared to less behaviorally inhibited CWS, exhibited more stuttering. Conclusions Findings are taken to suggest that one aspect of temperament (i.e., behavioral inhibition) is exhibited by some preschool-age CWS and that these children stutter more than CWS with lower behavioral inhibition. The present results seem to support continued study of the association between young children’s temperamental characteristics and stuttering, the diagnostic entity (i.e., CWS versus CWNS), as well as stuttering, the behavior (e.g., frequency of stuttered disfluencies). PMID:23773669

Birth weight and stuttering: Evidence from three birth cohorts.

PubMed

McAllister, Jan; Collier, Jacqueline

2014-03-01

Previous studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples. Logistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, <2500g; normal range; high birth weight, ≥4000g) and as a continuous variable. Separate analyses were carried out to determine the impact of birth weight and the other predictors on stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent. None of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6-3.6 times more likely than females to stutter. Our results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering. Copyright © 2013 Elsevier Inc. All rights reserved.

Severity of dysfluency correlates with basal ganglia activity in persistent developmental stuttering.

PubMed

Giraud, Anne-Lise; Neumann, Katrin; Bachoud-Levi, Anne-Catherine; von Gudenberg, Alexander W; Euler, Harald A; Lanfermann, Heinrich; Preibisch, Christine

2008-02-01

Previous studies suggest that anatomical anomalies [Foundas, A. L., Bollich, A. M., Corey, D. M., Hurley, M., & Heilman, K. M. (2001). Anomalous anatomy of speech-language areas in adults with persistent developmental stuttering. Neurology, 57, 207-215; Foundas, A. L., Corey, D. M., Angeles, V., Bollich, A. M., Crabtree-Hartman, E., & Heilman, K. M. (2003). Atypical cerebral laterality in adults with persistent developmental stuttering. Neurology, 61, 1378-1385; Foundas, A. L., Bollich, A. M., Feldman, J., Corey, D. M., Hurley, M., & Lemen, L. C. et al., (2004). Aberrant auditory processing and atypical planum temporale in developmental stuttering. Neurology, 63, 1640-1646; Jancke, L., Hanggi, J., & Steinmetz, H. (2004). Morphological brain differences between adult stutterers and non-stutterers. BMC Neurology, 4, 23], in particular a reduction of the white matter anisotropy underlying the left sensorimotor cortex [Sommer, M., Koch, M. A., Paulus, W., Weiller, C., & Buchel, C. (2002). Disconnection of speech-relevant brain areas in persistent developmental stuttering. Lancet, 360, 380-383] could be at the origin of persistent developmental stuttering (PDS). Because neural connections between the motor cortex and basal ganglia are implicated in speech motor functions, PDS could also be associated with a dysfunction in basal ganglia activity [Alm, P. (2004). Stuttering and the basal ganglia circuits: a critical review of possible relations. Journal of Communication Disorders, 37, 325-369]. This fMRI study reports a correlation between severity of stuttering and activity in the basal ganglia and shows that this activity is modified by fluency shaping therapy through long-term therapy effects that reflect speech production improvement. A model of dysfunction in stuttering and possible repair modes is proposed that accommodates the data presented here and observations previously made by us and by others.

Late Recovery from Stuttering: The Role of Hand Dominancy, Fine Motor and ‎Inhibition Control

PubMed Central

Mohammadi, Hiwa; Khazaie, Habibolah; Rezaei, Mansour; Joghataei, Mohammad Taghi

2016-01-01

Objective: There are controversial reports about factors that affect recovery from stuttering. In the ‎present study, the effect of hand dominancy, fine motor and inhibition control on late ‎recovery from stuttering was investigated among a group of Kurdish-Persian children who ‎stuttered in Iran.‎ Method: Twenty-two Kurdish-Persian children aged 7-14 years who stuttered were followed for 6 ‎years. Based on the evaluation of three experienced speech therapists and parental judgments, ‎these children were classified into recovered or persistent groups. Data about fine motor ‎control of hand and inhibition control were obtained, using Purdue Pegboard and Victoria ‎Strop Color Word Tests, respectively. Risk factors including sex, age, and family history of ‎stuttering, handedness, inhibitory control and fine motor control of hand were compared ‎between the groups and modeled to predict recovery from stuttering using logistic regression.‎ Results: From the 22 participants, 5 (22.7%) recovered from stuttering. The recovered and persistent ‎groups did not show significant differences in the interference effect. By dividing the scores ‎of the Purdue Pegboard tests to the right and left hand, we created a new Handedness Index ‎‎(HI). HI was significantly higher in the recovered group. The score of right hand was higher ‎than the left in the recovered group, but no difference was found between the two hands in ‎the persistent group. Among the investigated risk factors, only HI could predict the recovery ‎from or persistency of stuttering with 94% sensitivity and 84% specificity.‎ Conclusion: Handedness Index can predict the recovery from stuttering significantly among children who ‎stutter.‎ PMID:27252769

Emotional reactivity and regulation in preschool-age children who stutter.

PubMed

Ntourou, Katerina; Conture, Edward G; Walden, Tedra A

2013-09-01

This study experimentally investigated behavioral correlates of emotional reactivity and emotion regulation and their relation to speech (dis)fluency in preschool-age children who do (CWS) and do not (CWNS) stutter during emotion-eliciting conditions. Participants (18 CWS, 14 boys; 18 CWNS, 14 boys) completed two experimental tasks (1) a neutral ("apples and leaves in a transparent box," ALTB) and (2) a frustrating ("attractive toy in a transparent box," ATTB) task, both of which were followed by a narrative task. Dependent measures were emotional reactivity (positive affect, negative affect), emotion regulation (self-speech, distraction) exhibited during the ALTB and the ATTB tasks, percentage of stuttered disfluencies (SDs) and percentage of non-stuttered disfluencies (NSDs) produced during the narratives. Results indicated that preschool-age CWS exhibited significantly more negative emotion and more self-speech than preschool-age CWNS. For CWS only, emotion regulation behaviors (i.e., distraction, self-speech) during the experimental tasks were predictive of stuttered disfluencies during the subsequent narrative tasks. Furthermore, for CWS there was no relation between emotional processes and non-stuttered disfluencies, but CWNS's negative affect was significantly related to nonstuttered disfluencies. In general, present findings support the notion that emotional processes are associated with childhood stuttering. Specifically, findings are consistent with the notion that preschool-age CWS are more emotionally reactive than CWNS and that their self-speech regulatory attempts may be less than effective in modulating their emotions. The reader will be able to: (a) communicate the relevance of studying the role of emotion in developmental stuttering close to the onset of stuttering and (b) describe the main findings of the present study in relation to previous studies that have used different methodologies to investigate the role of emotion in developmental stuttering of young children who stutter. Copyright © 2013 Elsevier Inc. All rights reserved.

Parent perceptions of the impact of stuttering on their preschoolers and themselves.

PubMed

Langevin, Marilyn; Packman, Ann; Onslow, Mark

2010-01-01

Speech-language pathologists (SLPs) are advised to consider the distress of preschoolers and parents along with the social consequences of the child's stuttering when deciding whether to begin or delay treatment. Seventy-seven parents completed a survey that yielded quantitative and qualitative data that reflected their perceptions of the impact of stuttering on their children and themselves. Sixty-nine (89.6%) parents reported between 1 and 13 types of negative impact (modal=2). The most frequently reported reactions of children were frustration associated with their stuttering, withdrawal, reduced or changed verbal output, making comments about their inability to talk, and avoidances. The most frequently reported peer reaction was teasing (27.3%). Seventy parents (90.9%) reported that they were affected by their child's stuttering. Their most frequently reported reactions were worry/anxiety/concern, uncertainty about what to do, frustration, upset (parent term), self-blame (fear that they had caused the stuttering), taking time to listen, waiting for the child to finish talking, modifying their own speech, and asking the child to modify speech. Findings support calls for SLPs to consider the distress of preschool children and their parents and the social consequences of the children's stuttering when making the decision to begin or delay treatment. Readers will be able to describe parents' perceptions of the impact of stuttering on their children and themselves. In particular, readers will learn about (1) parents' perceptions of young children's awareness and reactions to their stuttering, (2) parents' perceptions of the social consequences of stuttering for young children; and (2) the emotional effect of stuttering on parents. Copyright 2010. Published by Elsevier Inc.

Direct versus Indirect Treatment for Preschool Children who Stutter: The RESTART Randomized Trial

PubMed Central

de Sonneville-Koedoot, Caroline; Stolk, Elly; Rietveld, Toni; Franken, Marie-Christine

2015-01-01

Objective Stuttering is a common childhood disorder. There is limited high quality evidence regarding options for best treatment. The aim of the study was to compare the effectiveness of direct treatment with indirect treatment in preschool children who stutter. Methods In this multicenter randomized controlled trial with an 18 month follow-up, preschool children who stutter who were referred for treatment were randomized to direct treatment (Lidcombe Program; n = 99) or indirect treatment (RESTART-DCM treatment; n = 100). Main inclusion criteria were age 3–6 years, ≥3% syllables stuttered (%SS), and time since onset ≥6 months. The primary outcome was the percentage of non-stuttering children at 18 months. Secondary outcomes included stuttering frequency (%SS), stuttering severity ratings by the parents and therapist, severity rating by the child, health-related quality of life, emotional and behavioral problems, and speech attitude. Results Percentage of non-stuttering children for direct treatment was 76.5% (65/85) versus 71.4% (65/91) for indirect treatment (Odds Ratio (OR), 0.6; 95% CI, 0.1–2.4, p = .42). At 3 months, children treated by direct treatment showed a greater decline in %SS (significant interaction time x therapy: β = -1.89; t(282.82) = -2.807, p = .005). At 18 months, stuttering frequency was 1.2% (SD 2.1) for direct treatment and 1.5% (SD 2.1) for indirect treatment. Direct treatment had slightly better scores on most other secondary outcome measures, but no differences between treatment approaches were significant. Conclusions Direct treatment decreased stuttering more quickly during the first three months of treatment. At 18 months, however, clinical outcomes for direct and indirect treatment were comparable. These results imply that at 18 months post treatment onset, both treatments are roughly equal in treating developmental stuttering in ways that surpass expectations of natural recovery. Follow-up data are needed to confirm these findings in the longer term. Trial Registration isrctn.org ISRCTN24362190 PMID:26218228

A preliminary investigation of daily variability of stuttering in adults.

PubMed

Constantino, Christopher D; Leslie, Paula; Quesal, Robert W; Yaruss, J Scott

2016-01-01

Variability in frequency of stuttering has made the results of treatment outcome studies difficult to interpret. Many factors that affect variability have been investigated; yet the typical range of variability experienced by speakers remains unknown. This study examined the day-to-day variability in the percentage of syllables containing stuttered and nonstuttered disfluencies in the speech of six adult speakers in three spontaneous speaking situations and two reading tasks. The frequency of moments stuttering during the tasks were compared within and between speakers and days to document the degree of variability in stuttering frequency and explore whether there were any consistent patterns. The Stuttering Severity Instrument-Fourth Edition (SSI-4) and Overall Assessment of the Speaker's Experience of Stuttering for Adults (OASES-A) were also tested for day-to-day variability. Correlations between frequency, severity, and life impact were made. The primary result of this study was the large range over which frequency of stuttering varied from day to day for the same individual. This variability did not correlate with any measures of stuttering severity but did correlate with life impact as measured by the OASES-A. No global pattern was detected in variability from day to day within or between participants. However, there were significantly more nonstuttered disfluencies present during the spontaneous speaking tasks than during the reading tasks. The day-to-day variability in the life impact of the disorder (OASES-A) was less than the day-to-day variability in observable stuttering behavior (percentage of syllables stuttered and SSI-4). Frequency of stuttering varies significantly from situation to situation and day to day, with observed variability exceeding the degree of change often reported in treatment outcomes studies from before to after treatment. This variability must be accounted for in future clinical and scientific work. Copyright © 2016 Elsevier Inc. All rights reserved.

Direct versus Indirect Treatment for Preschool Children who Stutter: The RESTART Randomized Trial.

PubMed

de Sonneville-Koedoot, Caroline; Stolk, Elly; Rietveld, Toni; Franken, Marie-Christine

2015-01-01

Stuttering is a common childhood disorder. There is limited high quality evidence regarding options for best treatment. The aim of the study was to compare the effectiveness of direct treatment with indirect treatment in preschool children who stutter. In this multicenter randomized controlled trial with an 18 month follow-up, preschool children who stutter who were referred for treatment were randomized to direct treatment (Lidcombe Program; n = 99) or indirect treatment (RESTART-DCM treatment; n = 100). Main inclusion criteria were age 3-6 years, ≥3% syllables stuttered (%SS), and time since onset ≥6 months. The primary outcome was the percentage of non-stuttering children at 18 months. Secondary outcomes included stuttering frequency (%SS), stuttering severity ratings by the parents and therapist, severity rating by the child, health-related quality of life, emotional and behavioral problems, and speech attitude. Percentage of non-stuttering children for direct treatment was 76.5% (65/85) versus 71.4% (65/91) for indirect treatment (Odds Ratio (OR), 0.6; 95% CI, 0.1-2.4, p = .42). At 3 months, children treated by direct treatment showed a greater decline in %SS (significant interaction time x therapy: β = -1.89; t(282.82) = -2.807, p = .005). At 18 months, stuttering frequency was 1.2% (SD 2.1) for direct treatment and 1.5% (SD 2.1) for indirect treatment. Direct treatment had slightly better scores on most other secondary outcome measures, but no differences between treatment approaches were significant. Direct treatment decreased stuttering more quickly during the first three months of treatment. At 18 months, however, clinical outcomes for direct and indirect treatment were comparable. These results imply that at 18 months post treatment onset, both treatments are roughly equal in treating developmental stuttering in ways that surpass expectations of natural recovery. Follow-up data are needed to confirm these findings in the longer term. isrctn.org ISRCTN24362190.

Self-help conferences for people who stutter: a qualitative investigation.

PubMed

Trichon, Mitchell; Tetnowski, John

2011-12-01

Self-help activities for people who stutter (PWS) have been gaining in popularity; however, there is a scarcity of evidence to support their utility in stuttering management. The purpose of this investigation was to understand the lived experience of individuals who attended a self-help conference(s) for PWS from the perspective of a PWS to learn its potential utility in stuttering management. The investigator used Interpretive Phenomenological Analysis (IPA) to systematically collect authentic data of this social phenomenon. Twelve participants were recruited from a self-help conference and the self-help community of PWS. Semi-structured interviews were conducted 4-18 months after each participant's last conference. Interviews were transcribed and analyzed. Themes were explained in investigator narratives and illustrated through participants' quotes. Interpreted themes of the experience of having attended a self-help conference(s) for PWS included: socializing opportunities with other PWS, affiliation, redefining oneself and post-conference disclosures. A conclusion of the study was that the experience of having attended a self-help conference(s) for PWS helped to minimize negative impact that stuttering can have on daily functioning. It appears that self-help conferences were perceived as a safer or "stutter-friendly" environment and promoted social interaction, relationship building, and community building through planned and unplanned activities. Another conclusion was that the experience of having attended self-help conferences for PWS helped participants to communicate more easily. Reported increases in social activity and an "openness" about stuttering, suggest self-help conferences' utility in stuttering management. These findings are supported by other studies about successful stuttering management and self-help activities for PWS. They have helped attendees who stutter to communicate more easily and suggest a reduction in the negative impact that stuttering has on their lives. The reader will be able to: (1) describe recurring themes associated with the lived experience having attended a self-help conference(s) for people who stutter (PWS) from the perspective of a group of adults who stutter, and (2) describe the potential benefits of attending self-help conferences for PWS in order to make appropriate evidence-based referrals to self-help conferences for PWS. Copyright © 2011 Elsevier Inc. All rights reserved.

Formant transitions in the fluent speech of Farsi-speaking people who stutter.

PubMed

Dehqan, Ali; Yadegari, Fariba; Blomgren, Michael; Scherer, Ronald C

2016-06-01

Second formant (F2) transitions can be used to infer attributes of articulatory transitions. This study compared formant transitions during fluent speech segments of Farsi (Persian) speaking people who stutter and normally fluent Farsi speakers. Ten Iranian males who stutter and 10 normally fluent Iranian males participated. Sixteen different "CVt" tokens were embedded within the phrase "Begu CVt an". Measures included overall F2 transition frequency extents, durations, and derived overall slopes, initial F2 transition slopes at 30ms and 60ms, and speaking rate. (1) Mean overall formant frequency extent was significantly greater in 14 of the 16 CVt tokens for the group of stuttering speakers. (2) Stuttering speakers exhibited significantly longer overall F2 transitions for all 16 tokens compared to the nonstuttering speakers. (3) The overall F2 slopes were similar between the two groups. (4) The stuttering speakers exhibited significantly greater initial F2 transition slopes (positive or negative) for five of the 16 tokens at 30ms and six of the 16 tokens at 60ms. (5) The stuttering group produced a slower syllable rate than the non-stuttering group. During perceptually fluent utterances, the stuttering speakers had greater F2 frequency extents during transitions, took longer to reach vowel steady state, exhibited some evidence of steeper slopes at the beginning of transitions, had overall similar F2 formant slopes, and had slower speaking rates compared to nonstuttering speakers. Findings support the notion of different speech motor timing strategies in stuttering speakers. Findings are likely to be independent of the language spoken. Educational objectives This study compares aspects of F2 formant transitions between 10 stuttering and 10 nonstuttering speakers. Readers will be able to describe: (a) characteristics of formant frequency as a specific acoustic feature used to infer speech movements in stuttering and nonstuttering speakers, (b) two methods of measuring second formant (F2) transitions: the visual criteria method and fixed time criteria method, (c) characteristics of F2 transitions in the fluent speech of stuttering speakers and how those characteristics appear to differ from normally fluent speakers, and (d) possible cross-linguistic effects on acoustic analyses of stuttering. Copyright © 2016 Elsevier Inc. All rights reserved.

Expressed parental concern regarding childhood stuttering and the Test of Childhood Stuttering.

PubMed

Tumanova, Victoria; Choi, Dahye; Conture, Edward G; Walden, Tedra A

The purpose of the present study was to determine whether the Test of Childhood Stuttering observational rating scales (TOCS; Gillam et al., 2009) (1) differed between parents who did versus did not express concern (independent from the TOCS) about their child's speech fluency; (2) correlated with children's frequency of stuttering measured during a child-examiner conversation; and (3) correlated with the length and complexity of children's utterances, as indexed by mean length of utterance (MLU). Participants were 183 young children ages 3:0-5:11. Ninety-one had parents who reported concern about their child's stuttering (65 boys, 26 girls) and 92 had parents who reported no such concern (50 boys, 42 girls). Participants' conversational speech during a child-examiner conversation was analyzed for (a) frequency of occurrence of stuttered and non-stuttered disfluencies, and (b) MLU. Besides expressing concern or lack thereof about their child's speech fluency, parents completed the TOCS observational rating scales documenting how often they observe different disfluency types in speech of their children, as well as disfluency-related consequences. There were three main findings. First, parents who expressed concern (independently from the TOCS) about their child's stuttering reported significantly higher scores on the TOCS Speech Fluency and Disfluency-Related Consequences rating scales. Second, children whose parents rated them higher on the TOCS Speech Fluency rating scale produced more stuttered disfluencies during a child-examiner conversation. Third, children with higher scores on the TOCS Disfluency-Related Consequences rating scale had shorter MLU during child-examiner conversation, across age and level of language ability. Findings support the use of the TOCS observational rating scales as one documentable, objective means to determine parental perception of and concern about their child's stuttering. Findings also support the notion that parents are reasonably accurate, if not reliable, judges of the quantity and quality (i.e., stuttered vs. non-stuttered) of their child's speech disfluencies. Lastly, findings that some children may decrease their verbal output in attempts to minimize instances of stuttering - as indexed by relatively low MLU and a high TOCS Disfluency-Related Consequences scores - provides strong support for sampling young children's speech and language across various situations to obtain the most representative index possible of the child's MLU and associated instances of stuttering. Copyright © 2018 Elsevier Inc. All rights reserved.

Utterance Complexity and Stuttering on Function Words in Preschool-Age Children Who Stutter

ERIC Educational Resources Information Center

Richels, Corrin; Buhr, Anthony; Conture, Edward; Ntourou, Katerina

2010-01-01

The purpose of the present investigation was to examine the relation between utterance complexity and utterance position and the tendency to stutter on function words in preschool-age children who stutter (CWS). Two separate studies involving two different groups of participants (Study 1, n = 30; Study 2, n = 30) were conducted. Participants were…

Struggling in Silence: A Qualitative Study of Six African American Male Stutterers in Educational Settings

ERIC Educational Resources Information Center

Ellis, Antonio L.; Hartlep, Nicholas D.

2017-01-01

Stuttering places students at-risk for being stereotyped and experiencing identity difficulties in school. This study hoped to fill a lacuna in the literature on the educational experiences of African American male stutterers. Six African American adult males who stuttered and lived in Washington, DC; Maryland; and/or Virginia participated in this…

Measurement of Trained Speech Patterns in Stuttering: Interjudge and Intrajudge Agreement of Experts by Means of Modified Time-Interval Analysis

ERIC Educational Resources Information Center

Alpermann, Anke; Huber, Walter; Natke, Ulrich; Willmes, Klaus

2010-01-01

Improved fluency after stuttering therapy is usually measured by the percentage of stuttered syllables. However, outcome studies rarely evaluate the use of trained speech patterns that speakers use to manage stuttering. This study investigated whether the modified time interval analysis can distinguish between trained speech patterns, fluent…

Unhelpful Thoughts and Beliefs Linked to Social Anxiety in Stuttering: Development of a Measure

ERIC Educational Resources Information Center

St Clare, Tamsen; Menzies, Ross G.; Onslow, Mark; Packman, Ann; Thompson, Robyn; Block, Susan

2009-01-01

Background: Those who stutter have a proclivity to social anxiety. Yet, to date, there is no comprehensive measure of thoughts and beliefs about stuttering that represent the cognitions associated with that anxiety. Aims: The present paper describes the development of a measure to assess unhelpful thoughts and beliefs about stuttering. Methods &…

Autonomic and Emotional Responses of Graduate Student Clinicians in Speech-Language Pathology to Stuttered Speech

ERIC Educational Resources Information Center

Guntupalli, Vijaya K.; Nanjundeswaran, Chayadevie; Dayalu, Vikram N.; Kalinowski, Joseph

2012-01-01

Background: Fluent speakers and people who stutter manifest alterations in autonomic and emotional responses as they view stuttered relative to fluent speech samples. These reactions are indicative of an aroused autonomic state and are hypothesized to be triggered by the abrupt breakdown in fluency exemplified in stuttered speech. Furthermore,…

How Effective Is Therapy for Childhood Stuttering? Dissecting and Reinterpreting the Evidence in Light of Spontaneous Recovery Rates

ERIC Educational Resources Information Center

Saltuklaroglu, Tim; Kalinowski, Joseph

2005-01-01

Background: Similar positive results (e.g. immediate decreases in stuttering frequency and a 60-80% recovery rate from stuttering) have been reported for numerous therapeutic protocols for treating childhood stuttering, many of which have been diametrically opposite in their orientations and implementations. For example, Johnson advocated indirect…

Brief Report: Treating Stuttering in an Adult with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Brundage, Shelley B.; Whelan, Cory J.; Burgess, Cathleen M.

2013-01-01

Stuttering and autism can co-occur and when they do it presents a significant communication challenge. This study examined the effectiveness of a modified version of the fluency rules program (FRP; Runyan and Runyan, Stuttering and related disorders of fluency, in 2007) to reduce stuttering frequency in a man with autism spectrum disorder (ASD).…

Alleviation of acquired stuttering with human centremedian thalamic stimulation.

PubMed Central

Bhatnagar, S C; Andy, O J

1989-01-01

Despite many investigations, the cerebral mechanism for stuttering remains unknown. Recently, increased attention has been paid to acquired stuttering of adult onset in the hope that the events associated with it might provide clues to the biological mechanism underlying stuttering. This attention has focused exclusively on the cortical substrates. We present our observations of acquired dysfluency, presumably of subcortical origin in a neurosurgical subject with intractable pain. The stuttering was relieved by thalamic electric stimulation. The effect of thalamic stimulation on the stuttering suggests that the pathophysiology of transient asynchronisation in the balancing and sequencing of multiple impulses is amenable to a diffusely orchestrated functional tuning of the thalamic and brainstem implicated subcortical structures and pathways. Images PMID:2795045

Stuttering

MedlinePlus

Stuttering may start with repeating consonants (k, g, t). If stuttering becomes worse, words and phrases are repeated. Later, vocal spasms develop. There is a forced, almost explosive sound to speech. The ...

Associations between beliefs about and reactions toward people who stutter.

