Bivariate Genetic Analyses of Stuttering and Nonfluency in a Large Sample of 5-Year-Old Twins

ERIC Educational Resources Information Center

van Beijsterveldt, Catharina Eugenie Maria; Felsenfeld, Susan; Boomsma, Dorret Irene

2010-01-01

Purpose: Behavioral genetic studies of speech fluency have focused on participants who present with clinical stuttering. Knowledge about genetic influences on the development and regulation of normal speech fluency is limited. The primary aims of this study were to identify the heritability of stuttering and high nonfluency and to assess the…

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.

Assessing Disfluencies in School-Age Children Who Stutter: How Much Speech Is Enough?

ERIC Educational Resources Information Center

Gregg, Brent A.; Sawyer, Jean

2015-01-01

The question of what size speech sample is sufficient to accurately identify stuttering and its myriad characteristics is a valid one. Short samples have a risk of over- or underrepresenting disfluency types or characteristics. In recent years, there has been a trend toward using shorter samples because they are less time-consuming for…

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.

Stuttering treatment for a school-age child with Down syndrome: a descriptive case report.

PubMed

Harasym, Jessica; Langevin, Marilyn

2012-12-01

Little is known about optimal treatment approaches and stuttering treatment outcomes for children with Down syndrome. The purpose of this study was to investigate outcomes for a child with Down syndrome who received a combination of fluency shaping therapy and parent delivered contingencies for normally fluent speech, prolonged speech, and stuttered speech. In-clinic speech measures obtained at post-treatment and at 4 months follow-up reflected improvements in fluency of 89.0% and 98.6%, respectively. The participant's beyond-clinic follow-up sample reflected an improvement of 95.5%. Following treatment, the participant demonstrated improved self-confidence, self-esteem, and improved participation and functioning at school. Findings suggest that fluency shaping with parental contingencies may be a viable treatment approach to reduce stuttering in children with Down syndrome. Future research using an experimental research design is warranted. Readers will be able to describe (a) prevalence estimates of stuttering in individuals with Down syndrome, (b) the main components of a fluency shaping program for a child with Down syndrome who stutters and has co-occurring speech and language delays, and (c) speech and parent-, teacher-, and self-report treatment outcomes. Copyright © 2012 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…

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.

Speech motor planning and execution deficits in early childhood stuttering.

PubMed

Walsh, Bridget; Mettel, Kathleen Marie; Smith, Anne

2015-01-01

Five to eight percent of preschool children develop stuttering, a speech disorder with clearly observable, hallmark symptoms: sound repetitions, prolongations, and blocks. While the speech motor processes underlying stuttering have been widely documented in adults, few studies to date have assessed the speech motor dynamics of stuttering near its onset. We assessed fundamental characteristics of speech movements in preschool children who stutter and their fluent peers to determine if atypical speech motor characteristics described for adults are early features of the disorder or arise later in the development of chronic stuttering. Orofacial movement data were recorded from 58 children who stutter and 43 children who do not stutter aged 4;0 to 5;11 (years; months) in a sentence production task. For single speech movements and multiple speech movement sequences, we computed displacement amplitude, velocity, and duration. For the phrase level movement sequence, we computed an index of articulation coordination consistency for repeated productions of the sentence. Boys who stutter, but not girls, produced speech with reduced amplitudes and velocities of articulatory movement. All children produced speech with similar durations. Boys, particularly the boys who stuttered, had more variable patterns of articulatory coordination compared to girls. This study is the first to demonstrate sex-specific differences in speech motor control processes between preschool boys and girls who are stuttering. The sex-specific lag in speech motor development in many boys who stutter likely has significant implications for the dramatically different recovery rates between male and female preschoolers who stutter. Further, our findings document that atypical speech motor development is an early feature of stuttering.

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.

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…

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.

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…

Duration of the speech disfluencies of beginning stutterers.

PubMed

Zebrowski, P M

1991-06-01

This study compared the duration of within-word disfluencies and the number of repeated units per instance of sound/syllable and whole-word repetitions of beginning stutterers to those produced by age- and sex-matched nonstuttering children. Subjects were 10 stuttering children [9 males and 1 female; mean age 4:1 (years:months); age range 3:2-5:1), and 10 nonstuttering children (9 males and 1 female; mean age 4:0; age range: 2:10-5:1). Mothers of the stuttering children reported that their children had been stuttering for 1 year or less. One 300-word conversational speech sample from each of the stuttering and nonstuttering children was analyzed for (a) mean duration of sound/syllable repetition and sound prolongation, (b) mean number of repeated units per instance of sound/syllable and whole-word repetition, and (c) various related measures of the frequency of all between- and within-word speech disfluencies. There were no significant between-group differences for either the duration of acoustically measured sound/syllable repetitions and sound prolongations or the number of repeated units per instance of sound/syllable and whole-word repetition. Unlike frequency and type of speech disfluency produced, average duration of within-word disfluencies and number of repeated units per repetition do not differentiate the disfluent speech of beginning stutterers and their nonstuttering peers. Additional analyses support findings from previous perceptual work that type and frequency of speech disfluency, not duration, are the principal characteristics listeners use in distinguishing these two talker groups.

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.

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),…

Classification of speech dysfluencies using LPC based parameterization techniques.

PubMed

Hariharan, M; Chee, Lim Sin; Ai, Ooi Chia; Yaacob, Sazali

2012-06-01

The goal of this paper is to discuss and compare three feature extraction methods: Linear Predictive Coefficients (LPC), Linear Prediction Cepstral Coefficients (LPCC) and Weighted Linear Prediction Cepstral Coefficients (WLPCC) for recognizing the stuttered events. Speech samples from the University College London Archive of Stuttered Speech (UCLASS) were used for our analysis. The stuttered events were identified through manual segmentation and were used for feature extraction. Two simple classifiers namely, k-nearest neighbour (kNN) and Linear Discriminant Analysis (LDA) were employed for speech dysfluencies classification. Conventional validation method was used for testing the reliability of the classifier results. The study on the effect of different frame length, percentage of overlapping, value of ã in a first order pre-emphasizer and different order p were discussed. The speech dysfluencies classification accuracy was found to be improved by applying statistical normalization before feature extraction. The experimental investigation elucidated LPC, LPCC and WLPCC features can be used for identifying the stuttered events and WLPCC features slightly outperforms LPCC features and LPC features.

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…

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.

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

Comparison of upper and lower lip muscle activity between stutterers and fluent speakers.

PubMed

de Felício, Cláudia Maria; Freitas, Rosana Luiza Rodrigues Gomes; Vitti, Mathias; Regalo, Simone Cecilio Hallak

2007-08-01

There is a widespread clinical view that stuttering is associated with high levels of muscles activity. The proposal of this research was to compare stutterers and fluent speakers with respect to the electromyographic activity of the upper and lower lip muscles. Ten individuals who stutter and 10 fluent speakers (control group) paired by gender and age were studied (mean age: 13.4 years). Groups were defined by the speech sample analysis of the ABFW-Language Test. A K6-I EMG (Myo-tronics Co., Seattle, WA, USA) with double disposable silver electrodes (Duotrodes, Myo-tronics Co., Seattle, WA) being used in order to analyze lip muscle activity. The clinical conditions investigated were movements during speech, orofacial non-speech tasks, and rest. Electromyographic data were normalized by lip pursing activity. The non-parametric Mann-Whitney test was used for the comparison of speech fluency profile, and the Student t-test for independent samples for group comparison regarding electromyographic data. There was a statistically significant difference between groups regarding speech fluency profile and upper lip activity in the following conditions: lip lateralization to the right and to the left and rest before exercises (P<0.05). There was no significant difference between groups regarding lower lip activity (P>0.05). The EMG activity of the upper lip muscle in the group with stuttering was significantly lower than in the control group in some of the clinical conditions analyzed. There was no significant difference between groups regarding the lower lip muscle. The subjects who stutter did not present higher levels of muscle activity in lip muscles than fluent speakers.

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.

Speech Disfluency-dependent Amygdala Activity in Adults Who Stutter: Neuroimaging of Interpersonal Communication in MRI Scanner Environment.

PubMed

Toyomura, Akira; Fujii, Tetsunoshin; Yokosawa, Koichi; Kuriki, Shinya

2018-03-15

Affective states, such as anticipatory anxiety, critically influence speech communication behavior in adults who stutter. However, there is currently little evidence regarding the involvement of the limbic system in speech disfluency during interpersonal communication. We designed this neuroimaging study and experimental procedure to sample neural activity during interpersonal communication between human participants, and to investigate the relationship between the amygdala activity and speech disfluency. Participants were required to engage in live communication with a stranger of the opposite sex in the MRI scanner environment. In the gaze condition, the stranger gazed at the participant without speaking, while in the live conversation condition, the stranger asked questions that the participant was required to answer. The stranger continued to gaze silently at the participant while the participant answered. Adults who stutter reported significantly higher discomfort than fluent controls during the experiment. Activity in the right amygdala, a key anatomical region in the limbic system involved in emotion, was significantly correlated with stuttering occurrences in adults who stutter. Right amygdala activity from pooled data of all participants also showed a significant correlation with discomfort level during the experiment. Activity in the prefrontal cortex, which forms emotion regulation neural circuitry with the amygdala, was decreased in adults who stutter than in fluent controls. This is the first study to demonstrate that amygdala activity during interpersonal communication is involved in disfluent speech in adults who stutter. Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.

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).

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.

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…

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.

Speech fluency profile on different tasks for individuals with Parkinson's disease.

PubMed

Juste, Fabiola Staróbole; Andrade, Claudia Regina Furquim de

2017-07-20

To characterize the speech fluency profile of patients with Parkinson's disease. Study participants were 40 individuals of both genders aged 40 to 80 years divided into 2 groups: Research Group - RG (20 individuals with diagnosis of Parkinson's disease) and Control Group - CG (20 individuals with no communication or neurological disorders). For all of the participants, three speech samples involving different tasks were collected: monologue, individual reading, and automatic speech. The RG presented a significant larger number of speech disruptions, both stuttering-like and typical dysfluencies, and higher percentage of speech discontinuity in the monologue and individual reading tasks compared with the CG. Both groups presented reduced number of speech disruptions (stuttering-like and typical dysfluencies) in the automatic speech task; the groups presented similar performance in this task. Regarding speech rate, individuals in the RG presented lower number of words and syllables per minute compared with those in the CG in all speech tasks. Participants of the RG presented altered parameters of speech fluency compared with those of the CG; however, this change in fluency cannot be considered a stuttering disorder.

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

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.

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.

Speech disruptions in relation to language growth in children who stutter: an exploratory study.

PubMed

Wagovich, Stacy A; Hall, Nancy E; Clifford, Betsy A

2009-12-01

Young children with typical fluency demonstrate a range of disfluencies, or speech disruptions. One type of disruption, revision, appears to increase in frequency as syntactic skills develop. To date, this phenomenon has not been studied in children who stutter (CWS). Rispoli, Hadley, and Holt (2008) suggest a schema for categorizing speech disruptions in terms of revisions and stalls. The purpose of this exploratory study was to use this schema to evaluate whether CWS show a pattern over time in their production of stuttering, revisions, and stalls. Nine CWS, ages 2;1 to 4;11, participated in the study, producing language samples each month for 10 months. MLU and vocd analyses were performed for samples across three time periods. Active declarative sentences within these samples were examined for the presence of disruptions. Results indicated that the proportion of sentences containing revisions increased over time, but proportions for stalls and stuttering did not. Visual inspection revealed that more stuttering and stalls occurred on longer utterances than on shorter utterances. Upon examination of individual children's language, it appears two-thirds of the children showed a pattern in which, as MLU increased, revisions increased as well. Findings are similar to studies of children with typical fluency, suggesting that, despite the fact that CWS display more (and different) disfluencies relative to typically fluent peers, revisions appear to increase over time and correspond to increases in MLU, just as is the case with peers. The reader will be able to: (1) describe the three types of speech disruptions assessed in this article; (2) compare present findings of disruptions in children who stutter to findings of previous research with children who are typically fluent; and (3) discuss future directions in this area of research, given the findings and implications of this study.

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.…

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.

Determining the effect of laser acupuncture in treating stutterers in comparison with speech therapy.

PubMed

Shafiei, Bijan; Heshmatipour, Mojtaba; Tavakol, Samira; Saghaei, Mahmud; Ghayumi, Zahra

2015-01-01

Investigation of strategies and methods of therapy in stutterers regarding to its characteristics, length of treatment, and relapse of stuttering is very important. Acupuncture has been introduced as a therapeutic method for the treatment of stuttering. The aim of the present research was the identification of the results of intervention of laser acupuncture in comparison with speech therapy in stutterers. This clinical - trial and case control research was conducted on 20 stutterers and 20 non-stutterers. In the present study, speech therapy and laser acupuncture were used on 10 persons who had developmental stuttering from childhood. The results were compared with the data of speech therapy and placebo laser in 10 control subjects. All of the subjects were followed up for 12 weeks after the intervention. The obtained data showed that accompanying of speech therapy with laser acupuncture resulted the increasing of maintenance and therapeutic effects of stuttering treatment and decreasing of relapsing. The speech rate and percent of stuttered words before and after the intervention in both groups (A and B) were decreased. Following the results after 12 weeks showed that the results were stable in laser group more than the other group and there was a significant difference between the two groups. The results of the present study showed that using of laser acupuncture therapy accompanying by speech therapy has many effects on the treatment of stuttering and prevents the relapsing of stuttering that is very common.

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.

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.

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.

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.

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…

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.

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.

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.

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.

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

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…

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…

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.

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.

A randomized control trial to investigate the impact of the Lidcombe Program on early stuttering in German-speaking preschoolers.

PubMed

Lattermann, Christina; Euler, Harald A; Neumann, Katrin

2008-03-01

In order to investigate whether the Lidcombe Program effects a short-term reduction of stuttered speech beyond natural recovery, 46 German preschool children were randomly assigned to a wait-contrast group or to an experimental group which received the Lidcombe Program for 16 weeks. The children were between 3;0 and 5;11 years old, their and both of their parents' native language was German, stuttering onset had been at least 6 months before, and their stuttering frequency was higher than 3% stuttered syllables. Spontaneous speech samples were recorded at home and in the clinic prior to treatment and after 4 months. Compared to the wait-contrast group, the treatment group showed a significantly higher decrease in stuttered syllables in home-measurements (6.9%SS vs. 1.6%SS) and clinic-measurements (6.8%SS vs. 3.6%SS), and the same increase in articulation rate. The program is considered an enrichment of currently applied early stuttering interventions in Germany. Readers will discuss and evaluate: (1) the short-term effects of the Lidcombe Program in comparison to natural recovery on stuttering; (2) the impact of the Lidcombe Program on early stuttering in German-speaking preschool children.

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.

Articulation rate and its relationship to disfluency type, duration, and temperament in preschool children who stutter.

PubMed

Tumanova, Victoria; Zebrowski, Patricia M; Throneburg, Rebecca N; Kulak Kayikci, Mavis E

2011-01-01

The purpose of this study was to examine the relationship between articulation rate, frequency and duration of disfluencies of different types, and temperament in preschool children who stutter (CWS). In spontaneous speech samples from 19 CWS (mean age=3:9; years:months), we measured articulation rate, the frequency and duration of (a) sound prolongations; (b) sound-syllable repetitions; (c) single syllable whole word repetitions; and (d) clusters. Temperament was assessed with the Children's Behavior Questionnaire (Rothbart et al., 2001). There was a significant negative correlation between articulation rate and average duration of sound prolongations (p<0.01), and between articulation rate and frequency of stuttering-like disfluencies (SLDs) (p<0.05). No other relationships proved statistically significant. Results do not support models of stuttering development that implicate particular characteristics of temperament as proximal contributors to stuttering; however, this is likely due to the fact that current methods, including the ones used in the present study, do not allow for the identification of a functional relationship between temperament and speech production. Findings do indicate that for some CWS, relatively longer sound prolongations co-occur with relatively slower speech rate, which suggests that sound prolongations, across a range of durations, may represent a distinct type of SLD, not just in their obvious perceptual characteristics, but in their potential influence on overall speech production at multiple levels. Readers will be able to describe the relationship between stuttering-like disfluencies, articulation rate and temperament in children who stutter, and discuss different measurements of articulation rate. Copyright © 2010 Elsevier Inc. All rights reserved.

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.

Stuttering

PubMed Central

Perez, Hector R.; Stoeckle, James H.

2016-01-01

Abstract Objective To provide an update on the epidemiology, genetics, pathophysiology, diagnosis, and treatment of developmental stuttering. Quality of evidence The MEDLINE and Cochrane databases were searched for past and recent studies on the epidemiology, genetics, pathophysiology, diagnosis, and treatment of developmental stuttering. Most recommendations are based on small studies, limited-quality evidence, or consensus. Main message Stuttering is a speech disorder, common in persons of all ages, that affects normal fluency and time patterning of speech. Stuttering has been associated with differences in brain anatomy, functioning, and dopamine regulation thought to be due to genetic causes. Attention to making a correct diagnosis or referral in children is important because there is growing consensus that early intervention with speech therapy for children who stutter is critical. For adults, stuttering can be associated with substantial psychosocial morbidity including social anxiety and low quality of life. Pharmacologic treatment has received attention in recent years, but clinical evidence is limited. The mainstay of treatment for children and adults remains speech therapy. Conclusion A growing body of research has attempted to uncover the pathophysiology of stuttering. Referral for speech therapy remains the best option for children and adults. PMID:27303004

The effect of filtered speech feedback on the frequency of stuttering

NASA Astrophysics Data System (ADS)

Rami, Manish Krishnakant

2000-10-01

This study investigated the effects of filtered components of speech and whispered speech on the frequency of stuttering. It is known that choral speech, shadowing, and altered auditory feedback are the only conditions which induce fluency without any additional effort than normally required to speak on the part of people who stutter. All these conditions use speech as a second signal. This experiment examined the role of components of speech signal as delineated by the source- filter theory of speech production. Three filtered speech signals, a whispered speech signal, and a choral speech signal formed the stimuli. It was postulated that if the speech signal in whole was necessary for producing fluency in people who stutter, then all other conditions except choral speech should fail to produce fluency enhancement. If the glottal source alone was adequate in restoring fluency, then only the conditions of NAF and whispered speech should fail in promoting fluency. In the event that full filter characteristics are necessary for the fluency creating effects, then all conditions except the choral speech and whispered speech should fail to produce fluency. If any part of the filter characteristics is sufficient in yielding fluency, then only the NAF and the approximate glottal source should fail to demonstrate an increase in the amount of fluency. Twelve adults who stuttered read passages under the six conditions while receiving auditory feedback consisting of one of the six experimental conditions: (a)NAF; (b)approximate glottal source; (c)glottal source and first formant; (d)glottal source and first two formants; and (e)whispered speech. Frequencies of stuttering were obtained for each condition and submitted to descriptive and inferential statistical analysis. Statistically significant differences in means were found within the choral feedback conditions. Specifically, the choral speech, the source and first formant, source and the first two formants, and the whispered speech conditions all decreased the frequency of stuttering while the approximate glottal source did not. It is suggested that articulatory events, chiefly the encoded speech output of the vocal tract origin, afford effective cues and induces fluent speech in people who stutter.

Phonation interval modification and speech performance quality during fluency-inducing conditions by adults who stutter

PubMed Central

Ingham, Roger J.; Bothe, Anne K.; Wang, Yuedong; Purkhiser, Krystal; New, Anneliese

2012-01-01

Purpose To relate changes in four variables previously defined as characteristic of normally fluent speech to changes in phonatory behavior during oral reading by persons who stutter (PWS) and normally fluent controls under multiple fluency-inducing (FI) conditions. Method Twelve PWS and 12 controls each completed 4 ABA experiments. During A phases, participants read normally. B phases were 4 different FI conditions: auditory masking, chorus reading, whispering, and rhythmic stimulation. Dependent variables were the durations of accelerometer-recorded phonated intervals; self-judged speech effort; and observer-judged stuttering frequency, speech rate, and speech naturalness. The method enabled a systematic replication of Ingham et al. (2009). Results All FI conditions resulted in decreased stuttering and decreases in the number of short phonated intervals, as compared with baseline conditions, but the only FI condition that satisfied all four characteristics of normally fluent speech was chorus reading. Increases in longer phonated intervals were associated with decreased stuttering but also with poorer naturalness and/or increased speech effort. Previous findings concerning the effects of FI conditions on speech naturalness and effort were replicated. Conclusions Measuring all relevant characteristics of normally fluent speech, in the context of treatments that aim to reduce the occurrence of short-duration PIs, may aid the search for an explanation of the nature of stuttering and may also maximize treatment outcomes for adults who stutter. PMID:22365886

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.

The effects of gated speech on the fluency of speakers who stutter

PubMed Central

Howell, Peter

2007-01-01

It is known that the speech of people who stutter improves when the speaker’s own vocalization is changed while the participant is speaking. One explanation of these effects is the disruptive rhythm hypothesis (DRH). DRH maintains that the manipulated sound only needs to disturb timing to affect speech control. The experiment investigated whether speech that was gated on and off (interrupted) affected the speech control of speakers who stutter. Eight children who stutter read a passage when they heard their voice normally and when the speech was gated. Fluency was enhanced (fewer errors were made and time to read a set passage was reduced) when speech was interrupted in this way. The results support the DRH. PMID:17726328

The effects of gated speech on the fluency of speakers who stutter.

PubMed

Howell, Peter

2007-01-01

It is known that the speech of people who stutter improves when the speaker's own vocalization is changed while the participant is speaking. One explanation of these effects is the disruptive rhythm hypothesis (DRH). The DRH maintains that the manipulated sound only needs to disturb timing to affect speech control. The experiment investigated whether speech that was gated on and off (interrupted) affected the speech control of speakers who stutter. Eight children who stutter read a passage when they heard their voice normally and when the speech was gated. Fluency was enhanced (fewer errors were made and time to read a set passage was reduced) when speech was interrupted in this way. The results support the DRH. Copyright 2007 S. Karger AG, Basel.

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

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…

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

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.

Stuttering: Clinical and research update.

PubMed

Perez, Hector R; Stoeckle, James H

2016-06-01

To provide an update on the epidemiology, genetics, pathophysiology, diagnosis, and treatment of developmental stuttering. The MEDLINE and Cochrane databases were searched for past and recent studies on the epidemiology, genetics, pathophysiology, diagnosis, and treatment of developmental stuttering. Most recommendations are based on small studies, limited-quality evidence, or consensus. Stuttering is a speech disorder, common in persons of all ages, that affects normal fluency and time patterning of speech. Stuttering has been associated with differences in brain anatomy, functioning, and dopamine regulation thought to be due to genetic causes. Attention to making a correct diagnosis or referral in children is important because there is growing consensus that early intervention with speech therapy for children who stutter is critical. For adults, stuttering can be associated with substantial psychosocial morbidity including social anxiety and low quality of life. Pharmacologic treatment has received attention in recent years, but clinical evidence is limited. The mainstay of treatment for children and adults remains speech therapy. A growing body of research has attempted to uncover the pathophysiology of stuttering. Referral for speech therapy remains the best option for children and adults. Copyright© the College of Family Physicians of Canada.

Comparisons of Stuttering Frequency during and after Speech Initiation in Unaltered Feedback, Altered Auditory Feedback and Choral Speech Conditions

ERIC Educational Resources Information Center

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

2009-01-01

Background: 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…

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…

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.

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.

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…

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.).…

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.

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.

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

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.

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

Primary school teachers’ opinions and attitudes towards stuttering in two South African urban education districts

PubMed Central

Harty, Michal; Louis, Kenneth O. St.; Thabane, Lehana; Kathard, Harsha

2016-01-01

Background As teachers form an important part of the intervention process with children who stutter in primary school, the primary aim was to describe primary school teachers’ attitudes in South Africa. The secondary aim was to compare teachers’ attitudes towards stuttering in South Africa with those from a pooled group of respondents in the Public Opinion Survey of Human Attributes–Stuttering (POSHA-S) database from different countries collected in 2009–2014. Method A quantitative, cross-sectional survey research design was used. Primary schools in two education districts in Western Cape, South Africa, were sampled. The POSHA-S, a self-administered questionnaire, was completed by a cluster sample of 469 participants. Results Overall positive attitudes towards stuttering were found, specifically related to the potential of people who stutter, although the result should be interpreted with caution as the sample was not homogenously positive. Teachers still had misconceptions about personality stereotypes and the cause of stuttering. The attitudes of the South African sample were slightly more positive compared with the samples in the current POSHA-S database. Conclusion When developing stuttering intervention strategies, there are a number of key considerations to take into account. The study provides a basis for speech-language therapists to think about intervention with teachers and which areas of stuttering to consider.