PubMed

Arnold, Hayley S; Li, Jian

2016-03-01

This study sought to assess whether beliefs about people who stutter (PWS) predict intended behavioral and affective reactions toward them in a large and varied sample of respondents while taking into account familiarity with PWS and the demographic variables of age, education, and gender. Analyses were based on 2206 residents of the United States of America. The seemingly unrelated regression (SUR) technique was used to test the relationship between beliefs about PWS and behavioral and affective reactions toward PWS. Variables such as familiarity with PWS and demographic data were also controlled in the statistical model. Findings indicated that, when demographic variables and familiarity were taken into account, the accuracy of participants' beliefs about PWS significantly predicted their intended behavioral and affective reactions toward PWS. The participants' gender and familiarity with PWS were also associated with these reactions toward PWS. The finding of an association between beliefs and intended reactions validates attempts to improve public treatment of PWS through improving the accuracy of beliefs about PWS. Additionally, because familiarity with PWS is a significant predictor of helpful and positive reactions toward PWS, interventions involving PWS educating others through direct interpersonal interactions may be one effective way to improve public reactions toward individuals who stutter. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of stuttering severity and therapy involvement on role entrapment of people who stutter.

PubMed

Gabel, Rodney M; Hughes, Stephanie; Daniels, Derek

2008-01-01

The primary purpose of this study was to examine whether a group of university students would report role entrapment of people who stutter (PWS) in the form of occupational stereotyping. The study also examined whether severity of stuttering (mild or severe) and level of therapy involvement (choosing or not choosing to attend therapy) affected the perceptions of role entrapment. To examine these issues, 260 students completed the Vocational Advice Scale (VAS) [Gabel, R. M., Blood, G. W., Tellis, G., & Althouse, M. T. (2004). Measuring role entrapment of people who stutter. Journal of Fluency Disorders, 29, 27-49]. Results suggested that stuttering severity and the level of therapy involvement did not appear alter the judges' reports for all of the careers except for the career of speech therapist. For the career of speech therapist, therapy involvement improved the participants' reports and stuttering severity had no effect. Additionally, findings suggested that university students reported that 16 of the careers listed on the VAS were appropriate choices for people who stutter and were less certain about advising for 27 of the careers. Thus, the findings from this study do not support the notion that stuttering leads to role entrapment in the form vocational stereotyping and variations in therapy involvement or stuttering severity do not change perceptions of role entrapment. LEARNER OUTCOMES: The reader will be able to (1) identify common stereotypes of PWS, (2) describe the possible effects of stereotyping and role entrapment, and (3) describe the effects of severity and therapy involvement of role entrapment of PWS.

Role of the left frontal aslant tract in stuttering: a brain stimulation and tractographic study.

PubMed

Kemerdere, Rahsan; de Champfleur, Nicolas Menjot; Deverdun, Jérémy; Cochereau, Jérôme; Moritz-Gasser, Sylvie; Herbet, Guillaume; Duffau, Hugues

2016-01-01

The neural correlates of stuttering are to date incompletely understood. Although the possible involvement of the basal ganglia, the cerebellum and certain parts of the cerebral cortex in this speech disorder has previously been reported, there are still not many studies investigating the role of white matter fibers in stuttering. Axonal stimulation during awake surgery provides a unique opportunity to study the functional role of structural connectivity. Here, our goal was to investigate the white matter tracts implicated in stuttering, by combining direct electrostimulation mapping and postoperative tractography imaging, with a special focus on the left frontal aslant tract. Eight patients with no preoperative stuttering underwent awake surgery for a left frontal low-grade glioma. Intraoperative cortical and axonal electrical mapping was used to interfere in speech processing and subsequently provoke stuttering. We further assessed the relationship between the subcortical sites leading to stuttering and the spatial course of the frontal aslant tract. All patients experienced intraoperative stuttering during axonal electrostimulation. On postsurgical tractographies, the subcortical distribution of stimulated sites matched the topographical position of the left frontal aslant tract. This white matter pathway was preserved during surgery, and no patients had postoperative stuttering. For the first time to our knowledge, by using direct axonal stimulation combined with postoperative tractography, we provide original data supporting a pivotal role of the left frontal aslant tract in stuttering. We propose that this speech disorder could be the result of a disconnection within a large-scale cortico-subcortical circuit subserving speech motor control.

A Functional Imaging Study of Self-Regulatory Capacities in Persons Who Stutter

PubMed Central

Liu, Jie; Wang, Zhishun; Huo, Yuankai; Davidson, Stephanie M.; Klahr, Kristin; Herder, Carl L.; Sikora, Chamonix O.; Peterson, Bradley S.

2014-01-01

Developmental stuttering is a disorder of speech fluency with an unknown pathogenesis. The similarity of its phenotype and natural history with other childhood neuropsychiatric disorders of frontostriatal pathology suggests that stuttering may have a closely related pathogenesis. We investigated in this study the potential involvement of frontostriatal circuits in developmental stuttering. We collected functional magnetic resonance imaging data from 46 persons with stuttering and 52 fluent controls during performance of the Simon Spatial Incompatibility Task. We examined differences between the two groups of blood-oxygen-level-dependent activation associated with two neural processes, the resolution of cognitive conflict and the context-dependent adaptation to changes in conflict. Stuttering speakers and controls did not differ on behavioral performance on the task. In the presence of conflict-laden stimuli, however, stuttering speakers activated more strongly the cingulate cortex, left anterior prefrontal cortex, right medial frontal cortex, left supplementary motor area, right caudate nucleus, and left parietal cortex. The magnitude of activation in the anterior cingulate cortex correlated inversely in stuttering speakers with symptom severity. Stuttering speakers also showed blunted activation during context-dependent adaptation in the left dorsolateral prefrontal cortex, a brain region that mediates cross-temporal contingencies. Frontostriatal hyper-responsivity to conflict resembles prior findings in other disorders of frontostriatal pathology, and therefore likely represents a general mechanism supporting functional compensation for an underlying inefficiency of neural processing in these circuits. The reduced activation of dorsolateral prefrontal cortex likely represents the inadequate readiness of stuttering speakers to execute a sequence of motor responses. PMID:24587104

Resting-State Brain Activity in Adult Males Who Stutter

PubMed Central

Zhu, Chaozhe; Wang, Liang; Yan, Qian; Lin, Chunlan; Yu, Chunshui

2012-01-01

Although developmental stuttering has been extensively studied with structural and task-based functional magnetic resonance imaging (fMRI), few studies have focused on resting-state brain activity in this disorder. We investigated resting-state brain activity of stuttering subjects by analyzing the amplitude of low-frequency fluctuation (ALFF), region of interest (ROI)-based functional connectivity (FC) and independent component analysis (ICA)-based FC. Forty-four adult males with developmental stuttering and 46 age-matched fluent male controls were scanned using resting-state fMRI. ALFF, ROI-based FCs and ICA-based FCs were compared between male stuttering subjects and fluent controls in a voxel-wise manner. Compared with fluent controls, stuttering subjects showed increased ALFF in left brain areas related to speech motor and auditory functions and bilateral prefrontal cortices related to cognitive control. However, stuttering subjects showed decreased ALFF in the left posterior language reception area and bilateral non-speech motor areas. ROI-based FC analysis revealed decreased FC between the posterior language area involved in the perception and decoding of sensory information and anterior brain area involved in the initiation of speech motor function, as well as increased FC within anterior or posterior speech- and language-associated areas and between the prefrontal areas and default-mode network (DMN) in stuttering subjects. ICA showed that stuttering subjects had decreased FC in the DMN and increased FC in the sensorimotor network. Our findings support the concept that stuttering subjects have deficits in multiple functional systems (motor, language, auditory and DMN) and in the connections between them. PMID:22276215

Functional Lateralization of Speech Processing in Adults and Children Who Stutter

PubMed Central

Sato, Yutaka; Mori, Koichi; Koizumi, Toshizo; Minagawa-Kawai, Yasuyo; Tanaka, Akihiro; Ozawa, Emi; Wakaba, Yoko; Mazuka, Reiko

2011-01-01

Developmental stuttering is a speech disorder in fluency characterized by repetitions, prolongations, and silent blocks, especially in the initial parts of utterances. Although their symptoms are motor related, people who stutter show abnormal patterns of cerebral hemispheric dominance in both anterior and posterior language areas. It is unknown whether the abnormal functional lateralization in the posterior language area starts during childhood or emerges as a consequence of many years of stuttering. In order to address this issue, we measured the lateralization of hemodynamic responses in the auditory cortex during auditory speech processing in adults and children who stutter, including preschoolers, with near-infrared spectroscopy. We used the analysis–resynthesis technique to prepare two types of stimuli: (i) a phonemic contrast embedded in Japanese spoken words (/itta/ vs. /itte/) and (ii) a prosodic contrast (/itta/ vs. /itta?/). In the baseline blocks, only /itta/ tokens were presented. In phonemic contrast blocks, /itta/ and /itte/ tokens were presented pseudo-randomly, and /itta/ and /itta?/ tokens in prosodic contrast blocks. In adults and children who do not stutter, there was a clear left-hemispheric advantage for the phonemic contrast compared to the prosodic contrast. Adults and children who stutter, however, showed no significant difference between the two stimulus conditions. A subject-by-subject analysis revealed that not a single subject who stutters showed a left advantage in the phonemic contrast over the prosodic contrast condition. These results indicate that the functional lateralization for auditory speech processing is in disarray among those who stutter, even at preschool age. These results shed light on the neural pathophysiology of developmental stuttering. PMID:21687442

Speech pathology student clinician attitudes and beliefs towards people who stutter: A mixed-method pilot study.

PubMed

Koutsodimitropoulos, Ellen; Buultjens, Melissa; St Louis, Kenneth O; Monfries, Melissa

2016-03-01

Stuttering is a disorder of fluency that extends beyond its physical nature and has social, emotional and vocational impacts. Research shows that individuals often exhibit negative attitudes towards people who stutter; however, there is limited research on the attitudes and beliefs of speech pathology students towards people who stutter in Australia. Existing research is predominantly quantitative; whereas this mixed-method study placed an emphasis on the qualitative component. The purpose of this study was to explore the attitudes and beliefs of final year Australian speech pathology students towards people who stutter. This mixed-method study applied the Public Opinion Survey of Human Attributes - Stuttering (POSHA-S) and semi-structured interviews to gather data from final year speech pathology students from a major university in Australia. The overall qualitative findings identified that final year Australian speech pathology students exhibit positive attitudes towards people who stutter. The results also illustrated the role of education in influencing attitudes of students as well as increasing their confidence to work with people who stutter. This research revealed that Australian final year speech pathology students exhibit positive attitudes towards people who stutter. They displayed an understanding that people who stutter may have acquired traits such as shyness as a response to their personal situation and environment, rather than those traits being endemic to them. Results also suggested that education can play a role in creating confident student clinicians in their transition to practice, and positively influence their attitudes and beliefs. Copyright © 2015 Elsevier Inc. All rights reserved.

Stuttering as a Symptom of Concussion: Confirmation of Association Using Nontraditional Information Sources.

PubMed

Cherry, Jonathan C; Gordon, Kevin Eric

2017-11-01

A 12-year-old girl presented to our pediatric emergency department after a head injury with symptoms of concussion and acute stuttering. A PubMed search identified only 1 similar pediatric case. We investigated whether new-onset stuttering may be seen in the presence of acute concussive symptoms using an infodemiologic approach. We conducted a search with a metabrowser search engine (www.dogpile.com) using the free-text words "concussion" and "stuttering." The first 100 hits were scanned specifically for forum posts, extracting reports of concussions that were followed by new-onset stuttering. Duplicates were minimized by cross-referencing user name, location, date, and reported age and sex. Of the first 100 hits, we identified 17 unique posts that described an injury leading to a concussion followed within a short interval by new-onset stuttering. Posts were primarily by the affected individual (76%) and 64% involved female individuals. Sports and falls/injury accounted for most injuries (71%). Forty-one percent of posts explicitly stated that the concussion had been formally diagnosed. For those that reported the timing of stuttering onset (47%), the stuttering was documented within 1 hour of the injury (4/8) or between 1 and 24 hours (4/8). The ease with which we found so many reports of stuttering after head injury with concussive symptoms confirms that new-onset stuttering may be a symptom of concussion. Our experience highlights both a failure of using conventional medical literature and a success of using nontraditional information sources in identifying uncommonly associated symptoms of frequently encountered conditions.

Influence of Methylphenidate on the Frequency of Stuttering: A Randomized Controlled Trial.

PubMed

Rabaeys, Henk; Bijleveld, Henny-Annie; Devroey, Dirk

2015-10-01

Recently, a case report described a decrease in frequency of stuttering after intake of methylphenidate (MPH). This study was undertaken to investigate if this effect could again be reproduced in a population of young healthy male adult persons with developmental stuttering. A double-blind randomized crossover trial, with a 2-week washout period, including 15 Dutch-speaking young healthy persons with developmental stuttering, assessed the effects of a single dose of 20 mg MPH compared with placebo on stuttering. Dependent and 1-sample t tests were used to detect significant differences. The end point was the number of stutter moments and self-perceived improvement. MPH yielded a significant decrease in the number of stutter moments when reading and speaking (P = 0.002), which was not the case with placebo (P = 0.090). There was a significant improvement from baseline after intake of MPH as compared with placebo (P = 0.003). Self-perceived improvement with MPH was not significantly better as compared with placebo (P = 0.28). This study showed that the participants had an objective statistically significant decrease in the frequency of stuttering with MPH, and this was not the case with placebo. This was also the case for a reduction in stutter moments when reading out loud and speaking spontaneously. However, this result was not subjectively perceived by the participants. © The Author(s) 2015.

Premonitory Awareness in Stuttering Scale (PAiS).

PubMed

Cholin, Joana; Heiler, Sabrina; Whillier, Alexander; Sommer, Martin

2016-09-01

Anticipation of stuttering events in persistent developmental stuttering is a frequent but inadequately measured phenomenon that is of both theoretical and clinical importance. Here, we describe the development and preliminary testing of a German version of the Premonitory Awareness in Stuttering Scale (PAiS): a 12-item questionnaire assessing immediate and prospective anticipation of stuttering that was translated and adapted from the Premonitory Urge for Tics Scale (PUTS) (Woods, Piacentini, Himle, & Chang, 2005). After refining the preliminary PAiS scale in a pilot study, we administered a revised version to 21 adults who stutter (AWS) and 21 age, gender and education-matched control participants. Results demonstrated that the PAiS had good internal consistency and discriminated the two speaker groups very effectively, with AWS reporting anticipation of speech disruptions significantly more often than adults with typical speech. Correlations between the PAiS total score and both the objective and subjective measures of stuttering severity revealed that AWS with high PAiS scores produced fewer stuttered syllables. This is possibly because these individuals are better able to adaptively use these anticipatory sensations to modulate their speech. These results suggest that, with continued refinement, the PAiS has the potential to provide clinicians and researchers with a practical and psychometrically sound tool that can quantify how a given AWS anticipates upcoming stuttering events. Copyright © 2016 Elsevier Inc. All rights reserved.

Stuttering and the Bilingual Child--New Ways to Help

ERIC Educational Resources Information Center

Childhood Education, 2004

2004-01-01

What should parents of a child who stutters do if their child speaks more than one language? Research shows that a child's language skills can affect his or her fluency, according to the nonprofit Stuttering Foundation of America. However, it has not been proven that speaking two languages in the home since birth causes stuttering. If the child is…

The Peer Attitudes toward Children Who Stutter Scale: Reliability, Known Groups Validity, and Negativity of Elementary School-Age Children's Attitudes

ERIC Educational Resources Information Center

Langevin, Marilyn

2009-01-01

Psychometric properties of the Peer Attitudes Toward Children who Stutter (PATCS) scale (Langevin, M., & Hagler, P. (2004). Development of a scale to measure peer attitudes toward children who stutter. In A.K. Bothe (Ed.), Evidence-based treatment of stuttering: empirical bases and clinical applications (pp. 139-171). Mahwah, NJ: Lawrence…

Long-term follow-up of a behavioral treatment for stuttering in children.

PubMed Central

Wagaman, J R; Miltenberger, R G; Woods, D

1995-01-01

We report 3.5-year follow-up data from children who participated in a study that evaluated a behavioral treatment for stuttering. Six of 7 subjects continued to be at or below the criterion of 3% stuttered words. Stuttering increased for 1 subject, but remained far below his baseline level. Social validity data are also reported. PMID:7601808

Afferent and Efferent Aspects of Mandibular Sensorimotor Control in Adults who Stutter

PubMed Central

Daliri, Ayoub; Prokopenko, Roman A.; Max, Ludo

2013-01-01

Purpose Individuals who stutter show sensorimotor deficiencies in speech and nonspeech movements. For the mandibular system, we dissociated the sense of kinesthesia from the efferent control component to examine whether kinesthetic integrity itself is compromised in stuttering or whether deficiencies occur only when generating motor commands. Method We investigated 11 stuttering and 11 nonstuttering adults’ kinesthetic sensitivity threshold and kinesthetic accuracy for passive jaw movements as well as their minimal displacement threshold and positioning accuracy for active jaw movements. We also investigated the correlation with an anatomical index of jaw size. Results The groups showed no statistically significant differences on sensory measures for passive jaw movements. Although some stuttering individuals performed more poorly than any nonstuttering participants on the active movement tasks, between-group differences for active movements were also not statistically significant. Unlike fluent speakers, however, the stuttering group showed a statistically significant correlation between mandibular size and performance in the active and passive near-threshold tasks. Conclusions Previously reported minimal movement differences were not replicated. Instead, stuttering individuals’ performance varied with anatomical properties. These correlational results are consistent with the hypothesis that stuttering participants generate and perceive movements based on less accurate internal models of the involved neuromechanical systems. PMID:23816664

Characteristics of Fluency and Speech in Two Families With High Incidences of Stuttering.

PubMed

Stager, Sheila V; Freeman, Frances J; Braun, Allen

2015-10-01

This study presents data from 2 families with high incidence of stuttering, comparing methods of phenotype assignment and exploring the presence of other fluency disorders and corresponding speech characteristics. Three methods for assigning phenotype of stuttering were used: self-identification, family identification, and expert identification. Agreement on which individuals were assigned by each of these methods was studied. Multiple measures of fluency and speech production were obtained. Self-reports and descriptions of blocking rather than self-identification as a person who stutters demonstrated the best agreement with expert identification of stuttering. Family identification showed poor agreement with both expert and self-identification of stuttering. Using binary categories of fluent or stuttering, 90% of individuals in 1 family were classified by expert consensus. Only 70% of the other family could be similarly categorized. Experts required 2 other categories, cluttering and other fluency disorders, to fully characterize dysfluency within this family. These 2 families also demonstrated differences in speech production. Some families with high incidence of stuttering may also have high incidence of other fluency disorders and other speech-production difficulties. This finding may have ramifications for genetic studies, including criteria for defining phenotype and collapsing data across multiple families.

The reliability of a severity rating scale to measure stuttering in an unfamiliar language.

PubMed

Hoffman, Laura; Wilson, Linda; Copley, Anna; Hewat, Sally; Lim, Valerie

2014-06-01

With increasing multiculturalism, speech-language pathologists (SLPs) are likely to work with stuttering clients from linguistic backgrounds that differ from their own. No research to date has estimated SLPs' reliability when measuring severity of stuttering in an unfamiliar language. Therefore, this study was undertaken to estimate the reliability of SLPs' use of a 9-point severity rating (SR) scale, to measure severity of stuttering in a language that was different from their own. Twenty-six Australian SLPs rated 20 speech samples (10 Australian English [AE] and 10 Mandarin) of adults who stutter using a 9-point SR scale on two separate occasions. Judges showed poor agreement when using the scale to measure stuttering in Mandarin samples. Results also indicated that 50% of individual judges were unable to reliably measure the severity of stuttering in AE. The results highlight the need for (a) SLPs to develop intra- and inter-judge agreement when using the 9-point SR scale to measure severity of stuttering in their native language (in this case AE) and in unfamiliar languages; and (b) research into the development and evaluation of practice and/or training packages to assist SLPs to do so.

Phonotactic Probability Effects in Children Who Stutter

PubMed Central

Anderson, Julie D.; Byrd, Courtney T.

2008-01-01

Purpose The purpose of this study was to examine the influence of phonotactic probability, the frequency of different sound segments and segment sequences, on the overall fluency with which words are produced by preschool children who stutter (CWS), as well as to determine whether it has an effect on the type of stuttered disfluency produced. Method A 500+ word language sample was obtained from 19 CWS. Each stuttered word was randomly paired with a fluently produced word that closely matched it in grammatical class, word length, familiarity, word and neighborhood frequency, and neighborhood density. Phonotactic probability values were obtained for the stuttered and fluent words from an online database. Results Phonotactic probability did not have a significant influence on the overall susceptibility of words to stuttering, but it did impact the type of stuttered disfluency produced. In specific, single-syllable word repetitions were significantly lower in phonotactic probability than fluently produced words, as well as part-word repetitions and sound prolongations. Conclusions In general, the differential impact of phonotactic probability on the type of stuttering-like disfluency produced by young CWS provides some support for the notion that different disfluency types may originate in the disruption of different levels of processing. PMID:18658056

A Hispanic mother's beliefs about stuttering aetiology: A systemic functional linguistic analysis.

PubMed

Medina, Angela M

2018-06-01

The aim of this study was to identify the linguistic resources a Hispanic mother used to convey her beliefs about the aetiology of her adult son's stuttering. A qualitative research paradigm was adopted for data collection and analysis. An Ecuadorian mother and her adult son who stutters recorded a conversation in Spanish about the son's stuttering. Tools derived from systemic functional linguistic (SFL) theory were used to analyse conversation transcripts and to describe the word choices and sentence structures the mother used to talk about her son's stuttering. The mother deflected community-assigned blame for causing her son's stuttering by configuring her 'strong' temperament as a separate, uncontrollable entity. She structured the pervasiveness of stigma, lack of resources and misinformation within the community as causes for her inability to identify and seek help for her son's stuttering, which also served as a means for deflecting blame. SFL-based analyses were appropriate tools for the investigation of how a Hispanic mother construes her views, attitudes and experiences relative to her son's stuttering. Clinical implications of findings regarding parent education and the utility of SFL-based tools in the speech-language therapy setting are discussed.

Speaking with a mirror: engagement of mirror neurons via choral speech and its derivatives induces stuttering inhibition.

PubMed

Kalinowski, Joseph; Saltuklaroglu, Tim

2003-04-01

'Choral speech', 'unison speech', or 'imitation speech' has long been known to immediately induce reflexive, spontaneous, and natural sounding fluency, even the most severe cases of stuttering. Unlike typical post-therapeutic speech, a hallmark characteristic of choral speech is the sense of 'invulnerability' to stuttering, regardless of phonetic context, situational environment, or audience size. We suggest that choral speech immediately inhibits stuttering by engaging mirror systems of neurons, innate primitive neuronal substrates that dominate the initial phases of language development due to their predisposition to reflexively imitate gestural action sequences in a fluent manner. Since mirror systems are primordial in nature, they take precedence over the much later developing stuttering pathology. We suggest that stuttering may best be ameliorated by reengaging mirror neurons via choral speech or one of its derivatives (using digital signal processing technology) to provide gestural mirrors, that are nature's way of immediately overriding the central stuttering block. Copyright 2003 Elsevier Science Ltd.

Application of the ICF in fluency disorders.

PubMed

Yaruss, J Scott

2007-11-01

Stuttering is a complicated communication disorder that can affect many aspects of a speaker's life. In addition to exhibiting observable disruptions in speech (e.g., part-word repetitions, prolongations, blocks), many people who stutter also experience broader consequences in their lives because of their stuttering. Examples include difficulty with social communication (e.g., speaking with other people, making introductions) and job-related tasks (e.g., talking on the phone, participating in meetings). Because it incorporates these types of daily experiences, the World Health Organization's International Classification of Functioning, Disability and Health (ICF) provides an ideal framework for considering the overall experience of the stuttering disorder. The purpose of this article is to highlight the ways in which the ICF can help clinicians, people who stutter, and the general public understand the multifaceted nature of stuttering. The article will also describe how clinicians can use the ICF as a framework for developing comprehensive evaluations and providing individualized treatment plans for people who stutter.

Dual diathesis-stressor model of emotional and linguistic contributions to developmental stuttering.

PubMed

Walden, Tedra A; Frankel, Carl B; Buhr, Anthony P; Johnson, Kia N; Conture, Edward G; Karrass, Jan M

2012-05-01

This study assessed emotional and speech-language contributions to childhood stuttering. A dual diathesis-stressor framework guided this study, in which both linguistic requirements and skills, and emotion and its regulation, are hypothesized to contribute to stuttering. The language diathesis consists of expressive and receptive language skills. The emotion diathesis consists of proclivities to emotional reactivity and regulation of emotion, and the emotion stressor consists of experimentally manipulated emotional inductions prior to narrative speaking tasks. Preschool-age children who do and do not stutter were exposed to three emotion-producing overheard conversations-neutral, positive, and angry. Emotion and emotion-regulatory behaviors were coded while participants listened to each conversation and while telling a story after each overheard conversation. Instances of stuttering during each story were counted. Although there was no main effect of conversation type, results indicated that stuttering in preschool-age children is influenced by emotion and language diatheses, as well as coping strategies and situational emotional stressors. Findings support the dual diathesis-stressor model of stuttering.

Speech rhythm in Kannada speaking adults who stutter.

PubMed

Maruthy, Santosh; Venugopal, Sahana; Parakh, Priyanka

2017-10-01

A longstanding hypothesis about the underlying mechanisms of stuttering suggests that speech disfluencies may be associated with problems in timing and temporal patterning of speech events. Fifteen adults who do and do not stutter read five sentences, and from these, the vocalic and consonantal durations were measured. Using these, pairwise variability index (raw PVI for consonantal intervals and normalised PVI for vocalic intervals) and interval based rhythm metrics (PercV, DeltaC, DeltaV, VarcoC and VarcoV) were calculated for all the participants. Findings suggested higher mean values in adults who stutter when compared to adults who do not stutter for all the rhythm metrics except for VarcoV. Further, statistically significant difference between the two groups was found for all the rhythm metrics except for VarcoV. Combining the present results with consistent prior findings based on rhythm deficits in children and adults who stutter, there appears to be strong empirical support for the hypothesis that individuals who stutter may have deficits in generation of rhythmic speech patterns.

Dual Diathesis-Stressor Model of Emotional and Linguistic Contributions to Developmental Stuttering

PubMed Central

Frankel, Carl B.; Buhr, Anthony P.; Johnson, Kia N.; Conture, Edward G.; Karrass, Jan M.

2013-01-01

This study assessed emotional and speech-language contributions to childhood stuttering. A dual diathesis-stressor framework guided this study, in which both linguistic requirements and skills, and emotion and its regulation, are hypothesized to contribute to stuttering. The language diathesis consists of expressive and receptive language skills. The emotion diathesis consists of proclivities to emotional reactivity and regulation of emotion, and the emotion stressor consists of experimentally manipulated emotional inductions prior to narrative speaking tasks. Preschool-age children who do and do not stutter were exposed to three emotion-producing overheard conversations—neutral, positive, and angry. Emotion and emotion-regulatory behaviors were coded while participants listened to each conversation and while telling a story after each overheard conversation. Instances of stuttering during each story were counted. Although there was no main effect of conversation type, results indicated that stuttering in preschool-age children is influenced by emotion and language diatheses, as well as coping strategies and situational emotional stressors. Findings support the dual diathesis-stressor model of stuttering. PMID:22016200

An investigation of the role of parental request for self-correction of stuttering in the Lidcombe Program.

PubMed

Donaghy, Michelle; Harrison, Elisabeth; O'Brian, Sue; Menzies, Ross; Onslow, Mark; Packman, Ann; Jones, Mark

2015-01-01

The Lidcombe Program is a behavioural treatment for stuttering in children younger than 6 years that is supported by evidence of efficacy and effectiveness. The treatment incorporates parent verbal contingencies for stutter-free speech and for stuttering. However, the contribution of those contingencies to reductions in stuttering in the program is unclear. Thirty-four parent-child dyads were randomized to two treatment groups. The control group received standard Lidcombe Program and the experimental group received Lidcombe Program without instruction to parents to use the verbal contingency request for self-correction. Treatment responsiveness was measured as time to 50% stuttering severity reduction. No differences were found between groups on primary outcome measures of the number of weeks and clinic visits to 50% reduction in stuttering severity. This clinical experiment challenges the assumption that the verbal contingency request for self-correction contributes to treatment efficacy. Results suggest the need for further research to explore this issue.

Assessing attentional biases with stuttering.

PubMed

Lowe, Robyn; Menzies, Ross; Packman, Ann; O'Brian, Sue; Jones, Mark; Onslow, Mark

2016-01-01

Many adults who stutter presenting for speech treatment experience social anxiety disorder. The presence of mental health disorders in adults who stutter has been implicated in a failure to maintain speech treatment benefits. Contemporary theories of social anxiety disorder propose that the condition is maintained by negative cognitions and information processing biases. Consistent with cognitive theories, the probe detection task has shown that social anxiety is associated with an attentional bias to avoid social information. This information processing bias is suggested to be involved in maintaining anxiety. Evidence is emerging for information processing biases being involved with stuttering. This study investigated information processing in adults who stutter using the probe detection task. Information processing biases have been implicated in anxiety maintenance in social anxiety disorder and therefore may have implications for the assessment and treatment of stuttering. It was hypothesized that stuttering participants compared with control participants would display an attentional bias to avoid attending to social information. Twenty-three adults who stutter and 23 controls completed a probe detection task in which they were presented with pairs of photographs: a face displaying an emotional expression-positive, negative or neutral-and an everyday household object. All participants were subjected to a mild social threat induction being told they would speak to a small group of people on completion of the task. The stuttering group scored significantly higher than controls for trait anxiety, but did not differ from controls on measures of social anxiety. Non-socially anxious adults who stutter did not display an attentional bias to avoid looking at photographs of faces relative to everyday objects. Higher scores on trait anxiety were positively correlated with attention towards photographs of negative faces. Attentional biases as assessed by the probe detection task may not be a characteristic of non-socially anxious adults who stutter. A vigilance to attend to threat information with high trait anxiety is consistent with findings of studies using the emotional Stroop task in stuttering and social anxiety disorder. Future research should investigate attentional processing in people who stutter who are socially anxious. It will also be useful for future studies to employ research paradigms that involve speaking. Continued research is warranted to explore information processing and potential biases that could be involved in the maintenance of anxiety and failure to maintain the benefits of speech treatment outcomes. © 2015 Royal College of Speech and Language Therapists.

Nonword Repetition and Phoneme Elision in Adults Who Do and Do Not Stutter

ERIC Educational Resources Information Center

Byrd, Courtney T.; Vallely, Megann; Anderson, Julie D.; Sussman, Harvey

2012-01-01

The purpose of the present study was to explore the phonological working memory of adults who stutter through the use of a non-word repetition and a phoneme elision task. Participants were 14 adults who stutter (M = 28 years) and 14 age/gender matched adults who do not stutter (M = 28 years). For the non-word repetition task, the participants had…

The Role of Selected Lexical Factors on Confrontation Naming Accuracy, Speed, and Fluency in Adults Who Do and Do Not Stutter

ERIC Educational Resources Information Center

Newman, Rochelle S.; Ratner, Nan Bernstein

2007-01-01

Purpose: The purpose of this study was to investigate whether lexical access in adults who stutter (AWS) differs from that in people who do not stutter. Specifically, the authors examined the role of 3 lexical factors on naming speed, accuracy, and fluency: word frequency, neighborhood density, and neighborhood frequency. If stuttering results…

Executive Functions Impact the Relation between Respiratory Sinus Arrhythmia and Frequency of Stuttering in Young Children Who Do and Do Not Stutter

ERIC Educational Resources Information Center

Jones, Robin M.; Walden, Tedra A.; Conture, Edward G.; Erdemir, Aysu; Lambert, Warren E.; Porges, Stephen W.

2017-01-01

Purpose: This study sought to determine whether respiratory sinus arrhythmia (RSA) and executive functions are associated with stuttered speech disfluencies of young children who do (CWS) and do not stutter (CWNS). Method: Thirty-six young CWS and 36 CWNS were exposed to neutral, negative, and positive emotion-inducing video clips, followed by…

The impact of adolescent stuttering and other speech problems on psychological well-being in adulthood: evidence from a birth cohort study.

PubMed

McAllister, Jan; Collier, Jacqueline; Shepstone, Lee

2013-01-01

Developmental stuttering is associated with increased risk of psychological distress and mental health difficulties. Less is known about the impact of other developmental speech problems on psychological outcomes, or the impact of stuttering and speech problems once other predictors have been adjusted for. To determine the impact of parent-reported adolescent stuttering and other speech difficulties on psychological distress and associated symptoms as measured by the Rutter Malaise Inventory. A British birth cohort dataset provided information about 217 cohort members who stuttered and 301 cohort members who had other kinds of speech problem at age 16 according to parental report, and 15,694 cohort members who had experienced neither stuttering nor other speech difficulties. The main analyses concerned associations between adolescent stuttering or speech difficulty and score on the Rutter Malaise Inventory at age 42. Other factors that had previously been shown to be associated with score on the Malaise Inventory were also included in the analyses. In the adjusted analyses that controlled for other predictors, cohort members who were reported to stutter had higher malaise scores than controls overall, indicating a higher level of psychological distress, but they were not at significantly more likely to have malaise scores in the range indicating a risk of serious mental health difficulties. Cohort members who were reported to have other speech difficulties during adolescence had malaise scores that overall did not differ significantly from those of controls in the adjusted analyses, but they were at significantly greater risk of serious mental health difficulties. These findings support those of other studies that indicate an association between stuttering and psychological distress. This study is the first to have shown that adolescents who experience speech difficulties other than stuttering are more likely than controls to be at risk of poorer mental health in adulthood. The results suggest a need for therapeutic provision to address psychosocial issues for both stuttering and other developmental speech disorders in adulthood, as well as further research into the consequences in adulthood of stuttering and other developmental speech disorders. © 2013 Royal College of Speech and Language Therapists.

Phonological complexity in school-aged children who stutter and exhibit a language disorder.

PubMed

Wolk, Lesley; LaSalle, Lisa R

2015-03-01

The Index of Phonological Complexity and the Word Complexity Measure are two measures of the phonological complexity of a word. Other phonological measures such as phonological neighborhood density have been used to compare stuttered versus fluent words. It appears that in preschoolers who stutter, the length and complexity of the utterance is more influential than the phonetic features of the stuttered word. The present hypothesis was that in school-age children who stutter, stuttered words would be more phonologically complex than fluent words, when the length and complexity of the utterance containing them is comparable. School-age speakers who stutter were hypothesized to differ from those with a concomitant language disorder. Sixteen speakers, six females and ten males (M age=12;3; Range=7;7 to 19;5) available from an online database, were divided into eight who had a concomitant language disorder (S+LD) and eight age- and sex-matched speakers who did not (S-Only). When all stuttered content words were identified, S+LD speakers produced more repetitions, and S-Only speakers produced more inaudible sound prolongations. When stuttered content words were matched to fluent content words and when talker groups were combined, stuttered words were significantly (p≤0.01) higher in both the Index of Phonological Complexity and the Word Complexity Measure and lower in density ("sparser") than fluent words. Results corroborate those of previous researchers. Future research directions are suggested, such as cross-sectional designs to evaluate developmental patterns of phonological complexity and stuttering plus language disordered connections. The reader will be able to: (a) Define and describe phonological complexity; (b) Define phonological neighborhood density and summarize the literature on the topic; (c) Describe the Index of Phonological Complexity (IPC) for a given word; (d) Describe the Word Complexity Measure (WCM) for a given word; (e) Summarize two findings from the current study and describe how each relates to studies of phonological complexity and fluency disorders. Copyright © 2014 Elsevier Inc. All rights reserved.

Origin and Pawn scaling for adults who do and do not stutter: A preliminary comparison.

PubMed

Lee, Kyungjae; Manning, Walter H; Herder, Carl

2015-09-01

In order to determine whether adults who stutter (AWS) would show changes in locus of causality during stuttering treatment and approximate those of adults who do not stutter (AWNS) this preliminary study compared the locus of causality as indicated by Origin and Pawn scaling procedures from two groups of young adults who do and do not stutter. A total of 20 age- and gender-matched undergraduate and graduate students who did (n = 10) and did not (n = 10) stutter participated. The AWS took part in a three week intensive stuttering treatment provided by the American Institute for Stuttering (AIS). Along with measures of treatment outcome, writing samples were analyzed for Origin and Pawn statements that indicated the participant's locus of causality. At the outset of treatment the AWS showed significantly greater Pawn scores than the control group of AWNS and similar occurrences of Origin statements. The AWS showed a statistically significant increase in pre- to post-treatment Origin scores and a statistically significant decrease in Pawn scores. Following treatment the AWS showed the Origin and Pawn score ratios similar to those of AWNS. A pattern of increasing Origin and decreasing Pawn scores may indicate a pattern of increasing agency during successful stuttering treatment. Moreover the post-treatment Origin and Pawn score ratios of AWS, which were not significantly different from those of AWNS, may indicate a change trend toward normalization. Further research will determine whether such change patterns are predictive of long-term maintenance. By reading this article the reader will be able to: (a) describe advantages of content analysis measure such as the Origin and Pawn Scales; (b) discuss the purposes and procedures of the Origin and Pawn Scales; (c) describe typical change pattern of Origin and Pawn scores of adults who stutter while receiving treatment; (d) discuss how successful treatment for stuttering can result in the normalization of one's locus of causality. Copyright © 2015 Elsevier Inc. All rights reserved.

Social support and its association with negative affect in adults who stutter.

PubMed

Blumgart, Elaine; Tran, Yvonne; Craig, Ashley

2014-06-01

The purpose of the research reported in this manuscript is to clarify the relationship between social support and negative affect for people who stutter. Social support results in many benefits that help individuals to achieve self-esteem, motivation to adjust adaptively, and to experience a sense of belonging. Lack of such support is likely to result in heightened anxiety and negative affect manifesting in many forms. This study used the Symptom Checklist--Revised (SCL-90-R) and the Significant Others Scale (SOS) to investigate social support and its relationship to negative affect in 200 adults who stutter, with comparisons made to 200 adults who do not stutter. Negative affect was assessed by interpersonal sensitivity, depressive mood and anxiety. The Significant Others Scale was used to provide an indication of the participants' actual and ideal levels of social support. It was found that (i) those participants who stuttered had significantly elevated levels of negative affect across the SCL-90-R domains of interpersonal sensitivity, depressive mood and anxiety; (ii) the group who stuttered was found to have lower levels of actual and ideal social support; and (iii) those who stuttered and who also had low social support had significantly elevated levels of negative affect. Results highlight the potentially harmful influence that poor social support has on mood states for adults who stutter. These findings have implications for treatment such as the necessity to address and integrate social support and social integration issues in the treatment process for adults who stutter. The reader will be able to: (a) describe the methodology of assessing social support using the Social Support Scale (SOS); (b) apply the concept of assessing social support in stuttering to treatment; (c) describe the protective contribution of helpful social support for adults who stutter; (d) describe the relationship between social support and negative mood states. Copyright © 2014 Elsevier Inc. All rights reserved.

The role of temporal speech cues in facilitating the fluency of adults who stutter.

PubMed

Park, Jin; Logan, Kenneth J

2015-12-01

Adults who stutter speak more fluently during choral speech contexts than they do during solo speech contexts. The underlying mechanisms for this effect remain unclear, however. In this study, we examined the extent to which the choral speech effect depended on presentation of intact temporal speech cues. We also examined whether speakers who stutter followed choral signals more closely than typical speakers did. 8 adults who stuttered and 8 adults who did not stutter read 60 sentences aloud during a solo speaking condition and three choral speaking conditions (240 total sentences), two of which featured either temporally altered or indeterminate word duration patterns. Effects of these manipulations on speech fluency, rate, and temporal entrainment with the choral speech signal were assessed. Adults who stutter spoke more fluently in all choral speaking conditions than they did when speaking solo. They also spoke slower and exhibited closer temporal entrainment with the choral signal during the mid- to late-stages of sentence production than the adults who did not stutter. Both groups entrained more closely with unaltered choral signals than they did with altered choral signals. Findings suggest that adults who stutter make greater use of speech-related information in choral signals when talking than adults with typical fluency do. The presence of fluency facilitation during temporally altered choral speech and conversation babble, however, suggests that temporal/gestural cueing alone cannot account for fluency facilitation in speakers who stutter. Other potential fluency enhancing mechanisms are discussed. The reader will be able to (a) summarize competing views on stuttering as a speech timing disorder, (b) describe the extent to which adults who stutter depend on an accurate rendering of temporal information in order to benefit from choral speech, and (c) discuss possible explanations for fluency facilitation in the presence of inaccurate or indeterminate temporal cues. Copyright © 2015 Elsevier Inc. All rights reserved.

When will a stuttering moment occur? The determining role of speech motor preparation.

PubMed

Vanhoutte, Sarah; Cosyns, Marjan; van Mierlo, Pieter; Batens, Katja; Corthals, Paul; De Letter, Miet; Van Borsel, John; Santens, Patrick

2016-06-01

The present study aimed to evaluate whether increased activity related to speech motor preparation preceding fluently produced words reflects a successful compensation strategy in stuttering. For this purpose, a contingent negative variation (CNV) was evoked during a picture naming task and measured by use of electro-encephalography. A CNV is a slow, negative event-related potential known to reflect motor preparation generated by the basal ganglia-thalamo-cortical (BGTC) - loop. In a previous analysis, the CNV of 25 adults with developmental stuttering (AWS) was significantly increased, especially over the right hemisphere, compared to the CNV of 35 fluent speakers (FS) when both groups were speaking fluently (Vanhoutte et al., (2015) doi: 10.1016/j.neuropsychologia.2015.05.013). To elucidate whether this increase is a compensation strategy enabling fluent speech in AWS, the present analysis evaluated the CNV of 7 AWS who stuttered during this picture naming task. The CNV preceding AWS stuttered words was statistically compared to the CNV preceding AWS fluent words and FS fluent words. Though no difference emerged between the CNV of the AWS stuttered words and the FS fluent words, a significant reduction was observed when comparing the CNV preceding AWS stuttered words to the CNV preceding AWS fluent words. The latter seems to confirm the compensation hypothesis: the increased CNV prior to AWS fluent words is a successful compensation strategy, especially when it occurs over the right hemisphere. The words are produced fluently because of an enlarged activity during speech motor preparation. The left CNV preceding AWS stuttered words correlated negatively with stuttering frequency and severity suggestive for a link between the left BGTC - network and the stuttering pathology. Overall, speech motor preparatory activity generated by the BGTC - loop seems to have a determining role in stuttering. An important divergence between left and right hemisphere is hypothesized. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lay beliefs about the efficacy of self-reliance, seeking help and external control as strategies for overcoming obesity, drug addiction, marital problems, stuttering and insomnia.

PubMed

Furnham, Adrian; McDermott, Mark R

1994-07-01

This study was concerned with peoples' beliefs about the importance of twenty-four different contributors towards overcoming five relatively common personal health problems, namely: obesity, drug addiction, marital difficulties, stuttering and insomnia. One hundred and twenty-two subjects completed a five-page questionnaire indicating how effective each of these contributors were to overcoming the problems as specified. Factor analysis revealed an interpretable structure similar to previous studies (Luk and Bond, 1992): the emerging three factors were labelled ' self-reliance", "seeking help" and "external control". Multiple regression showed that few individual difference variables as measured were related to perceived relevance of the different contributors. The results were discussed in terms of subjects' beliefs concerning the value of self-reliance as opposed to seeking help, and in relation to the importance of understanding lay beliefs about the efficacy of different forms of intervention.

Speech sound articulation abilities of preschool-age children who stutter.

PubMed

Clark, Chagit E; Conture, Edward G; Walden, Tedra A; Lambert, Warren E

2013-12-01

The purpose of this study was to assess the association between speech sound articulation and childhood stuttering in a relatively large sample of preschool-age children who do and do not stutter, using the Goldman-Fristoe Test of Articulation-2 (GFTA-2; Goldman & Fristoe, 2000). Participants included 277 preschool-age children who do (CWS; n=128, 101 males) and do not stutter (CWNS; n=149, 76 males). Generalized estimating equations (GEE) were performed to assess between-group (CWS versus CWNS) differences on the GFTA-2. Additionally, within-group correlations were performed to explore the relation between CWS' speech sound articulation abilities and their stuttering frequency and severity, as well as their sound prolongation index (SPI; Schwartz & Conture, 1988). No significant differences were found between the articulation scores of preschool-age CWS and CWNS. However, there was a small gender effect for the 5-year-old age group, with girls generally exhibiting better articulation scores than boys. Additional findings indicated no relation between CWS' speech sound articulation abilities and their stuttering frequency, severity, or SPI. Findings suggest no apparent association between speech sound articulation-as measured by one standardized assessment (GFTA-2)-and childhood stuttering for this sample of preschool-age children (N=277). After reading this article, the reader will be able to: (1) discuss salient issues in the articulation literature relative to children who stutter; (2) compare/contrast the present study's methodologies and main findings to those of previous studies that investigated the association between childhood stuttering and speech sound articulation; (3) identify future research needs relative to the association between childhood stuttering and speech sound development; (4) replicate the present study's methodology to expand this body of knowledge. Copyright © 2013 Elsevier Inc. All rights reserved.

Comparing the performance of people who stutter and people who do not stutter on the Test of Everyday Attention.

PubMed

Doneva, Silviya; Davis, Steve; Cavenagh, Penny

2018-08-01

Compelling findings into the relationship between stuttering and attentional ability have started to emerge, with some child and adult studies indicating poorer attentional ability among people who stutter (PWS). The purpose of the present research was to provide a more complete picture of the attentional abilities of PWS, as well as to gather insights into their individual attentional performance. We compared the attentional ability of PWS to that of people who do not stutter (PWNS) by using the Test of Everyday Attention (TEA). TEA is a clinical assessment battery with a very good validity and reliability comprising 8 subtests that pose differential demands on sustained attention, selective attention, attentional switching, and divided attention. Fifty age- and gender-matched PWS and PWNS (aged 19-77 years) took part in the study. Importantly, we also examined stuttering severity in the PWS group. PWS performed significantly worse on tasks tapping into visual selective and divided attentional resources. Furthermore despite failing to reach statistical significance, the results also revealed an interesting trend for stuttering to be associated with poorer performance on two subtests measuring attentional switching and one tapping into auditory selective attention. Moreover, as hypothesized, there was also a negative association between stuttering severity and performance on two TEA subtests measuring visual selective attention. Finally, the type of TEA test variant produced no significant effect on performance. We interpret these results as indicative of stuttering being associated with poorer performance on tasks measuring certain attentional abilities. These tie in well with theoretical models identifying speech production as particularly attention-demanding in stuttering or approaches placing attentional dysfunction at the heart of the condition. The present research also has practical implications for the use of attentional training to improve fluency.

Brief report: treating stuttering in an adult with autism spectrum disorder.

PubMed

Brundage, Shelley B; Whelan, Cory J; Burgess, Cathleen M

2013-02-01

Stuttering and autism can co-occur and when they do it presents a significant communication challenge. This study examined the effectiveness of a modified version of the fluency rules program (FRP; Runyan and Runyan, Stuttering and related disorders of fluency, in 2007) to reduce stuttering frequency in a man with autism spectrum disorder (ASD). The participant's percentage of stuttered words (%SW) was calculated during conversational interactions with multiple conversation partners both within and outside of the clinic treatment sessions. Visual inspection methods revealed a reduction in %SW from an average of 14.5 %SW during baseline to 2.07 %SW during the withdrawal phase. The mean baseline reduction in %SW from baseline to the second treatment phase was 91.8 %. The FRP holds promise for reducing %SW in persons with ASD who stutter.

Awareness and reactions of young stuttering children aged 2-7 years old towards their speech disfluency.

PubMed

Boey, Ronny A; Van de Heyning, Paul H; Wuyts, Floris L; Heylen, Louis; Stoop, Reinhard; De Bodt, Marc S

2009-01-01

Awareness has been an important factor in theories of onset and development of stuttering. So far it has been suggested that even young children might be aware of their speech difficulty. The purpose of the present study was to investigate (a) the number of stuttering children aware of their speech difficulty, (b) the description of reported behavioural expression of awareness, (c) the relationship with age-related variables and with stuttering severity. For a total group of 1122 children with mean age of 4 year 7 months (range 2-7 years old), parental-reported unambiguous verbal and non-verbal reactions as a response to stuttering were available. In the present study, awareness is observed for 56.7% of the very young children (i.e., 2 years old) and gradually increases with age up until 89.7% of the children at the age of seven. All considered age-related factors (i.e., chronological age, age at onset and time since onset) and stuttering severity are statistically significantly related to awareness. Readers will be able to: (1) Describe findings of awareness of speech disfluency of stuttering children based on an overview of literature; (2) Describe methodological aspects of studies on awareness; (3) Know reported data on awareness of speech disfluency in young stuttering children of the present study; (4) Describe the relationship of awareness of speech disfluency with chronological age, age at onset, time since onset, gender and stuttering severity.

Dissecting choral speech: properties of the accompanist critical to stuttering reduction.

PubMed

Kiefte, Michael; Armson, Joy

2008-01-01

The effects of choral speech and altered auditory feedback (AAF) on stuttering frequency were compared to identify those properties of choral speech that make it a more effective condition for stuttering reduction. Seventeen adults who stutter (AWS) participated in an experiment consisting of special choral speech conditions that were manipulated to selectively eliminate specific differences between choral speech and AAF. Consistent with previous findings, results showed that both choral speech and AAF reduced stuttering compared to solo reading. Although reductions under AAF were substantial, they were less dramatic than those for choral speech. Stuttering reduction for choral speech was highly robust even when the accompanist's voice temporally lagged that of the AWS, when there was no opportunity for dynamic interplay between the AWS and accompanist, and when the accompanist was replaced by the AWS's own voice, all of which approximate specific features of AAF. Choral speech was also highly effective in reducing stuttering across changes in speech rate and for both familiar and unfamiliar passages. We concluded that differences in properties between choral speech and AAF other than those that were manipulated in this experiment must account for differences in stuttering reduction. The reader will be able to (1) describe differences in stuttering reduction associated with altered auditory feedback compared to choral speech conditions and (2) describe differences between delivery of a second voice signal as an altered rendition of the speakers own voice (altered auditory feedback) and alterations in the voice of an accompanist (choral speech).