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…

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.

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.

Connecting Stuttering Management and Measurement: I. Core Speech Measures of Clinical Process and Outcome

ERIC Educational Resources Information Center

Shenker, Rosalee C.

2006-01-01

Background: There will always be a place for stuttering treatments designed to eliminate or reduce stuttered speech. When those treatments are required, direct speech measures of treatment process and outcome are needed in clinical practice. Aims: Based on the contents of published clinical trials of such treatments, three "core" measures of…

Revisiting Speech Rate and Utterance Length Manipulations in Stuttering Speakers

ERIC Educational Resources Information Center

Blomgren, Michael; Goberman, Alexander M.

2008-01-01

The goal of this study was to evaluate stuttering frequency across a multidimensional (2 x 2) 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…

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

PubMed Central

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

2014-01-01

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). Articulation rate and length of utterance were measured to seek the differences. Because articulation rate may reflect temporal aspects of speech motor control, it was predicted that the articulation rate would be different between perceptually fluent utterances and utterances containing disfluencies. The length of utterance was also expected to show different patterns. Method Participants were 14 preschool children who stutter. Disfluencies were identified from their spontaneous speech samples, and articulation rate in syllables per second and utterance length in syllables were measured for the four types of utterances. Results and discussion There was no significant difference in articulation rate between each type of utterance. Significantly longer utterances were found only in SLD+OD utterances compared to fluent utterances, suggesting that utterance length may be related to efforts in executing motor as well as linguistic planning. The SLD utterance revealed a significant negative correlation in that longer utterances tended to be slower in articulation rates. Longer utterances may place more demand on speech motor control due to more linguistic and/or grammatical features, resulting in stuttering-like disfluencies and a decreased rate. PMID:22995336

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.

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

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.

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

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.

Speech-Language Dissociations, Distractibility, and Childhood Stuttering

PubMed Central

Conture, Edward G.; Walden, Tedra A.; Lambert, Warren E.

2015-01-01

Purpose This study investigated the relation among speech-language dissociations, attentional distractibility, and childhood stuttering. Method Participants were 82 preschool-age children who stutter (CWS) and 120 who do not stutter (CWNS). Correlation-based statistics (Bates, Appelbaum, Salcedo, Saygin, & Pizzamiglio, 2003) identified dissociations across 5 norm-based speech-language subtests. The Behavioral Style Questionnaire Distractibility subscale measured attentional distractibility. Analyses addressed (a) between-groups differences in the number of children exhibiting speech-language dissociations; (b) between-groups distractibility differences; (c) the relation between distractibility and speech-language dissociations; and (d) whether interactions between distractibility and dissociations predicted the frequency of total, stuttered, and nonstuttered disfluencies. Results More preschool-age CWS exhibited speech-language dissociations compared with CWNS, and more boys exhibited dissociations compared with girls. In addition, male CWS were less distractible than female CWS and female CWNS. For CWS, but not CWNS, less distractibility (i.e., greater attention) was associated with more speech-language dissociations. Last, interactions between distractibility and dissociations did not predict speech disfluencies in CWS or CWNS. Conclusions The present findings suggest that for preschool-age CWS, attentional processes are associated with speech-language dissociations. Future investigations are warranted to better understand the directionality of effect of this association (e.g., inefficient attentional processes → speech-language dissociations vs. inefficient attentional processes ← speech-language dissociations). PMID:26126203

Primary school teachers' opinions and attitudes towards stuttering in two South African urban education districts.

PubMed

Abrahams, Kristen; Harty, Michal; St Louis, Kenneth O; Thabane, Lehana; Kathard, Harsha

2016-07-27

As teachers form an important part of the intervention process with childrenwho stutter in primary school, the primary aim was to describe primary school teachers'attitudes in South Africa. The secondary aim was to compare teachers' attitudes towardsstuttering in South Africa with those from a pooled group of respondents in the Public OpinionSurvey of Human Attributes-Stuttering (POSHA-S) database from different countries collectedin 2009-2014. A quantitative, cross-sectional survey research design was used. Primary schools intwo education districts in Western Cape, South Africa, were sampled. The POSHA-S, a selfadministeredquestionnaire, was completed by a cluster sample of 469 participants. Overall positive attitudes towards stuttering were found, specifically related to thepotential of people who stutter, although the result should be interpreted with caution as thesample was not homogenously positive. Teachers still had misconceptions about personalitystereotypes and the cause of stuttering. The attitudes of the South African sample were slightlymore positive compared with the samples in the current POSHA-S database. When developing stuttering intervention strategies, there are a number of keyconsiderations to take into account. The study provides a basis for speech-language therapiststo think about intervention with teachers and which areas of stuttering to consider.

Modulation of auditory processing during speech movement planning is limited in adults who stutter

PubMed Central

Daliri, Ayoub; Max, Ludo

2015-01-01

Stuttering is associated with atypical structural and functional connectivity in sensorimotor brain areas, in particular premotor, motor, and auditory regions. It remains unknown, however, which specific mechanisms of speech planning and execution are affected by these neurological abnormalities. To investigate pre-movement sensory modulation, we recorded 12 stuttering and 12 nonstuttering adults’ auditory evoked potentials in response to probe tones presented prior to speech onset in a delayed-response speaking condition vs. no-speaking control conditions (silent reading; seeing nonlinguistic symbols). Findings indicate that, during speech movement planning, the nonstuttering group showed a statistically significant modulation of auditory processing (reduced N1 amplitude) that was not observed in the stuttering group. Thus, the obtained results provide electrophysiological evidence in support of the hypothesis that stuttering is associated with deficiencies in modulating the cortical auditory system during speech movement planning. This specific sensorimotor integration deficiency may contribute to inefficient feedback monitoring and, consequently, speech dysfluencies. PMID:25796060

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.

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.

The Impact of Adolescent Stuttering and Other Speech Problems on Psychological Well-Being in Adulthood: Evidence from a Birth Cohort Study

ERIC Educational Resources Information Center

McAllister, Jan; Collier, Jacqueline; Shepstone, Lee

2013-01-01

Background: 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. Aims: To determine the impact…

Speech effort measurement and stuttering: investigating the chorus reading effect.

PubMed

Ingham, Roger J; Warner, Allison; Byrd, Anne; Cotton, John

2006-06-01

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. Twelve persistent stuttering (PS) adults and 12 normally fluent control participants completed 1-min base rate readings (BR-nonchorus) and CRs within a BR/CR/BR/CR/BR experimental design. Participants self-rated speech effort using a 9-point scale after each reading trial. Stuttering frequency, speech rate, and speech naturalness measures were also obtained. Instructions highlighting speech effort ratings during BR and CR phases were introduced after the first CR. CR improved speech effort ratings for the PS group, but the control group showed a reverse trend. Both groups' effort ratings were not significantly different during CR phases but were significantly poorer than the control group's effort ratings during BR phases. The highlighting strategy did not significantly change effort ratings. The findings show that CR will produce not only stutter-free and natural sounding speech but also reliable reductions in speech effort. However, these reductions do not reach effort levels equivalent to those achieved by normally fluent speakers, thereby conditioning its use as a gold standard of achievable normal fluency by PS speakers.

Overreliance on auditory feedback may lead to sound/syllable repetitions: simulations of stuttering and fluency-inducing conditions with a neural model of speech production.

PubMed

Civier, Oren; Tasko, Stephen M; Guenther, Frank H

2010-09-01

This paper investigates the hypothesis that stuttering may result in part from impaired readout of feedforward control of speech, which forces persons who stutter (PWS) to produce speech with a motor strategy that is weighted too much toward auditory feedback control. Over-reliance on feedback control leads to production errors which if they grow large enough, can cause the motor system to "reset" and repeat the current syllable. This hypothesis is investigated using computer simulations of a "neurally impaired" version of the DIVA model, a neural network model of speech acquisition and production. The model's outputs are compared to published acoustic data from PWS' fluent speech, and to combined acoustic and articulatory movement data collected from the dysfluent speech of one PWS. The simulations mimic the errors observed in the PWS subject's speech, as well as the repairs of these errors. Additional simulations were able to account for enhancements of fluency gained by slowed/prolonged speech and masking noise. Together these results support the hypothesis that many dysfluencies in stuttering are due to a bias away from feedforward control and toward feedback control. The reader will be able to (a) describe the contribution of auditory feedback control and feedforward control to normal and stuttered speech production, (b) summarize the neural modeling approach to speech production and its application to stuttering, and (c) explain how the DIVA model accounts for enhancements of fluency gained by slowed/prolonged speech and masking noise.

Using on-line altered auditory feedback treating Parkinsonian speech

NASA Astrophysics Data System (ADS)

Wang, Emily; Verhagen, Leo; de Vries, Meinou H.

2005-09-01

Patients with advanced Parkinson's disease tend to have dysarthric speech that is hesitant, accelerated, and repetitive, and that is often resistant to behavior speech therapy. In this pilot study, the speech disturbances were treated using on-line altered feedbacks (AF) provided by SpeechEasy (SE), an in-the-ear device registered with the FDA for use in humans to treat chronic stuttering. Eight PD patients participated in the study. All had moderate to severe speech disturbances. In addition, two patients had moderate recurring stuttering at the onset of PD after long remission since adolescence, two had bilateral STN DBS, and two bilateral pallidal DBS. An effective combination of delayed auditory feedback and frequency-altered feedback was selected for each subject and provided via SE worn in one ear. All subjects produced speech samples (structured-monologue and reading) under three conditions: baseline, with SE without, and with feedbacks. The speech samples were randomly presented and rated for speech intelligibility goodness using UPDRS-III item 18 and the speaking rate. The results indicted that SpeechEasy is well tolerated and AF can improve speech intelligibility in spontaneous speech. Further investigational use of this device for treating speech disorders in PD is warranted [Work partially supported by Janus Dev. Group, Inc.].

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.

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.

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.

Awareness and Reactions of Young Stuttering Children Aged 2-7 Years Old towards Their Speech Disfluency

ERIC Educational Resources Information Center

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…

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…

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.

Auditory-tactile echo-reverberating stuttering speech corrector

NASA Astrophysics Data System (ADS)

Kuniszyk-Jozkowiak, Wieslawa; Adamczyk, Bogdan

1997-02-01

The work presents the construction of a device, which transforms speech sounds into acoustical and tactile signals of echo and reverberation. Research has been done on the influence of the echo and reverberation, which are transmitted as acoustic and tactile stimuli, on speech fluency. Introducing the echo or reverberation into the auditory feedback circuit results in a reduction of stuttering. A bit less, but still significant corrective effects are observed while using the tactile channel for transmitting the signals. The use of joined auditory and tactile channels increases the effects of their corrective influence on the stutterers' speech. The results of the experiment justify the use of the tactile channel in the stutterers' therapy.

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".

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.

Do individuals with fragile X syndrome show developmental stuttering or not? Comment on "Speech fluency in fragile X syndrome" by van Borsel, Dor and Rondal.

PubMed

Howell, Peter

2008-02-01

Van Borsel, Dor, and Rondal (2007) examined the speech of seven boys and two young male adults with fragile X syndrome and considered whether their speech was comparable to that reported in the developmental stuttering literature. They listed five criteria which led them to conclude that the speech patterns of speakers with fragile X syndrome differed from those observed in developmental stuttering. The differences noted were: 1) distribution of type of dysfluency; 2) the class of word on which dysfluency occurred; 3) whether word length affected dysfluency; 4) number of times words and phrases were repeated; and 5) whether there were influences of material type on fluency (spontaneous speech, repeated material etc.). They concluded that the speech of speakers with fragile X syndrome differed from developmental stuttering. The comparisons that van Borsel et al. (2007) made between participant groups were not for speakers of comparable ages. Comparisons with groups of corresponding ages support the opposite conclusion, namely the young speakers with fragile X syndrome show patterns similar to developmental stuttering.

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.

Systematic Studies of Modified Vocalization: The Effect of Speech Rate on Speech Production Measures during Metronome-Paced Speech in Persons Who Stutter

ERIC Educational Resources Information Center

Davidow, Jason H.

2014-01-01

Background: Metronome-paced speech results in the elimination, or substantial reduction, of stuttering moments. The cause of fluency during this fluency-inducing condition is unknown. Several investigations have reported changes in speech pattern characteristics from a control condition to a metronome-paced speech condition, but failure to control…

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.

Stuttering and Lexical Category in Adult Arabic Speakers

ERIC Educational Resources Information Center

Abdalla, Fauzia; Robb, Michael P.; Al-Shatti, Tareq

2010-01-01

The purpose of this study was to test whether the content and function word dichotomy of speech disfluency found in English-speaking adults who stutter (AWS) was evident in a language other than English. A group of adult Arabic-speaking AWS were sampled across spontaneous speaking, oral reading, and single-word naming tasks. Moments of disfluency…

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.

Dissociations among linguistic, cognitive, and auditory-motor neuroanatomical domains in children who stutter.

PubMed

Choo, Ai Leen; Burnham, Evamarie; Hicks, Kristin; Chang, Soo-Eun

2016-01-01

The onset of developmental stuttering typically occurs between 2 to 4 years of age, coinciding with a period of rapid development in speech, language, motor and cognitive domains. Previous studies have reported generally poorer performance and uneven, or "dissociated" development across speech and language domains in children who stutter (CWS) relative to children who do not stutter (CWNS) (Anderson, Pellowski, & Conture, 2005). The aim of this study was to replicate and expand previous findings by examining whether CWS exhibit dissociated development across speech-language, cognitive, and motor domains that are also reflected in measures of neuroanatomical development. Participants were 66CWS (23 females) and 53CWNS (26 females) ranging from 3 to 10 years. Standardized speech, language, cognitive, and motor skills measures, and fractional anisotropy (FA) values derived from diffusion tensor imaging from speech relevant "dorsal auditory" left perisylvian areas (Hickok & Poeppel, 2007) were analyzed using a correlation-based statistical procedure (Coulter, Anderson, & Conture, 2009) that quantified dissociations across domains. Overall, CWS scored consistently lower on speech, language, cognitive and motor measures, and exhibited dissociated development involving these same measures and white matter neuroanatomical indices relative to CWNS. Boys who stutter exhibited a greater number of dissociations compared to girls who stutter. Results suggest a subgroup of CWS may have incongruent development across multiple domains, and the resolution of this imbalance may be a factor in recovery from stuttering. Copyright © 2016 Elsevier Inc. All rights reserved.

Factors Associated With Negative Attitudes Toward Speaking in Preschool-Age Children Who Do and Do Not Stutter.

PubMed

Groner, Stephen; Walden, Tedra; Jones, Robin

2016-01-01

This study explored relations between the negativity of children's speech-related attitudes as measured by the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT; Vanryckeghem & Brutten, 2007) and (a) age; (b) caregiver reports of stuttering and its social consequences; (c) types of disfluencies; and (d) standardized speech, vocabulary, and language scores. Participants were 46 preschool-age children who stutter (CWS; 12 females, 34 males) and 66 preschool-age children who do not stutter (CWNS; 35 females, 31 males). After a conversation, children completed standardized tests and the KiddyCAT while their caregivers completed scales on observed stuttering behaviors and their consequences. The KiddyCAT scores of both the CWS and the CWNS were significantly negatively correlated with age. Both groups' KiddyCAT scores increased with higher scores on the Speech Fluency Rating Scale of the Test of Childhood Stuttering (Gillam, Logan, & Pearson, 2009). Repetitions were a significant contributor to the CWNS's KiddyCAT scores, but no specific disfluency significantly contributed to the CWS's KiddyCAT scores. Greater articulation errors were associated with higher KiddyCAT scores in the CWNS. No standardized test scores were associated with KiddyCAT scores in the CWS. Attitudes that speech is difficult are not associated with similar aspects of communication for CWS and CWNS. Age significantly contributed to negative speech attitudes for CWS, whereas age, repetitions, and articulation errors contributed to negative speech attitudes for CWNS.

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…

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)…

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…

The Effect of Speech Rate on Stuttering Frequency, Phonated Intervals, Speech Effort, and Speech Naturalness during Chorus Reading

ERIC Educational Resources Information Center

Davidow, Jason H.; Ingham, Roger J.

2013-01-01

Purpose: This study examined the effect of speech rate on phonated intervals (PIs), in order to test whether a reduction in the frequency of short PIs is an important part of the fluency-inducing mechanism of chorus reading. The influence of speech rate on stuttering frequency, speaker-judged speech effort, and listener-judged naturalness was also…

Functional connectivity changes in adults with developmental stuttering: a preliminary study using quantitative electro-encephalography

PubMed Central

Joos, Kathleen; De Ridder, Dirk; Boey, Ronny A.; Vanneste, Sven

2014-01-01

Introduction: Stuttering is defined as speech characterized by verbal dysfluencies, but should not be seen as an isolated speech disorder, but as a generalized sensorimotor timing deficit due to impaired communication between speech related brain areas. Therefore we focused on resting state brain activity and functional connectivity. Method: We included 11 patients with developmental stuttering and 11 age matched controls. To objectify stuttering severity and the impact on quality of life (QoL), we used the Dutch validated Test for Stuttering Severity-Readers (TSS-R) and the Overall Assessment of the Speaker’s Experience of Stuttering (OASES), respectively. Furthermore, we used standardized low resolution brain electromagnetic tomography (sLORETA) analyses to look at resting state activity and functional connectivity differences and their correlations with the TSS-R and OASES. Results: No significant results could be obtained when looking at neural activity, however significant alterations in resting state functional connectivity could be demonstrated between persons who stutter (PWS) and fluently speaking controls, predominantly interhemispheric, i.e., a decreased functional connectivity for high frequency oscillations (beta and gamma) between motor speech areas (BA44 and 45) and the contralateral premotor (BA6) and motor (BA4) areas. Moreover, a positive correlation was found between functional connectivity at low frequency oscillations (theta and alpha) and stuttering severity, while a mixed increased and decreased functional connectivity at low and high frequency oscillations correlated with QoL. Discussion: PWS are characterized by decreased high frequency interhemispheric functional connectivity between motor speech, premotor and motor areas in the resting state, while higher functional connectivity in the low frequency bands indicates more severe speech disturbances, suggesting that increased interhemispheric and right sided functional connectivity is maladaptive. PMID:25352797

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.

The Effects of Self-Generated Synchronous and Asynchronous Visual Speech Feedback on Overt Stuttering Frequency

ERIC Educational Resources Information Center

Snyder, Gregory J.; Hough, Monica Strauss; Blanchet, Paul; Ivy, Lennette J.; Waddell, Dwight

2009-01-01

Purpose: Relatively recent research documents that visual choral speech, which represents an externally generated form of synchronous visual speech feedback, significantly enhanced fluency in those who stutter. As a consequence, it was hypothesized that self-generated synchronous and asynchronous visual speech feedback would likewise enhance…

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.

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…

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…

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…

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…

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…

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.…

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 &…

Articulation Rate and Its Relationship to Disfluency Type, Duration, and Temperament in Preschool Children Who Stutter

ERIC Educational Resources Information Center

Tumanova, Victoria; Zebrowski, Patricia M.; Throneburg, Rebecca N.; Kayikci, Mavis E. Kulak

2011-01-01

The purpose of this study was to examine the relationship between articulation rate, frequency and duration of disfluencies of different types, and temperament in preschool children who stutter (CWS). In spontaneous speech samples from 19 CWS (mean age = 3:9; years:months), we measured articulation rate, the frequency and duration of (a) sound…

Atypical central auditory speech-sound discrimination in children who stutter as indexed by the mismatch negativity.

PubMed

Jansson-Verkasalo, Eira; Eggers, Kurt; Järvenpää, Anu; Suominen, Kalervo; Van den Bergh, Bea; De Nil, Luc; Kujala, Teija

2014-09-01

Recent theoretical conceptualizations suggest that disfluencies in stuttering may arise from several factors, one of them being atypical auditory processing. The main purpose of the present study was to investigate whether speech sound encoding and central auditory discrimination, are affected in children who stutter (CWS). Participants were 10 CWS, and 12 typically developing children with fluent speech (TDC). Event-related potentials (ERPs) for syllables and syllable changes [consonant, vowel, vowel-duration, frequency (F0), and intensity changes], critical in speech perception and language development of CWS were compared to those of TDC. There were no significant group differences in the amplitudes or latencies of the P1 or N2 responses elicited by the standard stimuli. However, the Mismatch Negativity (MMN) amplitude was significantly smaller in CWS than in TDC. For TDC all deviants of the linguistic multifeature paradigm elicited significant MMN amplitudes, comparable with the results found earlier with the same paradigm in 6-year-old children. In contrast, only the duration change elicited a significant MMN in CWS. The results showed that central auditory speech-sound processing was typical at the level of sound encoding in CWS. In contrast, central speech-sound discrimination, as indexed by the MMN for multiple sound features (both phonetic and prosodic), was atypical in the group of CWS. Findings were linked to existing conceptualizations on stuttering etiology. The reader will be able (a) to describe recent findings on central auditory speech-sound processing in individuals who stutter, (b) to describe the measurement of auditory reception and central auditory speech-sound discrimination, (c) to describe the findings of central auditory speech-sound discrimination, as indexed by the mismatch negativity (MMN), in children who stutter. Copyright © 2014 Elsevier Inc. All rights reserved.

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.

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.

Speech dynamics are coded in the left motor cortex in fluent speakers but not in adults who stutter

PubMed Central

Hoang, T. N. Linh; Neef, Andreas; Paulus, Walter; Sommer, Martin

2015-01-01

The precise excitability regulation of neuronal circuits in the primary motor cortex is central to the successful and fluent production of speech. Our question was whether the involuntary execution of undesirable movements, e.g. stuttering, is linked to an insufficient excitability tuning of neural populations in the orofacial region of the primary motor cortex. We determined the speech-related time course of excitability modulation in the left and right primary motor tongue representation. Thirteen fluent speakers (four females, nine males; aged 23–44) and 13 adults who stutter (four females, nine males, aged 21–55) were asked to build verbs with the verbal prefix ‘auf’. Single-pulse transcranial magnetic stimulation was applied over the primary motor cortex during the transition phase between a fixed labiodental articulatory configuration and immediately following articulatory configurations, at different latencies after transition onset. Bilateral electromyography was recorded from self-adhesive electrodes placed on the surface of the tongue. Off-line, we extracted the motor evoked potential amplitudes and normalized these amplitudes to the individual baseline excitability during the fixed configuration. Fluent speakers demonstrated a prominent left hemisphere increase of motor cortex excitability in the transition phase (P = 0.009). In contrast, the excitability of the right primary motor tongue representation was unchanged. Interestingly, adults afflicted with stuttering revealed a lack of left-hemisphere facilitation. Moreover, the magnitude of facilitation was negatively correlated with stuttering frequency. Although orofacial midline muscles are bilaterally innervated from corticobulbar projections of both hemispheres, our results indicate that speech motor plans are controlled primarily in the left primary speech motor cortex. This speech motor planning-related asymmetry towards the left orofacial motor cortex is missing in stuttering. Moreover, a negative correlation between the amount of facilitation and stuttering severity suggests that we discovered a main physiological principle of fluent speech production and its role in stuttering. PMID:25595146

Scores on Riley's stuttering severity instrument versions three and four for samples of different length and for different types of speech material.

PubMed

Todd, Helena; Mirawdeli, Avin; Costelloe, Sarah; Cavenagh, Penny; Davis, Stephen; Howell, Peter

2014-12-01

Riley stated that the minimum speech sample length necessary to compute his stuttering severity estimates was 200 syllables. This was investigated. Procedures supplied for the assessment of readers and non-readers were examined to see whether they give equivalent scores. Recordings of spontaneous speech samples from 23 young children (aged between 2 years 8 months and 6 years 3 months) and 31 older children (aged between 10 years 0 months and 14 years 7 months) were made. Riley's severity estimates were scored on extracts of different lengths. The older children provided spontaneous and read samples, which were scored for severity according to reader and non-reader procedures. Analysis of variance supported the use of 200-syllable-long samples as the minimum necessary for obtaining severity scores. There was no significant difference in SSI-3 scores for the older children when the reader and non-reader procedures were used. Samples that are 200-syllables long are the minimum that is appropriate for obtaining stable Riley's severity scores. The procedural variants provide similar severity scores.