Stuttering, alcohol consumption and smoking.

PubMed

Heelan, Milly; McAllister, Jan; Skinner, Jane

2016-06-01

Limited research has been published regarding the association between stuttering and substance use. An earlier study provided no evidence for such an association, but the authors called for further research to be conducted using a community sample. The present study used data from a community sample to investigate whether an association between stuttering and alcohol consumption or regular smoking exists in late adolescence and adulthood. Regression analyses were carried out on data from a birth cohort study, the National Child Development Study (NCDS), whose initial cohort included 18,558 participants who have since been followed up until age 55. In the analyses, the main predictor variable was parent-reported stuttering at age 16. Parental socio-economic group, cohort member's sex and childhood behavioural problems were also included. The outcome variables related to alcohol consumption and smoking habits at ages 16, 23, 33, 41, 46, 50 and 55. No significant association was found between stuttering and alcohol consumption or stuttering and smoking at any of the ages. It was speculated that the absence of significant associations might be due to avoidance of social situations on the part of many of the participants who stutter, or adoption of alternative coping strategies. Because of the association between anxiety and substance use, individuals who stutter and are anxious might be found to drink or smoke excessively, but as a group, people who stutter are not more likely than those who do not to have high levels of consumption of alcohol or nicotine. Copyright © 2016 Elsevier Inc. All rights reserved.

Developmental Stuttering in Children Who Are Hard of Hearing

PubMed Central

Walker, Elizabeth A.; Oleson, Jacob J.

2017-01-01

Purpose A number of studies with large sample sizes have reported lower prevalence of stuttering in children with significant hearing loss compared to children without hearing loss. This study used a parent questionnaire to investigate the characteristics of stuttering (e.g., incidence, prevalence, and age of onset) in children who are hard of hearing (CHH). Method Three hundred three parents of CHH who participated in the Outcomes of Children With Hearing Loss study (Moeller & Tomblin, 2015) were sent questionnaires asking about their child's history of stuttering. Results One hundred ninety-four parents of CHH responded to the survey. Thirty-three CHH were reported to have stuttered at one point in time (an incidence of 17.01%), and 10 children were still stuttering at the time of survey submission (a prevalence of 5.15%). Compared to estimates in the general population, this sample displayed a significantly higher incidence and prevalence. The age of onset, recovery rate, and other characteristics were similar to hearing children. Conclusions Based on this sample, mild to moderately severe hearing loss does not appear to be a protective factor for stuttering in the preschool years. In fact, the incidence and prevalence of stuttering may be higher in this population compared to the general population. Despite the significant speech and language needs that children with mild to moderately severe hearing loss may have, speech-language pathologists should appropriately prioritize stuttering treatment as they would in the hearing population. Supplemental Material https://doi.org/10.23641/asha.5397154 PMID:28915514

Developmental Stuttering in Children Who Are Hard of Hearing.

PubMed

Arenas, Richard M; Walker, Elizabeth A; Oleson, Jacob J

2017-10-05

A number of studies with large sample sizes have reported lower prevalence of stuttering in children with significant hearing loss compared to children without hearing loss. This study used a parent questionnaire to investigate the characteristics of stuttering (e.g., incidence, prevalence, and age of onset) in children who are hard of hearing (CHH). Three hundred three parents of CHH who participated in the Outcomes of Children With Hearing Loss study (Moeller & Tomblin, 2015) were sent questionnaires asking about their child's history of stuttering. One hundred ninety-four parents of CHH responded to the survey. Thirty-three CHH were reported to have stuttered at one point in time (an incidence of 17.01%), and 10 children were still stuttering at the time of survey submission (a prevalence of 5.15%). Compared to estimates in the general population, this sample displayed a significantly higher incidence and prevalence. The age of onset, recovery rate, and other characteristics were similar to hearing children. Based on this sample, mild to moderately severe hearing loss does not appear to be a protective factor for stuttering in the preschool years. In fact, the incidence and prevalence of stuttering may be higher in this population compared to the general population. Despite the significant speech and language needs that children with mild to moderately severe hearing loss may have, speech-language pathologists should appropriately prioritize stuttering treatment as they would in the hearing population. https://doi.org/10.23641/asha.5397154.

Effects of measurement method and transcript availability on inexperienced raters' stuttering frequency scores.

PubMed

Chakraborty, Nalanda; Logan, Kenneth J

To examine the effects of measurement method and transcript availability on the accuracy, reliability, and efficiency of inexperienced raters' stuttering frequency measurements. 44 adults, all inexperienced at evaluating stuttered speech, underwent 20 min of preliminary training in stuttering measurement and then analyzed a series of sentences, with and without access to transcripts of sentence stimuli, using either a syllable-based analysis (SBA) or an utterance-based analysis (UBA). Participants' analyses were compared between groups and to a composite analysis from two experienced evaluators. Stuttering frequency scores from the SBA and UBA groups differed significantly from the experienced evaluators' scores; however, UBA scores were significantly closer to the experienced evaluators' scores and were completed significantly faster than the SBA scores. Transcript availability facilitated scoring accuracy and efficiency in both groups. The internal reliability of stuttering frequency scores was acceptable for the SBA and UBA groups; however, the SBA group demonstrated only modest point-by-point agreement with ratings from the experienced evaluators. Given its accuracy and efficiency advantages over syllable-based analysis, utterance-based fluency analysis appears to be an appropriate context for introducing stuttering frequency measurement to raters who have limited experience in stuttering measurement. To address accuracy gaps between experienced and inexperienced raters, however, use of either analysis must be supplemented with training activities that expose inexperienced raters to the decision-making processes used by experienced raters when identifying stuttered syllables. Copyright © 2018 Elsevier Inc. All rights reserved.

Jobs, sex, love and lifestyle: when nonstutterers assume the roles of stutterers.

PubMed

Zhang, Jianliang; Saltuklaroglu, Tim; Hough, Monica; Kalinowski, Joseph

2009-01-01

This study assessed the impact of stuttering via a questionnaire in which fluent individuals were asked to assume the mindset of persons who stutter (PWS) in various life aspects, including vocation, romance, daily activities, friends/social life, family and general lifestyle. The perceived impact of stuttering through the mind's eyes of nonstutterers is supposed to reflect respondents' abilities to impart 'theory of mind' in addressing social penalties related to stuttering. Ninety-one university students answered a questionnaire containing 56 statements on a 7-point Likert scale. Forty-four participants (mean age = 20.4, SD = 4.4) were randomly selected to assume a stuttering identity and 47 respondents (mean age = 20.5, SD = 3.1) to assume their normally fluent identity. Significant differences between groups were found in more than two thirds of items regarding employment, romance, and daily activities, and in fewer than half of items regarding family, friend/social life, and general life style (p <0.001). The social penalties associated with stuttering appear to be apparent to fluent individuals, especially in areas of vocation, romance, and daily activities, suggesting that nonstuttering individuals, when assuming the role of PWS, are capable of at least temporarily feeling the negative impact of stuttering. Copyright 2008 S. Karger AG, Basel.

Phonetic complexity and stuttering in Spanish

PubMed Central

Howell, Peter; Au-Yeung, James

2007-01-01

The current study investigated whether phonetic complexity affected stuttering rate for Spanish speakers. The speakers were assigned to three age groups (6-11, 12-17 and 18 years plus) that were similar to those used in an earlier study on English. The analysis was performed using Jakielski's (1998) Index of Phonetic Complexity (IPC) scheme in which each word is given an IPC score based on the number of complex attributes it includes for each of eight factors. Stuttering on function words for Spanish did not correlate with IPC score for any age group. This mirrors the finding for English that stuttering on these words is not affected by phonetic complexity. The IPC scores of content words correlated positively with stuttering rate for 6-11 year old and adult speakers. Comparison was made between the languages to establish whether or not experience with the factors determines the problem they pose for speakers (revealed by differences in stuttering rate). Evidence was obtained that four factors found to be important determinants of stuttering on content words in English for speakers aged 12 and above, also affected Spanish speakers. This occurred despite large differences in frequency of usage of these factors. It is concluded that phonetic factors affect stuttering rate irrespective of a speaker's experience with that factor. PMID:17364620

Phonetic complexity and stuttering in Spanish.

PubMed

Howell, Peter; Au-Yeung, James

2007-02-01

The current study investigated whether phonetic complexity affected stuttering rate for Spanish speakers. The speakers were assigned to three age groups (6-11, 12-17 and 18-years plus) that were similar to those used in an earlier study on English. The analysis was performed using Jakielski's Index of Phonetic Complexity (IPC) scheme in which each word is given an IPC score based on the number of complex attributes it includes for each of eight factors. Stuttering on function words for Spanish did not correlate with IPC score for any age group. This mirrors the finding for English that stuttering on these words is not affected by phonetic complexity. The IPC scores of content words correlated positively with stuttering rate for 6-11-year-old and adult speakers. Comparison was made between the languages to establish whether or not experience with the factors determines the problem they pose for speakers (revealed by differences in stuttering rate). Evidence was obtained that four factors found to be important determinants of stuttering on content words in English for speakers aged 12 and above, also affected Spanish speakers. This occurred despite large differences in frequency of usage of these factors. It is concluded that phonetic factors affect stuttering rate irrespective of a speaker's experience with that factor.

Effects of concurrent cognitive processing on the fluency of word repetition: comparison between persons who do and do not stutter.

PubMed

Bosshardt, Hans-Georg

2002-01-01

This study investigated how silent reading and word memorization may affect the fluency of concurrently repeated words. The words silently read or memorized were phonologically similar or dissimilar to the words of the repetition task. Fourteen adults who stutter and 16 who do not participated in the experiment. The two groups were matched for age, education, sex, forward and backward memory span and vocabulary. It was found that the disfluencies of persons who stutter significantly increased during word repetition when similar words were read or memorized concurrently. In contrast, the disfluencies of persons who do not stutter were not significantly affected by either secondary task. These results indicate that the speech of persons who stutter is more sensitive to interference from concurrently performed cognitive processing than that of nonstuttering persons. It is proposed that the phonological and articulatory systems of persons who stutter are protected less efficiently from interference by attention-demanding processing within the central executive system. Alternative interpretations are also discussed. Readers will learn how modern speech production theories and the concept of modularity can account for stuttering, and will be able to explain the greater vulnerability of stutterer's speech fluency to concurrent cognitive processing.

From Grapheme to Phonological Output: Performance of Adults Who Stutter on a Word Jumble Task

PubMed Central

McGill, Megann; Sussman, Harvey; Byrd, Courtney T.

2016-01-01

Purpose The purpose of the present study was to extend previous research by analyzing the ability of adults who stutter to use phonological working memory in conjunction with lexical access to perform a word jumble task. Method Forty English words consisting of 3-, 4-, 5-, and 6-letters (n = 10 per letter length category) were randomly jumbled using a web-based application. During the experimental task, 26 participants were asked to silently manipulate the scrambled letters to form a real word. Each vocal response was coded for accuracy and speech reaction time (SRT). Results Adults who stutter attempted to solve fewer word jumble stimuli than adults who do not stutter at the 4-letter, 5-letter, and 6-letter lengths. Additionally, adults who stutter were significantly less accurate solving word jumble tasks at the 4-letter, 5-letter, and 6-letter lengths compared to adults who do not stutter. At the longest word length (6-letter), SRT was significantly slower for the adults who stutter than the fluent controls. Conclusion Results of the current study lend further support to the notion that differences in various aspects of phonological processing, including vision-to-sound conversions, sub-vocal stimulus manipulation, and/or lexical access are compromised in adults who stutter. PMID:26963917

How Stuttering Develops: The Multifactorial Dynamic Pathways Theory

PubMed Central

Weber, Christine

2017-01-01

Purpose We advanced a multifactorial, dynamic account of the complex, nonlinear interactions of motor, linguistic, and emotional factors contributing to the development of stuttering. Our purpose here is to update our account as the multifactorial dynamic pathways theory. Method We review evidence related to how stuttering develops, including genetic/epigenetic factors; motor, linguistic, and emotional features; and advances in neuroimaging studies. We update evidence for our earlier claim: Although stuttering ultimately reflects impairment in speech sensorimotor processes, its course over the life span is strongly conditioned by linguistic and emotional factors. Results Our current account places primary emphasis on the dynamic developmental context in which stuttering emerges and follows its course during the preschool years. Rapid changes in many neurobehavioral systems are ongoing, and critical interactions among these systems likely play a major role in determining persistence of or recovery from stuttering. Conclusion Stuttering, or childhood onset fluency disorder (Diagnostic and Statistical Manual of Mental Disorders, 5th edition; American Psychiatric Association [APA], 2013), is a neurodevelopmental disorder that begins when neural networks supporting speech, language, and emotional functions are rapidly developing. The multifactorial dynamic pathways theory motivates experimental and clinical work to determine the specific factors that contribute to each child's pathway to the diagnosis of stuttering and those most likely to promote recovery. PMID:28837728

The Palin Parent Rating Scales: Parents' Perspectives of Childhood Stuttering and Its Impact.

PubMed

Millard, Sharon K; Davis, Stephen

2016-10-01

The goal of this study is to explore the psychometric properties of the Parent Rating Scales-V1 (S. K. Millard, S. Edwards, & F. M. Cook, 2009), an assessment tool for parents of children who stutter, and to refine the measure accordingly. We included 259 scales completed prior to therapy. An exploratory factor analysis determined the test constructs and identified the items that had greatest loadings on those factors. Items that did not load on the factors were removed, and normative scores calculated. The resulting 19-item questionnaire measures three factors: (a) the impact of stuttering on the child; (b) the severity of stuttering and its impact on the parents; and (c) the parents' knowledge about stuttering and confidence in managing it. Reliability was demonstrated, norms established, and an automated online version constructed. The Palin Parent Rating Scale is a valid and reliable tool, providing a method of exploring parents' perceptions of stuttering, the impact it has on the child and themselves, and the parents' knowledge of and confidence in managing the stuttering. This is an important addition to the existing range of assessments that may be used to evaluate stuttering in children up to age 14;6 (years;months) and allows the wider targets of parent-led therapy programs to be evaluated.

Characteristics of Fluency and Speech in Two Families With High Incidences of Stuttering

PubMed Central

Freeman, Frances J.; Braun, Allen

2015-01-01

Purpose This study presents data from 2 families with high incidence of stuttering, comparing methods of phenotype assignment and exploring the presence of other fluency disorders and corresponding speech characteristics. Method Three methods for assigning phenotype of stuttering were used: self-identification, family identification, and expert identification. Agreement on which individuals were assigned by each of these methods was studied. Multiple measures of fluency and speech production were obtained. Results Self-reports and descriptions of blocking rather than self-identification as a person who stutters demonstrated the best agreement with expert identification of stuttering. Family identification showed poor agreement with both expert and self-identification of stuttering. Using binary categories of fluent or stuttering, 90% of individuals in 1 family were classified by expert consensus. Only 70% of the other family could be similarly categorized. Experts required 2 other categories, cluttering and other fluency disorders, to fully characterize dysfluency within this family. These 2 families also demonstrated differences in speech production. Conclusion Some families with high incidence of stuttering may also have high incidence of other fluency disorders and other speech-production difficulties. This finding may have ramifications for genetic studies, including criteria for defining phenotype and collapsing data across multiple families. PMID:26126023

An investigation of the effects of a speech-restructuring treatment for stuttering on the distribution of intervals of phonation.

PubMed

Brown, Lisa; Wilson, Linda; Packman, Ann; Halaki, Mark; Onslow, Mark; Menzies, Ross

2016-12-01

The purpose of this study was to investigate whether stuttering reductions following the instatement phase of a speech-restructuring treatment for adults were accompanied by reductions in the frequency of short intervals of phonation (PIs). The study was prompted by the possibility that reductions in the frequency of short PIs is the mechanism underlying such reductions in stuttering. The distribution of PIs was determined for seven adults who stutter, before and immediately after the intensive phase of a speech-restructuring treatment program. Audiovisual recordings of conversational speech were made on both assessment occasions, with PIs recorded with an accelerometer. All seven participants had much lower levels of stuttering after treatment but these were associated with reductions in the frequency of short PIs for only four of them. For the other three participants, two showed no change in frequency of short PIs, while for the other participant the frequency of short PIs actually increased. Stuttering reduction with speech-restructuring treatment can co-occur with reduction in the frequency of short PIs. However, the latter does not appear necessary for this reduction in stuttering to occur. Thus, speech-restructuring treatment must have other, or additional, treatment agents for stuttering to reduce. Copyright © 2016 Elsevier Inc. All rights reserved.

Randomized clinical trial: the use of SpeechEasy® in stuttering treatment.

PubMed

Ritto, Ana Paula; Juste, Fabiola Staróbole; Stuart, Andrew; Kalinowski, Joseph; de Andrade, Claudia Regina Furquim

2016-11-01

Numerous studies have demonstrated the benefit of devices delivering altered auditory feedback (AAF) as a therapeutic alternative for those who stutter. The effectiveness of a device delivering AAF (SpeechEasy®) was compared with behavioural techniques in the treatment of stuttering in a randomized clinical trial. Two groups of adults who stutter participated: group 1 consisted of 10 men and one woman aged 21-42 years (mean = 30.0). Group 2 consisted of six men and one woman aged 20-50 years (mean = 35.6). Participants in group 1 were fit with a SpeechEasy® device and were not given any additional training (i.e., supplementary fluency enhancing techniques). Participants used the device daily for 6 months. Participants in group 2 received treatment in the form of a 12-week fluency promotion protocol with techniques based on both fluency shaping and stuttering modification. There were no statistically significant differences (p > .05) between groups in participants' stuttered syllables following treatment. That is, both therapeutic protocols achieved approximately 40% reduction in number of stuttered syllables from baseline measures, with no significant relapse after 3 or 6 months post-treatment. The results suggest that the SpeechEasy® device can be a viable option for the treatment of stuttering. © 2016 Royal College of Speech and Language Therapists.

How Stuttering Develops: The Multifactorial Dynamic Pathways Theory.

PubMed

Smith, Anne; Weber, Christine

2017-09-18

We advanced a multifactorial, dynamic account of the complex, nonlinear interactions of motor, linguistic, and emotional factors contributing to the development of stuttering. Our purpose here is to update our account as the multifactorial dynamic pathways theory. We review evidence related to how stuttering develops, including genetic/epigenetic factors; motor, linguistic, and emotional features; and advances in neuroimaging studies. We update evidence for our earlier claim: Although stuttering ultimately reflects impairment in speech sensorimotor processes, its course over the life span is strongly conditioned by linguistic and emotional factors. Our current account places primary emphasis on the dynamic developmental context in which stuttering emerges and follows its course during the preschool years. Rapid changes in many neurobehavioral systems are ongoing, and critical interactions among these systems likely play a major role in determining persistence of or recovery from stuttering. Stuttering, or childhood onset fluency disorder (Diagnostic and Statistical Manual of Mental Disorders, 5th edition; American Psychiatric Association [APA], 2013), is a neurodevelopmental disorder that begins when neural networks supporting speech, language, and emotional functions are rapidly developing. The multifactorial dynamic pathways theory motivates experimental and clinical work to determine the specific factors that contribute to each child's pathway to the diagnosis of stuttering and those most likely to promote recovery.

[Speech rhythm disorders due to synchronization induced in coupled inhibitory neurons].

PubMed

Skliarov, O P

2007-01-01

Leaked-integrate-and-fire coupled oscillators (LIFs) were used as a model of electrophysiological activity. The activity of these oscillators determines the speech rhythm, which is governed by the square-law map with inhibition as a controlling parameter. Regular rhythms of convulsive repetitions at early stuttering are changed, however, by a mixture of repetitions and neurotic pauses. This mixture is a "stumbling block" for clinicians. Due to delays, only inhibitory LIFs are capable to create the synchronic activity in-phase or in-anti-phase at medial or at low coupling. This activity has the form of slow oscillations damping to the background level. Splashes of the activity above or below the level lead to neurotic disorders or to convulsive repetitions. Really, increased due to GABA the coupling leads to a reduction of stuttering.

PARTICIPANT MODELING IN STUTTERING

PubMed Central

Bhargava, S.C.

1988-01-01

SUMMARY Participant modeling was tried in twenty five stutterers; auditory feedback of modelled speech and guided exposure were also done along with. The patients were able to have a fluent stuttering free speech in most situations. PMID:21927289

Influence of text type, topic familiarity, and stuttering frequency on listener recall, comprehension, and mental effort.

PubMed

Panico, James; Healey, E Charles

2009-04-01

To determine how text type, topic familiarity, and stuttering frequency influence listener recall, comprehension, and perceived mental effort. Sixty adults listened to familiar and unfamiliar narrative and expository texts produced with 0%, 5%, 10%, and 15% stuttering. Participants listened to 4 experimental text samples at only 1 stuttering frequency. After hearing the text samples, each listener performed a free recall task, answered cued recall questions, answered story comprehension questions, and rated their perceived mental effort. Free and cued recall as well as story comprehension scores were higher for narrative than for expository texts. Free and cued recall scores were better for familiar than for unfamiliar stories, although topic familiarity did not affect story comprehension scores. Samples with all levels of stuttering resulted in higher mental effort ratings for both text types and topic familiarities. Stuttering has a greater influence on listener recall and comprehension for narrative than for expository texts. Topic familiarity affects free and cued recall but has no influence on story comprehension. Regardless of the amount of stuttering, mental effort was high for both text types and levels of familiarity.

Comparison of audio and audiovisual measures of adult stuttering: Implications for clinical trials.

PubMed

O'Brian, Sue; Jones, Mark; Onslow, Mark; Packman, Ann; Menzies, Ross; Lowe, Robyn

2015-04-15

This study investigated whether measures of percentage syllables stuttered (%SS) and stuttering severity ratings with a 9-point scale differ when made from audiovisual compared with audio-only recordings. Four experienced speech-language pathologists measured %SS and assigned stuttering severity ratings to 10-minute audiovisual and audio-only recordings of 36 adults. There was a mean 18% increase in %SS scores when samples were presented in audiovisual compared with audio-only mode. This result was consistent across both higher and lower %SS scores and was found to be directly attributable to counts of stuttered syllables rather than the total number of syllables. There was no significant difference between stuttering severity ratings made from the two modes. In clinical trials research, when using %SS as the primary outcome measure, audiovisual samples would be preferred as long as clear, good quality, front-on images can be easily captured. Alternatively, stuttering severity ratings may be a more valid measure to use as they correlate well with %SS and values are not influenced by the presentation mode.

Analysis of oral narratives of children who stutter and their fluent peers: kindergarten through second grade.

PubMed

Bajaj, Amit

2007-03-01

Measures of language sample length (in c-units) and morphological, syntactic, and narrative abilities were obtained from oral narrative transcripts of 22 children who stutter and 22 children who do not stutter; participants attended kindergarten, first, and second grades. A two-way MANOVA yielded significant main effects for grade, with significant differences on some measures evidenced between participants in kindergarten and second grades. No significant differences between groups or group-grade interaction effects on the measures were obtained. Grade-wise comparisons (through t-tests) indicated that the performance of children who stutter did not differ significantly from their typically fluent peers on all dependent measures; however, kindergarten children who stutter obtained the most discrepant (lower) scores than their grade-matched fluent peers on the Narrative Scoring Scheme measure, with group differences approaching statistical significance on this measure. The findings suggest that children who do and do not stutter evidence similar expressive language abilities, even as subgroups of children who stutter may lag behind their grade-matched fluent peers in particular language domains.

Phonological neighborhood and word frequency effects on the stuttered disfluencies of children who stutter: comments on Anderson (2007).

PubMed

Howell, Peter

2010-10-01

This letter comments on a study by Anderson (2007) that compared the effects of word frequency, neighborhood density, and phonological neighborhood frequency on part-word repetitions, prolongations, and single-syllable word repetitions produced by children who stutter. Anderson discussed her results with respect to 2 theories about stuttering: the covert repair hypothesis and execution planning (EXPLAN) theory. Her remarks about EXPLAN theory are examined. Anderson considered that EXPLAN does not predict the relationship between word and neighborhood frequency and stuttering for part-word repetitions and prolongations (she considered that EXPLAN predicts that stuttering occurs on simple words for children). The actual predictions that EXPLAN makes are upheld by her results. She also considered that EXPLAN cannot account for why stuttering is affected by the same variables that lead to speech errors, and it is shown that this is incorrect. The effects of word frequency, neighborhood density, and phonological neighborhood frequency on part-word repetitions, prolongations, and single-syllable word repetitions reported by Anderson (2007) are consistent with the predictions of the EXPLAN model.

Stuttering, induced fluency, and natural fluency: a hierarchical series of activation likelihood estimation meta-analyses.