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.

Speech Problems

MedlinePlus

... if you're in your teens and still stuttering, you may not feel like it's so endearing. ... million Americans have the speech disorder known as stuttering (or stammering, as it's known in Britain). It's ...

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.

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

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

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.

The Prevalence of Stuttering, Voice, and Speech-Sound Disorders in Primary School Students in Australia

ERIC Educational Resources Information Center

McKinnon, David H.; McLeod, Sharynne; Reilly, Sheena

2007-01-01

Purpose: The aims of this study were threefold: to report teachers' estimates of the prevalence of speech disorders (specifically, stuttering, voice, and speech-sound disorders); to consider correspondence between the prevalence of speech disorders and gender, grade level, and socioeconomic status; and to describe the level of support provided to…

Speaking Rate Characteristics of Elementary-School-Aged Children Who Do and Do Not Stutter

ERIC Educational Resources Information Center

Logan, Kenneth J.; Byrd, Courtney T.; Mazzocchi, Elizabeth M.; Gillam, Ronald B.

2011-01-01

Purpose: To compare articulation and speech rates of school-aged children who do and do not stutter across sentence priming, structured conversation, and narration tasks and to determine factors that predict children's speech and articulation rates. Method: 34 children who stutter (CWS) and 34 age- and gender-matched children who do not stutter…

Long-Term Effectiveness of the SpeechEasy Fluency-Enhancement Device

ERIC Educational Resources Information Center

Gallop, Ronald F.; Runyan, Charles M.

2012-01-01

The SpeechEasy has been found to be an effective device for reduction of stuttering frequency for many people who stutter (PWS); published studies typically have compared stuttering reduction at initial fitting of the device to results achieved up to one year later. This study examines long-term effectiveness by examining whether effects of the…

Separating the Problem and the Person: Insights from Narrative Therapy with People Who Stutter

ERIC Educational Resources Information Center

Ryan, Fiona; O'Dwyer, Mary; Leahy, Margaret M.

2015-01-01

Stuttering is a complex disorder of speech that encompasses motor speech and emotional and cognitive factors. The use of narrative therapy is described here, focusing on the stories that clients tell about the problems associated with stuttering that they have encountered in their lives. Narrative therapy uses these stories to understand, analyze,…

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.

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.

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.

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.

Overreliance on auditory feedback may lead to sound/syllable repetitions: simulations of stuttering and fluency-inducing conditions with a neural model of speech production

PubMed Central

Civier, Oren; Tasko, Stephen M.; Guenther, Frank H.

2010-01-01

This paper investigates the hypothesis that stuttering may result in part from impaired readout of feedforward control of speech, which forces persons who stutter (PWS) to produce speech with a motor strategy that is weighted too much toward auditory feedback control. Over-reliance on feedback control leads to production errors which, if they grow large enough, can cause the motor system to “reset” and repeat the current syllable. This hypothesis is investigated using computer simulations of a “neurally impaired” version of the DIVA model, a neural network model of speech acquisition and production. The model’s outputs are compared to published acoustic data from PWS’ fluent speech, and to combined acoustic and articulatory movement data collected from the dysfluent speech of one PWS. The simulations mimic the errors observed in the PWS subject’s speech, as well as the repairs of these errors. Additional simulations were able to account for enhancements of fluency gained by slowed/prolonged speech and masking noise. Together these results support the hypothesis that many dysfluencies in stuttering are due to a bias away from feedforward control and toward feedback control. PMID:20831971

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.

The Behavior Assessment Battery: a preliminary study of non-stuttering Pakistani grade-school children.

PubMed

Vanryckeghem, Martine; Mukati, Samad A

2006-01-01

In recent years, the importance of a multimodal approach to the assessment of the person who stutters (PWS) has become increasingly recognized. The Behavior Assessment Battery (BAB), which is a normed test procedure developed by G. Brutten, makes it possible to assess the multidimensional facets of this disorder. The emotional and speech-disruptive components that differentiate one who stutters from one who does not (PWNS) are evaluated by means of the Speech Situation Checklist (SSC), their use of behaviours secondary to stuttering are assessed through the Behavior Checklist (BCL) and the person's speech-related attitude is determined via the Communication Attitude Test (CAT). Each of these BAB tests has been shown to be a reliable and valid measure whose obtained normative data are essentially equivalent in Western countries. Because of the lack of normative data on children from non-Western cultures, the present preliminary study was aimed to investigate if the affective, behavioural and cognitive reports of non-stuttering Pakistani children on the BAB measures are like those of their Western peers. Forty-five non-stuttering Pakistani children between the ages of 8 and 11 were administered the SSC, BCL and CAT. As in previous studies, the mean score of the normally fluent children on each of the BAB tests fell into the lower end of the possible distribution of scores. Intercorrelations between the different tests were statistically significant. Although the BCL and CAT results were similar to those found in Western-based investigations, the emotional reaction and speech disruption scores on the SSC reported by Pakistani children sampled were numerically higher to an extent that is noteworthy. The latter finding suggests that this particular BAB measure might be affected by cultural differences. It points to the possibility that the norms of test procedures, such as the BAB, might not be fully appropriate for use in other than Western cultures.

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.

Investigating the Inner Speech of People Who Stutter: Evidence for (and against) the Covert Repair Hypothesis

ERIC Educational Resources Information Center

Brocklehurst, Paul H.; Corley, Martin

2011-01-01

In their Covert Repair Hypothesis, Postma and Kolk (1993) suggest that people who stutter make greater numbers of phonological encoding errors, which are detected during the monitoring of inner speech and repaired, with stuttering-like disfluencies as a consequence. Here, we report an experiment that documents the frequency with which such errors…

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…

The Impact of Social-Cognitive Stress on Speech Variability, Determinism, and Stability in Adults Who Do and Do Not Stutter

ERIC Educational Resources Information Center

Jackson, Eric S.; Tiede, Mark; Beal, Deryk; Whalen, D. H.

2016-01-01

Purpose: This study examined the impact of social-cognitive stress on sentence-level speech variability, determinism, and stability in adults who stutter (AWS) and adults who do not stutter (AWNS). We demonstrated that complementing the spatiotemporal index (STI) with recurrence quantification analysis (RQA) provides a novel approach to both…

Language and Motor Abilities of Preschool Children Who Stutter: Evidence from Behavioral and Kinematic Indices of Nonword Repetition Performance

ERIC Educational Resources Information Center

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…

A Lag in Speech Motor Coordination during Sentence Production Is Associated with Stuttering Persistence in Young Children

ERIC Educational Resources Information Center

Usler, Evan; Smith, Anne; Weber, Christine

2017-01-01

Purpose: The purpose of this study was to determine if indices of speech motor coordination during the production of sentences varying in sentence length and syntactic complexity were associated with stuttering persistence versus recovery in 5- to 7-year-old children. Methods: We compared children with persistent stuttering (CWS-Per) with children…

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

[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.

Phonological Encoding in the Silent Speech of Persons Who Stutter

ERIC Educational Resources Information Center

Sasisekaran, Jayanthi; De Nil, Luc F.; Smyth, Ron; Johnson, Carla

2006-01-01

The purpose of the present study was to investigate the role of phonological encoding in the silent speech of persons who stutter (PWS) and persons who do not stutter (PNS). Participants were 10 PWS (M=30.4 years, S.D.=7.8), matched in age, gender, and handedness with 11 PNS (M=30.1 years, S.D.=7.8). Each participant performed five tasks: a…

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.

Systematic Studies of Modified Vocalization: Speech Production Changes During a Variation of Metronomic Speech in Persons Who Do and Do Not Stutter

PubMed Central

Davidow, Jason H.; Bothe, Anne K.; Ye, Jun

2011-01-01

The most common way to induce fluency using rhythm requires persons who stutter to speak one syllable or one word to each beat of a metronome, but stuttering can also be eliminated when the stimulus is of a particular duration (e.g., 1 s). The present study examined stuttering frequency, speech production changes, and speech naturalness during rhythmic speech that alternated 1 s of reading with 1 s of silence. A repeated-measures design was used to compare data obtained during a control reading condition and during rhythmic reading in 10 persons who stutter (PWS) and 10 normally fluent controls. Ratings for speech naturalness were also gathered from naïve listeners. Results showed that mean vowel duration increased significantly, and the percentage of short phonated intervals decreased significantly, for both groups from the control to the experimental condition. Mean phonated interval length increased significantly for the fluent controls. Mean speech naturalness ratings during the experimental condition were approximately 7 on a 1–9 scale (1 = highly natural; 9 = highly unnatural), and these ratings were significantly correlated with vowel duration and phonated intervals for PWS. The findings indicate that PWS may be altering vocal fold vibration duration to obtain fluency during this rhythmic speech style, and that vocal fold vibration duration may have an impact on speech naturalness during rhythmic speech. Future investigations should examine speech production changes and speech naturalness during variations of this rhythmic condition. Educational Objectives The reader will be able to: (1) describe changes (from a control reading condition) in speech production variables when alternating between 1 s of reading and 1 s of silence, (2) describe which rhythmic conditions have been found to sound and feel the most natural, (3) describe methodological issues for studies about alterations in speech production variables during fluency-inducing conditions, and (4) describe which fluency-inducing conditions have been shown to involve a reduction in short phonated intervals. PMID:21664528

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 ...

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…

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

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

Stuttering adults' lack of pre-speech auditory modulation normalizes when speaking with delayed auditory feedback.

PubMed

Daliri, Ayoub; Max, Ludo

2018-02-01

Auditory modulation during speech movement planning is limited in adults who stutter (AWS), but the functional relevance of the phenomenon itself remains unknown. We investigated for AWS and adults who do not stutter (AWNS) (a) a potential relationship between pre-speech auditory modulation and auditory feedback contributions to speech motor learning and (b) the effect on pre-speech auditory modulation of real-time versus delayed auditory feedback. Experiment I used a sensorimotor adaptation paradigm to estimate auditory-motor speech learning. Using acoustic speech recordings, we quantified subjects' formant frequency adjustments across trials when continually exposed to formant-shifted auditory feedback. In Experiment II, we used electroencephalography to determine the same subjects' extent of pre-speech auditory modulation (reductions in auditory evoked potential N1 amplitude) when probe tones were delivered prior to speaking versus not speaking. To manipulate subjects' ability to monitor real-time feedback, we included speaking conditions with non-altered auditory feedback (NAF) and delayed auditory feedback (DAF). Experiment I showed that auditory-motor learning was limited for AWS versus AWNS, and the extent of learning was negatively correlated with stuttering frequency. Experiment II yielded several key findings: (a) our prior finding of limited pre-speech auditory modulation in AWS was replicated; (b) DAF caused a decrease in auditory modulation for most AWNS but an increase for most AWS; and (c) for AWS, the amount of auditory modulation when speaking with DAF was positively correlated with stuttering frequency. Lastly, AWNS showed no correlation between pre-speech auditory modulation (Experiment II) and extent of auditory-motor learning (Experiment I) whereas AWS showed a negative correlation between these measures. Thus, findings suggest that AWS show deficits in both pre-speech auditory modulation and auditory-motor learning; however, limited pre-speech modulation is not directly related to limited auditory-motor adaptation; and in AWS, DAF paradoxically tends to normalize their otherwise limited pre-speech auditory modulation. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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.

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.

The Disfluent Speech of Bilingual Spanish-English Children: Considerations for Differential Diagnosis of Stuttering

ERIC Educational Resources Information Center

Byrd, Courtney T.; 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…

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.

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…

A Lag in Speech Motor Coordination During Sentence Production Is Associated With Stuttering Persistence in Young Children

PubMed Central

Smith, Anne; Weber, Christine

2017-01-01

Purpose The purpose of this study was to determine if indices of speech motor coordination during the production of sentences varying in sentence length and syntactic complexity were associated with stuttering persistence versus recovery in 5- to 7-year-old children. Methods We compared children with persistent stuttering (CWS-Per) with children who had recovered (CWS-Rec), and children who do not stutter (CWNS). A kinematic measure of articulatory coordination, lip aperture variability (LAVar), and overall movement duration were computed for perceptually fluent sentence productions varying in length and syntactic complexity. Results CWS-Per exhibited higher LAVar across sentence types compared to CWS-Rec and CWNS. For the participants who successfully completed the experimental paradigm, the demands of increasing sentence length and syntactic complexity did not appear to disproportionately affect the speech motor coordination of CWS-Per compared to their recovered and fluent peers. However, a subset of CWS-Per failed to produce the required number of accurate utterances. Conclusions These findings support our hypothesis that the speech motor coordination of school-age CWS-Per, on average, is less refined and less mature compared to CWS-Rec and CWNS. Childhood recovery from stuttering is characterized, in part, by overcoming an earlier occurring maturational lag in speech motor development. PMID:28056137

Effects of sentence-structure complexity on speech initiation time and disfluency.

PubMed

Tsiamtsiouris, Jim; Cairns, Helen Smith

2013-03-01

There is general agreement that stuttering is caused by a variety of factors, and language formulation and speech motor control are two important factors that have been implicated in previous research, yet the exact nature of their effects is still not well understood. Our goal was to test the hypothesis that sentences of high structural complexity would incur greater processing costs than sentences of low structural complexity and these costs would be higher for adults who stutter than for adults who do not stutter. Fluent adults and adults who stutter participated in an experiment that required memorization of a sentence classified as low or high structural complexity followed by production of that sentence upon a visual cue. Both groups of speakers initiated most sentences significantly faster in the low structural complexity condition than in the high structural complexity condition. Adults who stutter were over-all slower in speech initiation than were fluent speakers, but there were no significant interactions between complexity and group. However, adults who stutter produced significantly more disfluencies in sentences of high structural complexity than in those of low complexity. After reading this article, the learner will be able to: (a) identify integral parts of all well-known models of adult sentence production; (b) summarize the way that sentence structure might negatively influence the speech production processes; (c) discuss whether sentence structure influences speech initiation time and disfluencies. Copyright © 2012 Elsevier Inc. All rights reserved.

Measuring Stuttering in Preschool-Aged Children across Different Languages: An International Study.

PubMed

Bosshardt, Hans-Georg; Packman, Ann; Blomgren, Michael; Kretschmann, Jens

2015-01-01

Many speech-language pathologists (SLPs) are working in linguistically diverse communities and have to identify and measure stuttering in a language other than their own. The aim of the present study was to extend our understanding of how well SLPs can measure stuttering in other languages and to encourage collaboration between SLPs across cultures. Speech samples consisted of seven preschool-aged children each speaking one of the following languages: Danish, English, French, German, Greek, Italian, and Persian (Farsi). The judges were classified in seven groups of SLPs (n = 170) each speaking one of the seven languages of the children and two more English-speaking groups. Each judge rated the severity of stuttering in each child using a 10-point scale. The study was conducted over the Internet. Overall, the judges' proficiency in a child's language was not systematically related to the variability and agreement of the severity ratings, accounting for maximally 4.6% of the variance. SLPs should not be overly concerned about the appropriateness of their severity ratings if they feel less proficient in the native language of the stuttering children. It may also be encouraging for beginning clinicians that the severity ratings were not systematically related to professional experience. © 2016 S. Karger AG, Basel.

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.

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.

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 effectiveness of the SpeechEasy fluency-enhancement device.

PubMed

Gallop, Ronald F; Runyan, Charles M

2012-12-01

The SpeechEasy has been found to be an effective device for reduction of stuttering frequency for many people who stutter (PWS); published studies typically have compared stuttering reduction at initial fitting of the device to results achieved up to one year later. This study examines long-term effectiveness by examining whether effects of the SpeechEasy were maintained for longer periods, from 13 to 59 months. Results indicated no significant change for seven device users from post-fitting to the time of the study (t=-.074, p=.943); however, findings varied greatly on a case-by-case basis. Most notably, when stuttering frequency for eleven users and former users, prior to device fitting, was compared to current stuttering frequency while not wearing the device, the change over time was found to be statistically significant (t=2.851, p=.017), suggesting a carry-over effect of the device. There was no significant difference in stuttering frequency when users were wearing versus not wearing the device currently (t=1.949, p=0.92). Examinations of these results, as well as direction for future research, are described herein. The reader will be able to: (a) identify and briefly describe two types of altered auditory feedback which the SpeechEasy incorporates in order to help reduce stuttering; (b) describe the carry-over effect found in this study, suggest effectiveness associated with the device over a longer period of time than previously reported, as well as its implications, and (c) list factors that might be assessed in future research involving this device in order to more narrowly determine which prospective users are most likely to benefit from employing the SpeechEasy. Copyright © 2012 Elsevier Inc. All rights reserved.

Do Individuals with Fragile X Syndrome Show Developmental Stuttering or Not? Comment on "Speech Fluency in Fragile X Syndrome" by Van Borsel, Dor and Rondal

ERIC Educational Resources Information Center

Howell, Peter

2008-01-01

Van Borsel, Dor, and Rondal (2007) examined the speech of seven boys and two young male adults with fragile X syndrome and considered whether their speech was comparable to that reported in the developmental stuttering literature. They listed five criteria which led them to conclude that the speech patterns of speakers with fragile X syndrome…

The Particularities of the Monologue Speech Type Manifestations in Stuttering Schoolchildren with Tatar-Russian Bilingualism Compared to the Normality

ERIC Educational Resources Information Center

Osipovskaya, Marina P.; Sharifzyanova, Kadriya Sh.; Zamaletdinova, Zalfira I.

2016-01-01

Actuality of studying of an issue on specific manifestations of a monologue speech type in bilingual schoolchildren with stutter has been stipulated by the necessity of elaboration of a constituent concept on central mechanisms underlying this kind of communication disorder, on the nature of disturbances of speech formation mechanisms in the…

Mild Traumatic Brain Injury and Conduction Aphasia from a Close Proximity Blast Resulting in Arcuate Fasciculus Damage Diagnosed on DTI Tractography

DTIC Science & Technology

2009-11-01

communication which are described below as conduction aphasia and neurogenic stuttering secondary to the aphasia. Also, his family felt that his personality... stuttering , and “mumbling” speech. In continued evaluation, estimated premorbid intellectual ability was at least in the average range. Speech...language production resulted in mild neurogenic stuttering . There was also some evidence of visuoconstructional dysfunction. In addition there was

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.

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

Genetic studies of stuttering in a founder population.

PubMed

Wittke-Thompson, Jacqueline K; Ambrose, Nicoline; Yairi, Ehud; Roe, Cheryl; Cook, Edwin H; Ober, Carole; Cox, Nancy J

2007-01-01

Genome-wide linkage and association analyses were conducted to identify genetic determinants of stuttering in a founder population in which 48 individuals affected with stuttering are connected in a single 232-person genealogy. A novel approach was devised to account for all necessary relationships to enable multipoint linkage analysis. Regions with nominal evidence for linkage were found on chromosomes 3 (P=0.013, 208.8 centiMorgans (cM)), 13 (P=0.012, 52.6 cM), and 15 (P=0.02, 100 cM). Regions with nominal evidence for association with stuttering that overlapped with a linkage signal are located on chromosomes 3 (P=0.0047, 195 cM), 9 (P=0.0067, 46.5 cM), and 13 (P=0.0055, 52.6 cM). We also conducted the first meta-analysis for stuttering using results from linkage studies in the Hutterites and The Illinois International Genetics of Stuttering Project and identified regions with nominal evidence for linkage on chromosomes 2 (P=0.013, 180-195 cM) and 5 (P=0.0051, 105-120 cM; P=0.015, 120-135 cM). None of the linkage signals detected in the Hutterite sample alone, or in the meta-analysis, meet genome-wide criteria for significance, although some of the stronger signals overlap linkage mapping signals previously reported for other speech and language disorders. After reading this article, the reader will be able to: (1) summarize information about the background of common disorders and methodology of genetic studies; (2) evaluate the role of genetics in stuttering; (3) discuss the value of using founder populations in genetic studies; (4) articulate the importance of combining several studies in a meta-analysis; (5) discuss the overlap of genetic signals identified in stuttering with other speech and language disorders.

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

Diffusion imaging of cerebral white matter in persons who stutter: evidence for network-level anomalies

PubMed Central

Cai, Shanqing; Tourville, Jason A.; Beal, Deryk S.; Perkell, Joseph S.; Guenther, Frank H.; Ghosh, Satrajit S.

2013-01-01

Deficits in brain white matter have been a main focus of recent neuroimaging studies on stuttering. However, no prior study has examined brain connectivity on the global level of the cerebral cortex in persons who stutter (PWS). In the current study, we analyzed the results from probabilistic tractography between regions comprising the cortical speech network. An anatomical parcellation scheme was used to define 28 speech production-related ROIs in each hemisphere. We used network-based statistic (NBS) and graph theory to analyze the connectivity patterns obtained from tractography. At the network-level, the probabilistic corticocortical connectivity from the PWS group were significantly weaker than that from persons with fluent speech (PFS). NBS analysis revealed significant components in the bilateral speech networks with negative correlations with stuttering severity. To facilitate comparison with previous studies, we also performed tract-based spatial statistics (TBSS) and regional fractional anisotropy (FA) averaging. Results from tractography, TBSS and regional FA averaging jointly highlight the importance of several regions in the left peri-Rolandic sensorimotor and premotor areas, most notably the left ventral premotor cortex (vPMC) and middle primary motor cortex, in the neuroanatomical basis of stuttering. PMID:24611042

Diffusion imaging of cerebral white matter in persons who stutter: evidence for network-level anomalies.

PubMed

Cai, Shanqing; Tourville, Jason A; Beal, Deryk S; Perkell, Joseph S; Guenther, Frank H; Ghosh, Satrajit S

2014-01-01

Deficits in brain white matter have been a main focus of recent neuroimaging studies on stuttering. However, no prior study has examined brain connectivity on the global level of the cerebral cortex in persons who stutter (PWS). In the current study, we analyzed the results from probabilistic tractography between regions comprising the cortical speech network. An anatomical parcellation scheme was used to define 28 speech production-related ROIs in each hemisphere. We used network-based statistic (NBS) and graph theory to analyze the connectivity patterns obtained from tractography. At the network-level, the probabilistic corticocortical connectivity from the PWS group were significantly weaker than that from persons with fluent speech (PFS). NBS analysis revealed significant components in the bilateral speech networks with negative correlations with stuttering severity. To facilitate comparison with previous studies, we also performed tract-based spatial statistics (TBSS) and regional fractional anisotropy (FA) averaging. Results from tractography, TBSS and regional FA averaging jointly highlight the importance of several regions in the left peri-Rolandic sensorimotor and premotor areas, most notably the left ventral premotor cortex (vPMC) and middle primary motor cortex, in the neuroanatomical basis of stuttering.

A model of serial order problems in fluent, stuttered and agrammatic speech.

PubMed

Howell, Peter

2007-10-01

Many models of speech production have attempted to explain dysfluent speech. Most models assume that the disruptions that occur when speech is dysfluent arise because the speakers make errors while planning an utterance. In this contribution, a model of the serial order of speech is described that does not make this assumption. It involves the coordination or 'interlocking' of linguistic planning and execution stages at the language-speech interface. The model is examined to determine whether it can distinguish two forms of dysfluent speech (stuttered and agrammatic speech) that are characterized by iteration and omission of whole words and parts of words.

Acceptance and Commitment Therapy for adults who stutter: psychosocial adjustment and speech fluency.

PubMed

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

2012-12-01

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) readiness for therapy and change, (c) utilisation of mindfulness skills and psychological flexibility, and (d) frequency of stuttering. The findings provide innovative evidence for Acceptance and Commitment Therapy as an effective intervention with statistically significant improvements in psychosocial functioning, preparation for change and therapy, utilisation of mindfulness skills, and overall speech fluency. Follow-up data collected at three months post-treatment revealed that therapeutic gains were successfully maintained over time. These findings enhance the understanding of the impact of stuttering on psychological wellbeing and offer a new perspective on what might constitute successful stuttering treatment. Further, clinical research support is provided for Acceptance and Commitment Therapy delivered in a group format as a promising and novel intervention for adults who stutter. The reader will be able to: (a) appreciate the potential for Acceptance and Commitment Therapy for adults who stutter; (b) identify the improvements participants experienced in psychosocial functioning and frequency of stuttered speech; (c) appreciate the six core processes of Acceptance and Commitment Therapy; and (d) appreciate the differences between an ACT model of intervention for adults who stutter compared to a CBT approach. Copyright © 2012 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.