PubMed

Budde, Kristin S; Barron, Daniel S; Fox, Peter T

2014-12-01

Developmental stuttering is a speech disorder most likely due to a heritable form of developmental dysmyelination impairing the function of the speech-motor system. Speech-induced brain-activation patterns in persons who stutter (PWS) are anomalous in various ways; the consistency of these aberrant patterns is a matter of ongoing debate. Here, we present a hierarchical series of coordinate-based meta-analyses addressing this issue. Two tiers of meta-analyses were performed on a 17-paper dataset (202 PWS; 167 fluent controls). Four large-scale (top-tier) meta-analyses were performed, two for each subject group (PWS and controls). These analyses robustly confirmed the regional effects previously postulated as "neural signatures of stuttering" (Brown, Ingham, Ingham, Laird, & Fox, 2005) and extended this designation to additional regions. Two smaller-scale (lower-tier) meta-analyses refined the interpretation of the large-scale analyses: (1) a between-group contrast targeting differences between PWS and controls (stuttering trait); and (2) a within-group contrast (PWS only) of stuttering with induced fluency (stuttering state). Copyright © 2014 Elsevier Inc. All rights reserved.

Psychogenic Stuttering of Adult Onset.

ERIC Educational Resources Information Center

Mahr, Greg; Leith, William

1992-01-01

The characteristic features of psychogenic stuttering of adult onset are reviewed, and four cases of this disorder are presented. Psychogenic stuttering of adult onset is classified as a conversion reaction, and tentative criteria for this diagnosis are proposed. (Author/JDD)

Life Experiences of People Who Stutter, and the Perceived Impact of Stuttering on Quality of Life: Personal Accounts of South African Individuals

ERIC Educational Resources Information Center

Klompas, Michelle; Ross, Eleanor

2004-01-01

The purpose of the study was to investigate the life experiences of a group of South African adults who stutter and the impact of stuttering on their quality of life. Participants were 16 adults with a mean age of 28.9 and ranging from 20 to 59 years. Methods involved individual interviews designed to explore the life domains of education; social…

Methylphenidate as a treatment for stuttering: a case report.

PubMed

Devroey, D; Beerens, G; Van De Vijver, E

2012-10-01

A randomized placebo controlled trial with methylphenidate (MPH) was set up to identify the effects of MPH on cognition in healthy young adults (ea. without attention deficit hyperactivity disorder, ADHD). Subjects repeatedly performed tests of the immediate and delayed memory and vigilance tasks after administration of placebo or 20 mg MPH. We report the case of an 18 year old man who participated in the study. He suffered from stuttering since childhood. During the study phase he reported a remarkable relief of the stuttering after the intake of 20 mg MPH. For D-amphetamine the beneficial effect on stuttering has been demonstrated but it was never implemented in clinical practice because of important adverse events. MPH, an amphetamine analogue, doesn't present these side effects. For this reason, MPH seems to merit further investigation in a randomized-controlled trial as a possible agent in the treatment of stuttering.Methylphenidate, Stuttering.

Strategies for Teachers to Manage Stuttering in the Classroom: A Call for Research.

PubMed

Davidow, Jason H; Zaroogian, Lisa; Garcia-Barrera, Mauricio A

2016-10-01

This clinical focus article highlights the need for future research involving ways to assist children who stutter in the classroom. The 4 most commonly recommended strategies for teachers were found via searches of electronic databases and personal libraries of the authors. The peer-reviewed evidence for each recommendation was subsequently located and detailed. There are varying amounts of evidence for the 4 recommended teacher strategies outside of the classroom, but there are no data for 2 of the strategies, and minimal data for the others, in a classroom setting. That is, there is virtually no evidence regarding whether or not the actions put forth influence, for example, stuttering frequency, stuttering severity, participation, or the social, emotional, and cognitive components of stuttering in the classroom. There is a need for researchers and speech-language pathologists in the schools to study the outcomes of teacher strategies in the classroom for children who stutter.

Utterance rate and linguistic properties as determinants of lexical dysfluencies in children who stutter

PubMed Central

Howell, Peter; Au-Yeung, James; Pilgrim, Lesley

2007-01-01

Two important determinants of variation in stuttering frequency are utterance rate and the linguistic properties of the words being spoken. Little is known how these determinants interrelate. It is hypothesized that those linguistic factors that lead to change in word duration, alter utterance rate locally within an utterance that then gives rise to an increase in stuttering frequency. According to the hypothesis, utterance rate variation should occur locally within the linguistic segments in an utterance that is known to increase the likelihood of stuttering. The hypothesis is tested using length of tone unit as the linguistic factor. Three predictions are confirmed: Utterance rate varies locally within the tone units and this local variation affects stuttering frequency; stuttering frequency is positively related to the length of tone units; variations in utterance rate are correlated with tone unit length. Alternative theoretical formulations of these findings are considered. PMID:9921672

The effect of emotion on articulation rate in persistence and recovery of childhood stuttering.

PubMed

Erdemir, Aysu; Walden, Tedra A; Jefferson, Caswell M; Choi, Dahye; Jones, Robin M

2018-06-01

This study investigated the possible association of emotional processes and articulation rate in pre-school age children who stutter and persist (persisting), children who stutter and recover (recovered) and children who do not stutter (nonstuttering). The participants were ten persisting, ten recovered, and ten nonstuttering children between the ages of 3-5 years; who were classified as persisting, recovered, or nonstuttering approximately 2-2.5 years after the experimental testing took place. The children were exposed to three emotionally-arousing video clips (baseline, positive and negative) and produced a narrative based on a text-free storybook following each video clip. From the audio-recordings of these narratives, individual utterances were transcribed and articulation rates were calculated. Results indicated that persisting children exhibited significantly slower articulation rates following the negative emotion condition, unlike recovered and nonstuttering children whose articulation rates were not affected by either of the two emotion-inducing conditions. Moreover, all stuttering children displayed faster rates during fluent compared to stuttered speech; however, the recovered children were significantly faster than the persisting children during fluent speech. Negative emotion plays a detrimental role on the speech-motor control processes of children who persist, whereas children who eventually recover seem to exhibit a relatively more stable and mature speech-motor system. This suggests that complex interactions between speech-motor and emotional processes are at play in stuttering recovery and persistency; and articulation rates following negative emotion or during stuttered versus fluent speech might be considered as potential factors to prospectively predict persistence and recovery from stuttering. Copyright © 2017 Elsevier Inc. All rights reserved.

Rhythmic speech and stuttering reduction in a syllable-timed language.

PubMed

Law, Thomas; Packman, Ann; Onslow, Mark; To, Carol K-S; Tong, Michael C-F; Lee, Kathy Y-S

2018-06-06

Speaking rhythmically, also known as syllable-timed speech (STS), has been known for centuries to be a fluency-inducing condition for people who stutter. Cantonese is a tonal syllable-timed language and it has been shown that, of all languages, Cantonese is the most rhythmic (Mok, 2009). However, it is not known if STS reduces stuttering in Cantonese as it does in English. This is the first study to investigate the effects of STS on stuttering in a syllable-timed language. Nineteen native Cantonese-speaking adults who stutter were engaged in conversational tasks in Cantonese under two conditions: one in their usual speaking style and one using STS. The speakers' percentage syllables stuttered (%SS) and speech rhythmicity were rated. The rhythmicity ratings were used to estimate the extent to which speakers were using STS in the syllable-timed condition. Results revealed a statistically significant reduction in %SS in the STS condition; however, this reduction was not as large as in previous studies in other languages and the amount of stuttering reduction varied across speakers. The rhythmicity ratings showed that some speakers were perceived to be speaking more rhythmically than others and that the perceived rhythmicity correlated positively with reductions in stuttering. The findings were unexpected, as it was anticipated that speakers of a highly rhythmic language such as Cantonese would find STS easy to use and that the consequent reductions in stuttering would be great, even greater perhaps than in a stress-timed language such as English. The theoretical and clinical implications of the findings are discussed.

Psychological counseling as an adjunct to stuttering treatment: Clients' experiences and perceptions.

PubMed

Lindsay, Alanna; Langevin, Marilyn

2017-06-01

Stuttering can trigger anxiety and other psychological and emotional reactions, and limit participation in society. It is possible that psychological counseling could enhance stuttering treatment outcomes; however, little is known about how clients view such counseling. The purpose of this study was to gain an understanding of clients' experiences with, and perceptions of, a psychological counseling service that was offered as an optional adjunct to speech therapy for stuttering. Nine individuals who stutter (13-38 years old) participated in semi-structured interviews. Six participants had taken part in psychological counseling; three participants did not do so. Interview data were analyzed using grounded theory as a guiding framework. Four thematic clusters emerged from participants' accounts: insights into personal decision-making, why others may not participate in counseling, psychological counseling as a worthwhile part of therapy, and counseling as a necessary component in a stuttering treatment program. In addition to experiencing barriers and facilitators to help-seeking that are reported in related fields, participants accounts also revealed novel facilitators (i.e., a 'why not' mentality and the importance of having a pre-existing relationship with the clinician who offered the service) and barriers (i.e., viewing the service as a 'limited resource,' and, the overwhelming nature of intensive stuttering treatment programs). Findings suggest that clients value the option to access psychological counseling with trained mental health professionals to support the stuttering treatment provided by speech-language pathologists. Participants made recommendations for the integration of psychological counseling into stuttering treatment programs. Copyright © 2017 Elsevier Inc. All rights reserved.

Developing the therapeutic relationship: from 'expert' professional to 'expert' person who stutters.

PubMed

Botterill, Willie

2011-09-01

This article looks back over the years and identifies some of the most influential thinkers, writers, and researchers who have had a profound effect on the way the therapy at the Michael Palin Centre for Stammering Children in London has evolved. It tracks the changes that have occurred in theoretical perspective, treatments offered, and the delivery of therapy. In particular this author is interested in the changing nature of the therapeutic relationship between professionals and people who stutter (PWS), and describes the way it has developed from the "expert professional" towards a more collaborative relationship that recognises the "expert patient". It was inspired by a book written in 1902 by Mr Beasley, a person who stammered. After several unsuccessful attempts to find a 'cure' he found his own solution to his stuttering and then used what he had learned to help many others. Much of what he wrote was well ahead of his time and reminds us, the professionals, of the importance of listening to and taking account of the views of PWS in therapy and designing treatment that meets the needs of the individual. This article also looks briefly at evidence based practice (EBP) and the issues involved in measuring outcomes that reflect the complex and individual nature of the problem. Finally the importance of the research in developing the knowledge and skill base of clinicians as well as PWS is acknowledged and discussed and the way ahead signposted. The reader will learn about (1) the early history and development of stuttering therapy, (2) the influence of a variety of psychotherapeutic approaches, (3) the relevance of designing therapy to meet the needs of the PWS, and (4) discuss the role of 'common' factors in EBP. Copyright © 2011 Elsevier Inc. All rights reserved.

[P300 event-related potentials in stutterers pre and post treatment: a pilot study].

PubMed

Andrade, Claudia Regina Furquim de; Sassi, Fernanda Chiarion; Matas, Carla Gentile; Neves, Ivone Ferreira; Martins, Vanessa Oliveira

2007-01-01

P300 event-related potential has been used as an instrument to establish the diagnosis of several disorders as well as to assess therapeutic outcomes. to investigate the relationship between stuttering amelioration and cerebral activity. P300 event-related potentials were obtained in three adult males, all stutterers, aged 20 to 31 years, pre and post-treatment, verifying changes in wave amplitude and latency between waves. results indicate a significant positive correlation between the reduction in the percentage of stuttered syllables and the improvement in wave amplitude for the right ear. stutterers can exhibit different patterns of interhemispheric activity with a tonal P300 task after undergoing a fluency-enhancing program.

The nature and treatment of stuttering as revealed by fMRI A within- and between-group comparison.

PubMed

Neumann, Katrin; Euler, Harald A; von Gudenberg, Alexander Wolff; Giraud, Anne-Lise; Lanfermann, Heinrich; Gall, Volker; Preibisch, Christine

2003-01-01

This article reviews some of our recent functional magnetic resonance imaging (fMRI) studies of stuttering. Using event-related fMRI experiments, we investigated brain activation during speech production. Results of three studies comparing persons who stutter (PWS) and persons who do not stutter (PWNS) are outlined. Their findings point to a region in the right frontal operculum (RFO) that was consistently implicated in stuttering. During overt reading and before fluency shaping therapy, PWS showed higher and more distributed neuronal activation than PWNS. Immediately after therapy differential activations were even more distributed and left sided. They extended to frontal, temporal, and parietal regions, anterior cingulate, insula, and putamen. These over-activations were slightly reduced and again more right sided two years after therapy. Left frontal deactivations remained stable over two years of observation, and therefore possibly indicate a dysfunction. After therapy, we noted higher activations in persons who stutter moderately than in those who stutter severely. These activations might reflect patterns of compensation. We discuss why these findings suggest that fluency-inducing techniques might synchronize a disturbed signal transmission between auditory, speech motor planning, and motor areas. The reader will learn about and be able to: (1) identify regions of brain activations and deactivations specific for PWS; (2) describe brain activation changes induced by fluency shaping therapy; and (3) discuss the correlation between stuttering severity and brain activation.

Communication attitudes in children who stutter: A meta-analytic review.

PubMed

Guttormsen, Linn Stokke; Kefalianos, Elaina; Næss, Kari-Anne B

2015-12-01

This article presents a meta-analytic review of differences in communication attitudes between children who stutter (CWS) and children who do not stutter (CWNS). To be included in this review, the studies had to include a group of CWS and CWNS between the ages of 3-18 years and a measurement of communication attitudes. The journal articles were identified by using the key words stutter*, speech disfluenc*, fluency disorder*, and stammer* cross-referenced to awareness*, reaction*, attitude*, KiddyCAT, CAT, A-19 Scale, PASS and OASES. A total of 18 studies met the inclusion criteria for this meta-analysis. The results showed that CWS exhibit more negative communication attitudes than CWNS from the preschool years. The differences between the groups increased with age, but were not influenced by gender. The results indicate that negative communication attitudes can be an effect of stuttering. Key issues requiring further investigation are whether communication attitudes differ as a function of age at stuttering onset and whether communication attitudes influence the development of stuttering. After reading this article, the reader will be able to: (a) summarise empirical findings with regard to the relationship between communication attitudes and childhood stuttering; (b) describe the different instruments used to measure communication attitudes; (c) discuss the relationship between communication attitudes, age and gender. Copyright © 2015 Elsevier Inc. All rights reserved.

A country-wide probability sample of public attitudes toward stuttering in Portugal.

PubMed

Valente, Ana Rita S; St Louis, Kenneth O; Leahy, Margaret; Hall, Andreia; Jesus, Luis M T

2017-06-01

Negative public attitudes toward stuttering have been widely reported, although differences among countries and regions exist. Clear reasons for these differences remain obscure. Published research is unavailable on public attitudes toward stuttering in Portugal as well as a representative sample that explores stuttering attitudes in an entire country. This study sought to (a) determine the feasibility of a country-wide probability sampling scheme to measure public stuttering attitudes in Portugal using a standard instrument (the Public Opinion Survey of Human Attributes-Stuttering [POSHA-S]) and (b) identify demographic variables that predict Portuguese attitudes. The POSHA-S was translated to European Portuguese through a five-step process. Thereafter, a local administrative office-based, three-stage, cluster, probability sampling scheme was carried out to obtain 311 adult respondents who filled out the questionnaire. The Portuguese population held stuttering attitudes that were generally within the average range of those observed from numerous previous POSHA-S samples. Demographic variables that predicted more versus less positive stuttering attitudes were respondents' age, region of the country, years of school completed, working situation, and number of languages spoken. Non-predicting variables were respondents' sex, marital status, and parental status. A local administrative office-based, probability sampling scheme generated a respondent profile similar to census data and indicated that Portuguese attitudes are generally typical. Copyright © 2017 Elsevier Inc. All rights reserved.

The role of anxiety in stuttering: Evidence from functional connectivity.

PubMed

Yang, Yang; Jia, Fanlu; Siok, Wai Ting; Tan, Li Hai

2017-03-27

Persistent developmental stuttering is a neurologically based speech disorder associated with cognitive-linguistic, motor and emotional abnormalities. Previous studies investigating the relationship between anxiety and stuttering have yielded mixed results, but it has not yet been examined whether anxiety influences brain activity underlying stuttering. Here, using functional magnetic resonance imaging (fMRI), we investigated the functional connectivity associated with state anxiety in a syllable repetition task, and trait anxiety during rest in adults who stutter (N=19) and fluent controls (N=19). During the speech task, people who stutter (PWS) showed increased functional connectivity of the right amygdala with the prefrontal gyrus (the left ventromedial frontal gyrus and right middle frontal gyrus) and the left insula compared to controls. During rest, PWS showed stronger functional connectivity between the right hippocampus and the left orbital frontal gyrus, and between the left hippocampus and left motor areas than controls. Taken together, our results suggest aberrant bottom-up and/or top-down interactions for anxiety regulation, which might be responsible for the higher level of state anxiety during speech and for the anxiety-prone trait in PWS. To our knowledge, this is the first study to examine the neural underpinnings of anxiety in PWS, thus yielding new insight into the causes of stuttering which might aid strategies for the diagnosis and treatment of stuttering. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Understanding perceptions of stuttering among school-based speech-language pathologists: an application of attribution theory.

PubMed

Boyle, Michael P

2014-01-01

The purpose of this study was to investigate whether attribution theory could explain speech-language pathologists (SLPs) perceptions of children with communication disorders such as stuttering. Specifically, it was determined whether perceptions of onset and offset controllability, as well as biological and non-biological attributions for communication disorders were related to willingness to help, sympathy, and anger toward children with these disorders. It was also of interest to determine if blame for stuttering was related to perceived controllability of stuttering and negative attitudes toward people who stutter (PWS). A survey was developed to measure perceived onset and offset controllability, biological and non-biological attributions, willingness to help, sympathy, and anger toward middle school children with developmental stuttering, functional articulation disorders, and cerebral palsy. In addition, a scale was developed to measure blame and negative attitudes toward PWS in general. Surveys were mailed to 1000 school-based SLPs. Data from 330 participants were analyzed. Supporting the hypotheses of attribution theory, higher perceived onset and offset controllability of the disorder was linked to less willingness to help, lower sympathy, and more anger across conditions. Increased biological attributions were associated with more reported sympathy. Increased blame for stuttering was linked to higher perceived controllability of stuttering, more dislike of PWS, and more agreement with negative stereotypes about PWS. Educating SLPs about the variable loss of control inherent in stuttering could improve attitudes and increase understanding of PWS. Reductions in blame may facilitate feelings of sympathy and empathy for PWS and reduce environmental barriers for clients. Learning outcomes Readers should be able to: (1) identify the main principles of Weiner's attribution theory (2) identify common negative perceptions of people who stutter (3) describe how disorders of stuttering, articulation disorders, and cerebral palsy are differentiated in terms of perceived onset and offset controllability, and biological and non-biological attributions (4) describe relationships between perceived onset and offset controllability of disorders and sympathy, anger, and willingness to help. Copyright © 2014 Elsevier Inc. All rights reserved.

Preschool speech articulation and nonword repetition abilities may help predict eventual recovery or persistence of stuttering.

PubMed

Spencer, Caroline; Weber-Fox, Christine

2014-09-01

In preschool children, we investigated whether expressive and receptive language, phonological, articulatory, and/or verbal working memory proficiencies aid in predicting eventual recovery or persistence of stuttering. Participants included 65 children, including 25 children who do not stutter (CWNS) and 40 who stutter (CWS) recruited at age 3;9-5;8. At initial testing, participants were administered the Test of Auditory Comprehension of Language, 3rd edition (TACL-3), Structured Photographic Expressive Language Test, 3rd edition (SPELT-3), Bankson-Bernthal Test of Phonology-Consonant Inventory subtest (BBTOP-CI), Nonword Repetition Test (NRT; Dollaghan & Campbell, 1998), and Test of Auditory Perceptual Skills-Revised (TAPS-R) auditory number memory and auditory word memory subtests. Stuttering behaviors of CWS were assessed in subsequent years, forming groups whose stuttering eventually persisted (CWS-Per; n=19) or recovered (CWS-Rec; n=21). Proficiency scores in morphosyntactic skills, consonant production, verbal working memory for known words, and phonological working memory and speech production for novel nonwords obtained at the initial testing were analyzed for each group. CWS-Per were less proficient than CWNS and CWS-Rec in measures of consonant production (BBTOP-CI) and repetition of novel phonological sequences (NRT). In contrast, receptive language, expressive language, and verbal working memory abilities did not distinguish CWS-Rec from CWS-Per. Binary logistic regression analysis indicated that preschool BBTOP-CI scores and overall NRT proficiency significantly predicted future recovery status. Results suggest that phonological and speech articulation abilities in the preschool years should be considered with other predictive factors as part of a comprehensive risk assessment for the development of chronic stuttering. At the end of this activity the reader will be able to: (1) describe the current status of nonlinguistic and linguistic predictors for recovery and persistence of stuttering; (2) summarize current evidence regarding the potential value of consonant cluster articulation and nonword repetition abilities in helping to predict stuttering outcome in preschool children; (3) discuss the current findings in relation to potential implications for theories of developmental stuttering; (4) discuss the current findings in relation to potential considerations for the evaluation and treatment of developmental stuttering. Copyright © 2014 Elsevier Inc. All rights reserved.

Stuttering Severity and Educational Attainment

ERIC Educational Resources Information Center

O'Brian, Sue; Jones, Mark; Packman, Ann; Menzies, Ross; Onslow, Mark

2011-01-01

Purpose: This study investigated the relationship between self-reported stuttering severity ratings and educational attainment. Method: Participants were 147 adults seeking treatment for stuttering. At pretreatment assessment, each participant reported the highest educational level they had attained and rated their typical and worst stuttering…

Structural and functional abnormalities of the motor system in developmental stuttering

PubMed Central

Watkins, Kate E.; Smith, Stephen M.; Davis, Steve; Howell, Peter

2007-01-01

Summary Though stuttering is manifest in its motor characteristics, the cause of stuttering may not relate purely to impairments in the motor system as stuttering frequency is increased by linguistic factors, such as syntactic complexity and length of utterance, and decreased by changes in perception, such as masking or altering auditory feedback. Using functional and diffusion imaging, we examined brain structure and function in the motor and language areas in a group of young people who stutter. During speech production, irrespective of fluency or auditory feedback, the people who stuttered showed overactivity relative to controls in the anterior insula, cerebellum and midbrain bilaterally and underactivity in the ventral premotor, Rolandic opercular and sensorimotor cortex bilaterally and Heschl’s gyrus on the left. These results are consistent with a recent meta-analysis of functional imaging studies in developmental stuttering. Two additional findings emerged from our study. First, we found overactivity in the midbrain, which was at the level of the substantia nigra and extended to the pedunculopontine nucleus, red nucleus and subthalamic nucleus. This overactivity is consistent with suggestions in previous studies of abnormal function of the basal ganglia or excessive dopamine in people who stutter. Second, we found underactivity of the cortical motor and premotor areas associated with articulation and speech production. Analysis of the diffusion data revealed that the integrity of the white matter underlying the underactive areas in ventral premotor cortex was reduced in people who stutter. The white matter tracts in this area via connections with posterior superior temporal and inferior parietal cortex provide a substrate for the integration of articulatory planning and sensory feedback, and via connections with primary motor cortex, a substrate for execution of articulatory movements. Our data support the conclusion that stuttering is a disorder related primarily to disruption in the cortical and subcortical neural systems supporting the selection, initiation and execution of motor sequences necessary for fluent speech production. PMID:17928317

Structural and functional abnormalities of the motor system in developmental stuttering.

PubMed

Watkins, Kate E; Smith, Stephen M; Davis, Steve; Howell, Peter

2008-01-01

Though stuttering is manifest in its motor characteristics, the cause of stuttering may not relate purely to impairments in the motor system as stuttering frequency is increased by linguistic factors, such as syntactic complexity and length of utterance, and decreased by changes in perception, such as masking or altering auditory feedback. Using functional and diffusion imaging, we examined brain structure and function in the motor and language areas in a group of young people who stutter. During speech production, irrespective of fluency or auditory feedback, the people who stuttered showed overactivity relative to controls in the anterior insula, cerebellum and midbrain bilaterally and underactivity in the ventral premotor, Rolandic opercular and sensorimotor cortex bilaterally and Heschl's gyrus on the left. These results are consistent with a recent meta-analysis of functional imaging studies in developmental stuttering. Two additional findings emerged from our study. First, we found overactivity in the midbrain, which was at the level of the substantia nigra and extended to the pedunculopontine nucleus, red nucleus and subthalamic nucleus. This overactivity is consistent with suggestions in previous studies of abnormal function of the basal ganglia or excessive dopamine in people who stutter. Second, we found underactivity of the cortical motor and premotor areas associated with articulation and speech production. Analysis of the diffusion data revealed that the integrity of the white matter underlying the underactive areas in ventral premotor cortex was reduced in people who stutter. The white matter tracts in this area via connections with posterior superior temporal and inferior parietal cortex provide a substrate for the integration of articulatory planning and sensory feedback, and via connections with primary motor cortex, a substrate for execution of articulatory movements. Our data support the conclusion that stuttering is a disorder related primarily to disruption in the cortical and subcortical neural systems supporting the selection, initiation and execution of motor sequences necessary for fluent speech production.

Sex steroid hormones and sex hormone binding globulin levels, CYP17 MSP AI (-34T:C) and CYP19 codon 39 (Trp:Arg) variants in children with developmental stuttering.