Systematic studies of modified vocalization: speech production changes during a variation of metronomic speech in persons who do and do not stutter.

PubMed

Davidow, Jason H; Bothe, Anne K; Ye, Jun

2011-06-01

The most common way to induce fluency using rhythm requires persons who stutter to speak one syllable or one word to each beat of a metronome, but stuttering can also be eliminated when the stimulus is of a particular duration (e.g., 1 second [s]). The present study examined stuttering frequency, speech production changes, and speech naturalness during rhythmic speech that alternated 1s of reading with 1s of silence. A repeated-measures design was used to compare data obtained during a control reading condition and during rhythmic reading in 10 persons who stutter (PWS) and 10 normally fluent controls. Ratings for speech naturalness were also gathered from naïve listeners. Results showed that mean vowel duration increased significantly, and the percentage of short phonated intervals decreased significantly, for both groups from the control to the experimental condition. Mean phonated interval length increased significantly for the fluent controls. Mean speech naturalness ratings during the experimental condition were approximately "7" on a 1-9 scale (1=highly natural; 9=highly unnatural), and these ratings were significantly correlated with vowel duration and phonated intervals for PWS. The findings indicate that PWS may be altering vocal fold vibration duration to obtain fluency during this rhythmic speech style, and that vocal fold vibration duration may have an impact on speech naturalness during rhythmic speech. Future investigations should examine speech production changes and speech naturalness during variations of this rhythmic condition. The reader will be able to: (1) describe changes (from a control reading condition) in speech production variables when alternating between 1s of reading and 1s of silence, (2) describe which rhythmic conditions have been found to sound and feel the most natural, (3) describe methodological issues for studies about alterations in speech production variables during fluency-inducing conditions, and (4) describe which fluency-inducing conditions have been shown to involve a reduction in short phonated intervals. Copyright © 2011 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.

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

ERIC Educational Resources Information Center

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

2016-01-01

Purpose: 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. Method: Nineteen adults who stutter and twenty adults who do…

Visual feedback in stuttering therapy

NASA Astrophysics Data System (ADS)

Smolka, Elzbieta

1997-02-01

The aim of this paper is to present the results concerning the influence of visual echo and reverberation on the speech process of stutterers. Visual stimuli along with the influence of acoustic and visual-acoustic stimuli have been compared. Following this the methods of implementing visual feedback with the aid of electroluminescent diodes directed by speech signals have been presented. The concept of a computerized visual echo based on the acoustic recognition of Polish syllabic vowels has been also presented. All the research nd trials carried out at our center, aside from cognitive aims, generally aim at the development of new speech correctors to be utilized in stuttering therapy.

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.

Stuttering generalization self-measure: Preliminary development of a self-measuring tool.

PubMed

Alameer, Mohammad; Meteyard, Lotte; Ward, David

2017-09-01

Generalization of treatment is considered a difficult task for clinicians and people who stutter (PWS), and can constitute a barrier to long-term treatment success. To our knowledge, there are no standardized tests that collect measurement of the behavioral and cognitive aspects alongside the client's self-perception in real-life speaking situations. This paper describes the preliminary development of a Stuttering Generalization Self-Measure (SGSM). The purpose of SGSM is to assess 1) stuttering severity and 2) speech-anxiety level during real-life situations as perceived by PWS. Additionally, this measurement aims to 3) investigate correlations between stuttering severity and speech-anxiety level within the same real-life situation. The SGSM initially reported includes nine speaking situations designed that are developed to cover a variety of frequent speaking scenario situations. However, two of these were less commonly encountered by participants and subsequently not included in the final analyses. Items were created according to five listener categories (family and close friends, acquaintances, strangers, persons of authority, and giving a short speech to small audience). Forty-three participants (22 PWS, and 21 control) aged 18 to 53 years were asked to complete the assessment in real-life situations. Analyses indicated that test-retest reliability was high for both groups. Discriminant validity was also achieved as the SGSM scores significantly differed between the controls and PWS two groups for stuttering and speech-anxiety. Convergent validity was confirmed by significant correlations between the SGSM and other speech-related anxiety measures. Copyright © 2017 Elsevier Inc. All rights reserved.

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,…

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.

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

Carry-over fluency induced by extreme prolongations: A new behavioral paradigm.

PubMed

Briley, P M; Barnes, M P; Kalinowski, J S

2016-04-01

Extreme prolongations, which can be generated via extreme delayed auditory feedback (DAF) (e.g., 250-500 ms) or mediated cognitively with timing applications (e.g., analog stopwatch) at 2 s per syllable, have long been behavioral techniques used to inhibit stuttering. Some therapies have used this rate solely to establish initial fluency, while others use extremely slowed speech to establish fluency and add other strategic techniques such as easy onsets and diaphragmatic breathing. Extreme prolongations generate effective, efficient, and immediate forward flowing fluent speech, removing the signature behaviors of discrete stuttering (i.e., syllable repetitions and audible and inaudible postural fixations). Prolonged use of extreme prolongations establishes carry-over fluency, which is spontaneous, effortless speech absent of most, if not all, overt and covert manifestations of stuttering. The creation of this immediate fluency and the immense potential of extreme prolongations to generate long periods of carry-over fluency have been overlooked by researchers and clinicians alike. Clinicians depart from these longer prolongation durations as they attempt to achieve the same fluent results at a near normal rate of speech. Clinicians assume they are re-teaching fluency and slow rates will give rise to more normal rates with less control, but without carry-over fluency, controls and cognitive mediation are always needed for the inherently unstable speech systems of persons who stutter to experience fluent speech. The assumption being that the speech system is untenable without some level of cognitive and motoric monitoring that is always necessary. The goal is omnipresent "near normal rate sounding fluency" with continuous mediation via cognitive and motoric processes. This pursuit of "normal sounding fluency" continues despite ever-present relapse. Relapse has become so common that acceptance of stuttering is the new therapy modality because relapse has come to be understood as somewhat inevitable. Researchers and clinicians fail to recognize that immediate amelioration of stuttering and its attendant carry-over fluency are signs of a different pathway to fluency. In this path, clinicians focus on extreme prolongations and the extent of their carry-over. While fluency is automatically generated under these extreme prolongations, the realization is that communication at this rate in routine speaking tasks is not feasible. The perceived solution is a systematic reduction in the duration of these prolongations, which attempts to approximate "normal speech." Typically, the reintroduction of speech at a normalized rate precipitates a laborious style that is undesirable to the person who stutters (PWS) and is discontinued, once departed from the comforts of the clinical setting. The inevitable typically occurs; the well-intentioned therapist instructs the PWS to focus on the techniques while speaking at a rate that is nearest normal speech, but the overlooked extreme prolongations are unlikely to ever be revisited. The foundation of this hypothesis is that the departure from fluency generators (e.g. extreme prolongations) is the cause of regression to the stuttering set point. In turn, we postulate that the continued use of extreme prolongations, as a solitary practice method, will establish and nurture different neural pathways that will create a modality of fluent speech, able to be experienced without cognitive or motoric mediation. This would therefore result in fewer occurrences of stuttering due to a phenomenon called carry-over fluency. Thus, we hypothesize that the use of extreme prolongations fosters neural pathways for fluent speech, which will result in carry-over fluency that does not require mediation by the speaker. Copyright © 2016 Elsevier Ltd. All rights reserved.

The impact of threat and cognitive stress on speech motor control in people who stutter.

PubMed

Lieshout, Pascal van; Ben-David, Boaz; Lipski, Melinda; Namasivayam, Aravind

2014-06-01

In the present study, an Emotional Stroop and Classical Stroop task were used to separate the effect of threat content and cognitive stress from the phonetic features of words on motor preparation and execution processes. A group of 10 people who stutter (PWS) and 10 matched people who do not stutter (PNS) repeated colour names for threat content words and neutral words, as well as for traditional Stroop stimuli. Data collection included speech acoustics and movement data from upper lip and lower lip using 3D EMA. PWS in both tasks were slower to respond and showed smaller upper lip movement ranges than PNS. For the Emotional Stroop task only, PWS were found to show larger inter-lip phase differences compared to PNS. General threat words were executed with faster lower lip movements (larger range and shorter duration) in both groups, but only PWS showed a change in upper lip movements. For stutter specific threat words, both groups showed a more variable lip coordination pattern, but only PWS showed a delay in reaction time compared to neutral words. Individual stuttered words showed no effects. Both groups showed a classical Stroop interference effect in reaction time but no changes in motor variables. This study shows differential motor responses in PWS compared to controls for specific threat words. Cognitive stress was not found to affect stuttering individuals differently than controls or that its impact spreads to motor execution processes. After reading this article, the reader will be able to: (1) discuss the importance of understanding how threat content influences speech motor control in people who stutter and non-stuttering speakers; (2) discuss the need to use tasks like the Emotional Stroop and Regular Stroop to separate phonetic (word-bound) based impact on fluency from other factors in people who stutter; and (3) describe the role of anxiety and cognitive stress on speech motor processes. Copyright © 2014 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.

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.

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.

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.

The Impact of Social-Cognitive Stress on Speech Variability, Determinism, and Stability in Adults Who Do and Do Not Stutter.

PubMed

Jackson, Eric S; Tiede, Mark; Beal, Deryk; Whalen, D H

2016-12-01

This study examined the impact of social-cognitive stress on sentence-level speech variability, determinism, and stability in adults who stutter (AWS) and adults who do not stutter (AWNS). We demonstrated that complementing the spatiotemporal index (STI) with recurrence quantification analysis (RQA) provides a novel approach to both assessing and interpreting speech variability in stuttering. Twenty AWS and 21 AWNS repeated sentences in audience and nonaudience conditions while their lip movements were tracked. Across-sentence variability was assessed via the STI; within-sentence determinism and stability were assessed via RQA. Compared with the AWNS, the AWS produced speech that was more variable across sentences and more deterministic and stable within sentences. Audience presence contributed to greater within-sentence determinism and stability in the AWS. A subset of AWS who were more susceptible to experiencing anxiety exhibited reduced across-sentence variability in the audience condition compared with the nonaudience condition. This study extends the assessment of speech variability in AWS and AWNS into the social-cognitive domain and demonstrates that the characterization of speech within sentences using RQA is complementary to the across-sentence STI measure. AWS seem to adopt a more restrictive, less flexible speaking approach in response to social-cognitive stress, which is presumably a strategy for maintaining observably fluent speech.

The Impact of Social–Cognitive Stress on Speech Variability, Determinism, and Stability in Adults Who Do and Do Not Stutter

PubMed Central

Tiede, Mark; Beal, Deryk; Whalen, D. H.

2016-01-01

Purpose This study examined the impact of social–cognitive stress on sentence-level speech variability, determinism, and stability in adults who stutter (AWS) and adults who do not stutter (AWNS). We demonstrated that complementing the spatiotemporal index (STI) with recurrence quantification analysis (RQA) provides a novel approach to both assessing and interpreting speech variability in stuttering. Method Twenty AWS and 21 AWNS repeated sentences in audience and nonaudience conditions while their lip movements were tracked. Across-sentence variability was assessed via the STI; within-sentence determinism and stability were assessed via RQA. Results Compared with the AWNS, the AWS produced speech that was more variable across sentences and more deterministic and stable within sentences. Audience presence contributed to greater within-sentence determinism and stability in the AWS. A subset of AWS who were more susceptible to experiencing anxiety exhibited reduced across-sentence variability in the audience condition compared with the nonaudience condition. Conclusions This study extends the assessment of speech variability in AWS and AWNS into the social–cognitive domain and demonstrates that the characterization of speech within sentences using RQA is complementary to the across-sentence STI measure. AWS seem to adopt a more restrictive, less flexible speaking approach in response to social–cognitive stress, which is presumably a strategy for maintaining observably fluent speech. PMID:27936276

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…

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…

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.

A Mutation Associated with Stuttering Alters Mouse Pup Ultrasonic Vocalizations.

PubMed

Barnes, Terra D; Wozniak, David F; Gutierrez, Joanne; Han, Tae-Un; Drayna, Dennis; Holy, Timothy E

2016-04-13

A promising approach to understanding the mechanistic basis of speech is to study disorders that affect speech without compromising other cognitive or motor functions. Stuttering, also known as stammering, has been linked to mutations in the lysosomal enzyme-targeting pathway, but how this remarkably specific speech deficit arises from mutations in a family of general "cellular housekeeping" genes is unknown. To address this question, we asked whether a missense mutation associated with human stuttering causes vocal or other abnormalities in mice. We compared vocalizations from mice engineered to carry a mutation in the Gnptab (N-acetylglucosamine-1-phosphotransferase subunits alpha/beta) gene with wild-type littermates. We found significant differences in the vocalizations of pups with the human Gnptab stuttering mutation compared to littermate controls. Specifically, we found that mice with the mutation emitted fewer vocalizations per unit time and had longer pauses between vocalizations and that the entropy of the temporal sequence was significantly reduced. Furthermore, Gnptab missense mice were similar to wild-type mice on an extensive battery of non-vocal behaviors. We then used the same language-agnostic metrics for auditory signal analysis of human speech. We analyzed speech from people who stutter with mutations in this pathway and compared it to control speech and found abnormalities similar to those found in the mouse vocalizations. These data show that mutations in the lysosomal enzyme-targeting pathway produce highly specific effects in mouse pup vocalizations and establish the mouse as an attractive model for studying this disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

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.

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

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.

Common features of fluency-evoking conditions studied in stuttering subjects and controls: an H(2)15O PET study.

PubMed

Stager, Sheila V; Jeffries, Keith J; Braun, Allen R

2003-01-01

We used H(2)15O PET to characterize the common features of two successful but markedly different fluency-evoking conditions -- paced speech and singing -- in order to identify brain mechanisms that enable fluent speech in people who stutter. To do so, we compared responses under fluency-evoking conditions with responses elicited by tasks that typically elicit dysfluent speech (quantifying the degree of stuttering and using this measure as a confounding covariate in our analyses). We evaluated task-related activations in both stuttering subjects and age- and gender-matched controls. Areas that were either uniquely activated during fluency-evoking conditions, or in which the magnitude of activation was significantly greater during fluency-evoking than dysfluency-evoking tasks included auditory association areas that process speech and voice and motor regions related to control of the larynx and oral articulators. This suggests that a common fluency-evoking mechanism might relate to more effective coupling of auditory and motor systems -- that is, more efficient self-monitoring, allowing motor areas to more effectively modify speech. These effects were seen in both PWS and controls, suggesting that they are due to the sensorimotor or cognitive demands of the fluency-evoking tasks themselves. While responses seen in both groups were bilateral, however, the fluency-evoking tasks elicited more robust activation of auditory and motor regions within the left hemisphere of stuttering subjects, suggesting a role for the left hemisphere in compensatory processes that enable fluency. The reader will learn about and be able to: (1) compare brain activation patterns under fluency- and dysfluency-evoking conditions in stuttering and control subjects; (2) appraise the common features, both central and peripheral, of fluency-evoking conditions; and (3) discuss ways in which neuroimaging methods can be used to understand the pathophysiology of stuttering.

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.

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

PubMed

Carey, Brenda; O'Brian, Sue; Onslow, Mark; Packman, Ann; Menzies, Ross

2012-07-01

This Phase I clinical trial explored the viability of webcam Internet delivery of the Camperdown Program for adolescents who stutter. Method and Procedure Participants were 3 adolescents ages 13, 15, and 16 years, with moderate-severe stuttering. Each was treated with the Camperdown Program delivered by webcam with no clinic attendance. Primary outcome measures were percentage of syllables stuttered and number of treatment sessions to maintenance. Secondary outcome measures were speech naturalness, situation avoidance, self-reported stuttering severity, and parent and adolescent satisfaction. Data were collected pre treatment and at 1 day, 6 months, and 12 months post entry to maintenance. Participants entered maintenance after means of 18 sessions and 11 clinician hours. Group mean reduction of stuttering from pre treatment to entry to maintenance was 83%, from pre treatment to 6 months post entry to maintenance was 93%, and from pre treatment to 12 months post entry to maintenance was 74%. Self-reported stuttering severity ratings confirmed these results. Post entry to maintenance speech naturalness for participants fell within the range of that of 3 matched controls. However, avoidance of speech situations showed no corresponding improvements for 2 of the participants. The service delivery model was efficacious and efficient. All of the participants and their parents also found it appealing. Results justify a Phase II trial of the delivery model.

Phase II trial of a syllable-timed speech treatment for school-age children who stutter.

PubMed

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

2016-06-01

A recent clinical trial (Andrews et al., 2012) showed Syllable Timed Speech (STS) to be a potentially useful treatment agent for the reduction of stuttering for school-age children. The present trial investigated a modified version of this program that incorporated parent verbal contingencies. Participants were 22 stuttering children aged 6-11 years. Treatment involved training the children and their parents to use STS in conversation. Parents were also taught to use verbal contingencies in response to their child's stuttered and stutter-free speech and to praise their child's use of STS. Outcome assessments were conducted pre-treatment, at the completion of Stage 1 of the program and 6 months and 12 months after Stage 1 completion. Outcomes are reported for the 19 children who completed Stage 1 of the program. The group mean percent stuttering reduction was 77% from pre-treatment to 12 months post-treatment, and 82% with the two least responsive participants removed. There was considerable variation in response to the treatment. Eleven of the children showed reduced avoidance of speaking situations and 18 were more satisfied with their fluency post-treatment. However, there was some suggestion that stuttering control was not sufficient to fully eliminate situation avoidance for the children. The results of this trial are sufficiently encouraging to warrant further clinical trials of the method. Copyright © 2016 Elsevier Inc. All rights reserved.

Coordination of Oral and Laryngeal Movements in the Perceptually Fluent Speech of Adults Who Stutter

ERIC Educational Resources Information Center

Max, Ludo; Gracco, Vincent L.

2005-01-01

This work investigated whether stuttering and nonstuttering adults differ in the coordination of oral and laryngeal movements during the production of perceptually fluent speech. This question was addressed by completing correlation analyses that extended previous acoustic studies by others as well as inferential analyses based on the…

Speech and Nonspeech Sequence Skill Learning in Adults Who Stutter

ERIC Educational Resources Information Center

Smits-Bandstra, Sarah; De Nil, Luc; Saint-Cyr, Jean A.

2006-01-01

Two studies compared the speech and nonspeech sequence skill learning of nine persons who stutter (PWS) and nine matched fluent speakers (PNS). Sequence skill learning was defined as a continuing process of stable improvement in speed and/or accuracy of sequencing performance over practice and was measured by comparing PWS's and PNS's performance…

Influences of Sentence Length and Syntactic Complexity on the Speech Motor Control of Children Who Stutter

ERIC Educational Resources Information Center

MacPherson, Megan K.; Smith, Anne

2013-01-01

Purpose: To investigate the potential effects of increased sentence length and syntactic complexity on the speech motor control of children who stutter (CWS). Method: Participants repeated sentences of varied length and syntactic complexity. Kinematic measures of articulatory coordination variability and movement duration during perceptually…

Selecting the Right Marines for Recruiting Duty: The Important Role of the Commander

DTIC Science & Technology

2012-04-05

stutters or has other speech impediments should not be assigned to recruiting duty. Recruiters School cannot teach a Marine to become an articulate...Impediment A sergeant reported to the RS with an obvious speech impediment that was characterized by a persistent stuttering problem. It was clear to

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.

The prevalence of stuttering, voice, and speech-sound disorders in primary school students in Australia.

PubMed

McKinnon, David H; McLeod, Sharynne; Reilly, Sheena

2007-01-01

The aims of this study were threefold: to report teachers' estimates of the prevalence of speech disorders (specifically, stuttering, voice, and speech-sound disorders); to consider correspondence between the prevalence of speech disorders and gender, grade level, and socioeconomic status; and to describe the level of support provided to schoolchildren with speech disorders. Students with speech disorders were identified from 10,425 students in Australia using a 4-stage process: training in the data collection process, teacher identification, confirmation by a speech-language pathologist, and consultation with district special needs advisors. The prevalence of students with speech disorders was estimated; specifically, 0.33% of students were identified as stuttering, 0.12% as having a voice disorder, and 1.06% as having a speech-sound disorder. There was a higher prevalence of speech disorders in males than in females. As grade level increased, the prevalence of speech disorders decreased. There was no significant difference in the pattern of prevalence across the three speech disorders and four socioeconomic groups; however, students who were identified with a speech disorder were more likely to be in the higher socioeconomic groups. Finally, there was a difference between the perceived and actual level of support that was provided to these students. These prevalence figures are lower than those using initial identification by speech-language pathologists and similar to those using parent report.

Mirror neurons as a model for the science and treatment of stuttering.

PubMed

Snyder, Gregory J; Waddell, Dwight E; Blanchet, Paul

2016-01-06

Persistent developmental stuttering is generally considered a speech disorder and affects ∼1% of the global population. While mainstream treatments continue to rely on unreliable behavioral speech motor targets, an emerging research perspective utilizes the mirror neuron system hypothesis as a neural substrate in the science and treatment of stuttering. The purpose of this exploratory study is to test the viability of the mirror neuron system hypothesis in the fluency enhancement of those who stutter. Participants were asked to speak while they were producing self-generated manual gestures, producing and visually perceiving self-generated manual gestures, and visually perceiving manual gestures, relative to a nonmanual gesture control speaking condition. Data reveal that all experimental speaking conditions enhanced fluent speech in all research participants, and the simultaneous perception and production of manual gesturing trended toward greater efficacious fluency enhancement. Coupled with existing research, we interpret these data as suggestive of fluency enhancement through subcortical involvement within multiple levels of an action understanding mirror neuron network. In addition, incidental findings report that stuttering moments were observed to simultaneously occur both orally and manually. Consequently, these data suggest that stuttering behaviors are compensatory, distal manifestations over multiple expressive modalities to an underlying centralized genetic neural substrate of the disorder.

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.

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

ERIC Educational Resources Information Center

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

2017-01-01

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…

A Controlled Clinical Trial for Stuttering in Persons Aged 9 to 14 Years.

ERIC Educational Resources Information Center

Craig, Ashley; And Others

1996-01-01

This paper presents results of a controlled trial of 3 child stuttering treatment strategies in 97 subjects. All 3 treatments (electromyography feedback, intensive smooth speech, and home-based smooth speech) were very successful in the long term for 70% of the group, with electromyography and home-based treatment appearing to be especially…

Brain Correlates of Stuttering and Syllable Production: Gender Comparison and Replication.

ERIC Educational Resources Information Center

Ingham, Roger J.; Fox, Peter T.; Ingham, Janis C.; Xiong, Jinhu; Zamarripa, Frank; Hardies, L. Jean; Lancaster, Jack L.

2004-01-01

This article reports a gender replication study of the P. T. Fox et a. (2000) performance correlation analysis of neural systems that distinguish between normal and stuttered speech in adult males. Positron-emission tomographic (PET) images of cerebral blood flow (CBF) were correlated with speech behavior scores obtained during PET imaging for 10…

Phonation Interval Modification and Speech Performance Quality during Fluency-Inducing Conditions by Adults Who Stutter

ERIC Educational Resources Information Center

Ingham, Roger J.; Bothe, Anne K.; Wang, Yuedong; Purkhiser, Krystal; New, Anneliese

2012-01-01

Purpose: To relate changes in four variables previously defined as characteristic of normally fluent speech to changes in phonatory behavior during oral reading by persons who stutter (PWS) and normally fluent controls under multiple fluency-inducing (FI) conditions. Method: Twelve PWS and 12 controls each completed 4 ABA experiments. During A…

The Lidcombe Program of early stuttering intervention for Malaysian families: Four case studies.