PubMed

Mohammadi, Hiwa; Joghataei, Mohammad Taghi; Rahimi, Zohreh; Faghihi, Faezeh; Khazaie, Habibolah; Farhangdoost, Hashem; Mehrpour, Masoud

2017-12-01

Developmental stuttering is known to be a sexually dimorphic and male-biased speech motor control disorder. In the present case-control study, we investigated the relationship between developmental stuttering and steroid hormones. Serum levels of testosterone, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), oestradiol, progesterone, cortisol, and sex hormone binding globulin (SHBG), as well as the 2nd/4th digit ratio (2D:4D), an indicator of prenatal testosterone level, were compared between children who stutter (CWS) and children who do not stutter (CWNS). Moreover, two SNPs (CYP17 -34 T:C (MSP AI) and CYP19 T:C (Trp:Arg)) of cytochrome P450, which is involved in steroid metabolism pathways, were analysed between the groups. Our results showed significantly higher levels of testosterone, DHT, and oestradiol in CWS in comparison with CWNS. The severity of stuttering was positively correlated with the serum levels of testosterone, DHEA, and cortisol, whereas no association was seen between the stuttering and digit ratio, progesterone, or SHBG. The CYP17CC genotype was significantly associated with the disorder. Copyright © 2017 Elsevier Inc. All rights reserved.

The effects of actors vocal exercises for relaxation on fluency: A preliminary study.

PubMed

Monteagudo, Emily; Sawyer, Jean; Sivek-Eskra, Alyssa

2017-12-01

To determine the efficacy of treatment based on Kristin Linklater's technique for vocal preparation for performance for use with people who stutter. A protocol for a treatment for stuttering involving breathing exercises, relaxation techniques, and focus on awareness was designed by the first author from Linklater's published exercises in her book Freeing the Natural Voice (2006). Four adults who stutter participated in a 12-week, single-case reversal design study. Treatment efficacy was determined by baseline and post-treatment measures on the OASES, self-report naturalness, tension and severity scale, and percentage of stuttering-like disfluency (SLD). Qualitative measures included a daily tension and practice log, a program completion questionnaire, and accounts from the clinicians administering the treatment protocol. Three of four participants scored lower on the OASES post-treatment, suggesting that the impact of stuttering on their daily lives had decreased. All four experienced a reduction in the number of SLD counted throughout treatment sessions compared to baseline data. A treatment for stuttering based on Linklater's work including regulation of breathing, relaxation, and awareness of breath may be effective in improving fluency and decreasing the impact of stuttering and warrants further study. Copyright © 2017 Elsevier Inc. All rights reserved.

The Disfluent Speech of Bilingual Spanish–English Children: Considerations for Differential Diagnosis of Stuttering

PubMed Central

Bedore, Lisa M.; Ramos, Daniel

2015-01-01

Purpose The primary purpose of this study was to describe the frequency and types of speech disfluencies that are produced by bilingual Spanish–English (SE) speaking children who do not stutter. The secondary purpose was to determine whether their disfluent speech is mediated by language dominance and/or language produced. Method Spanish and English narratives (a retell and a tell in each language) were elicited and analyzed relative to the frequency and types of speech disfluencies produced. These data were compared with the monolingual English-speaking guidelines for differential diagnosis of stuttering. Results The mean frequency of stuttering-like speech behaviors in the bilingual SE participants ranged from 3% to 22%, exceeding the monolingual English standard of 3 per 100 words. There was no significant frequency difference in stuttering-like or non-stuttering-like speech disfluency produced relative to the child's language dominance. There was a significant difference relative to the language the child was speaking; all children produced significantly more stuttering-like speech disfluencies in Spanish than in English. Conclusion Results demonstrate that the disfluent speech of bilingual SE children should be carefully considered relative to the complex nature of bilingualism. PMID:25215876

Safety Behaviors and Stuttering.

PubMed

Lowe, Robyn; Helgadottir, Fjola; Menzies, Ross; Heard, Rob; O'Brian, Sue; Packman, Ann; Onslow, Mark

2017-05-24

Those who are socially anxious may use safety behaviors during feared social interactions to prevent negative outcomes. Safety behaviors are associated with anxiety maintenance and poorer treatment outcomes because they prevent fear extinction. Social anxiety disorder is often comorbid with stuttering. Speech pathologists reported in a recent publication (Helgadottir, Menzies, Onslow, Packman, & O'Brian, 2014a) that they often recommended procedures for clients that could be safety behaviors. This study investigated the self-reported use of safety behaviors by adults who stutter. Participants were 133 adults who stutter enrolled in an online cognitive-behavior therapy program. Participants completed a questionnaire about their use of potential safety behaviors when anxious during social encounters. Correlations were computed between safety behaviors and pretreatment scores on measures of fear of negative evaluation and negative cognitions. Of 133 participants, 132 reported that they used safety behaviors. Many of the safety behaviors correlated with higher scores for fear of negative evaluation and negative cognitions. Adults who stutter report using safety behaviors, and their use is associated with pretreatment fear of negative evaluation and unhelpful thoughts about stuttering. These results suggest that the negative effects of safety behaviors may extend to those who stutter, and further research is needed.

Voxel-based morphometry of auditory and speech-related cortex in stutterers.

PubMed

Beal, Deryk S; Gracco, Vincent L; Lafaille, Sophie J; De Nil, Luc F

2007-08-06

Stutterers demonstrate unique functional neural activation patterns during speech production, including reduced auditory activation, relative to nonstutterers. The extent to which these functional differences are accompanied by abnormal morphology of the brain in stutterers is unclear. This study examined the neuroanatomical differences in speech-related cortex between stutterers and nonstutterers using voxel-based morphometry. Results revealed significant differences in localized grey matter and white matter densities of left and right hemisphere regions involved in auditory processing and speech production.

Influence of stuttering variation on talker group classification in preschool children: Preliminary findings

PubMed Central

Johnson, Kia N.; Karrass, Jan; Conture, Edward G.; Walden, Tedra

2010-01-01

The purpose of this study was to investigate whether variations in disfluencies of young children who do (CWS) and do not stutter (CWNS) significantly change their talker group classification or diagnosis from stutterer to nonstutterer, and vice versa. Participants consisted of 17 3- to 5-year-old CWS and 9 3- to 5-year-old CWNS, with no statistically significant between-group difference in chronological age (CWS: M = 45.53 months, SD = 8.32; CWNS: M = 47.67 months, SD = 6.69). All participants had speech, language, and hearing development within normal limits, with the exception of stuttering for CWS. Both talker groups participated in a series of speaking samples that varied by: (a) conversational partner [parent and clinician], (b) location [home and clinic], and (c) context [conversation and narrative]. The primary dependent measures for this study were the number of stuttering-like disfluencies (SLD) per total number of spoken words [%SLD] and the ratio of SLD to total disfluencies (TD) [SLD/TD]. Results indicated that significant variability of stuttering did not exist as a result of conversational partner or location. Changes in context, however, did impact the CWS, who demonstrated higher SLD/TD in the conversation sample versus a narrative sample. Consistent with hypotheses, CWS and CWNS were accurately identified as stutterers and nonstutterers, respectively, regardless of changes to conversational partner, location or context for the overall participant sample. Present findings were taken to suggest that during assessment, variations in stuttering frequency resulting from changes in conversational partner, location or context do not significantly influence the diagnosis of stuttering, especially for children not on the talker group classification borderline between CWS and CWNS. PMID:19167719

Structural connectivity of right frontal hyperactive areas scales with stuttering severity

PubMed Central

Neef, Nicole E; Bütfering, Christoph; Schmidt-Samoa, Carsten; Friederici, Angela D; Paulus, Walter; Sommer, Martin

2018-01-01

Abstract A neuronal sign of persistent developmental stuttering is the magnified coactivation of right frontal brain regions during speech production. Whether and how stuttering severity relates to the connection strength of these hyperactive right frontal areas to other brain areas is an open question. Scrutinizing such brain–behaviour and structure–function relationships aims at disentangling suspected underlying neuronal mechanisms of stuttering. Here, we acquired diffusion-weighted and functional images from 31 adults who stutter and 34 matched control participants. Using a newly developed structural connectivity measure, we calculated voxel-wise correlations between connection strength and stuttering severity within tract volumes that originated from functionally hyperactive right frontal regions. Correlation analyses revealed that with increasing speech motor deficits the connection strength increased in the right frontal aslant tract, the right anterior thalamic radiation, and in U-shaped projections underneath the right precentral sulcus. In contrast, with decreasing speech motor deficits connection strength increased in the right uncinate fasciculus. Additional group comparisons of whole-brain white matter skeletons replicated the previously reported reduction of fractional anisotropy in the left and right superior longitudinal fasciculus as well as at the junction of right frontal aslant tract and right superior longitudinal fasciculus in adults who stutter compared to control participants. Overall, our investigation suggests that right fronto-temporal networks play a compensatory role as a fluency enhancing mechanism. In contrast, the increased connection strength within subcortical-cortical pathways may be implied in an overly active global response suppression mechanism in stuttering. Altogether, this combined functional MRI–diffusion tensor imaging study disentangles different networks involved in the neuronal underpinnings of the speech motor deficit in persistent developmental stuttering. PMID:29228195

An evaluation of G-protein coupled membrane estrogen receptor-1 level in stuttering.

PubMed

Bilal, Nagihan; Kurutas, Ergül Belge; Orhan, Israfil

2018-02-01

Stuttering is a widespread but little understood disease. There has been a recent increase in neuropathophysiological, genetic, and biochemical studies related to the etiopathogenesis. As developmental stuttering continues in adult males, hormonal factors are thought to have an effect. In this study, an evaluation was made for the first time of serum GPER-1 level in patients with a stutter. Prospective case control. The study included 30 patients with a stutter, aged < 18 years, and 35 age-matched children as the control group. The Stuttering Severity Instrument-3 form was administered to the patients. Evaluations were made of serum GPER-1, TSH, estradiol, prolactin, and progesterone and testosterone levels. GPER-1 level was determined as 0.51 (0.42-0.67) ng/mL in the patients and as 0.19 (0.13-0.25) ng/mL in the control group, and the difference was statistically significant (p < 0.001). A statistically significant difference was determined between genders with GPER-1 level of 0.56 (0.44-0.68) ng/mL in the male stuttering patient group and 0.44 (0.35-0.49) ng/mL in the female patient group (p = 0.026). Differential diagnosis with ROC analysis for the serum GPER-1 levels was statistically significant [Area under the ROC curve (AUC): 0.998, confidence interval, CI 0.992-1.000, p < 0.001]. The GPER-1 levels of the stuttering patients were found to be higher than those of the control group and GPER-1 levels of male patients were higher than those of females. As GPER-1 has high sensitivity and sensitivity, it could be considered important in the diagnosis and treatment of stuttering.

A Persian-version of the stuttering severity instrument-version four (SSI-4): How the new additions to SSI-4 complement its stuttering severity score?

PubMed

Tahmasebi, Neda; Shafie, Bijan; Karimi, Hamid; Mazaheri, Masood

The fourth version of the Stuttering Severity Instrument (SSI-4) has been available since 2009. It has some modifications and new features which make it more appropriate at least for clinical practice, although further documentation is needed. The objective of the current research was to translate SSI-4 into Persian language and to discuss its relative and absolute reliability as well as its criterion validity for Persian adults who stutter (PWS). We also aimed to study how the new subjective self-reports of the SSI-4 complement the stuttering severity score obtained from the SSI-3 or the SSI-4. The cross-cultural guideline recommended by the International Quality of Life Assessment project was used to translate the SSI-4 into Persian language. Thirty five PWS from ages 17 to 42 were recruited and 10 speech and language pathologists assessed their stuttering severity using either the SSI-4 or stuttering severity ratings (SR) to test validity and reliability of the Persian translated version. A very high inter-judge relative reliability along with a poor absolute inter-judge reliability was found for the SSI-4 scores. The results were more promising for the intra-judge absolute reliability. Test-retest reliability of the complementary questions to the SSI-4 was also found acceptable. However, no strong relationship was found between the SSI-4 scores and its complementary questions. The Persian version of the SSI-4 can be used reliably by trained SLPs for research and clinical purposes, but not to document small changes in stuttering severity. We argue that the response of participants to the complementary self-report questions should also be considered in calculating their stuttering severity score. Copyright © 2018 Elsevier Inc. All rights reserved.

Structural connectivity of right frontal hyperactive areas scales with stuttering severity.

PubMed

Neef, Nicole E; Anwander, Alfred; Bütfering, Christoph; Schmidt-Samoa, Carsten; Friederici, Angela D; Paulus, Walter; Sommer, Martin

2018-01-01

A neuronal sign of persistent developmental stuttering is the magnified coactivation of right frontal brain regions during speech production. Whether and how stuttering severity relates to the connection strength of these hyperactive right frontal areas to other brain areas is an open question. Scrutinizing such brain-behaviour and structure-function relationships aims at disentangling suspected underlying neuronal mechanisms of stuttering. Here, we acquired diffusion-weighted and functional images from 31 adults who stutter and 34 matched control participants. Using a newly developed structural connectivity measure, we calculated voxel-wise correlations between connection strength and stuttering severity within tract volumes that originated from functionally hyperactive right frontal regions. Correlation analyses revealed that with increasing speech motor deficits the connection strength increased in the right frontal aslant tract, the right anterior thalamic radiation, and in U-shaped projections underneath the right precentral sulcus. In contrast, with decreasing speech motor deficits connection strength increased in the right uncinate fasciculus. Additional group comparisons of whole-brain white matter skeletons replicated the previously reported reduction of fractional anisotropy in the left and right superior longitudinal fasciculus as well as at the junction of right frontal aslant tract and right superior longitudinal fasciculus in adults who stutter compared to control participants. Overall, our investigation suggests that right fronto-temporal networks play a compensatory role as a fluency enhancing mechanism. In contrast, the increased connection strength within subcortical-cortical pathways may be implied in an overly active global response suppression mechanism in stuttering. Altogether, this combined functional MRI-diffusion tensor imaging study disentangles different networks involved in the neuronal underpinnings of the speech motor deficit in persistent developmental stuttering. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain.

White matter developmental trajectories associated with persistence and recovery of childhood stuttering.

PubMed

Chow, Ho Ming; Chang, Soo-Eun

2017-04-08

Stuttering affects the fundamental human ability of fluent speech production, and can have a significant negative impact on an individual's psychosocial development. While the disorder affects about 5% of all preschool children, approximately 80% of them recover naturally within a few years of stuttering onset. The pathophysiology and neuroanatomical development trajectories associated with persistence and recovery of stuttering are still largely unknown. Here, the first mixed longitudinal diffusion tensor imaging (DTI) study of childhood stuttering has been reported. A total of 195 high quality DTI scans from 35 children who stutter (CWS) and 43 controls between 3 and 12 years of age were acquired, with an average of three scans per child, each collected approximately a year apart. Fractional anisotropy (FA), a measure reflecting white matter structural coherence, was analyzed voxel-wise to examine group and age-related differences using a linear mixed-effects (LME) model. Results showed that CWS exhibited decreased FA relative to controls in the left arcuate fasciculus, underlying the inferior parietal and posterior temporal areas, and the mid body of corpus callosum. Further, white matter developmental trajectories reflecting growth rate of these tract regions differentiated children with persistent stuttering from those who recovered from stuttering. Specifically, a reduction in FA growth rate (i.e., slower FA growth with age) in persistent children relative to fluent controls in the left arcuate fasciculus and corpus callosum was found, which was not evident in recovered children. These findings provide first glimpses into the possible neural mechanisms of onset, persistence, and recovery of childhood stuttering. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Assessing Attentional Biases with Stuttering

ERIC Educational Resources Information Center

Lowe, Robyn; Menzies, Ross; Packman, Ann; O'Brian, Sue; Jones, Mark; Onslow, Mark

2016-01-01

Background: Many adults who stutter presenting for speech treatment experience social anxiety disorder. The presence of mental health disorders in adults who stutter has been implicated in a failure to maintain speech treatment benefits. Contemporary theories of social anxiety disorder propose that the condition is maintained by negative…

How the Brain Repairs Stuttering

ERIC Educational Resources Information Center

Kell, Christian A.; Neumann, Katrin; von Kriegstein, Katharina; Posenenske, Claudia; von Gudenberg, Alexander W.; Euler, Harald; Giraud, Anne-Lise

2009-01-01

Stuttering is a neurodevelopmental disorder associated with left inferior frontal structural anomalies. While children often recover, stuttering may also spontaneously disappear much later after years of dysfluency. These rare cases of unassisted recovery in adulthood provide a model of optimal brain repair outside the classical windows of…

Power2: Relapse Management with Adolescents Who Stutter.

ERIC Educational Resources Information Center

Blood, Gordon W.

1995-01-01

This article describes a cognitive-behavioral treatment package for relapse management in adolescents who stutter. The package includes game-based training techniques in problem solving, communication skills, and assertiveness; coping responses for stuttering episodes; and realistic expectations for fluency and relapse. Follow-up results with…

Stuttering, Induced Fluency, and Natural Fluency: A Hierarchical Series of Activation Likelihood Estimation Meta-Analyses

PubMed Central

Budde, Kristin S.; Barron, Daniel S.; Fox, Peter T.

2015-01-01

Developmental stuttering is a speech disorder most likely due to a heritable form of developmental dysmyelination impairing the function of the speech-motor system. Speech-induced brain-activation patterns in persons who stutter (PWS) are anomalous in various ways; the consistency of these aberrant patterns is a matter of ongoing debate. Here, we present a hierarchical series of coordinate-based meta-analyses addressing this issue. Two tiers of meta-analyses were performed on a 17-paper dataset (202 PWS; 167 fluent controls). Four large-scale (top-tier) meta-analyses were performed, two for each subject group (PWS and controls). These analyses robustly confirmed the regional effects previously postulated as “neural signatures of stuttering” (Brown 2005) and extended this designation to additional regions. Two smaller-scale (lower-tier) meta-analyses refined the interpretation of the large-scale analyses: 1) a between-group contrast targeting differences between PWS and controls (stuttering trait); and 2) a within-group contrast (PWS only) of stuttering with induced fluency (stuttering state). PMID:25463820

Electrophysiological evidence for a general auditory prediction deficit in adults who stutter

PubMed Central

Daliri, Ayoub; Max, Ludo

2015-01-01

We previously found that stuttering individuals do not show the typical auditory modulation observed during speech planning in nonstuttering individuals. In this follow-up study, we further elucidate this difference by investigating whether stuttering speakers’ atypical auditory modulation is observed only when sensory predictions are based on movement planning or also when predictable auditory input is not a consequence of one’s own actions. We recorded 10 stuttering and 10 nonstuttering adults’ auditory evoked potentials in response to random probe tones delivered while anticipating either speaking aloud or hearing one’s own speech played back and in a control condition without auditory input (besides probe tones). N1 amplitude of nonstuttering speakers was reduced prior to both speaking and hearing versus the control condition. Stuttering speakers, however, showed no N1 amplitude reduction in either the speaking or hearing condition as compared with control. Thus, findings suggest that stuttering speakers have general auditory prediction difficulties. PMID:26335995

Brain activity in adults who stutter: Similarities across speaking tasks and correlations with stuttering frequency and speaking rate

PubMed Central

Ingham, Roger J.; Grafton, Scott T.; Bothe, Anne K.; Ingham, Janis C.

2012-01-01

Many differences in brain activity have been reported between persons who stutter (PWS) and typically fluent controls during oral reading tasks. An earlier meta-analysis of imaging studies identified stutter-related regions, but recent studies report less agreement with those regions. A PET study on adult dextral PWS (n = 18) and matched fluent controls (CONT, n = 12) is reported that used both oral reading and monologue tasks. After correcting for speech rate differences between the groups the task-activation differences were surprisingly small. For both analyses only some regions previously considered stutter-related were more activated in the PWS group than in the CONT group, and these were also activated during eyes-closed rest (ECR). In the PWS group, stuttering frequency was correlated with cortico-striatal-thalamic circuit activity in both speaking tasks. The neuroimaging findings for the PWS group, relative to the CONT group, appear consistent with neuroanatomic abnormalities being increasingly reported among PWS. PMID:22564749

Evidence, Goals, and Outcomes in Stuttering Treatment: Applications With an Adolescent Who Stutters.

PubMed

Marcotte, Anne K

2018-01-09

The purpose of this clinical focus article is to summarize 1 possible process that a clinician might follow in designing and conducting a treatment program with John, a 14-year-old male individual who stutters. The available research evidence, practitioner experience, and consideration of individual preferences are combined to address goals, treatment procedures, and outcomes for John. The stuttering treatment research literature includes multiple well-designed reviews and individual studies that have shown the effectiveness of prolonged speech (and smooth speech and related variations) for improving stuttered speech and for improving social, emotional, cognitive, and related variables in adolescents who stutter. Based on that evidence, and incorporating the additional elements of practitioner experience and client preferences, this clinical focus article suggests that John would be likely to benefit from a treatment program based on prolonged speech. The basic structure of 1 possible such program is also described, with an emphasis on the goals and outcomes that John could be expected to achieve.

Impaired motor inhibition in adults who stutter - evidence from speech-free stop-signal reaction time tasks.

PubMed

Markett, Sebastian; Bleek, Benjamin; Reuter, Martin; Prüss, Holger; Richardt, Kirsten; Müller, Thilo; Yaruss, J Scott; Montag, Christian

2016-10-01

Idiopathic stuttering is a fluency disorder characterized by impairments during speech production. Deficits in the motor control circuits of the basal ganglia have been implicated in idiopathic stuttering but it is unclear how these impairments relate to the disorder. Previous work has indicated a possible deficiency in motor inhibition in children who stutter. To extend these findings to adults, we designed two experiments to probe executive motor control in people who stutter using manual reaction time tasks that do not rely on speech production. We used two versions of the stop-signal reaction time task, a measure for inhibitory motor control that has been shown to rely on the basal ganglia circuits. We show increased stop-signal reaction times in two independent samples of adults who stutter compared to age- and sex-matched control groups. Additional measures involved simple reaction time measurements and a task-switching task where no group difference was detected. Results indicate a deficiency in inhibitory motor control in people who stutter in a task that does not rely on overt speech production and cannot be explained by general deficits in executive control or speeded motor execution. This finding establishes the stop-signal reaction time as a possible target for future experimental and neuroimaging studies on fluency disorders and is a further step towards unraveling the contribution of motor control deficits to idiopathic stuttering. Copyright © 2016 Elsevier Ltd. All rights reserved.

A pilot study into a possible relationship between diet and stuttering.

PubMed

Hum, Jean; Rietveld, Toni; Wiedijk, Piet; van Lieshout, Pascal

2017-06-01

There are theoretical and empirical reasons to consider a potential role for copper metabolism in the brain in how it could influence stuttering. However, a link between stuttering and dietary intake has never been researched in a systematic way. This pilot study therefore aimed to explore a possible association between ingested amounts of copper and thiamine (vitamin B1) with stuttering frequency using a double blind cross-over longitudinal paradigm. 19 adults who stutter between 20 and 51 years old filled out an online survey for 9 consecutive weeks. The survey consisted of self-assessed fluency and mood state scales, as well as food journals. After 4 weeks, the participants consumed either copper or thiamine supplements for 2 weeks, followed by a 1-week washout period, and another period of two weeks taking the other supplement. Formal speech assessments were done pre/post baseline and at the end of each supplement intake. Participants were not informed about the nature of the supplements during the experiment and the investigators were blinded to the order of the supplements. The results demonstrated that copper and thiamine had no measurable effect on the amount of stuttering (self and formal assessments) but there was a moderate, significant correlation between mood state and fluency. The findings do not support notions of dietary influences of ingested copper or thiamine on stuttering but do provide modest support for a relationship between variations in stuttering and self-perceived anxiety. Copyright © 2017 Elsevier Inc. All rights reserved.

Counseling, Support, and Advocacy for Clients Who Stutter

ERIC Educational Resources Information Center

Altholz, Suzanne; Golensky, Martha

2004-01-01

Fluency disorders are communicative disabilities that can lead to psychosocial and emotional issues. The most prevalent of these disorders is stuttering. People who stutter may cope with stigmatization and discrimination throughout their lives as a result of misconceptions and misinformation about the disability's etiology and manifestations.…

Phonetic Ability in Stuttering

ERIC Educational Resources Information Center

Wingate, M. E.

1971-01-01

On two tests of phonetic manipulation 25 male stutterers were found to be inferior to matched controls. Results are reported to be consistent with previous findings of author and to interrelate with earlier research suggesting that some inadequacy in sound-making skills is an important aspect of stuttering. (Author/KW)

Stuttering Attitudes among Turkish Family Generations and Neighbors from Representative Samples

ERIC Educational Resources Information Center

Ozdemir, R. Sertan; St. Louis, Kenneth O.; Topbas, Seyhun

2011-01-01

Purpose: Attitudes toward stuttering, measured by the "Public Opinion Survey of Human Attributes-Stuttering" ("POSHA-S"), are compared among (a) two different representative samples; (b) family generations (children, parents, and either grandparents or uncles and aunts) and neighbors; (c) children, parents, grandparents/adult…

Individual Differences in Neural Regions Functionally Related to Real and Imagined Stuttering

ERIC Educational Resources Information Center

Wymbs, Nicholas F.; Ingham, Roger J.; Ingham, Janis C.; Paolini, Katherine E.; Grafton, Scott T.