PubMed

Vong, Etain; Wilson, Linda; Lincoln, Michelle

2016-09-01

This study investigated the outcomes of implementing the Lidcombe Program, an evidence-based early intervention for stuttering, with four preschool children in Malaysia. Early stuttering intervention is currently underdeveloped in Malaysia, where stuttering treatment is often more assertion-based than evidence-based. Therefore, introducing an evidence-based early stuttering intervention is an important milestone for Malaysian preschoolers who stutter. The participants ranged from 3 years 3 months to 4 years 9 months at the start of the study. Beyond-clinic speech samples were obtained at 1 month and 1 week pretreatment and immediately post-Stage 1, and at 1 month, 3 months, 6 months and 12 months post-Stage 1. Two participants, who were bilingual, achieved near-zero levels of stuttering at 12 months posttreatment. Near zero levels of stuttering were also present in their untreated languages. One participant withdrew due to reasons not connected with the research or treatment. The remaining participant, who presented with severe stuttering, completed Stage 1 but had some relapse in Stage 2 and demonstrated mild stuttering 12 months post-Stage 1. The outcomes were achieved without the need to significantly adapt Lidcombe Program procedures to Malaysian culture. Further research to continue evaluation of the Lidcombe Program with Malaysian families and to estimate proportion of those who will respond is warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

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

Development of A Two-Stage Procedure for the Automatic Recognition of Dysfluencies in the Speech of Children Who Stutter: I. Psychometric Procedures Appropriate for Selection of Training Material for Lexical Dysfluency Classifiers

PubMed Central

Howell, Peter; Sackin, Stevie; Glenn, Kazan

2007-01-01

This program of work is intended to develop automatic recognition procedures to locate and assess stuttered dysfluencies. This and the following article together, develop and test recognizers for repetitions and prolongations. The automatic recognizers classify the speech in two stages: In the first, the speech is segmented and in the second the segments are categorized. The units that are segmented are words. Here assessments by human judges on the speech of 12 children who stutter are described using a corresponding procedure. The accuracy of word boundary placement across judges, categorization of the words as fluent, repetition or prolongation, and duration of the different fluency categories are reported. These measures allow reliable instances of repetitions and prolongations to be selected for training and assessing the recognizers in the subsequent paper. PMID:9328878

Communicative and psychological dimensions of the KiddyCAT

PubMed Central

Clark, Chagit E.; Conture, Edward G.; Frankel, Carl B.; Walden, Tedra A.

2012-01-01

Purpose The purpose of the present study was to investigate the underlying constructs of the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT; Vanryckeghem & Brutten, 2007), especially those related to awareness of stuttering and negative speech-associated attitudes. Method Participants were 114 preschool-age children who stutter (CWS; n = 52; 15 females) and children who do not stutter (CWNS; n = 62; 31 females). Their scores on the KiddyCAT were assessed to determine whether they differed with respect to talker group (CWS vs. CWNS), chronological age, younger versus older age groups, and gender. A categorical data principal components factor analysis (CATPCA) assessed the quantity and quality of the KiddyCAT dimensions. Results Findings indicated that preschool-age CWS scored significantly higher than CWNS on the KiddyCAT, regardless of age or gender. Additionally, the extraction of a single factor from the CATPCA indicated that one dimension—speech difficulty—appears to underlie the KiddyCAT items. Conclusions As reported by its test developers, the KiddyCAT differentiates between CWS and CWNS. Furthermore, one factor, which appears related to participants’ attitudes towards speech difficulty, underlies the questionnaire. Findings were taken to suggest that children’s responses to the KiddyCAT are related to their perception that speech is difficult, which, for CWS, may be associated with relatively frequent experiences with their speaking difficulties (i.e., stuttering). PMID:22333753

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

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.

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…

[Using delayed auditory feedback in the treatment of stuttering: evidence to consider].

PubMed

Van Borsel, John; Sierens, Sarah; Pereira, Mônica Medeiros de Britto

2007-01-01

There is some indication that the use of delayed auditory feedback (DAF) is a potentially helpful technique in the treatment of stuttering. Several devices for DAF are also commercially. However, not all individuals who stutter experience a positive effect on speech fluency when speaking under DAF. And those who do show a positive effect, may differ considerably as to the degree and the conditions in which the effect is seen. Therefore, the decision whether or not to attempt the use of DAF in an given client is usually not straightforward. Starting from a literature review, the present paper discusses and illustrates factors to take into account when considering the use of RAA in an individual client. Four types of factors are distinguished: factors inherent to the client such as gender, age, stuttering severity, dysfluency pattern, origin of stuttering, and biological subtype; factors outside the client including delay time, intensity, manner of delivery, speech mode, and speech situation; possible side-effects like a reduction in speech rate, an increase of speaking fundamental frequency and vocal intensity, lengthening of vowels, and a possible effect on speech naturalness; others namely cosmetics, finances, and the long-term effect. The review shows that most likely multiple factors play a role, but with the currently available data it is very hard to predict whether a given individual will or will not benefit from the use of DAF. Overall, the evidence for the influence of the different factors is still meager. Moreover, some studies present data of a quality that can hardly be considered "evidence".

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.

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.

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…

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.

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…

Applications of orofacial myofunctional techniques to speech therapy.

PubMed

Landis, C F

1994-11-01

A speech-language pathologist describes how she uses oral myofunctional therapy techniques in the treatment of speech articulation disorders, voice disorders, stuttering and apraxia of speech. Specific exercises are detailed.

Sensorimotor Oscillations Prior to Speech Onset Reflect Altered Motor Networks in Adults Who Stutter

PubMed Central

Mersov, Anna-Maria; Jobst, Cecilia; Cheyne, Douglas O.; De Nil, Luc

2016-01-01

Adults who stutter (AWS) have demonstrated atypical coordination of motor and sensory regions during speech production. Yet little is known of the speech-motor network in AWS in the brief time window preceding audible speech onset. The purpose of the current study was to characterize neural oscillations in the speech-motor network during preparation for and execution of overt speech production in AWS using magnetoencephalography (MEG). Twelve AWS and 12 age-matched controls were presented with 220 words, each word embedded in a carrier phrase. Controls were presented with the same word list as their matched AWS participant. Neural oscillatory activity was localized using minimum-variance beamforming during two time periods of interest: speech preparation (prior to speech onset) and speech execution (following speech onset). Compared to controls, AWS showed stronger beta (15–25 Hz) suppression in the speech preparation stage, followed by stronger beta synchronization in the bilateral mouth motor cortex. AWS also recruited the right mouth motor cortex significantly earlier in the speech preparation stage compared to controls. Exaggerated motor preparation is discussed in the context of reduced coordination in the speech-motor network of AWS. It is further proposed that exaggerated beta synchronization may reflect a more strongly inhibited motor system that requires a stronger beta suppression to disengage prior to speech initiation. These novel findings highlight critical differences in the speech-motor network of AWS that occur prior to speech onset and emphasize the need to investigate further the speech-motor assembly in the stuttering population. PMID:27642279

Lexical tone and stuttering in Cantonese.

PubMed

Law, Thomas; Packman, Ann; Onslow, Mark; To, Carol K-S; Tong, Michael C-F; Lee, Kathy Y-S

2018-01-01

Cantonese is a tone language, in which the variation of the fundamental frequency contour of a syllable can change meaning. There are six different lexical tones in Cantonese. While research with Western languages has shown an association between stuttering and syllabic stress, nothing is known about whether stuttering in Cantonese speakers is associated with one or more of the six lexical tones. Such an association has been reported in conversational speech in Mandarin, which is also a tone language, but which varies markedly from Cantonese. Twenty-four native Cantonese-speaking adults who stutter participated in this study, ranging in age from 18-33 years. There were 18 men and 6 women. Participants read aloud 13 Cantonese syllables, each of which was produced with six contrastive lexical tones. All 78 syllables were embedded in the same carrier sentence, to reduce the influence of suprasegmental or linguistic stress, and were presented in random order. No significant differences were found for stuttering moments across the six lexical tones. It is suggested that this is because lexical tones, at least in Cantonese, do not place the task demands on the speech motor system that typify varying syllabic stress in Western languages: variations not only in fundamental frequency, but also in duration and intensity. The findings of this study suggest that treatments for adults who stutter in Western languages, such as speech restructuring, can be used with Cantonese speakers without undue attention to lexical tone.

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.

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.

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

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.

Communicative and psychological dimensions of the KiddyCAT.

PubMed

Clark, Chagit E; Conture, Edward G; Frankel, Carl B; Walden, Tedra A

2012-01-01

The purpose of the present study was to investigate the underlying constructs of the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT; Vanryckeghem & Brutten, 2007), especially those related to awareness of stuttering and negative speech-associated attitudes. Participants were 114 preschool-age children who stutter (CWS; n=52; 15 females) and children who do not stutter (CWNS; n=62; 31 females). Their scores on the KiddyCAT were assessed to determine whether they differed with respect to talker group (CWS vs. CWNS), chronological age, younger versus older age groups, and gender. A categorical data principal components factor analysis (CATPCA) assessed the quantity and quality of the KiddyCAT dimensions. Findings indicated that preschool-age CWS scored significantly higher than CWNS on the KiddyCAT, regardless of age or gender. Additionally, the extraction of a single factor from the CATPCA indicated that one dimension-speech difficulty-appears to underlie the KiddyCAT items. As reported by its test developers, the KiddyCAT differentiates between CWS and CWNS. Furthermore, one factor, which appears related to participants' attitudes towards speech difficulty, underlies the questionnaire. Findings were taken to suggest that children's responses to the KiddyCAT are related to their perception that speech is difficult, which, for CWS, may be associated with relatively frequent experiences with their speaking difficulties (i.e., stuttering). After reading this article, the reader will be able to: (1) Better understand the concepts of attitude and awareness; (2) compare historical views with more recent empirical findings regarding preschool-age CWS' attitudes/awareness towards their stuttering; (3) describe the underlying dimension of the KiddyCAT questionnaire; (4) interpret KiddyCAT results and describe implications of those results. Copyright © 2012 Elsevier Inc. All rights reserved.

Speech Skill Learning of Persons Who Stutter and Fluent Speakers under Single and Dual Task Conditions

ERIC Educational Resources Information Center

Smits-Bandstra, Sarah; De Nil, Luc

2009-01-01

Two studies compared the accuracy and efficiency of initiating oral reading of nonsense syllables by persons who stutter (PWS) and fluent speakers (PNS) over practise. Findings of Study One, comparing 12 PWS and 12 PNS, replicated previous findings of slow speech sequence initiation over practise by PWS relative to PNS. In Study Two, nine PWS and…

Japanese normative data for the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) Scales for adults who stutter.

PubMed

Chu, Shin Ying; Sakai, Naomi; Mori, Koichi; Iverach, Lisa

2017-03-01

This study reports Japanese normative data for the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) scales. We outline the translation process, and evaluate the psychometric properties of the Japanese version of the UTBAS scales. The translation of the UTBAS scales into Japanese (UTBAS-J) was completed using the standard forward-backward translation process, and was administered to 130 Japanese adults who stutter. To validate the UTBAS-J scales, scores for the Japanese and Australian cohorts were compared. Spearman correlations were conducted between the UTBAS-J and the Modified Erickson Communication Attitude scale (S-24), the self-assessment scale of speech (SA scale), and age. The test-retest reliability and internal consistency of the UTBAS-J were assessed. Independent t-tests were conducted to evaluate the differences in the UTBAS-J scales according to gender, speech treatment experience, and stuttering self-help group participation experience. The UTBAS-J showed good test-retest reliability, high internal consistency, and moderate to high significant correlations with S-24 and SA scale. A weak correlation was found between the UTBAS-J scales with age. No significant relationships were found between UTBAS-J scores, gender and speech treatment experience. However, those who participated in the stuttering self-help group demonstrated lower UTBAS-J scores than those who did not. Given the current scarcity of clinical assessment tools for adults who stutter in Japan, the UTBAS-J holds promise as an assessment tool and outcome measure for use in clinical and research environments. Copyright © 2016 Elsevier Inc. All rights reserved.

The effect of speech rate on stuttering frequency, phonated intervals, speech effort, and speech naturalness during chorus reading.

PubMed

Davidow, Jason H; Ingham, Roger J

2013-01-01

This study examined the effect of speech rate on phonated intervals (PIs), in order to test whether a reduction in the frequency of short PIs is an important part of the fluency-inducing mechanism of chorus reading. The influence of speech rate on stuttering frequency, speaker-judged speech effort, and listener-judged naturalness was also examined. An added purpose was to determine if chorus reading could be further refined so as to provide a perceptual guide for gauging the level of physical effort exerted during speech production. A repeated-measures design was used to compare data obtained during control reading conditions and during several chorus reading conditions produced at different speech rates. Participants included 8 persons who stutter (PWS) between the ages of 16 and 32 years. There were significant reductions in the frequency of short PIs from the habitual reading condition during slower chorus conditions, no change when speech rates were matched between habitual reading and chorus conditions, and an increase in the frequency of short PIs during chorus reading produced at a faster rate than the habitual condition. Speech rate did not have an effect on stuttering frequency during chorus reading. In general, speech effort ratings improved and naturalness ratings worsened as speech rate decreased. These results provide evidence that (a) a reduction in the frequency of short PIs is not necessary for fluency improvement during chorus reading, and (b) speech rate may be altered to provide PWS with a more appropriate reference for how physically effortful normally fluent speech production should be. Future investigations should examine the necessity of changes in the activation of neural regions during chorus reading, the possibility of defining individualized units on a 9-point effort scale, and if there are upper and lower speech rate boundaries for receiving ratings of "highly natural sounding" speech during chorus reading. The reader will be able to: (1) describe the effect of changes in speech rate on the frequency of short phonated intervals during chorus reading, (2) describe changes to speaker-judged speech effort as speech rate changes during chorus reading, (3) and describe the effect of changes in speech rate on listener-judged naturalness ratings during chorus reading. Copyright © 2012 Elsevier Inc. All rights reserved.

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…

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.…

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…

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…

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…

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.

Aggravated stuttering following subthalamic deep brain stimulation in Parkinson's disease - two cases

PubMed Central

2011-01-01

Stuttering is a speech disorder with disruption of verbal fluency which is occasionally present in patients with Parkinson's disease (PD). Long-term medical management of PD is frequently complicated by fluctuating motor functions and dyskinesias. High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment of motor fluctuations and is the most common surgical procedure in PD. Here we report the re-occurrence and aggravation of stuttering following STN-DBS in two male patients treated for advanced PD. In both patients the speech fluency improved considerably when the neurostimulator was turned off, indicating that stuttering aggravation was related to neurostimulation of the STN itself, its afferent or efferent projections and/or to structures localized in the immediate proximity. This report supports previous studies demonstrating that lesions of the basal ganglia-thalamocortical motor circuit, including the STN, is involved in the development of stuttering. In advanced PD STN-DBS is generally an effective and safe treatment. However, patients with PD and stuttering should be informed about the risk of aggravated symptoms following surgical therapy. PMID:21477305

Neurogenic stuttering: a review of the literature.

PubMed

Cruz, C; Amorim, H; Beca, G; Nunes, R

2018-01-16

Neurogenic stuttering is a disorder of neurologic origin in the rhythm of speech during which the patient knows exactly what he wants to say but is unable to because of an involuntary prolongation, cessation or repetition of a sound. To assemble new insights regarding the epidemiology, pathophysiology, diagnosis, evaluation and treatment of neurogenic stuttering. A review of all PubMed and Scopus published articles between January 2000 and September 2016 was performed. Thirty-three publications were analyzed. Neurogenic stuttering is a rare entity whose epidemiological incidence is yet not fully established. It is correlated with several neurological diseases and with several possible localizations within the nervous system. Notwithstanding the recent advances in the understanding of the underlying mechanism, it is not yet possible to establish a single pathophysiological mechanism of neurogenic stuttering. The differential diagnosis is complex and requires the detailed knowledge of other language disorders. The treatment is currently based on specific speech language therapy strategies. Neurogenic stuttering is a complex disorder which is not fully understood. Additional studies might help to better explain the underlying pathophysiological mechanism and to open doors to novel therapeutic methods.

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

Anxiety and speaking in people who stutter: an investigation using the emotional Stroop task.

PubMed

Hennessey, Neville W; Dourado, Esther; Beilby, Janet M

2014-06-01

People with anxiety disorders show an attentional bias towards threat or negative emotion words. This exploratory study examined whether people who stutter (PWS), who can be anxious when speaking, show similar bias and whether reactions to threat words also influence speech motor planning and execution. Comparisons were made between 31 PWS and 31 fluent controls in a modified emotional Stroop task where, depending on a visual cue, participants named the colour of threat and neutral words at either a normal or fast articulation rate. In a manual version of the same task participants pressed the corresponding colour button with either a long or short duration. PWS but not controls were slower to respond to threat words than neutral words, however, this emotionality effect was only evident for verbal responding. Emotionality did not interact with speech rate, but the size of the emotionality effect among PWS did correlate with frequency of stuttering. Results suggest PWS show an attentional bias to threat words similar to that found in people with anxiety disorder. In addition, this bias appears to be contingent on engaging the speech production system as a response modality. No evidence was found to indicate that emotional reactivity during the Stroop task constrains or destabilises, perhaps via arousal mechanisms, speech motor adjustment or execution for PWS. The reader will be able to: (1) explain the importance of cognitive aspects of anxiety, such as attentional biases, in the possible cause and/or maintenance of anxiety in people who stutter, (2) explain how the emotional Stroop task can be used as a measure of attentional bias to threat information, and (3) evaluate the findings with respect to the relationship between attentional bias to threat information and speech production in people who stutter. Copyright © 2013 Elsevier Inc. All rights reserved.

Further development and validation of the Unhelpful Thoughts and Beliefs About Stuttering (UTBAS) scales: relationship to anxiety and social phobia among adults who stutter.

PubMed

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

2011-01-01

In an initial validation study, the Unhelpful Thoughts and Beliefs About Stuttering (UTBAS I) scale, demonstrated excellent psychometric properties as a self-report measure of the frequency of unhelpful cognitions associated with social anxiety for adults who stutter. The aim was to further validate the original UTBAS I scale, and to develop two additional scales to assess beliefs (UTBAS II) and anxiety (UTBAS III) associated with negative thoughts. A total of 140 adults seeking speech-restructuring treatment for stuttering completed the original UTBAS I scale, the newly developed UTBAS II and III scales, and self-report measures of psychological functioning. Participants also completed a first-stage screener for the presence of anxious personality disorder, and a diagnostic assessment to evaluate the presence of social phobia, according to criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the International Classification of Diseases (ICD-10). The mean UTBAS I score for the present sample did not differ significantly from the mean score reported in the original UTBAS I validation study. Convergent validity was confirmed by significant correlations between the UTBAS Total score and all anxiety-related measures. Discriminant validity was established by the absence of strong correlations between the UTBAS Total score and some of the self-report measures of unrelated constructs, although it was found to tap into the negative cognitions associated with depression and life problems. Approximately one-quarter of participants met criteria for a diagnosis of DSM-IV or ICD-10 social phobia (23.5% and 27.2% respectively), and nearly one-third met first-stage screening criteria for anxious personality disorder (30%). The mean UTBAS scores for participants who met criteria for these disorders were significantly higher than scores for participants who did not, confirming known-groups validity. The present study demonstrates the validity and utility of the UTBAS scales in assessing negative cognitions associated with speech-related anxiety among adults who stutter. Results also confirm previous evidence of a high rate of social phobia among adults who stutter, and reveal that the UTBAS discriminates between adults with and without social phobia. In terms of clinical applications, the UTBAS scales could be used to screen for indicators of social phobia among adults who stutter, and may prove useful in identifying negative cognitions which have the potential to impact treatment outcomes. © 2011 Royal College of Speech & Language Therapists.

Effects of a metronome on the filled pauses of fluent speakers.

PubMed

Christenfeld, N

1996-12-01

Filled pauses (the "ums" and "uhs" that litter spontaneous speech) seem to be a product of the speaker paying deliberate attention to the normally automatic act of talking. This is the same sort of explanation that has been offered for stuttering. In this paper we explore whether a manipulation that has long been known to decrease stuttering, synchronizing speech to the beats of a metronome, will then also decrease filled pauses. Two experiments indicate that a metronome has a dramatic effect on the production of filled pauses. This effect is not due to any simplification or slowing of the speech and supports the view that a metronome causes speakers to attend more to how they are talking and less to what they are saying. It also lends support to the connection between stutters and filled pauses.

[Study of stutter originating from the frustrated clinging instinct and its relation to anxiety and self-esteem].

PubMed

Nagy, Beáta Erika; Józsa, Tamás

2016-05-22

The analytic and family therapeutic theories connected to the topic of stutter have to be actualized. The aim of this work was to point out connections which originate from the instinct of frustrated clinging, however, these can be interpretated in new ways these days. Two questionnaires in 48 subjects suffering from stutter were used; Rosenberg's Self-Esteem Scale measured the children's self representation, while the Multidimensional Anxiety Scale for Children measured the degree of their anxiety. At first the subjects had to anwser the questions as themselves, for the second time they had to anwser as an ordinary person without a speech disorder. The hypothesis of the authors was verified: stutterers attributed a significant role to the speech disorder of the subjects in connection with their self-esteem. According to this a significant amount of their anxiety is based on their deficit. An unexpected result was that girls and boys estimated ordinary people's level of anxiety similarly. There was no significant difference between boys and girls regarding the level of other's self-esteem. Based on the thesis of evolutionary psychology, the adequate use of speech is more important to women who have a connecting role in the family. This results that they see stutter as a major problem.

Hemispheric Lateralization of Motor Thresholds in Relation to Stuttering

PubMed Central

Alm, Per A.; Karlsson, Ragnhild; Sundberg, Madeleine; Axelson, Hans W.

2013-01-01

Stuttering is a complex speech disorder. Previous studies indicate a tendency towards elevated motor threshold for the left hemisphere, as measured using transcranial magnetic stimulation (TMS). This may reflect a monohemispheric motor system impairment. The purpose of the study was to investigate the relative side-to-side difference (asymmetry) and the absolute levels of motor threshold for the hand area, using TMS in adults who stutter (n = 15) and in controls (n = 15). In accordance with the hypothesis, the groups differed significantly regarding the relative side-to-side difference of finger motor threshold (p = 0.0026), with the stuttering group showing higher motor threshold of the left hemisphere in relation to the right. Also the absolute level of the finger motor threshold for the left hemisphere differed between the groups (p = 0.049). The obtained results, together with previous investigations, provide support for the hypothesis that stuttering tends to be related to left hemisphere motor impairment, and possibly to a dysfunctional state of bilateral speech motor control. PMID:24146930

Systematic studies of modified vocalization: the effect of speech rate on speech production measures during metronome-paced speech in persons who stutter.

PubMed

Davidow, Jason H

2014-01-01

Metronome-paced speech results in the elimination, or substantial reduction, of stuttering moments. The cause of fluency during this fluency-inducing condition is unknown. Several investigations have reported changes in speech pattern characteristics from a control condition to a metronome-paced speech condition, but failure to control speech rate between conditions limits our ability to determine if the changes were necessary for fluency. This study examined the effect of speech rate on several speech production variables during one-syllable-per-beat metronomic speech in order to determine changes that may be important for fluency during this fluency-inducing condition. Thirteen persons who stutter (PWS), aged 18-62 years, completed a series of speaking tasks. Several speech production variables were compared between conditions produced at different metronome beat rates, and between a control condition and a metronome-paced speech condition produced at a rate equal to the control condition. Vowel duration, voice onset time, pressure rise time and phonated intervals were significantly impacted by metronome beat rate. Voice onset time and the percentage of short (30-100 ms) phonated intervals significantly decreased from the control condition to the equivalent rate metronome-paced speech condition. A reduction in the percentage of short phonated intervals may be important for fluency during syllable-based metronome-paced speech for PWS. Future studies should continue examining the necessity of this reduction. In addition, speech rate must be controlled in future fluency-inducing condition studies, including neuroimaging investigations, in order for this research to make a substantial contribution to finding the fluency-inducing mechanism of fluency-inducing conditions. © 2013 Royal College of Speech and Language Therapists.

The Anticipatory Struggle Hypothesis: Implications of Research on the Variability of Stuttering

ERIC Educational Resources Information Center

Bloodstein, Oliver

1972-01-01

The hypothesis that a person stutters because he believes in the difficulty of speech, anticipates failure, and struggles to avoid it, is said to be consistent with experimental findings on the metronome effect, the adaptation effect, the effects of white noise and delayed auditory feedback, and operant control of stuttering. (Author/GW)

(Non)Verbal Behavior of Young Stutterers and Their Mothers. Final Report.

ERIC Educational Resources Information Center

Conture, Edward G.

This final report describes activities and accomplishments of a 3-year project which analyzed the speech and related behaviors of 28 young children (mean age 52.5 months) who stuttered, their mothers, and similar non-stuttering children and mothers. A loosely structured conversation between each mother and child was recorded and analyzed. In…

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…

Patterns of Stuttering in a Spanish/English Bilingual: A Case Report

ERIC Educational Resources Information Center

Ardila, Alfredo; Ramos, Eliane; Barrocas, Robert

2011-01-01

Stuttering patterns may differ when comparing two languages. In bilinguals, specific patterns of stuttering in each one of the languages may potentially be found. This study reports on the case of a 27-year-old Spanish/English simultaneous bilingual whose dominant language is English. Speech and language testing was performed in both languages…

The Influence of Phonetic Complexity on Stuttered Speech

ERIC Educational Resources Information Center

Coalson, Geoffrey A.; Byrd, Courtney T.; Davis, Barbara L.

2012-01-01

The primary purpose of this study was to re-examine the influence of phonetic complexity on stuttering in young children through the use of the Word Complexity Measure (WCM). Parent-child conversations were transcribed for 14 children who stutter (mean age = 3 years, 7 months; SD = 11.20 months). Lexical and linguistic factors were accounted for…

Short report

PubMed Central

Quinn, P. T.; Andrews, Gavin

1977-01-01

Stuttering associated with neurological pathology in normal adult speakers is uncommon, has no consistent clinicopathological picture, and its significance is too easily dismissed. A case is reported showing that stuttering may be a presenting symptom of progressive neurological disease, and another case demonstrates that a speech disorder which is indistinguishable from common stuttering may follow cerebral follow injury in adulthood. PMID:915515

Speech and Communication Disorders

MedlinePlus

... to being completely unable to speak or understand speech. Causes include Hearing disorders and deafness Voice problems, ... or those caused by cleft lip or palate Speech problems like stuttering Developmental disabilities Learning disorders Autism ...

Systematic Studies of Modified Vocalization: The Effect of Speech Rate on Speech Production Measures During Metronome-Paced Speech in Persons who Stutter

PubMed Central

Davidow, Jason H.

2013-01-01

Background Metronome-paced speech results in the elimination, or substantial reduction, of stuttering moments. The cause of fluency during this fluency-inducing condition is unknown. Several investigations have reported changes in speech pattern characteristics from a control condition to a metronome-paced speech condition, but failure to control speech rate between conditions limits our ability to determine if the changes were necessary for fluency. Aims This study examined the effect of speech rate on several speech production variables during one-syllable-per-beat metronomic speech, in order to determine changes that may be important for fluency during this fluency-inducing condition. Methods and Procedures Thirteen persons who stutter (PWS), aged 18–62 years, completed a series of speaking tasks. Several speech production variables were compared between conditions produced at different metronome beat rates, and between a control condition and a metronome-paced speech condition produced at a rate equal to the control condition. Outcomes & Results Vowel duration, voice onset time, pressure rise time, and phonated intervals were significantly impacted by metronome beat rate. Voice onset time and the percentage of short (30–100 ms) phonated intervals significantly decreased from the control condition to the equivalent rate metronome-paced speech condition. Conclusions & Implications A reduction in the percentage of short phonated intervals may be important for fluency during syllable-based metronome-paced speech for PWS. Future studies should continue examining the necessity of this reduction. In addition, speech rate must be controlled in future fluency-inducing condition studies, including neuroimaging investigations, in order for this research to make a substantial contribution to finding the fluency-inducing mechanism of fluency-inducing conditions. PMID:24372888

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 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.

Identifying correlates of self-stigma in adults who stutter: Further establishing the construct validity of the Self-Stigma of Stuttering Scale (4S).

PubMed

Boyle, Michael P

2015-03-01

This study was set up to further establish the construct validity of the Self-Stigma of Stuttering Scale (4S) by demonstrating its associations with other established scales and replicating its original factor structure and reliability estimates. Web surveys were completed by 354 adults who stutter recruited from Board Certified Specialists in Fluency Disorders, and adult chapters of the National Stuttering Association. Participants completed a series of psychometrically validated scales measuring self-stigma, hope, empowerment, quality of life, social support, anxiety, depression, and self-rated speech disruption. Higher subscale and total stigma scores on the 4S were associated with significantly lower levels of hope, empowerment, quality of life, and social support, and significantly higher levels of anxiety, depression, and self-rated speech disruption. The original factor structure of the 4S was replicated, and reliability estimates of the subscales ranged from adequate to excellent. The findings of this study support the construct validity of the 4S and its use by clinicians and researchers intending to measure the construct of self-stigma in adults who stutter. Readers should be able to: (a) distinguish between the various components of self-stigma; (b) describe how the various components of the self-stigma model relate to hope, empowerment, quality of life, and social support, self-rated speech disruption, anxiety, and depression; (c) summarize the psychometric properties of the Self-Stigma of Stuttering Scale (4S) in terms of reliability, factor structure, and construct validity; (d) discuss how the 4S could be used in research and clinical practice. Copyright © 2015 Elsevier Inc. All rights reserved.

PRESCHOOL SPEECH ARTICULATION AND NONWORD REPETITION ABILITIES MAY HELP PREDICT EVENTUAL RECOVERY OR PERSISTENCE OF STUTTERING

PubMed Central

Spencer, Caroline; Weber-Fox, Christine

2014-01-01

Purpose 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. Methods 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. Results 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. Conclusion 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. PMID:25173455

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.

An Experimental Clinical Trial of a Cognitive-Behavior Therapy Package for Chronic Stuttering

ERIC Educational Resources Information Center

Menzies, Ross G.; O'Brian, Sue; Onslow, Mark; Packman, Ann; St Clare, Tamsen; Block, Susan

2008-01-01

Purpose: The aims of the present study were to (a) examine the rate of social phobia among adults who stutter, (b) study the effects of speech restructuring treatment on social anxiety, and (c) study the effects on anxiety and stuttering of a cognitive-behavior therapy (CBT) package for social anxiety. Method: Thirty-two adults with chronic…

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…

An Analysis of Difficulties of Children with Stuttering Enrolled in Turkish Primary Inclusive Classes Who Encounter in Academic and Social Activities: From Their Perspectives

ERIC Educational Resources Information Center

Sari, Hakan; Gökdag, Hatice

2017-01-01

Stuttering means that children have difficulties in rhythm, sound, syllable, word and phrase repetitions, or flow of speech cut in the form of extension or block form. In the "International Classification of Diseases" (1992) ("International Classification of Diseases-10" ("ICD-10"), Stuttering was defined as speech…

Lateralization of brain activation in fluent and non-fluent preschool children: a magnetoencephalographic study of picture-naming.

PubMed

Sowman, Paul F; Crain, Stephen; Harrison, Elisabeth; Johnson, Blake W

2014-01-01

The neural causes of stuttering remain unknown. One explanation comes from neuroimaging studies that have reported abnormal lateralization of activation in the brains of people who stutter. However, these findings are generally based on data from adults with a long history of stuttering, raising the possibility that the observed lateralization anomalies are compensatory rather than causal. The current study investigated lateralization of brain activity in language-related regions of interest in young children soon after the onset of stuttering. We tested 24 preschool-aged children, half of whom had a positive diagnosis of stuttering. All children participated in a picture-naming experiment whilst their brain activity was recorded by magnetoencephalography. Source analysis performed during an epoch prior to speech onset was used to assess lateralized activation in three regions of interest. Activation was significantly lateralized to the left hemisphere in both groups and not different between groups. This study shows for the first time that significant speech preparatory brain activation can be identified in young children during picture-naming and supports the contention that, in stutterers, aberrant lateralization of brain function may be the result of neuroplastic adaptation that occurs as the condition becomes chronic.

Impact of the telephone assistive device (TAD) on stuttering severity while speaking on the telephone.

PubMed

Chambers, Nola

2009-01-01

There is extensive experimental evidence that altered auditory feedback (AAF) can have a clinically significant effect on the severity of speech symptoms in people who stutter. However, there is less evidence regarding whether these experimental effects can be observed in naturalistic everyday settings particularly when using the telephone. This study aimed to investigate the effectiveness of the Telephone Assistive Device (TAD), which is designed to provide AAF on the telephone to people who stutter, on reducing stuttering severity. Nine adults participated in a quasi-experimental study. Stuttering severity was measured first without and then with the device in participants' naturalistic settings while making and receiving telephone calls (immediate benefit). Participants were then allowed a week of repeated use of the device following which all measurements were repeated (delayed benefit). Overall, results revealed significant immediate benefits from the TAD in all call conditions. Delayed benefits in received and total calls were also significant. There was substantial individual variability in response to the TAD but none of the demographic or speech-related factors measured in the study were found to significantly impact the benefit (immediate or delayed) derived from the TAD. Results have implications for clinical decision making for adults who stutter.

The Core of the Stuttering Block

ERIC Educational Resources Information Center

Schwartz, Martin F.

1974-01-01

A model of the core of the stuttering block is presented, based on evidence that the disorder is essentially an inappropriate, vigorous contraction of the posterior cricoarytenoid in response to the subglottal air pressures required for speech. (Author)

White matter pathways in persistent developmental stuttering: Lessons from tractography.

PubMed

Kronfeld-Duenias, Vered; Civier, Oren; Amir, Ofer; Ezrati-Vinacour, Ruth; Ben-Shachar, Michal

2018-03-01

Fluent speech production relies on the coordinated processing of multiple brain regions. This highlights the role of neural pathways that connect distinct brain regions in producing fluent speech. Here, we aim to investigate the role of the white matter pathways in persistent developmental stuttering (PDS), where speech fluency is disrupted. We use diffusion weighted imaging and tractography to compare the white matter properties between adults who do and do not stutter. We compare the diffusion properties along 18 major cerebral white matter pathways. We complement the analysis with an overview of the methodology and a roadmap of the pathways implicated in PDS according to the existing literature. We report differences in the microstructural properties of the anterior callosum, the right inferior longitudinal fasciculus and the right cingulum in people who stutter compared with fluent controls. Persistent developmental stuttering is consistently associated with differences in bilateral distributed networks. We review evidence showing that PDS involves differences in bilateral dorsal fronto-temporal and fronto-parietal pathways, in callosal pathways, in several motor pathways and in basal ganglia connections. This entails an important role for long range white matter pathways in this disorder. Using a wide-lens analysis, we demonstrate differences in additional, right hemispheric pathways, which go beyond the replicable findings in the literature. This suggests that the affected circuits may extend beyond the known language and motor pathways. Copyright © 2017 Elsevier Inc. All rights reserved.

Nonword repetition and nonword reading abilities in adults who do and do not stutter.

PubMed

Sasisekaran, Jayanthi

2013-09-01

In the present study a nonword repetition and a nonword reading task were used to investigate the behavioral (speech accuracy) and speech kinematic (movement variability measured as lip aperture variability index; speech duration) profiles of groups of young adults who do (AWS) and do not stutter (control). Participants were 9 AWS (8 males, Mean age=32.2, SD=14.7) and 9 age- and sex-matched control participants (Mean age=31.8, SD=14.6). For the nonword repetition task, participants were administered the Nonword Repetition Test (Dollaghan & Campbell, 1998). For the reading task, participants were required to read out target nonwords varying in length (6 vs. 11 syllables). Repeated measures analyses of variance were conducted to compare the groups in percent speech accuracy for both tasks; only for the nonword reading task, the groups were compared in movement variability and speech duration. The groups were comparable in percent accuracy in nonword repetition. Findings from nonword reading revealed a trend for the AWS to show a lower percent of accurate productions compared to the control group. AWS also showed significantly higher movement variability and longer speech durations compared to the control group in nonword reading. Some preliminary evidence for group differences in practice effect (seen as differences between the early vs. later 5 trials) was evident in speech duration. Findings suggest differences between AWS and control groups in phonemic encoding and/or speech motor planning and production. Findings from nonword repetition vs. reading highlight the need for careful consideration of nonword properties. At the end of this activity the reader will be able to: (a) summarize the literature on nonword repetition skills in adults who stutter, (b) describe processes underlying nonword repetition and nonword reading, (c) summarize whether or not adults who stutter differ from those who do not in the behavioral and kinematic markers of nonword reading performance, (d) discuss future directions for research. Copyright © 2013 Elsevier Inc. All rights reserved.

A Resource Manual for Speech and Hearing Programs in Oklahoma.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Education, Oklahoma City.

Administrative aspects of the Oklahoma speech and hearing program are described, including state requirements, school administrator role, and organizational and operational procedures. Information on speech and language development and remediation covers language, articulation, stuttering, voice disorders, cleft palate, speech improvement,…

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.

Past tense marking in the spontaneous speech of preschool children who do and do not stutter.

PubMed

Bauman, Jessica; Hall, Nancy E; Wagovich, Stacy A; Weber-Fox, Christine M; Ratner, Nan Bernstein

2012-12-01

The aim of this study was to identify whether different patterns of errors exist in irregular past-tense verbs in children who stutter (CWS) and children who do not stutter (CWNS). Spontaneous language samples of thirty-one age- and gender-matched pairs of children (total N=62) between the ages of 24 months and 59 months were analyzed. Results indicated that children who do and do not stutter over-regularize irregular past-tense verbs (i.e., saying runned for ran) with comparable frequency. However, two nonsignificant trends which suggest possible intra-group differences were noted. First, irregular past tense verbs represented a greater portion of total verbs for CWS than for CWNS. Second, CWS appeared to double-mark (i.e., say ranned for ran) more often than CWNS. Results are discussed in light of theories about the acquisition of the irregular past-tense and about differences in language skills between CWS and CWNS. After reading this article, the reader will be able to: (a) summarize previous findings about connections between stuttering and language in CWS and CWNS; (b) describe similarities and differences between irregular past-tense verb use and errors in CWS and CWNS; (c) discuss possible connections between the declarative-procedural model and stuttering. Copyright © 2012 Elsevier Inc. All rights reserved.

Real enough: using virtual public speaking environments to evoke feelings and behaviors targeted in stuttering assessment and treatment.

PubMed

Brundage, Shelley B; Hancock, Adrienne B

2015-05-01

Virtual reality environments (VREs) are computer-generated, 3-dimensional worlds that allow users to experience situations similar to those encountered in the real world. The purpose of this study was to investigate VREs for potential use in assessing and treating persons who stutter (PWS) by determining the extent to which PWS's affective, behavioral, and cognitive measures in a VRE correlate with those same measures in a similar live environment. Ten PWS delivered speeches-first to a live audience and, on another day, to 2 virtual audiences (neutral and challenging audiences). Participants completed standard tests of communication apprehension and confidence prior to each condition, and frequency of stuttering was measured during each speech. Correlational analyses revealed significant, positive correlations between virtual and live conditions for affective and cognitive measures as well as for frequency of stuttering. These findings suggest that virtual public speaking environments engender affective, behavioral, and cognitive reactions in PWS that correspond to those experienced in the real world. Therefore, the authentic, safe, and controlled environments provided by VREs may be useful for stuttering assessment and treatment.

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.

Effect of delayed auditory feedback on normal speakers at two speech rates

NASA Astrophysics Data System (ADS)

Stuart, Andrew; Kalinowski, Joseph; Rastatter, Michael P.; Lynch, Kerry

2002-05-01

This study investigated the effect of short and long auditory feedback delays at two speech rates with normal speakers. Seventeen participants spoke under delayed auditory feedback (DAF) at 0, 25, 50, and 200 ms at normal and fast rates of speech. Significantly two to three times more dysfluencies were displayed at 200 ms (p<0.05) relative to no delay or the shorter delays. There were significantly more dysfluencies observed at the fast rate of speech (p=0.028). These findings implicate the peripheral feedback system(s) of fluent speakers for the disruptive effects of DAF on normal speech production at long auditory feedback delays. Considering the contrast in fluency/dysfluency exhibited between normal speakers and those who stutter at short and long delays, it appears that speech disruption of normal speakers under DAF is a poor analog of stuttering.

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.

Yaruss, Coleman, and Hammer (2006): an exemplar of non-evidence-based practice in stuttering treatment.

PubMed

Ingham, Roger J

2007-07-01

This letter is a response to a recent report by J. S. Yaruss, C. Coleman, and D. Hammer (2006) that described a treatment program for preschool children who stutter. Problems with the Yaruss et al. study fall into four domains: (a) failure to provide clinicians with replicable procedures, (b) failure to collect valid and reliable speech performance data, (c) failure to control for predictable improvement in children who have been stuttering for less than 15 months, and (d) the advocacy of procedures for which there is no credible research evidence. The claims made for the efficacy of this treatment are problematic and essentially violate the principles of evidence-based practice as recommended by the American Speech-Language-Hearing Association (ASHA).

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.

Attitudes toward speech disorders: sampling the views of Cantonese-speaking Americans.

PubMed

Bebout, L; Arthur, B

1997-01-01

Speech-language pathologists who serve clients from cultural backgrounds that are not familiar to them may encounter culturally influenced attitudinal differences. A questionnaire with statements about 4 speech disorders (dysfluency, cleft pallet, speech of the deaf, and misarticulations) was given to a focus group of Chinese Americans and a comparison group of non-Chinese Americans. The focus group was much more likely to believe that persons with speech disorders could improve their own speech by "trying hard," was somewhat more likely to say that people who use deaf speech and people with cleft palates might be "emotionally disturbed," and generally more likely to view deaf speech as a limitation. The comparison group was more pessimistic about stuttering children's acceptance by their peers than was the focus group. The two subject groups agreed about other items, such as the likelihood that older children with articulation problems are "less intelligent" than their peers.

Systematic studies of modified vocalization: effects of speech rate and instatement style during metronome stimulation.

PubMed

Davidow, Jason H; Bothe, Anne K; Richardson, Jessica D; Andreatta, Richard D

2010-12-01

This study introduces a series of systematic investigations intended to clarify the parameters of the fluency-inducing conditions (FICs) in stuttering. Participants included 11 adults, aged 20-63 years, with typical speech-production skills. A repeated measures design was used to examine the relationships between several speech production variables (vowel duration, voice onset time, fundamental frequency, intraoral pressure, pressure rise time, transglottal airflow, and phonated intervals) and speech rate and instatement style during metronome-entrained rhythmic speech. Measures of duration (vowel duration, voice onset time, and pressure rise time) differed across different metronome conditions. When speech rates were matched between the control condition and metronome condition, voice onset time was the only variable that changed. Results confirm that speech rate and instatement style can influence speech production variables during the production of fluency-inducing conditions. Future studies of normally fluent speech and of stuttered speech must control both features and should further explore the importance of voice onset time, which may be influenced by rate during metronome stimulation in a way that the other variables are not.

Investigating Speech Motor Practice and Learning in People Who Stutter

ERIC Educational Resources Information Center

Namasivayam, Aravind Kumar; van Lieshout, Pascal

2008-01-01

In this exploratory study, we investigated whether or not people who stutter (PWS) show motor practice and learning changes similar to those of people who do not stutter (PNS). To this end, five PWS and five PNS repeated a set of non-words at two different rates (normal and fast) across three test sessions (T1, T2 on the same day and T3 on a…

Safety Behaviors and Stuttering

ERIC Educational Resources Information Center

Lowe, Robyn; Helgadottir, Fjola; Menzies, Ross; Heard, Rob; O'Brian, Sue; Packman, Ann; Onslow, Mark

2017-01-01

Purpose: 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…

Control and prediction components of movement planning in stuttering vs. nonstuttering adults

PubMed Central

Daliri, Ayoub; Prokopenko, Roman A.; Flanagan, J. Randall; Max, Ludo

2014-01-01

Purpose Stuttering individuals show speech and nonspeech sensorimotor deficiencies. To perform accurate movements, the sensorimotor system needs to generate appropriate control signals and correctly predict their sensory consequences. Using a reaching task, we examined the integrity of these control and prediction components, separately, for movements unrelated to the speech motor system. Method Nine stuttering and nine nonstuttering adults made fast reaching movements to visual targets while sliding an object under the index finger. To quantify control, we determined initial direction error and end-point error. To quantify prediction, we calculated the correlation between vertical and horizontal forces applied to the object—an index of how well vertical force (preventing slip) anticipated direction-dependent variations in horizontal force (moving the object). Results Directional and end-point error were significantly larger for the stuttering group. Both groups performed similarly in scaling vertical force with horizontal force. Conclusions The stuttering group's reduced reaching accuracy suggests limitations in generating control signals for voluntary movements, even for non-orofacial effectors. Typical scaling of vertical force with horizontal force suggests an intact ability to predict the consequences of planned control signals. Stuttering may be associated with generalized deficiencies in planning control signals rather than predicting the consequences of those signals. PMID:25203459

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.

Computational modeling of stuttering caused by impairments in a basal ganglia thalamo-cortical circuit involved in syllable selection and initiation

PubMed Central

Civier, Oren; Bullock, Daniel; Max, Ludo; Guenther, Frank H.

2013-01-01

A typical white-matter integrity and elevated dopamine levels have been reported for individuals who stutter. We investigated how such abnormalities may lead to speech dysfluencies due to their effects on a syllable-sequencing circuit that consists of basal ganglia (BG), thalamus, and left ventral premotor cortex (vPMC). “Neurally impaired” versions of the neurocomputational speech production model GODIVA were utilized to test two hypotheses: (1) that white-matter abnormalities disturb the circuit via corticostriatal projections carrying copies of executed motor commands, and (2) that dopaminergic abnormalities disturb the circuit via the striatum. Simulation results support both hypotheses: in both scenarios, the neural abnormalities delay readout of the next syllable’s motor program, leading to dysfluency. The results also account for brain imaging findings during dysfluent speech. It is concluded that each of the two abnormality types can cause stuttering moments, probably by affecting the same BG-thalamus-vPMC circuit. PMID:23872286

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.

[Gray matter abnormalities in developmental stuttering determined with voxel-based morphometry].

PubMed

Song, Lu-ping; Peng, Dan-ling; Jin, Zhen; Yao, Li; Ning, Ning; Guo, Xiao-juan; Zhang, Tong

2007-11-06

To investigate the differences of regional grey matter volume between adults with persistent developmental stuttering and fluent speaking adults, and to determine whether stutterers have anomalous anatomy of speech-relevant brain areas that possibly affect speech fluency. High-resolution magnetic resonance imaging (MRI) scanning was performed on 10 adults with developmental stuttering, aged 26 (21 - 35) with the onset age of 4 (3 - 7) and 12 age, sex, hand preference, and education-matched controls. The customized brain templates were created in order to improve spatial normalization and segmentation. Then automated preprocessing of MRI data was conducted using an optimized version of VBM, a fully automated unbiased and objective whole-brain MRI analysis technique. VBM analysis revealed that compared with the controls, the stuttering adults had significant clusters of locally gray matter volume increased in the superior temporal, middle temporal, precentral and postcentral gyrus, and inferior parietal lobule of the bilateral hemisphere (P < 0.001), the numbers of increased gray matter volume in the right and left hemispheres were 60,247 and 48,782 voxels respectively. The, Grey matter decrease was shown with an overall decreased gray matter volume of 32 394 voxels, mainly in the bilateral cerebella posterior lobe and dorsal part of medulla, especially inferior semi-lunar lobule, followed by cerebellar tonsil and bilateral medulla in comparison with the controls (P < 0.001). The reduction of the regional gray matter volume of bilateral cerebella and medulla is related to the neural mechanism of the controlling disorder of speech production and may be the essential cause of stuttering. Some areas with increased gray matter volume in temporal lobe, parietal lobe, and frontal lobe, may be the result of long term functional compensation for the cerebella and medulla function deficiency.

Speaking-related changes in cortical functional connectivity associated with assisted and spontaneous recovery from developmental stuttering.