2013-01-01

Recent brain imaging investigations of developmental stuttering show considerable disagreement regarding which regions are related to stuttering. These divergent findings have been mainly derived from group studies. To investigate functional neurophysiology with improved precision, an individual-participant approach (N = 4) using event-related…

Audiovocal Integration in Adults Who Stutter

ERIC Educational Resources Information Center

Loucks, Torrey; Chon, HeeCheong; Han, Woojae

2012-01-01

Background: Altered auditory feedback can facilitate speech fluency in adults who stutter. However, other findings suggest that adults who stutter show anomalies in "audiovocal integration", such as longer phonation reaction times to auditory stimuli and less effective pitch tracking. Aims: To study audiovocal integration in adults who stutter…

Public Attitudes toward Stuttering in Turkey: Probability versus Convenience Sampling

ERIC Educational Resources Information Center

Ozdemir, R. Sertan; St. Louis, Kenneth O.; Topbas, Seyhun

2011-01-01

Purpose: A Turkish translation of the "Public Opinion Survey of Human Attributes-Stuttering" ("POSHA-S") was used to compare probability versus convenience sampling to measure public attitudes toward stuttering. Method: A convenience sample of adults in Eskisehir, Turkey was compared with two replicates of a school-based,…

Establishing the Validity of Recovery from Stuttering without Formal Treatment.

ERIC Educational Resources Information Center

Finn, Patrick

1996-01-01

This study examined a validation procedure combining self-reports with independent verification to identify cases of recovery from stuttering without formal treatment. A Speech Behavior Checklist was administered to 42 individuals familiar with recovered subjects' past speech. Analysis of subjects' descriptions of their past stuttering was…

Semantic and Phonological Encoding in Adults Who Stutter: Silent Responses to Pictorial Stimuli

ERIC Educational Resources Information Center

Vincent, Irena

2017-01-01

Purpose: Research on language planning in adult stuttering is relatively sparse and offers diverging arguments about a potential causative relationship between semantic and phonological encoding and fluency breakdowns. This study further investigated semantic and phonological encoding efficiency in adults who stutter (AWS) by means of silent…

How Stuttering Develops: The Multifactorial Dynamic Pathways Theory

ERIC Educational Resources Information Center

Smith, Anne; Weber, Christine

2017-01-01

Purpose: We advanced a multifactorial, dynamic account of the complex, nonlinear interactions of motor, linguistic, and emotional factors contributing to the development of stuttering. Our purpose here is to update our account as the multifactorial dynamic pathways theory. Method: We review evidence related to how stuttering develops, including…

Modifying Attitudes of Arab School Teachers toward Stuttering

ERIC Educational Resources Information Center

Abdalla, Fauzia; St. Louis, Kenneth O.

2014-01-01

Purpose: The authors of this quasi-experimental design study explored the effect of an educational documentary video that presented factual and emotional aspects of stuttering on changing attitudes toward stuttering of preservice trainees and in-service public school teachers in Kuwait. Method: Participants were 99 preservice trainees (48 control,…

Preschoolers Who Do and Do Not Stutter

ERIC Educational Resources Information Center

Walsh, Bridget; Smith, Anne

2013-01-01

Purpose: In this study, the authors determined whether basic patterns of muscle activation for speech were similar in preschool children who stutter and in their fluent peers. Method: Right and left lower lip muscle activity were recorded during conversational speech and sentence repetition in 64 preschool children diagnosed as stuttering (CWS)…

Corpus Callosum Morphology in Children Who Stutter

ERIC Educational Resources Information Center

Choo, Ai Leen; Chang, Soo-Eun; Zengin-Bolatkale, Hatun; Ambrose, Nicoline G.; Loucks, Torrey M.

2012-01-01

Multiple studies have reported both functional and neuroanatomical differences between adults who stutter and their normally fluent peers. However, the reasons for these differences remain unclear although some developmental data suggest that structural brain differences may be present in school-age children who stutter. In the present study, the…

Public Awareness and Knowledge of Stuttering in Rio De Janeiro

ERIC Educational Resources Information Center

de Britto Pereira, Monica Medeiros; Rossi, Jamile Perni; Van Borsel, John

2008-01-01

This study reports the results of an investigation of public awareness and knowledge of stuttering in Rio de Janeiro, Brazil. A total number of 606 street recruited respondents answered questions on various aspects of stuttering, including prevalence, onset, gender distribution, occurrence in different cultures, cause, treatment, intelligence, and…

Characteristics of Fluency and Speech in Two Families with High Incidences of Stuttering

ERIC Educational Resources Information Center

Stager, Sheila V.; Freeman, Frances J.; Braun, Allen

2015-01-01

Purpose: This study presents data from 2 families with high incidence of stuttering, comparing methods of phenotype assignment and exploring the presence of other fluency disorders and corresponding speech characteristics. Method: Three methods for assigning phenotype of stuttering were used: self-identification, family identification, and expert…

Speech Effort Measurement and Stuttering: Investigating the Chorus Reading Effect

ERIC Educational Resources Information Center

Ingham, Roger J.; Warner, Allison; Byrd, Anne; Cotton, John

2006-01-01

Purpose: The purpose of this study was to investigate chorus reading's (CR's) effect on speech effort during oral reading by adult stuttering speakers and control participants. The effect of a speech effort measurement highlighting strategy was also investigated. Method: Twelve persistent stuttering (PS) adults and 12 normally fluent control…

I Miss My Mochaccino

ERIC Educational Resources Information Center

Margrain, Lisa

2011-01-01

Stuttering is a communication disorder which can include repetitions, prolongations, or having gaps in speech (blocks, with no sound). Stuttering is also known as stammering, although the correct term is actually dysphemia. In this article, the author shares her stuttering experience so that others will realize what it is like to live with a…

Afferent and Efferent Aspects of Mandibular Sensorimotor Control in Adults Who Stutter

ERIC Educational Resources Information Center

Daliri, Ayoub; Prokopenko, Roman A.; Max, Ludo

2013-01-01

Purpose: Individuals who stutter show sensorimotor deficiencies in speech and nonspeech movements. For the mandibular system, the authors dissociated the sense of kinesthesia from the efferent control component to examine whether kinesthetic integrity itself is compromised in stuttering or whether deficiencies occur only when generating motor…

The Efficacy of Stuttering Measurement Training: Evaluating Two Training Programs

ERIC Educational Resources Information Center

Bainbridge, Lauren A.; Stavros, Candace; Ebrahimian, Mineh; Wang, Yuedong; Ingham, Roger J.

2015-01-01

Purpose: Two stuttering measurement training programs currently used for training clinicians were evaluated for their efficacy in improving the accuracy of total stuttering event counting. Method: Four groups, each with 12 randomly allocated participants, completed a pretest-posttest design training study. They were evaluated by their counts of…

A Clinician Survey of Speech and Non-Speech Characteristics of Neurogenic Stuttering

ERIC Educational Resources Information Center

Theys, Catherine; van Wieringen, Astrid; De Nil, Luc F.

2008-01-01

This study presents survey data on 58 Dutch-speaking patients with neurogenic stuttering following various neurological injuries. Stroke was the most prevalent cause of stuttering in our patients, followed by traumatic brain injury, neurodegenerative diseases, and other causes. Speech and non-speech characteristics were analyzed separately for…

Fluoxetine for persistent developmental stuttering.

PubMed

Kumar, Amardeep; Balan, Sabish

2007-01-01

Stuttering is a disturbance in the normal fluency and time patterning of speech. Developmental stuttering (DS), with or without associated psychiatric illness, is the most common form and includes all cases with gradual onset in childhood that are not the result of acquired brain damage. Persistent developmental stuttering (PDS) is DS that has not undergone spontaneous or speech therapy-induced remission. Adults in speech therapy behavioral programs will often show regression and even total relapse if they stop practicing. This case report deals with a patient of PDS who responded significantly to treatment with fluoxetine.

Successful Management of Psychotropics Induced Stuttering Priapism with Pseudoephedrine in a Patient with Schizophrenia.

PubMed

Thippaiah, Srinagesh Mannekote; Nagaraja, Soumya; Birur, Badari; Pandurangi, Ananda

2018-02-05

Stuttering Priapism is a recurrent, persistent penile erection in the absence of sexual desire due to altered genital hemodynamics, affecting the arterial component (high flow, non-ischemic) or the veno-occlusive mechanism (low flow, ischemic). Both typical and atypical antipsychotics increase the risk for priapism with greater implications in typicals than atypicals. Prompt recognition and treatment are important as 40% to 50% of patients with stuttering priapism may develop an erectile dysfunction if left untreated. There are several case reports in the literature about the association between psychotropic agents and priapism. However, there are no reports of successfully treating stuttering priapism using pseudoephedrine (sudafed) in the adult population. Here we present successful management of psychotropics induced stuttering priapism with pseudoephedrine in a male patient with schizophrenia.

Speech Situation Checklist-Revised: Investigation With Adults Who Do Not Stutter and Treatment-Seeking Adults Who Stutter.

PubMed

Vanryckeghem, Martine; Matthews, Michael; Xu, Peixin

2017-11-08

The aim of this study was to evaluate the usefulness of the Speech Situation Checklist for adults who stutter (SSC) in differentiating people who stutter (PWS) from speakers with no stutter based on self-reports of anxiety and speech disruption in communicative settings. The SSC's psychometric properties were examined, norms were established, and suggestions for treatment were formulated. The SSC was administered to 88 PWS seeking treatment and 209 speakers with no stutter between the ages of 18 and 62. The SSC consists of 2 sections investigating negative emotional reaction and speech disruption in 38 speech situations that are identical in both sections. The SSC-Emotional Reaction and SSC-Speech Disruption data show that these self-report tests differentiate PWS from speakers with no stutter to a statistically significant extent and have great discriminative value. The tests have good internal reliability, content, and construct validity. Age and gender do not affect the scores of the PWS. The SSC-Emotional Reaction and SSC-Speech Disruption seem to be powerful measures to investigate negative emotion and speech breakdown in an array of speech situations. The item scores give direction to treatment by suggesting speech situations that need a clinician's attention in terms of generalization and carry-over of within-clinic therapeutic gains into in vivo settings.

Auditory evoked fields to vocalization during passive listening and active generation in adults who stutter.

PubMed

Beal, Deryk S; Cheyne, Douglas O; Gracco, Vincent L; Quraan, Maher A; Taylor, Margot J; De Nil, Luc F

2010-10-01

We used magnetoencephalography to investigate auditory evoked responses to speech vocalizations and non-speech tones in adults who do and do not stutter. Neuromagnetic field patterns were recorded as participants listened to a 1 kHz tone, playback of their own productions of the vowel /i/ and vowel-initial words, and actively generated the vowel /i/ and vowel-initial words. Activation of the auditory cortex at approximately 50 and 100 ms was observed during all tasks. A reduction in the peak amplitudes of the M50 and M100 components was observed during the active generation versus passive listening tasks dependent on the stimuli. Adults who stutter did not differ in the amount of speech-induced auditory suppression relative to fluent speakers. Adults who stutter had shorter M100 latencies for the actively generated speaking tasks in the right hemisphere relative to the left hemisphere but the fluent speakers showed similar latencies across hemispheres. During passive listening tasks, adults who stutter had longer M50 and M100 latencies than fluent speakers. The results suggest that there are timing, rather than amplitude, differences in auditory processing during speech in adults who stutter and are discussed in relation to hypotheses of auditory-motor integration breakdown in stuttering. Copyright 2010 Elsevier Inc. All rights reserved.

Enhancing treatment for school-age children who stutter II. Reducing bullying through role-playing and self-disclosure.

PubMed

Murphy, William P; Yaruss, J Scott; Quesal, Robert W

2007-01-01

This paper describes several treatment strategies that clinicians can use to help children who stutter who are experiencing bullying and other negative reactions from their peers. Specific strategies include problem-solving activities designed to help the child develop appropriate responses to bullying and a classroom presentation designed to educate peers about stuttering. To facilitate clinicians' application of these techniques, the strategies are presented in the context of a case study involving a 9-year-old boy who participated in a comprehensive treatment program for stuttering. Following treatment, the child exhibited an increased ability to respond to bullying experiences in a constructive fashion. In addition, negative comments by the child's peers diminished following the classroom presentation. Findings suggest that clinicians can help children overcome bullying and other negative reactions associated with stuttering through a number of well-supported treatment strategies that can be applied in a variety of clinical settings. After reading this article, participants will be able to: (1) define bullying and teasing and explain the difference between the two experiences; (2) describe two strategies for helping children who stutter successfully manage bullying experiences at school and in other settings; and (3) explain two strategies for educating children about stuttering and about bullying.

The Neurobiological Grounding of Persistent Stuttering: from Structure to Function.

PubMed

Neef, Nicole E; Anwander, Alfred; Friederici, Angela D

2015-09-01

Neuroimaging and transcranial magnetic stimulation provide insights into the neuronal mechanisms underlying speech disfluencies in chronic persistent stuttering. In the present paper, the goal is not to provide an exhaustive review of existing literature, but rather to highlight robust findings. We, therefore, conducted a meta-analysis of diffusion tensor imaging studies which have recently implicated disrupted white matter connectivity in stuttering. A reduction of fractional anisotropy in persistent stuttering has been reported at several different loci. Our meta-analysis revealed consistent deficits in the left dorsal stream and in the interhemispheric connections between the sensorimotor cortices. In addition, recent fMRI meta-analyses link stuttering to reduced left fronto-parieto-temporal activation while greater fluency is associated with boosted co-activations of right fronto-parieto-temporal areas. However, the physiological foundation of these irregularities is not accessible with MRI. Complementary, transcranial magnetic stimulation (TMS) reveals local excitatory and inhibitory regulation of cortical dynamics. Applied to a speech motor area, TMS revealed reduced speech-planning-related neuronal dynamics at the level of the primary motor cortex in stuttering. Together, this review provides a focused view of the neurobiology of stuttering to date and may guide the rational design of future research. This future needs to account for the perpetual dynamic interactions between auditory, somatosensory, and speech motor circuits that shape fluent speech.

Personal Perceptions and Perceived Public Opinion About Stuttering in the United States: Implications for Anti-Stigma Campaigns.

PubMed

Boyle, Michael P

2017-08-15

This exploratory study was the first to obtain quantitative and qualitative data on both personal perceptions and perceived public opinion about stuttering in order to identify topics to include in anti-stigma programs for stuttering. Three-hundred ten adults in the United States completed a web survey that assessed knowledge about stuttering and attitudes toward people who stutter (PWS) with questions addressing personal perceptions (direct questions) and perceived public opinion (indirect questions). Many participants reported favorable personal perceptions of PWS regarding their intelligence, competence, and potential for success. However, most participants did not personally believe PWS were confident, and most believed they were shy. Perceived public opinion was more unfavorable as a majority agreed that the public is uncomfortable talking with PWS and that the public would recommend PWS avoid jobs requiring high speech demands and avoid talking to large audiences. A minority of participants agreed PWS are perceived publicly as capable or mentally healthy. The survey demonstrated misunderstandings and negative perceptions of PWS, especially when measured with perceived public opinion. Results can increase our understanding of content areas that should be included in anti-stigma programs for stuttering and highlight different methods for analyzing public perceptions of stuttering.

Speaker and Observer Perceptions of Physical Tension during Stuttering.

PubMed

Tichenor, Seth; Leslie, Paula; Shaiman, Susan; Yaruss, J Scott

2017-01-01

Speech-language pathologists routinely assess physical tension during evaluation of those who stutter. If speakers experience tension that is not visible to clinicians, then judgments of severity may be inaccurate. This study addressed this potential discrepancy by comparing judgments of tension by people who stutter and expert clinicians to determine if clinicians could accurately identify the speakers' experience of physical tension. Ten adults who stutter were audio-video recorded in two speaking samples. Two board-certified specialists in fluency evaluated the samples using the Stuttering Severity Instrument-4 and a checklist adapted for this study. Speakers rated their tension using the same forms, and then discussed their experiences in a qualitative interview so that themes related to physical tension could be identified. The degree of tension reported by speakers was higher than that observed by specialists. Tension in parts of the body that were less visible to the observer (chest, abdomen, throat) was reported more by speakers than by specialists. The thematic analysis revealed that speakers' experience of tension changes over time and that these changes may be related to speakers' acceptance of stuttering. The lack of agreement between speaker and specialist perceptions of tension suggests that using self-reports is a necessary component for supporting the accurate diagnosis of tension in stuttering. © 2018 S. Karger AG, Basel.

Self-Perceived Competence and Social Acceptance of Young Children Who Stutter: Initial Findings

PubMed Central

Hertsberg, Naomi; Zebrowski, Patricia M.

2016-01-01

Purpose The goals of this study were to determine whether young children who stutter (CWS) perceive their own competence and social acceptance differently than young children who do not stutter (CWNS), and to identify the predictors of perceived competence and social acceptance in young speakers. Method We administered the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PSPCSA; Harter & Pike, 1984) to 13 CWS and 14 CWNS and examined group differences. We also collected information on the children's genders, temperaments, stuttering frequencies, language abilities, and phonological skills to identify which of these factors predicted PSPCSA scores. Results CWS, as a group, did not differ from CWNS in their perceived general competence or social acceptance. Gender predicted scores of perceived general competence, and stuttering frequency predicted perceived social acceptance. Temperament, language abilities, and phonological skills were not significant predictors of perceived competence or social acceptance in our sample. Conclusions While CWS did not significantly differ from CWNS in terms of perceived competence and social acceptance, when both talker groups were considered together, girls self-reported greater perceived competence than boys. Further, lower stuttering frequency was associated with greater perceived social acceptance. These preliminary findings provide motivation for further empirical study of the psychosocial components of childhood stuttering. PMID:27614314

Proton Chemical Shift Imaging of the Brain in Pediatric and Adult Developmental Stuttering.

PubMed

O'Neill, Joseph; Dong, Zhengchao; Bansal, Ravi; Ivanov, Iliyan; Hao, Xuejun; Desai, Jay; Pozzi, Elena; Peterson, Bradley S

2017-01-01

Developmental stuttering is a neuropsychiatric condition of incompletely understood brain origin. Our recent functional magnetic resonance imaging study indicates a possible partial basis of stuttering in circuits enacting self-regulation of motor activity, attention, and emotion. To further characterize the neurophysiology of stuttering through in vivo assay of neurometabolites in suspect brain regions. Proton chemical shift imaging of the brain was performed in a case-control study of children and adults with and without stuttering. Recruitment, assessment, and magnetic resonance imaging were performed in an academic research setting. Ratios of N-acetyl-aspartate plus N-acetyl-aspartyl-glutamate (NAA) to creatine (Cr) and choline compounds (Cho) to Cr in widespread cerebral cortical, white matter, and subcortical regions were analyzed using region of interest and data-driven voxel-based approaches. Forty-seven children and adolescents aged 5 to 17 years (22 with stuttering and 25 without) and 47 adults aged 21 to 51 years (20 with stuttering and 27 without) were recruited between June 2008 and March 2013. The mean (SD) ages of those in the stuttering and control groups were 12.2 (4.2) years and 13.4 (3.2) years, respectively, for the pediatric cohort and 31.4 (7.5) years and 30.5 (9.9) years, respectively, for the adult cohort. Region of interest-based findings included lower group mean NAA:Cr ratio in stuttering than nonstuttering participants in the right inferior frontal cortex (-7.3%; P = .02), inferior frontal white matter (-11.4%; P < .001), and caudate (-10.6%; P = .04), while the Cho:Cr ratio was higher in the bilateral superior temporal cortex (left: +10.0%; P = .03 and right: +10.8%; P = .01), superior temporal white matter (left: +14.6%; P = .003 and right: +9.5%; P = .02), and thalamus (left: +11.6%; P = .002 and right: +11.1%; P = .001). False discovery rate-corrected voxel-based findings were highly consistent with region of interest findings. Additional voxel-based findings in the stuttering sample included higher NAA:Cr and Cho:Cr ratios (regression coefficient, 197.4-275; P < .001) in the posterior cingulate, lateral parietal, hippocampal, and parahippocampal cortices and amygdala, as well as lower NAA:Cr and Cho:Cr ratios (regression coefficient, 119.8-275; P < .001) in the superior frontal and frontal polar cortices. Affected regions comprised nodes of the Bohland speech-production (motor activity regulation), default-mode (attention regulation), and emotional-memory (emotion regulation) networks. Regional correlations were also observed between local metabolites and stuttering severity (r = 0.40-0.52; P = .001-.02). This spectroscopy study of stuttering demonstrates brainwide neurometabolite alterations, including several regions implicated by other neuroimaging modalities. Prior ascription of a role in stuttering to inferior frontal and superior temporal gyri, caudate, and other structures is affirmed. Consistent with prior functional magnetic resonance imaging findings, these results further intimate neurometabolic aberrations in stuttering in brain circuits subserving self-regulation of speech production, attention, and emotion.

Temporal variability in sung productions of adolescents who stutter.

PubMed

Falk, Simone; Maslow, Elena; Thum, Georg; Hoole, Philip

2016-01-01

Singing has long been used as a technique to enhance and reeducate temporal aspects of articulation in speech disorders. In the present study, differences in temporal structure of sung versus spoken speech were investigated in stuttering. In particular, the question was examined if singing helps to reduce VOT variability of voiceless plosives, which would indicate enhanced temporal coordination of oral and laryngeal processes. Eight German adolescents who stutter and eight typically fluent peers repeatedly spoke and sang a simple German congratulation formula in which a disyllabic target word (e.g., /'ki:ta/) was repeated five times. Every trial, the first syllable of the word was varied starting equally often with one of the three voiceless German stops /p/, /t/, /k/. Acoustic analyses showed that mean VOT and stop gap duration reduced during singing compared to speaking while mean vowel and utterance duration was prolonged in singing in both groups. Importantly, adolescents who stutter significantly reduced VOT variability (measured as the Coefficient of Variation) during sung productions compared to speaking in word-initial stressed positions while the control group showed a slight increase in VOT variability. However, in unstressed syllables, VOT variability increased in both adolescents who do and do not stutter from speech to song. In addition, vowel and utterance durational variability decreased in both groups, yet, adolescents who stutter were still more variable in utterance duration independent of the form of vocalization. These findings shed new light on how singing alters temporal structure and in particular, the coordination of laryngeal-oral timing in stuttering. Future perspectives for investigating how rhythmic aspects could aid the management of fluent speech in stuttering are discussed. Readers will be able to describe (1) current perspectives on singing and its effects on articulation and fluency in stuttering and (2) acoustic parameters such as VOT variability which indicate the efficiency of control and coordination of laryngeal-oral movements. They will understand and be able to discuss (3) how singing reduces temporal variability in the productions of adolescents who do and do not stutter and 4) how this is linked to altered articulatory patterns in singing as well as to its rhythmic structure. Copyright © 2016 Elsevier Inc. All rights reserved.

Immediate effects of AAF devices on the characteristics of stuttering: a clinical analysis.

PubMed

Unger, Julia P; Glück, Christian W; Cholewa, Jürgen

2012-06-01

The present study investigated the immediate effects of altered auditory feedback (AAF) and one Inactive Condition (AAF parameters set to 0) on clinical attributes of stuttering during scripted and spontaneous speech. Two commercially available, portable AAF devices were used to create the combined delayed auditory feedback (DAF) and frequency altered feedback (FAF) effects. Thirty adults, who stutter, aged 18-68 years (M=36.5; SD=15.2), participated in this investigation. Each subject produced four sets of 5-min of oral reading, three sets of 5-min monologs as well as 10-min dialogs. These speech samples were analyzed to detect changes in descriptive features of stuttering (frequency, duration, speech/articulatory rate, core behaviors) across the various speech samples and within two SSI-4 (Riley, 2009) based severity ratings. A statistically significant difference was found in the frequency of stuttered syllables (%SS) during both Active Device conditions (p=.000) for all speech samples. The most sizable reductions in %SS occurred within scripted speech. In the analysis of stuttering type, it was found that blocks were reduced significantly (Device A: p=.017; Device B: p=.049). To evaluate the impact on severe and mild stuttering, participants were grouped into two SSI-4 based categories; mild and moderate-severe. During the Inactive Condition those participants within the moderate-severe group (p=.024) showed a statistically significant reduction in overall disfluencies. This result indicates, that active AAF parameters alone may not be the sole cause of a fluency-enhancement when using a technical speech aid. The reader will learn and be able to describe: (1) currently available scientific evidence on the use of altered auditory feedback (AAF) during scripted and spontaneous speech, (2) which characteristics of stuttering are impacted by an AAF device (frequency, duration, core behaviors, speech & articulatory rate, stuttering severity), (3) the effects of an Inactive Condition on people who stutter (PWS) falling into two severity groups, and (4) how the examined participants perceived the use of AAF devices. Copyright © 2012 Elsevier Inc. All rights reserved.

Self-stigma and its associations with stress, physical health, and health care satisfaction in adults who stutter.