PubMed

Kell, Christian A; Neumann, Katrin; Behrens, Marion; von Gudenberg, Alexander W; Giraud, Anne-Lise

2018-03-01

We previously reported speaking-related activity changes associated with assisted recovery induced by a fluency shaping therapy program and unassisted recovery from developmental stuttering (Kell et al., Brain 2009). While assisted recovery re-lateralized activity to the left hemisphere, unassisted recovery was specifically associated with the activation of the left BA 47/12 in the lateral orbitofrontal cortex. These findings suggested plastic changes in speaking-related functional connectivity between left hemispheric speech network nodes. We reanalyzed these data involving 13 stuttering men before and after fluency shaping, 13 men who recovered spontaneously from their stuttering, and 13 male control participants, and examined functional connectivity during overt vs. covert reading by means of psychophysiological interactions computed across left cortical regions involved in articulation control. Persistent stuttering was associated with reduced auditory-motor coupling and enhanced integration of somatosensory feedback between the supramarginal gyrus and the prefrontal cortex. Assisted recovery reduced this hyper-connectivity and increased functional connectivity between the articulatory motor cortex and the auditory feedback processing anterior superior temporal gyrus. In spontaneous recovery, both auditory-motor coupling and integration of somatosensory feedback were normalized. In addition, activity in the left orbitofrontal cortex and superior cerebellum appeared uncoupled from the rest of the speech production network. These data suggest that therapy and spontaneous recovery normalizes the left hemispheric speaking-related activity via an improvement of auditory-motor mapping. By contrast, long-lasting unassisted recovery from stuttering is additionally supported by a functional isolation of the superior cerebellum from the rest of the speech production network, through the pivotal left BA 47/12. Copyright © 2017 Elsevier Inc. All rights reserved.

Attentional Regulation in Young Twins with Probable Stuttering, High Nonfluency, and Typical Fluency

ERIC Educational Resources Information Center

Felsenfeld, Susan; van Beljsterveldt, Catharina Eugenie Maria; Boomsma, Dorret Irene

2010-01-01

Purpose: Using a sample of 20,445 Dutch twins, this study examined the relationship between speech fluency and attentional regulation in children. A secondary objective was to identify etiological overlap between nonfluency and poor attention using fluency-discordant twin pairs. Method: Three fluency groups were created at age 5 using a parent…

The prevalence of speech disorder in primary school students in Yazd-Iran.

PubMed

Karbasi, Sedighah Akhavan; Fallah, Razieh; Golestan, Motaharah

2011-01-01

Communication disorder is a widespread disabling problems and associated with adverse, long term outcome that impact on individuals, families and academic achievement of children in the school years and affect vocational choices later in adulthood. The aim of this study was to determine prevalence of speech disorders specifically stuttering, voice, and speech-sound disorders in primary school students in Iran-Yazd. In a descriptive study, 7881 primary school students in Yazd evaluated in view from of speech disorders with use of direct and face to face assessment technique in 2005. The prevalence of total speech disorders was 14.8% among whom 13.8% had speech-sound disorder, 1.2% stuttering and 0.47% voice disorder. The prevalence of speech disorders was higher than in males (16.7%) as compared to females (12.7%). Pattern of prevalence of the three speech disorders was significantly different according to gender, parental education and by number of family member. There was no significant difference across speech disorders and birth order, religion and paternal consanguinity. These prevalence figures are higher than more studies that using parent or teacher reports.

Neurophysiologic markers of primary motor cortex for laryngeal muscles and premotor cortex in caudal opercular part of inferior frontal gyrus investigated in motor speech disorder: a navigated transcranial magnetic stimulation (TMS) study.

PubMed

Rogić Vidaković, Maja; Jerković, Ana; Jurić, Tomislav; Vujović, Igor; Šoda, Joško; Erceg, Nikola; Bubić, Andreja; Zmajević Schönwald, Marina; Lioumis, Pantelis; Gabelica, Dragan; Đogaš, Zoran

2016-11-01

Transcranial magnetic stimulation studies have so far reported the results of mapping the primary motor cortex (M1) for hand and tongue muscles in stuttering disorder. This study was designed to evaluate the feasibility of repetitive navigated transcranial magnetic stimulation (rTMS) for locating the M1 for laryngeal muscle and premotor cortical area in the caudal opercular part of inferior frontal gyrus, corresponding to Broca's area in stuttering subjects by applying new methodology for mapping these motor speech areas. Sixteen stuttering and eleven control subjects underwent rTMS motor speech mapping using modified patterned rTMS. The subjects performed visual object naming task during rTMS applied to the (a) left M1 for laryngeal muscles for recording corticobulbar motor-evoked potentials (CoMEP) from cricothyroid muscle and (b) left premotor cortical area in the caudal opercular part of inferior frontal gyrus while recording long latency responses (LLR) from cricothyroid muscle. The latency of CoMEP in control subjects was 11.75 ± 2.07 ms and CoMEP amplitude was 294.47 ± 208.87 µV, and in stuttering subjects CoMEP latency was 12.13 ± 0.75 ms and 504.64 ± 487.93 µV CoMEP amplitude. The latency of LLR in control subjects was 52.8 ± 8.6 ms and 54.95 ± 4.86 in stuttering subjects. No significant differences were found in CoMEP latency, CoMEP amplitude, and LLR latency between stuttering and control-fluent speakers. These results indicate there are probably no differences in stuttering compared to controls in functional anatomy of the pathway used for transmission of information from premotor cortex to the M1 cortices for laryngeal muscle representation and from there via corticobulbar tract to laryngeal muscles.

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.

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.

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.

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.

Weak Responses to Auditory Feedback Perturbation during Articulation in Persons Who Stutter: Evidence for Abnormal Auditory-Motor Transformation

PubMed Central

Cai, Shanqing; Beal, Deryk S.; Ghosh, Satrajit S.; Tiede, Mark K.; Guenther, Frank H.; Perkell, Joseph S.

2012-01-01

Previous empirical observations have led researchers to propose that auditory feedback (the auditory perception of self-produced sounds when speaking) functions abnormally in the speech motor systems of persons who stutter (PWS). Researchers have theorized that an important neural basis of stuttering is the aberrant integration of auditory information into incipient speech motor commands. Because of the circumstantial support for these hypotheses and the differences and contradictions between them, there is a need for carefully designed experiments that directly examine auditory-motor integration during speech production in PWS. In the current study, we used real-time manipulation of auditory feedback to directly investigate whether the speech motor system of PWS utilizes auditory feedback abnormally during articulation and to characterize potential deficits of this auditory-motor integration. Twenty-one PWS and 18 fluent control participants were recruited. Using a short-latency formant-perturbation system, we examined participants’ compensatory responses to unanticipated perturbation of auditory feedback of the first formant frequency during the production of the monophthong [ε]. The PWS showed compensatory responses that were qualitatively similar to the controls’ and had close-to-normal latencies (∼150 ms), but the magnitudes of their responses were substantially and significantly smaller than those of the control participants (by 47% on average, p<0.05). Measurements of auditory acuity indicate that the weaker-than-normal compensatory responses in PWS were not attributable to a deficit in low-level auditory processing. These findings are consistent with the hypothesis that stuttering is associated with functional defects in the inverse models responsible for the transformation from the domain of auditory targets and auditory error information into the domain of speech motor commands. PMID:22911857

Effects of perceptual and conceptual similarity in lexical priming of young children who stutter: preliminary findings.

PubMed

Hartfield, Kia N; Conture, Edward G

2006-01-01

The purpose of this study was to investigate the influence of conceptual and perceptual properties of words on the speed and accuracy of lexical retrieval of children who do (CWS) and do not stutter (CWNS) during a picture-naming task. Participants consisted of 13 3-5-year-old CWS and the same number of CWNS. All participants had speech, language, and hearing development within normal limits, with the exception of stuttering for CWS. Both talker groups participated in a picture-naming task where they named, one at a time, computer-presented, black-on-white drawings of common age-appropriate objects. These pictures were named during four auditory priming conditions: (a) a neutral prime consisting of a tone, (b) a word prime physically related to the target word, (c) a word prime functionally related to the target word, and (d) a word prime categorically related to the target word. Speech reaction time (SRT) was measured from the offset of presentation of the picture target to the onset of participant's verbal speech response. Results indicated that CWS were slower than CWNS across priming conditions (i.e., neutral, physical, function, category) and that the speed of lexical retrieval of CWS was more influenced by functional than perceptual aspects of target pictures named. Findings were taken to suggest that CWS tend to organize lexical information functionally more so than physically and that this tendency may relate to difficulties establishing normally fluent speech and language. The reader will learn about and be able to (1) communicate the relevance of examining lexical retrieval in relation to childhood stuttering and (2) describe the method of measuring speech reaction times of accurate and fluent responses during a picture-naming task as a means of assessing lexical retrieval skills.

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.

Genetic Studies of Stuttering in a Founder Population

PubMed Central

Wittke-Thompson, Jacqueline K.; Ambrose, Nicoline; Yairi, Ehud; Roe, Cheryl; Cook, Edwin H.; Ober, Carole; Cox, Nancy J.

2007-01-01

Genome-wide linkage and association analyses were conducted to identify genetic determinants of stuttering in a founder population in which 48 individuals affected with stuttering are connected in a single 232-person genealogy. A novel approach was devised to account for all necessary relationships to enable multipoint linkage analysis. Regions with nominal evidence for linkage were found on chromosomes 3 (P=0.013, 208.8 centiMorgans (cM)), 13 (P=0.012, 52.6 cM), and 15 (P=0.02, 100 cM). Regions with nominal evidence for association with stuttering that overlapped with a linkage signal are located on chromosomes 3 (P=0.0047, 195 cM), 9 (P=0.0067, 46.5 cM), and 13 (P=0.0055, 52.6 cM). We also conducted the first meta-analysis for stuttering using results from linkage studies in the Hutterites and The Illinois International Genetics of Stuttering Project and identified regions with nominal evidence for linkage on chromosomes 2 (P=0.013, 180–195 cM) and 5 (P=0.0051, 105–120 cM; P=0.015, 120–135 cM). None of the linkage signals detected in the Hutterite sample alone, or in the meta-analysis, meet genome-wide criteria for significance, although some of the stronger signals overlap linkage mapping signals previously reported for other speech and language disorders. PMID:17276504

Communicative and Psychological Dimensions of the KiddyCAT

ERIC Educational Resources Information Center

Clark, Chagit E.; Conture, Edward G.; Frankel, Carl B.; Walden, Tedra A.

2012-01-01

Purpose: The purpose of the present study was to investigate the underlying constructs of the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT; Vanryckeghem & Brutten, 2007), especially those related to awareness of stuttering and negative speech-associated attitudes. Method: Participants were 114…

Anomalous White Matter Morphology in Adults Who Stutter

ERIC Educational Resources Information Center

Cieslak, Matthew; Ingham, Rojer J.; Ingham, Janis C.; Grafton, Scott T.

2015-01-01

Aims: Developmental stuttering is now generally considered to arise from genetic determinants interacting with neurologic function. Changes within speech-motor white matter (WM) connections may also be implicated. These connections can now be studied in great detail by high-angular-resolution diffusion magnetic resonance imaging. Therefore,…

Cortical Plasticity Associated with Stuttering Therapy

ERIC Educational Resources Information Center

Neumann, Katrin; Preibisch, Christine; Euler, Harald A.; von Gudenberg, Alexander Wolff; Lanfermann, Heinrich; Gall, Volker; Giraud, Anne-Lise

2005-01-01

Neuroimaging studies have indicated that persistent developmental stuttering (PDS) may be associated both with an abnormality in white matter of left-hemispheric speech areas and a right-hemispheric hyperactivity. The latter may compensate for the deficient structural connectivity in the left hemisphere. To investigate the effects of stuttering…

Comprehensive Stuttering Treatment for Adolescents: A Case Study.

PubMed

Coleman, Craig E

2018-01-09

This article will focus on a hypothetical case study to highlight comprehensive assessment and treatment for adolescent children who stutter. Assessment and treatment are laid out with a literature review utilizing the components of the International Classification of Functioning, Disability and Health model. Specific assessment and treatment strategies and approaches are discussed. Using the International Classification of Functioning, Disability and Health model can help guide clinicians through the assessment and treatment process to ensure that all areas of stuttering are considered. Comprehensive assessment and treatment helps clinicians address all relevant elements of a stuttering disorder, rather than focusing exclusively on reducing speech disruptions.

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.

Corpus Callosum Differences Associated with Persistent Stuttering in Adults

ERIC Educational Resources Information Center

Choo, Ai Leen; Kraft, Shelly Jo; Olivero, William; Ambrose, Nicoline G.; Sharma, Harish; Chang, Soo-Eun; Loucks, Torrey M.

2011-01-01

Recent studies have implicated anatomical differences in speech-relevant brain regions of adults who stutter (AWS) compared to normally fluent adults (NFA). The present study focused on the region of the corpus callosum (CC) which is involved in interhemispheric processing between the left and right cerebral hemispheres. Two-dimensional…

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

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.

Functional brain activation differences in stuttering identified with a rapid fMRI sequence

PubMed Central

Kraft, Shelly Jo; Choo, Ai Leen; Sharma, Harish; Ambrose, Nicoline G.

2011-01-01

The purpose of this study was to investigate whether brain activity related to the presence of stuttering can be identified with rapid functional MRI (fMRI) sequences that involved overt and covert speech processing tasks. The long-term goal is to develop sensitive fMRI approaches with developmentally appropriate tasks to identify deviant speech motor and auditory brain activity in children who stutter closer to the age at which recovery from stuttering is documented. Rapid sequences may be preferred for individuals or populations who do not tolerate long scanning sessions. In this report, we document the application of a picture naming and phoneme monitoring task in three minute fMRI sequences with adults who stutter (AWS). If relevant brain differences are found in AWS with these approaches that conform to previous reports, then these approaches can be extended to younger populations. Pairwise contrasts of brain BOLD activity between AWS and normally fluent adults indicated the AWS showed higher BOLD activity in the right inferior frontal gyrus (IFG), right temporal lobe and sensorimotor cortices during picture naming and and higher activity in the right IFG during phoneme monitoring. The right lateralized pattern of BOLD activity together with higher activity in sensorimotor cortices is consistent with previous reports, which indicates rapid fMRI sequences can be considered for investigating stuttering in younger participants. PMID:22133409

Speech-Language Therapy (For Parents)

MedlinePlus

... pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct vocabulary and ... topic for: Parents Kids Teens Delayed Speech or Language Development Stuttering Cleft Lip and Palate Hearing Evaluation in ...

Parents' reactions to children's stuttering and style of coping with stress.

PubMed

Humeniuk, Ewa; Tarkowski, Zbigniew

2016-09-01

The aim of the research was to determine: (a) how parents react to their child's stuttering, (b) what stress coping strategies they utilise, as well as (c) whether stress coping style depends on parents' reaction to their child's stuttering. The research involved 23 mothers and 23 fathers of children who stutter (CWS) at the age of three to six years old. The Reaction to Speech Disfluency Scale (RSDS), developed by the authors, was used in the research. To determine the parents' coping the Coping Inventory in Stressful Situations (CISS) by N.S. Endler and D.A Parker was applied. The strongest reactions are observed on the cognitive level. Stronger cognitive, emotional and behavioural reactions are observed in the mothers towards their disfluently speaking sons and in the fathers towards their daughters. Having analysed the profiles of coping styles, it can be noticed that the task-oriented coping is most frequently adapted by the fathers. The mothers most often use the avoidance-oriented coping. No relevant correlation was observed between the fathers' coping style and their reactions to the child's disfluent speech. As far as the mothers are concerned, it has been proved that an increase in behavioural reactions correlates with the avoidance-oriented coping. The cognitive reactions of the parents' towards their child's stuttering were most frequent, while the emotional ones were the least frequent. Confronted with a stressful situation, the fathers most often adapt the task-oriented coping, whereas the mothers use the avoidance-oriented coping. the reader will be able to (1) learn what the key reactions of parents to their children's stuttering are, (2) describe stuttering as a stress factor for the parents, (3) describe the factors which influence parents' reactions to their child's stuttering and their coping style. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Evaluating satisfaction of patients with stutter regarding the tele-speech therapy method and infrastructure.

PubMed

Eslami Jahromi, Maryam; Ahmadian, Leila

2018-07-01

Investigating the required infrastructure for the implementation of telemedicine and the satisfaction of target groups improves the acceptance of this technology and facilitates the delivery of healthcare services. The aim of this study was to assess the satisfaction of patients with stutter concerning the therapeutic method and the infrastructure used to receive tele-speech therapy services. This descriptive-analytical study was conducted on all patients with stutter aged between 14 and 39 years at Jahrom Social Welfare Bureau (n = 30). The patients underwent speech therapy sessions through video conferencing with Skype. Data were collected by a researcher-made questionnaire. Its content validity was confirmed by three medical informatics specialists. Data were analyzed using SPSS version 19. The mean and standard deviation of patient satisfaction scores concerning the infrastructure and the tele-speech therapy method were 3.15 ± 0.52 and 3.49 ± 0.52, respectively. No significant relationship was found between the patients satisfaction and their gender, education level and age (p > 0.05). The results of this study showed that the number of speech therapy sessions did not affect the overall satisfaction of the patients (p > 0.05), but the number of therapeutic sessions had a direct relationship with their satisfaction with the infrastructure used for tele-speech therapy (p < 0.05). The present study showed that patients were satisfied with tele-speech therapy. According to most patients the low speed of the Internet connection in the country was a major challenge for receiving tele-speech therapy. The results suggest that healthcare planner and policy makers invest on increasing bandwidth to improve the success rate of telemedicine programs. Copyright © 2018 Elsevier B.V. All rights reserved.

[Speech fluency developmental profile in Brazilian Portuguese speakers].

PubMed

Martins, Vanessa de Oliveira; Andrade, Claudia Regina Furquim de

2008-01-01

speech fluency varies from one individual to the next, fluent or stutterer, depending on several factors. Studies that investigate the influence of age on fluency patterns have been identified; however these differences were investigated in isolated age groups. Studies about life span fluency variations were not found. to verify the speech fluency developmental profile. speech samples of 594 fluent participants of both genders, with ages between 2:0 and 99:11 years, speakers of the Brazilian Portuguese language, were analyzed. Participants were grouped as follows: pre-scholars, scholars, early adolescence, late adolescence, adults and elderlies. Speech samples were analyzed according to the Speech Fluency Profile variables and were compared regarding: typology of speech disruptions (typical and less typical), speech rate (words and syllables per minute) and frequency of speech disruptions (percentage of speech discontinuity). although isolated variations were identified, overall there was no significant difference between the age groups for the speech disruption indexes (typical and less typical speech disruptions and percentage of speech discontinuity). Significant differences were observed between the groups when considering speech rate. the development of the neurolinguistic system for speech fluency, in terms of speech disruptions, seems to stabilize itself during the first years of life, presenting no alterations during the life span. Indexes of speech rate present variations in the age groups, indicating patterns of acquisition, development, stabilization and degeneration.

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.

Mood and Substance Use Disorders among Adults Seeking Speech Treatment for Stuttering

ERIC Educational Resources Information Center

Iverach, Lisa; Jones, Mark; O'Brian, Sue; Block, Susan; Lincoln, Michelle; Harrison, Elisabeth; Hewat, Sally; Menzies, Ross G.; Packman, Ann; Onslow, Mark

2010-01-01

Objectives: Stuttering has been associated with a range of anxiety disorders, including social phobia. In the general community, anxiety disorders are frequently associated with increased rates of mood and substance use disorders. Therefore, in the present study, the authors sought to determine the rate of mood and substance use disorders among…

The Effect of Rhythmic Auditory Stimulation on the Disfluency of Nonstutterers

ERIC Educational Resources Information Center

Silverman, Franklin H.

1971-01-01

Twenty adult male nonstutterers became more fluent when pacing their speech with a metronome. The degree to which they became more fluent was within the range which has been reported for stutterers. This finding suggests that the effect of the metronome on stuttering is not primarily a result of distraction. (Author/KW)

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…

Spatiotemporal Dynamics of Speech Sound Perception in Chronic Developmental Stuttering

ERIC Educational Resources Information Center

Liotti, Mario; Ingham, Janis C.; Takai, Osamu; Paskos, Delia Kothmann; Perez, Ricardo; Ingham, Roger J.

2010-01-01

High-density ERPs were recorded in eight adults with persistent developmental stuttering (PERS) and eight matched normally fluent (CONT) control volunteers while participants either repeatedly uttered the vowel "ah" or listened to their own previously recorded vocalizations. The fronto-central N1 auditory wave was reduced in response to spoken…

Stuttering and Natural Speech Processing of Semantic and Syntactic Constraints on Verbs

ERIC Educational Resources Information Center

Weber-Fox, Christine; Hampton, Amanda

2008-01-01

Purpose: Previous findings from event-related brain potentials (ERPs) indicate that adults who stutter (AWS) exhibit processing differences for visually presented linguistic information. This study explores how neural activations for AWS may differ for a linguistic task that does not require preparation for overt articulation or engage the…

Reduced Activation of Left Orbitofrontal Cortex Precedes Blocked Vocalization: A Magnetoencephalographic Study

ERIC Educational Resources Information Center

Sowman, Paul F.; Crain, Stephen; Harrison, Elisabeth; Johnson, Blake W.

2012-01-01

While stuttering is known to be characterized by anomalous brain activations during speech, very little data is available describing brain activations during stuttering. To our knowledge there are no reports describing brain activations that precede blocking. In this case report we present magnetoencephalographic data from a person who stutters…

Parent Perceptions of the Impact of Stuttering on Their Preschoolers and Themselves

ERIC Educational Resources Information Center

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…

Mindfulness Training in Stuttering Therapy: A Tutorial for Speech-Language Pathologists

ERIC Educational Resources Information Center

Boyle, Michael P.

2011-01-01

The use of mindfulness training for increasing psychological well-being in a variety of clinical and nonclinical populations has exploded over the last decade. In the area of stuttering, it has been widely recognized that effective long-term management often necessitates treatment of cognitive and affective dimensions of the disorder in addition…

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.

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.

Phonological priming in young children who stutter: holistic versus incremental processing.

PubMed

Byrd, Courtney T; Conture, Edward G; Ohde, Ralph N

2007-02-01

To investigate the holistic versus incremental phonological encoding processes of young children who stutter (CWS; N = 26) and age- and gender-matched children who do not stutter (CWNS; N = 26) via a picture-naming auditory priming paradigm. Children named pictures during 3 auditory priming conditions: neutral, holistic, and incremental. Speech reaction time (SRT) was measured from the onset of picture presentation to the onset of participant response. CWNS shifted from being significantly faster in the holistic priming condition to being significantly faster in the incremental priming condition from 3 to 5 years of age. In contrast, the majority of 3- and 5-year-old CWS continued to exhibit faster SRT in the holistic than the incremental condition. CWS are delayed in making the developmental shift in phonological encoding from holistic to incremental processing, a delay that may contribute to their difficulties establishing fluent speech.

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.

Coordinated interpersonal timing in the conversations of children who stutter and their mothers and fathers.

PubMed

Savelkoul, Eileen M; Zebrowski, Patricia M; Feldstein, Stanley; Cole-Harding, Shirley

2007-01-01

Coordinated interpersonal timing (CIT) is a measure of "conversational congruence," or "attunement," and refers to the degree to which the temporal aspects of the vocal behaviors of co-conversationalists are correlated over the course of a conversation [Jasnow, M., & Feldstein, S. (1986). Adult-like temporal characteristics of mother-infant vocal interaction. Child Development, 57, 754-761]. In the present study, CIT was examined in a group of children who stutter (CWS), and a matched group of nonstuttering children (CWDNS; children who do not stutter), during conversations with either their mother or father recorded in two separate sessions (i.e., mother-child, father-child). Separate audio signals for both the child and parent (mother or father) were analyzed using AVTA software, which allowed for the quantification of sound and silence patterns in simultaneous speech. Squared cross-correlations (i.e., coefficients of CIT) for the durations of five vocal behavior states were obtained for each subject, through time series regression analysis using lag procedures. Vocal state behaviors within conversational turns included: vocalization, pauses, turn switching pauses, and interruptive and noninterruptive simultaneous speech. Results indicated that CWS and their parents showed mutual influence (i.e., CIT in both directions, child to parent and parent to child, or bi-directional influence) for more vocal state behaviors than did CWDNS and their parents. In addition, the CWS exhibited CIT with their parents for the durations of more vocal state behaviors than did the CWDNS (i.e., unidirectional influence). Findings suggest that children who stutter may be more easily influenced by the subtle timing aspects of conversation. Taken further, some of these children may perceive conversations with their parents as either challenging or difficult because of an element of unpredictability brought into conversations by the production of stuttering, the social skills of the child, and the nature of the parent-child relationship. Consequently, these children may be engaging in more pervasive coordination of the temporal characteristics of their speech to those of their conversational partner, as a mechanism by which to more effectively manage verbal interaction. After reading this paper, the learner will be able to: (1) describe the phenomenon of coordinated interpersonal timing (CIT); (2) summarize research findings in CIT as they apply to the verbal interactions of children and their parents; (3) summarize research findings in parent-stuttering child interaction, especially those related to the temporal aspects of both parent and child conversational speech, and (4) discuss the applicability of the findings from the present study to the treatment of childhood stuttering.