PubMed

Boyle, Michael P; Fearon, Alison N

2018-06-01

The aim of this study was to identify potential relationships between self-stigma (stigma awareness and stigma application) and stress, physical health, and health care satisfaction among a large sample of adults who stutter. It was hypothesized that both stigma awareness and stigma application would be inversely related to measures of physical health and health care satisfaction, and positively related to stress. Furthermore, it was anticipated that stress mediated the relationship between self-stigma and physical health. A sample of adults who stutter in the United States (n=397) completed a web survey that assessed levels of stigma awareness and stigma application, stress, physical health, and health care satisfaction. Correlational analyses were conducted to determine the relationships between these variables. Higher levels of stigma awareness and stigma application were associated with increased stress, decreased overall physical health, and decreased health care satisfaction (i.e., discomfort obtaining health care due to stuttering, and adverse health care outcomes due to stuttering), and these relationships were statistically significant. Stress was identified as a mediator between stigma application and physical health. Because adults who stutter with higher levels of self-stigma are at risk for decreased physical health through increased stress, and lower satisfaction with their health care experiences as a result of stuttering, it is important for professionals to assess and manage self-stigma in clients who stutter. Self-stigma has implications for not only psychological well-being, but stress, physical health, and health care satisfaction as well. Copyright © 2017 Elsevier Inc. All rights reserved.

Increased motor preparation activity during fluent single word production in DS: A correlate for stuttering frequency and severity.

PubMed

Vanhoutte, Sarah; Santens, Patrick; Cosyns, Marjan; van Mierlo, Pieter; Batens, Katja; Corthals, Paul; De Letter, Miet; Van Borsel, John

2015-08-01

Abnormal speech motor preparation is suggested to be a neural characteristic of stuttering. One of the neurophysiological substrates of motor preparation is the contingent negative variation (CNV). The CNV is an event-related, slow negative potential that occurs between two defined stimuli. Unfortunately, CNV tasks are rarely studied in developmental stuttering (DS). Therefore, the present study aimed to evaluate motor preparation in DS by use of a CNV task. Twenty five adults who stutter (AWS) and 35 fluent speakers (FS) were included. They performed a picture naming task while an electro-encephalogram was recorded. The slope of the CNV was evaluated at frontal, central and parietal electrode sites. In addition, a correlation analysis was performed with stuttering severity and frequency measures. There was a marked increase in CNV slope in AWS as compared to FS. This increase was observed over the entire scalp with respect to stimulus onset, and only over the right hemisphere with respect to lip movement onset. Moreover, strong positive correlations were found between CNV slope and stuttering frequency and severity. As the CNV is known to reflect the activity in the basal ganglia-thalamo-cortical-network, the present findings confirm an increased activation of this loop during speech motor preparation in stuttering. The more a person stutters, the more neurons of this cortical-subcortical network seem to be activated. Because this increased CNV slope was observed during fluent single word production, it is discussed whether or not this observation refers to a successful compensation strategy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Association between Rare Variants in AP4E1, a Component of Intracellular Trafficking, and Persistent Stuttering

PubMed Central

Raza, M. Hashim; Mattera, Rafael; Morell, Robert; Sainz, Eduardo; Rahn, Rachel; Gutierrez, Joanne; Paris, Emily; Root, Jessica; Solomon, Beth; Brewer, Carmen; Basra, M. Asim Raza; Khan, Shaheen; Riazuddin, Sheikh; Braun, Allen; Bonifacino, Juan S.; Drayna, Dennis

2015-01-01

Stuttering is a common, highly heritable neurodevelopmental disorder characterized by deficits in the volitional control of speech. Whole-exome sequencing identified two heterozygous AP4E1 coding variants, c.1549G>A (p.Val517Ile) and c.2401G>A (p.Glu801Lys), that co-segregate with persistent developmental stuttering in a large Cameroonian family, and we observed the same two variants in unrelated Cameroonians with persistent stuttering. We found 23 other rare variants, including predicted loss-of-function variants, in AP4E1 in unrelated stuttering individuals in Cameroon, Pakistan, and North America. The rate of rare variants in AP4E1 was significantly higher in unrelated Pakistani and Cameroonian stuttering individuals than in population-matched control individuals, and coding variants in this gene are exceptionally rare in the general sub-Saharan West African, South Asian, and North American populations. Clinical examination of the Cameroonian family members failed to identify any symptoms previously reported in rare individuals carrying homozygous loss-of-function mutations in this gene. AP4E1 encodes the ε subunit of the heterotetrameric (ε-β4-μ4-σ4) AP-4 complex, involved in protein sorting at the trans-Golgi network. We found that the μ4 subunit of AP-4 interacts with NAGPA, an enzyme involved in the synthesis of the mannose 6-phosphate signal that targets acid hydrolases to the lysosome and the product of a gene previously associated with stuttering. These findings implicate deficits in intracellular trafficking in persistent stuttering. PMID:26544806

The Japanese version of the overall assessment of the speaker's experience of stuttering for adults (OASES-A-J): Translation and psychometric evaluation.

PubMed

Sakai, Naomi; Chu, Shin Ying; Mori, Koichi; Yaruss, J Scott

2017-03-01

This study evaluates the psychometric performance of the Japanese version of the Overall Assessment of the Speaker's Experience of Stuttering for Adults (OASES-A), a comprehensive assessment tool of individuals who stutter. The OASES-A-J was administered to 200 adults who stutter in Japan. All respondents also evaluated their own speech (SA scale), satisfaction of their own speech (SS scale) and the Japanese translation version of the Modified Erickson Communication Attitude scale (S-24). The test-retest reliability and internal consistency of the OASES-A-J were assessed. To examine the concurrent validity of the questionnaire, Pearson correlation was conducted between the OASES-A-J Impact score and the S-24 scale, SA scale and SS scale. In addition, Pearson correlation among the impact scores of each section and total were calculated to examine the construct validity. The OASES-A-J showed a good test-retest reliability (r=0.81-0.95) and high internal consistency (α>0.80). Concurrent validity was moderate to high (0.55-0.75). Construct validity was confirmed by the relation between internal consistency in each section and correlation among sections' impact scores. Japanese adults showed higher negative impact for 'General Information', 'Reactions to Stuttering' and 'Quality of Life' sections. These results suggest that the OASES-A-J is a reliable and valid instrument to measure the impact of stuttering on Japanese adults who stutter. The OASES-A-J could be used as a clinical tool in Japanese stuttering field. Copyright © 2016 Elsevier Inc. All rights reserved.

Veridical and False Recall in Adults Who Stutter

ERIC Educational Resources Information Center

Byrd, Courtney T.; Sheng, Li; Ratner, Nan Bernstein; Gkalitsiou, Zoi

2015-01-01

Purpose: This study used a false memory paradigm to explore the veridical and false recall of adults who stutter. Method: Twelve adults who stutter and 12 age-matched typically fluent peers listened to and then verbally recalled lists of words that consisted of either semantic or phonological associates or an equal number of semantic and…

Respiratory Control in Stuttering Speakers: Evidence from Respiratory High-Frequency Oscillations.

ERIC Educational Resources Information Center

Denny, Margaret; Smith, Anne

2000-01-01

This study examined whether stuttering speakers (N=10) differed from fluent speakers in relations between the neural control systems for speech and life support. It concluded that in some stuttering speakers the relations between respiratory controllers are atypical, but that high participation by the high frequency oscillation-producing circuitry…

Korean Speech-Language Pathologists' Attitudes toward Stuttering According to Clinical Experiences

ERIC Educational Resources Information Center

Lee, Kyungjae

2014-01-01

Background: Negative attitudes toward stuttering and people who stutter (PWS) are found in various groups of people in many regions. However the results of previous studies examining the influence of fluency coursework and clinical certification on the attitudes of speech-language pathologists (SLPs) toward PWS are equivocal. Furthermore, there…

Evaluation of the Self-Stigma of Stuttering Scale (4S)

ERIC Educational Resources Information Center

Boyle, Michael P.

2013-01-01

Purpose: To create a psychometrically sound scale that measures different levels of internalized stigma (i.e., self-stigma) among adults who stutter and to analyze factor structure, reliability, and initial construct validity of the scale. Method: Two-hundred ninety-one adults who stutter were recruited from Board Recognized Specialists in Fluency…

Gaze Aversion to Stuttered Speech: A Pilot Study Investigating Differential Visual Attention to Stuttered and Fluent Speech

ERIC Educational Resources Information Center

Bowers, Andrew L.; Crawcour, Stephen C.; Saltuklaroglu, Tim; Kalinowski, Joseph

2010-01-01

Background: People who stutter are often acutely aware that their speech disruptions, halted communication, and aberrant struggle behaviours evoke reactions in communication partners. Considering that eye gaze behaviours have emotional, cognitive, and pragmatic overtones for communicative interactions and that previous studies have indicated…

Semantic and Phonological Encoding Times in Adults Who Stutter: Brain Electrophysiological Evidence

ERIC Educational Resources Information Center

Maxfield, Nathan D.

2017-01-01

Purpose: Some psycholinguistic theories of stuttering propose that language production operates along a different time course in adults who stutter (AWS) versus typically fluent adults (TFA). However, behavioral evidence for such a difference has been mixed. Here, the time course of semantic and phonological encoding in picture naming was compared…

Developing Physiologic Stress Profiles for School-Age Children Who Stutter

ERIC Educational Resources Information Center

Ortega, Aishah Y.; Ambrose, Nicoline G.

2011-01-01

Purpose: Physiologic reactivity profiles were generated for 9 school-age children with a history of stuttering. Utilizing salivary sampling, stress biomarkers cortisol and alpha-amylase were measured in response to normal daily stressors. Children with a history of stuttering were characterized as high or low autonomic reactors when compared to…

Cognitive Processing Load as a Determinant of Stuttering: Summary of a Research Programme

ERIC Educational Resources Information Center

Bosshardt, Hans-Georg

2006-01-01

The present paper integrates the results of experimental studies in which cognitive differences between stuttering and nonstuttering adults were investigated. In a monitoring experiment it was found that persons who stutter encode semantic information more slowly than nonstuttering persons. In dual-task experiments the two groups were compared in…

Two- to Six-Year Controlled-Trial Stuttering Outcomes for Children and Adolescents.

ERIC Educational Resources Information Center

Hancock, Karen; Craig, Ashley; McCready, Chris; McCaul, Annette; Costello, Deborah; Gilmore, Gillian; Campbell, Karen

1998-01-01

A study investigated the effectiveness of three stuttering treatments (intensive smooth speech, parent-home smooth speech, and intensive electromyography feedback) for 62 students (ages 11 to 18) who stutter after two to six years after treatment. Results indicate treatment gains were maintained and that there were no significant differences among…

Investigating Personality in Stuttering: Results of a Case Control Study Using the NEO-FFI

ERIC Educational Resources Information Center

Bleek, Benjamin; Montag, Christian; Faber, Jennifer; Reuter, Martin

2011-01-01

A recent study by Iverach et al. ("Journal of Communication Disorders," 2010) compared persons who stutter with two normative samples in the context of the five-factor model of personality measured by the NEO Five-Factor Inventory (NEO-FFI). Persons who stutter were characterized by higher "Neuroticism," lower…

Morphophonological Practice: An Ethnographic Study of Grammar and Discourse in Four American English Stuttering Speech Communities

ERIC Educational Resources Information Center

Dumas, Nathaniel William

2010-01-01

Using the Practice Theory Approach to Language, this dissertation examines how social actors use communicative practices within activities to constitute a communicative context that I call the American English Stuttering Speech Community (AESSC). Building on previous linguistic research on stuttering and sociological research on collectives of…

Evidence-Based Treatment and Stuttering--Historical Perspective

ERIC Educational Resources Information Center

Prins, David; Ingham, Roger J.

2009-01-01

Purpose: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based. Method: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking…

Emotional Reactivity, Regulation and Childhood Stuttering: A Behavioral and Electrophysiological Study

ERIC Educational Resources Information Center

Arnold, Hayley S.; Conture, Edward G.; Key, Alexandra P. F.; Walden, Tedra

2011-01-01

The purpose of this preliminary study was to assess whether behavioral and psychophysiological correlates of emotional reactivity and regulation are associated with developmental stuttering, as well as determine the feasibility of these methods in preschool-age children. Nine preschool-age children who stutter (CWS) and nine preschool-age children…

Clinician Percent Syllables Stuttered, Clinician Severity Ratings and Speaker Severity Ratings: Are They Interchangeable?

ERIC Educational Resources Information Center

Karimi, Hamid; Jones, Mark; O'Brian, Sue; Onslow, Mark

2014-01-01

Background: At present, percent syllables stuttered (%SS) is the gold standard outcome measure for behavioural stuttering treatment research. However, ordinal severity rating (SR) procedures have some inherent advantages over that method. Aims: To establish the relationship between Clinician %SS, Clinician SR and self-reported Speaker SR. To…

Enhancing Treatment for School-Age Children Who Stutter I. Reducing Negative Reactions through Desensitization and Cognitive Restructuring

ERIC Educational Resources Information Center

Murphy, William P.; Yaruss, J. Scott; Quesal, Robert W.

2007-01-01

This paper describes several treatment strategies that clinicians can use to address negative affective, behavioral, and cognitive reactions that school-age children who stutter may experience as part of their disorder. Specific strategies include desensitization to stuttering, cognitive restructuring, self-acceptance, purposeful self-disclosure,…

Dual Diathesis-Stressor Model of Emotional and Linguistic Contributions to Developmental Stuttering

ERIC Educational Resources Information Center

Walden, Tedra A.; Frankel, Carl B.; Buhr, Anthony P.; Johnson, Kia N.; Conture, Edward G.; Karrass, Jan M.

2012-01-01

This study assessed emotional and speech-language contributions to childhood stuttering. A dual diathesis-stressor framework guided this study, in which both linguistic requirements and skills, and emotion and its regulation, are hypothesized to contribute to stuttering. The language diathesis consists of expressive and receptive language skills.…

Stuttering Behavior and Physiological Stress Profiles: A Preliminary Investigation of School-Aged Children

ERIC Educational Resources Information Center

Ortega, Aishah Y.

2009-01-01

The impact of observable increases in stress during moments of stuttering has long been an interesting area of research. Although stuttering type, severity, and associated behaviors may vary widely among individuals, it is not uncommon to find stress management, relaxation, and desensitization incorporated into the therapeutic remediation of…

A Stuttering Education and Bullying Awareness and Prevention Resource: A Feasibility Study

ERIC Educational Resources Information Center

Langevin, Marilyn; Prasad, N. G. Narasimha

2012-01-01

Purpose: This pretest-posttest study examined the feasibility of using a curriculum-level stuttering education and bullying awareness and prevention program to improve peer attitudes toward children who stutter and attitudes toward bullying. Knowledge about potential responses to bullying and students' liking of the program also were examined.…

The Role of Hemispheral Asymmetry and Regional Activity of Quantitative EEG in Children with Stuttering

ERIC Educational Resources Information Center

Ozge, Aynur; Toros, Fevziye; Comelekoglu, Ulku

2004-01-01

We investigated the role of delayed cerebral maturation, hemisphere asymmetry and regional differences in children with stuttering and healthy controls during resting state and hyperventilation, using conventional EEG techniques and quantitative EEG (QEEG) analysis. This cross-sectional case control study included 26 children with stuttering and…

Emotional and Physiological Responses of Fluent Listeners while Watching the Speech of Adults Who Stutter

ERIC Educational Resources Information Center

Guntupalli, Vijaya K.; Everhart, D. Erik; Kalinowski, Joseph; Nanjundeswaran, Chayadevie; Saltuklaroglu, Tim

2007-01-01

Background: People who stutter produce speech that is characterized by intermittent, involuntary part-word repetitions and prolongations. In addition to these signature acoustic manifestations, those who stutter often display repetitive and fixated behaviours outside the speech producing mechanism (e.g. in the head, arm, fingers, nares, etc.).…

Stuttering Frequency in Relation to Lexical Diversity, Syntactic Complexity, and Utterance Length

ERIC Educational Resources Information Center

Wagovich, Stacy A.; Hall, Nancy E.

2018-01-01

Children's frequency of stuttering can be affected by utterance length, syntactic complexity, and lexical content of language. Using a unique small-scale within-subjects design, this study explored whether language samples that contain more stuttering have (a) longer, (b) syntactically more complex, and (c) lexically more diverse utterances than…

Using Network Science Measures to Predict the Lexical Decision Performance of Adults Who Stutter

ERIC Educational Resources Information Center

Castro, Nichol; Pelczarski, Kristin M.; Vitevitch, Michael S.

2017-01-01

Purpose: Methods from network science have examined various aspects of language processing. Clinical populations may also benefit from these novel analyses. Phonological and lexical factors have been examined in adults who stutter (AWS) as potential contributing factors to stuttering, although differences reported are often subtle. We reexamined…

What Stuttering Reveals about the Development of the Gesture-Speech Relationship.

ERIC Educational Resources Information Center

Mayberry, Rachel I.; Jaques, Joselynne; DeDe, Gayle

1998-01-01

Investigated effects of stuttering on gesture for adults and children. Found through transcription of videotaped narratives that during bouts of stuttering, the coexpressed gesture always waits for fluent speech to resume. Also found that the lower ratio of spoken words to coexpressed gestures for children may be due to lower attentional/cognitive…

Anxiety Levels in Adolescents Who Stutter

ERIC Educational Resources Information Center

Blood, Gordon W.; Blood, Ingrid M.; Maloney, Kristy; Meyer, Crystal; Qualls, Constance Dean

2007-01-01

High levels of anxiety can negatively affect the lives of children and adolescents. Thirty-six adolescents who stutter and 36 adolescents who do not stutter were administered standardized scales for anxiety and self-esteem. Significant differences were found for the total T-scores for "Revised Children's Manifest Anxiety Scale" for the two groups,…

The Need for Self-Report Data in the Assessment of Stuttering Therapy Efficacy: Repetitions and Prolongations of Speech. The Stuttering Syndrome

ERIC Educational Resources Information Center

Guntupalli, Vijaya K.; Kalinowski, Joseph; Saltuklaroglu, Tim

2006-01-01

Background: Bloodstein reviewed hundreds of studies that investigated the efficacy of therapeutic protocols for ameliorating the stuttering syndrome. Surprisingly, almost all were effective in significantly reducing overtly perceptible behaviours such as repetitions and prolongations of speech sounds. These results seem highly improbable…

Developmental Stuttering in Children Who Are Hard of Hearing

ERIC Educational Resources Information Center

Arena, Richard M.; Walker, Elizabeth A.; Oleson, Jacob J.

2017-01-01

Purpose: A number of studies with large sample sizes have reported lower prevalence of stuttering in children with significant hearing loss compared to children without hearing loss. This study used a parent questionnaire to investigate the characteristics of stuttering (e.g., incidence, prevalence, and age of onset) in children who are hard of…

Characteristics of Disfluency Clusters over Time in Preschool Children Who Stutter

ERIC Educational Resources Information Center

Sawyer, Jean; Yairi, Ehud

2010-01-01

Purpose: Disfluency clusters in preschool children were analyzed to determine whether they occurred at rates above chance, whether they changed over time, and whether they could differentiate children who would later persist in, or recover from, stuttering. Method: Thirty-two children recruited near stuttering onset were grouped on the basis of…

Speech Sequence Skill Learning in Adults Who Stutter

ERIC Educational Resources Information Center

Bauerly, Kim R.; De Nil, Luc F.

2011-01-01

The present study compared the ability of 12 people who stutter (PWS) and 12 people who do not stutter (PNS) to consolidate a novel sequential speech task. Participants practiced 100 repetitions of a single, monosyllabic, nonsense word sequence during an initial practice session and returned 24-h later to perform an additional 50 repetitions.…

Stuttering Treatment Research 1970-2005: I. Systematic Review Incorporating Trial Quality Assessment of Behavioral, Cognitive, and Related Approaches

ERIC Educational Resources Information Center

Bothe, Anne K.; Davidow, Jason H.; Bramlett, Robin E.; Ingham, Roger J.

2006-01-01

Purpose: To complete a systematic review, with trial quality assessment, of published research about behavioral, cognitive, and related treatments for developmental stuttering. Goals included the identification of treatment recommendations and research needs based on the available high-quality evidence about stuttering treatment for preschoolers,…

Arab School Teachers' Knowledge, Beliefs and Reactions regarding Stuttering

ERIC Educational Resources Information Center

Abdalla, Fauzia A.; St. Louis, Kenneth O.

2012-01-01

Purpose: Stereotypes toward stuttering and people who stutter (PWS) are widespread in the general public irrespective of age, level of education, culture, geographic location and profession. Negative attitudes held by persons of authority like teachers can lead to social, economic and educational obstacles in the lives of PWS. Method: The current…

The Influence of Anticipation of Word Misrecognition on the Likelihood of Stuttering

ERIC Educational Resources Information Center

Brocklehurst, Paul H.; Lickley, Robin J.; Corley, Martin

2012-01-01

This study investigates whether the experience of stuttering can result from the speaker's anticipation of his words being misrecognized. Twelve adults who stutter (AWS) repeated single words into what appeared to be an automatic speech-recognition system. Following each iteration of each word, participants provided a self-rating of whether they…

Characteristics of Young Children Close to the Onset of Stuttering

ERIC Educational Resources Information Center

Cavenagh, Penny; Costelloe, Sarah; Davis, Steve; Howell, Peter

2015-01-01

Five factors (gender, handedness, some aspects of general health, family history, and intelligence) that could assist speech-language pathologists in identification of children who stutter (CWS) in 42 CWS and 34 fluent control children (children who do not stutter [CWNS]) were investigated. The data reported here were obtained from assessments…

Absolute and Relative Reliability of Percentage of Syllables Stuttered and Severity Rating Scales

ERIC Educational Resources Information Center

Karimi, Hamid; O'Brian, Sue; Onslow, Mark; Jones, Mark

2014-01-01

Purpose: Percentage of syllables stuttered (%SS) and severity rating (SR) scales are measures in common use to quantify stuttering severity and its changes during basic and clinical research conditions. However, their reliability has not been assessed with indices measuring both relative and absolute reliability. This study was designed to provide…

Stuttering, Temperament, and Anxiety: Data from a Community Cohort Ages 2-4 Years

ERIC Educational Resources Information Center

Kefalianos, Elaina; Onslow, Mark; Ukoumunne, Obioha; Block, Susan; Reilly, Sheena

2014-01-01

Purpose: The purpose of this study was to ascertain whether and when temperament differences, including precursors of anxiety, emerge before onset and during stuttering development. Method: The authors prospectively studied temperament characteristics of a community cohort of children who stutter (N = 183) and children in the control group (N =…

Sounds Affecting the Moments of Stuttering in Multilingualism: A Case Study

ERIC Educational Resources Information Center

Morrish, Taryn; Nesbitt, Amy; le Roux, Mia; Zsilavecz, Ursula; van der Linde, Jeannie

2017-01-01

Research involving stuttering in multilingual individuals is limited. Speech-language therapists face the challenge of treating a diverse client base, which includes multilingual individuals. The aim of this study was to examine the stuttering moments across English, Afrikaans, and German in a multilingual speaker. A single multilingual adult with…

Webcam Delivery of the Camperdown Program for Adolescents Who Stutter: A Phase II Trial

ERIC Educational Resources Information Center

Carey, Brenda; O'Brian, Sue; Lowe, Robyn; Onslow, Mark

2014-01-01

Purpose: This Phase II clinical trial examined stuttering adolescents' responsiveness to the Webcam-delivered Camperdown Program. Method: Sixteen adolescents were treated by Webcam with no clinic attendance. Primary outcome was percentage of syllables stuttered (%SS). Secondary outcomes were number of sessions, weeks and hours to maintenance,…

Randomized Clinical Trial: The Use of SpeechEasy® in Stuttering Treatment

ERIC Educational Resources Information Center

Ritto, Ana Paula; Juste, Fabiola Staróbole; Stuart, Andrew; Kalinowski, Joseph; de Andrade, Claudia Regina Furquim

2016-01-01

Background: Numerous studies have demonstrated the benefit of devices delivering altered auditory feedback (AAF) as a therapeutic alternative for those who stutter. Aims: The effectiveness of a device delivering AAF (SpeechEasy®) was compared with behavioural techniques in the treatment of stuttering in a randomized clinical trial. Methods &…

Stuttering in Preschool Children: Direct versus Indirect Treatment

ERIC Educational Resources Information Center

Nippold, Marilyn A.

2018-01-01

Purpose: The purpose of this article is to discuss the controversial topic of stuttering in preschool children and how to evaluate the options for treatment, emphasizing the role of external research evidence. Method: A hypothetical but realistic case study of a 3-year-old boy who stutters is described. Two contrasting approaches to treatment are…

Effects of Length, Complexity, and Grammatical Correctness on Stuttering in Spanish-Speaking Preschool Children

ERIC Educational Resources Information Center

Watson, Jennifer B.; Byrd, Courtney T.; Carlo, Edna J.

2011-01-01

Purpose: To explore the effects of utterance length, syntactic complexity, and grammatical correctness on stuttering in the spontaneous speech of young, monolingual Spanish-speaking children. Method: Spontaneous speech samples of 11 monolingual Spanish-speaking children who stuttered, ages 35 to 70 months, were examined. Mean number of syllables,…