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.

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.

Communication Attitude of Italian Children Who Do and Do Not Stutter

ERIC Educational Resources Information Center

Bernardini, Simona; Vanryckeghem, Martine; Brutten, Gene J.; Cocco, Luisella; Zmarich, Claudio

2009-01-01

The purpose of this factorial study was to establish normative data for the Italian version of the Communication Attitude Test (CAT) in order to determine whether or not the speech-associated attitude reported by Italian children who stutter (CWS) differs significantly from that of their nonstuttering peers (CWNS). Toward this end, the Italian CAT…

Group Therapy for School-Aged Children Who Stutter: A Survey of Current Practices

ERIC Educational Resources Information Center

Liddle, Hilary; James, Sarah; Hardman, Margaret

2011-01-01

Although group therapy is recommended for school-aged children who stutter (CWS), it is not widely researched. This study aimed to explore this provision, using a postal survey which investigated the current practices of Speech & Language Therapists (SLTs) in the UK. Seventy percent of SLT services provided some group therapy, but the level of…

Severity of Dysfluency Correlates with Basal Ganglia Activity in Persistent Developmental Stuttering

ERIC Educational Resources Information Center

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

2008-01-01

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,…

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)…

Stuttering Treatment for a School-Age Child with Down Syndrome: A Descriptive Case Report

ERIC Educational Resources Information Center

Harasym, Jessica; Langevin, Marilyn

2012-01-01

Background: Little is known about optimal treatment approaches and stuttering treatment outcomes for children with Down syndrome. Aims and method: The purpose of this study was to investigate outcomes for a child with Down syndrome who received a combination of fluency shaping therapy and parent delivered contingencies for normally fluent speech,…

Functional Brain Activation Differences in Stuttering Identified with a Rapid fMRI Sequence

ERIC Educational Resources Information Center

Loucks, Torrey; Kraft, Shelly Jo; Choo, Ai Leen; Sharma, Harish; Ambrose, Nicoline G.

2011-01-01

The purpose of this study was to investigate whether brain activity related to the presence of stuttering can be identified with rapid functional MRI (fMRI) sequences that involved overt and covert speech processing tasks. The long-term goal is to develop sensitive fMRI approaches with developmentally appropriate tasks to identify deviant speech…

Delayed Auditory Feedback in the Treatment of Stuttering: Clients as Consumers

ERIC Educational Resources Information Center

Van Borsel, John; Reunes, Gert; Van den Bergh, Nathalie

2003-01-01

Purpose: To investigate the effect of repeated exposure to delayed auditory feedback (DAF) during a 3-month period outside a clinical environment and with only minimal clinical guidance on speech fluency in people who stutter. Method: A pretest-post-test design was used with repeated exposure to DAF during 3 months as the independent variable.…

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.

Sharing stories: life history narratives in stuttering research.

PubMed

Kathard, H

2001-01-01

The life experiences of people who stutter (PWS) have not featured prominently in research. Historically, the profession of speech and language therapy has amassed data and developed its theory of stuttering within a positivistic frame. As a consequence, the existing over-arching theory of research and practice does not engage holistically with the dynamic personal, socio-cultural and political contexts of the individual who stutters. Therefore a conceptual shift is required in ontology, epistemology and methodology underpinning the knowledge construction process. The use of the life history narratives as a research tool is promoted. An exploratory study of a single participant is presented to illuminate the methodological approach and emerging theoretical constructs.

Investigating speech motor practice and learning in people who stutter.

PubMed

Namasivayam, Aravind Kumar; van Lieshout, Pascal

2008-03-01

In this exploratory study, we investigated whether or not people who stutter (PWS) show motor practice and learning changes similar to those of people who do not stutter (PNS). To this end, five PWS and five PNS repeated a set of non-words at two different rates (normal and fast) across three test sessions (T1, T2 on the same day and T3 on a separate day, at least 1 week apart). The results indicated that PWS and PNS may resemble each other on a number of performance variables (such as movement amplitude and duration), but they differ in terms of practice and learning on variables that relate to movement stability and strength of coordination patterns. These findings are interpreted in support of recent claims about speech motor skill limitations in PWS. The reader will be able to: (1) define oral articulatory changes associated with motor practice and learning and their measurement; (2) summarize findings from previous studies examining motor practice and learning in PWS; and (3) discuss hypotheses that could account for the present findings that suggest PWS and PNS differ in their speech motor learning abilities.

Individual Variability in Delayed Auditory Feedback Effects on Speech Fluency and Rate in Normally Fluent Adults

ERIC Educational Resources Information Center

Chon, HeeCheong; Kraft, Shelly Jo; Zhang, Jingfei; Loucks, Torrey; Ambrose, Nicoline G.

2013-01-01

Purpose: Delayed auditory feedback (DAF) is known to induce stuttering-like disfluencies (SLDs) and cause speech rate reductions in normally fluent adults, but the reason for speech disruptions is not fully known, and individual variation has not been well characterized. Studying individual variation in susceptibility to DAF may identify factors…

Investigation of the Reliability of the SSI-3 for Preschool Persian-Speaking Children Who Stutter

ERIC Educational Resources Information Center

Bakhtiar, Mehdi; Seifpanahi, Sadegh; Ansari, Hossein; Ghanadzade, Mehdi; Packman, Ann

2010-01-01

There is a pressing need in Iran for the translation of widely used speech-language assessment tools into Persian. This study reports the interjudge and intrajudge reliability of a Persian translation of the Stuttering Severity Instrument-3 (SSI-3) (Riley, 1994). There was greater than 80% interjudge and intrajudge agreement on scale scores for…

The Integrity of Anticipatory Coarticulation in Fluent and Non-Fluent Tokens of Adults Who Stutter

ERIC Educational Resources Information Center

Sussman, Harvey M.; Byrd, Courtney T.; Guitar, Barry

2011-01-01

This article analysed the acoustic structure of voiced stop ++ vowel sequences in a group of persons who stutter (PWS). This phonetic unit was chosen because successful production is highly dependent on the differential tweaking of right-to-left anticipatory coarticulation as a function of stop place. Thus, essential elements of both speech motor…

End-word dysfluencies in young children: a clinical report.

PubMed

MacMillan, Verity; Kokolakis, Artemi; Sheedy, Stacey; Packman, Ann

2014-01-01

We report on 12 children with end-word dysfluencies (EWDs). Our aim was to document this little-reported type of dysfluency and to develop a possible explanation for them and how they relate to developmental stuttering. Audio recordings were made for 9 of the 12 children in the study. The EWDs were identified by consensus of two specialist speech pathologists and confirmed on acoustic displays. A segment of participant 1's speech was transcribed, including phonetic transcription of EWDs. The EWDs typically consisted of repetitions of the nucleus and/or the coda. However, there were also some EWDs that consisted of fixed postures on the nucleus (when in final position) or coda. We also report on the infrequent occurrence of broken words. Ten of the 12 children also stuttered, with 9 of them coming from four families, each with a history of stuttering. This study indicates that EWDs may be more prevalent than previously thought, but they may go largely unnoticed due to their perceptually fleeting nature. The hypothesis was developed that EWDs be regarded as another type of developmental dysfluency, along with stuttering and cluttering. Ideas for further research are suggested. © 2014 S. Karger AG, Basel.

45 CFR 1308.9 - Eligibility criteria: Speech or language impairments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN... language impairments. (a) A speech or language impairment means a communication disorder such as stuttering... language disorder may be characterized by difficulty in understanding and producing language, including...

Exchange of Stuttering From Function Words to Content Words With Age

PubMed Central

Howell, Peter; Au-Yeung, James; Sackin, Stevie

2007-01-01

Dysfluencies on function words in the speech of people who stutter mainly occur when function words precede, rather than follow, content words (Au-Yeung, Howell, & Pilgrim, 1998). It is hypothesized that such function word dysfluencies occur when the plan for the subsequent content word is not ready for execution. Repetition and hesitation on the function words buys time to complete the plan for the content word. Stuttering arises when speakers abandon the use of this delaying strategy and carry on, attempting production of the subsequent, partly prepared content word. To test these hypotheses, the relationship between dysfluency on function and content words was investigated in the spontaneous speech of 51 people who stutter and 68 people who do not stutter. These participants were subdivided into the following age groups: 2–6-year-olds, 7–9-year-olds, 10–12-year-olds, teenagers (13–18 years), and adults (20–40 years). Very few dysfluencies occurred for either fluency group on function words that occupied a position after a content word. For both fluency groups, dysfluency within each phonological word occurred predominantly on either the function word preceding the content word or on the content word itself, but not both. Fluent speakers had a higher percentage of dysfluency on initial function words than content words. Whether dysfluency occurred on initial function words or content words changed over age groups for speakers who stutter. For the 2–6-year-old speakers that stutter, there was a higher percentage of dysfluencies on initial function words than content words. In subsequent age groups, dysfluency decreased on function words and increased on content words. These data are interpreted as suggesting that fluent speakers use repetition of function words to delay production of the subsequent content words, whereas people who stutter carry on and attempt a content word on the basis of an incomplete plan. PMID:10229451

A systematic literature review of neuroimaging research on developmental stuttering between 1995 and 2016.

PubMed

Etchell, Andrew C; Civier, Oren; Ballard, Kirrie J; Sowman, Paul F

2018-03-01

Stuttering is a disorder that affects millions of people all over the world. Over the past two decades, there has been a great deal of interest in investigating the neural basis of the disorder. This systematic literature review is intended to provide a comprehensive summary of the neuroimaging literature on developmental stuttering. It is a resource for researchers to quickly and easily identify relevant studies for their areas of interest and enable them to determine the most appropriate methodology to utilize in their work. The review also highlights gaps in the literature in terms of methodology and areas of research. We conducted a systematic literature review on neuroimaging studies on developmental stuttering according to the PRISMA guidelines. We searched for articles in the pubmed database containing "stuttering" OR "stammering" AND either "MRI", "PET", "EEG", "MEG", "TMS"or "brain" that were published between 1995/​01/​01 and 2016/​01/​01. The search returned a total of 359 items with an additional 26 identified from a manual search. Of these, there were a total of 111 full text articles that met criteria for inclusion in the systematic literature review. We also discuss neuroimaging studies on developmental stuttering published throughout 2016. The discussion of the results is organized first by methodology and second by population (i.e., adults or children) and includes tables that contain all items returned by the search. There are widespread abnormalities in the structural architecture and functional organization of the brains of adults and children who stutter. These are evident not only in speech tasks, but also non-speech tasks. Future research should make greater use of functional neuroimaging and noninvasive brain stimulation, and employ structural methodologies that have greater sensitivity. Newly planned studies should also investigate sex differences, focus on augmenting treatment, examine moments of dysfluency and longitudinally or cross-sectionally investigate developmental trajectories in stuttering. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

The transition to increased automaticity during finger sequence learning in adult males who stutter.

PubMed

Smits-Bandstra, Sarah; De Nil, Luc; Rochon, Elizabeth

2006-01-01

The present study compared the automaticity levels of persons who stutter (PWS) and persons who do not stutter (PNS) on a practiced finger sequencing task under dual task conditions. Automaticity was defined as the amount of attention required for task performance. Twelve PWS and 12 control subjects practiced finger tapping sequences under single and then dual task conditions. Control subjects performed the sequencing task significantly faster and less variably under single versus dual task conditions while PWS' performance was consistently slow and variable (comparable to the dual task performance of control subjects) under both conditions. Control subjects were significantly more accurate on a colour recognition distracter task than PWS under dual task conditions. These results suggested that control subjects transitioned to quick, accurate and increasingly automatic performance on the sequencing task after practice, while PWS did not. Because most stuttering treatment programs for adults include practice and automatization of new motor speech skills, findings of this finger sequencing study and future studies of speech sequence learning may have important implications for how to maximize stuttering treatment effectiveness. As a result of this activity, the participant will be able to: (1) Define automaticity and explain the importance of dual task paradigms to investigate automaticity; (2) Relate the proposed relationship between motor learning and automaticity as stated by the authors; (3) Summarize the reviewed literature concerning the performance of PWS on dual tasks; and (4) Explain why the ability to transition to automaticity during motor learning may have important clinical implications for stuttering treatment effectiveness.

The Effects of Fluency Enhancing Conditions on Sensorimotor Control of Speech in Typically Fluent Speakers: An EEG Mu Rhythm Study

PubMed Central

Kittilstved, Tiffani; Reilly, Kevin J.; Harkrider, Ashley W.; Casenhiser, Devin; Thornton, David; Jenson, David E.; Hedinger, Tricia; Bowers, Andrew L.; Saltuklaroglu, Tim

2018-01-01

Objective: To determine whether changes in sensorimotor control resulting from speaking conditions that induce fluency in people who stutter (PWS) can be measured using electroencephalographic (EEG) mu rhythms in neurotypical speakers. Methods: Non-stuttering (NS) adults spoke in one control condition (solo speaking) and four experimental conditions (choral speech, delayed auditory feedback (DAF), prolonged speech and pseudostuttering). Independent component analysis (ICA) was used to identify sensorimotor μ components from EEG recordings. Time-frequency analyses measured μ-alpha (8–13 Hz) and μ-beta (15–25 Hz) event-related synchronization (ERS) and desynchronization (ERD) during each speech condition. Results: 19/24 participants contributed μ components. Relative to the control condition, the choral and DAF conditions elicited increases in μ-alpha ERD in the right hemisphere. In the pseudostuttering condition, increases in μ-beta ERD were observed in the left hemisphere. No differences were present between the prolonged speech and control conditions. Conclusions: Differences observed in the experimental conditions are thought to reflect sensorimotor control changes. Increases in right hemisphere μ-alpha ERD likely reflect increased reliance on auditory information, including auditory feedback, during the choral and DAF conditions. In the left hemisphere, increases in μ-beta ERD during pseudostuttering may have resulted from the different movement characteristics of this task compared with the solo speaking task. Relationships to findings in stuttering are discussed. Significance: Changes in sensorimotor control related feedforward and feedback control in fluency-enhancing speech manipulations can be measured using time-frequency decompositions of EEG μ rhythms in neurotypical speakers. This quiet, non-invasive, and temporally sensitive technique may be applied to learn more about normal sensorimotor control and fluency enhancement in PWS. PMID:29670516

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.

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.

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

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

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.

Development of an internet version of the Lidcombe Program of early stuttering intervention: A trial of Part 1.

PubMed

Van Eerdenbrugh, Sabine; Packman, Ann; Onslow, Mark; O'brian, Sue; Menzies, Ross

2018-04-01

There is evidence that access to treatment for early stuttering is not available for all who need it. An internet version of the Lidcombe Program for early stuttering (Internet-LP) has been developed to deal with this shortfall. The LP is suitable for such development because it is delivered by parents in the child's everyday environment, with training by a speech-language pathologist. A Phase I trial of Internet-LP Part 1, comprising parent training, is reported here. Eight parents of pre-schoolers who stutter were recruited and six completed the trial. Post-trial assessment indicated that the parents scored well for identifying and measuring stuttering and for knowledge about conducting practice sessions, including how to present verbal contingencies during practice sessions. The results prompted minor adjustments to Part 1 and guided the construction of Part 2, which instructs parents during the remainder of the treatment process.

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

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.

Relationship between Speech Production and Perception in People Who Stutter.

PubMed

Lu, Chunming; Long, Yuhang; Zheng, Lifen; Shi, Guang; Liu, Li; Ding, Guosheng; Howell, Peter

2016-01-01

Speech production difficulties are apparent in people who stutter (PWS). PWS also have difficulties in speech perception compared to controls. It is unclear whether the speech perception difficulties in PWS are independent of, or related to, their speech production difficulties. To investigate this issue, functional MRI data were collected on 13 PWS and 13 controls whilst the participants performed a speech production task and a speech perception task. PWS performed poorer than controls in the perception task and the poorer performance was associated with a functional activity difference in the left anterior insula (part of the speech motor area) compared to controls. PWS also showed a functional activity difference in this and the surrounding area [left inferior frontal cortex (IFC)/anterior insula] in the production task compared to controls. Conjunction analysis showed that the functional activity differences between PWS and controls in the left IFC/anterior insula coincided across the perception and production tasks. Furthermore, Granger Causality Analysis on the resting-state fMRI data of the participants showed that the causal connection from the left IFC/anterior insula to an area in the left primary auditory cortex (Heschl's gyrus) differed significantly between PWS and controls. The strength of this connection correlated significantly with performance in the perception task. These results suggest that speech perception difficulties in PWS are associated with anomalous functional activity in the speech motor area, and the altered functional connectivity from this area to the auditory area plays a role in the speech perception difficulties of PWS.

Speech disorders in neurofibromatosis type 1: a sample survey.

PubMed

Cosyns, Marjan; Vandeweghe, Lies; Mortier, Geert; Janssens, Sandra; Van Borsel, John

2010-01-01

Neurofibromatosis type 1 (NF1) is an autosomal-dominant neurocutaneous disorder with an estimated prevalence of two to three cases per 10,000 population. While the physical characteristics have been well documented, speech disorders have not been fully characterized in NF1 patients. This study serves as a pilot to identify key issues in the speech of NF1 patients. In particular, the aim is to explore further the occurrence and nature of problems associated with speech as perceived by the patients themselves. A questionnaire was sent to 149 patients with NF1 registered at the Department of Genetics, Ghent University Hospital. The questionnaire inquired about articulation, hearing, breathing, voice, resonance and fluency. Sixty individuals ranging in age from 4.5 to 61.3 years returned completed questionnaires and these served as the database for the study. The results of this sample survey were compared with data of the normal population. About two-thirds of participants experienced at least one speech or speech-related problem of any type. Compared with the normal population, the NF1 group indicated more articulation difficulties, hearing impairment, abnormalities in loudness, and stuttering. The results indicate that speech difficulties are an area of interest in the NF1 population. Further research to elucidate these findings is needed.

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

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.

Effects of Perceptual and Conceptual Similarity in Lexical Priming of Young Children Who Stutter: Preliminary Findings

PubMed Central

Hartfield, Kia N.; Conture, Edward G.

2007-01-01

The purpose of this study was to investigate the influence of conceptual and perceptual properties of words on the speed and accuracy of lexical retrieval of children who do (CWS) and do not stutter (CWNS) during a picture-naming task. Participants consisted of 13 3- to 5-year-old CWS and the same number of CWNS. All participants had speech, language, and hearing development within normal limits, with the exception of stuttering for CWS. Both talker groups participated in a picture-naming task where they named, one at a time, computer-presented, black-on-white drawings of common age-appropriate objects. These pictures were named during four auditory priming conditions: (a) a neutral prime consisting of a tone, (b) a word prime physically related to the target word, (c) a word prime functionally related to the target word, and (d) a word prime categorically related to the target word. Speech reaction time (SRT) was measured from the offset of presentation of the picture target to the onset of participant’s verbal speech response. Results indicated that CWS were slower than CWNS across priming conditions (i.e., neutral, physical, function, category) and that the speed of lexical retrieval of CWS was more influenced by functional than perceptual aspects of target pictures named. Findings were taken to suggest that CWS tend to organize lexical information functionally more so than physically and that this tendency may relate to difficulties establishing normally fluent speech and language. PMID:17010422

Speech sequence skill learning in adults who stutter.

PubMed

Bauerly, Kim R; De Nil, Luc F

2011-12-01

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. Results showed significantly slower sequence durations in the PWS compared to PNS following extensive practice and consolidation. However, the hypothesis that poor performance gains in PWS compared to PNS during practice would be maintained following a 24-h consolidation period was not supported. Further descriptive analysis revealed large within group differences in PWS which to some extent were attributed to a subgroup of PWS who failed to show any improvements in performance following practice or consolidation. The results and the possible presence of subgroups of PWS are discussed with regard to their limitations in motor learning abilities. The reader will be able to (1) explain the difference between practice and learning, (2) define consolidation and explain the importance of measuring performance following a consolidation period, (3) understand past research on PWS' performance during both speech and nonspeech motor tasks, and (4) explain why individual differences in practice effects and learning may have important implications for client variability in treatment outcome. Copyright © 2011 Elsevier Inc. All rights reserved.

Video self-modeling as a post-treatment fluency recovery strategy for adults.

PubMed

Harasym, Jessica; Langevin, Marilyn; Kully, Deborah

2015-06-01

This multiple-baseline across subjects study investigated the effectiveness of video self-modeling (VSM) in reducing stuttering and bringing about improvements in associated self-report measures. Participants' viewing practices and perceptions of the utility of VSM also were explored. Three adult males who had previously completed speech restructuring treatment viewed VSM recordings twice per week for 6 weeks. Weekly speech data, treatment viewing logs, and pre- and post-treatment self-report measures were obtained. An exit interview also was conducted. Two participants showed a decreasing trend in stuttering frequency. All participants appeared to engage in fewer avoidance behaviors and had less expectations to stutter. All participants perceived that, in different ways, the VSM treatment had benefited them and all participants had unique viewing practices. Given the increasing availability and ease in using portable audio-visual technology, VSM appears to offer an economical and clinically useful tool for clients who are motivated to use the technology to recover fluency. Readers will be able to describe: (a) the tenets of video-self modeling; (b) the main components of video-self modeling as a fluency recovery treatment as used in this study; and (c) speech and self-report outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

The Psychosocial Development and Increased Fluency of Users of the SpeechEasyRTM Device: A Multiple Unit Case Study

ERIC Educational Resources Information Center

Horgan, David James

2010-01-01

This dissertation study explored the efficacy of the SpeechEasy[R] device for individuals who are gainfully employed stutterers and who participated in workplace education learning activities. This study attempted to fill a gap in the literature regarding efficacy of the SpeechEasy[R] device. It employed a qualitative multiple unit case study…

The BigCAT: A Normative and Comparative Investigation of the Communication Attitude of Nonstuttering and Stuttering Adults

ERIC Educational Resources Information Center

Vanryckeghem, Martine; Brutten, Gene J.

2011-01-01

The purpose of this investigation was to provide normative and comparative data for the BigCAT, the adult form of the Communication Attitude Test, a sub-test of the Behavior Assessment Battery. The BigCAT, a 35-item self-report test of speech-associated attitude was administered to 96 adults who stutter (PWS) and 216 adults who do not (PWNS). The…

Effects of Perceptual and Conceptual Similarity in Lexical Priming of Young Children Who Stutter: Preliminary Findings

ERIC Educational Resources Information Center

Hartfield, Kia N.; Conture, Edward G.

2006-01-01

The purpose of this study was to investigate the influence of conceptual and perceptual properties of words on the speed and accuracy of lexical retrieval of children who do (CWS) and do not stutter (CWNS) during a picture-naming task. Participants consisted of 13 3-5-year-old CWS and the same number of CWNS. All participants had speech, language,…

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.

Comparison of pausing behavior in children who stutter and children who have Asperger syndrome.

PubMed

Beltrame, Jessica Monique; Viera, Renata Alves Torello; Tamanaha, Ana Carina; Arcuri, Cláudia Fassin; Osborn, Ellen; Perissinoto, Jacy; Schiefer, Ana Maria

2011-12-01

The objective of this research was to compare the number and types of grammatical and non-grammatical silent pauses presented by stutterers and subjects with Asperger syndrome in their narratives. Ten children who stutter and four participants with Asperger syndrome (mean ages of both groups 10 years) were assessed at the Speech and Language Disorders Department of the Universidade Federal de São Paulo/Brasil. They narrated a story based on a pre-selected sequence of pictures. They were filmed and their productions were analyzed using version 5.0.47 of Praat (http://www.fon.hum.uva.nl/praat/download_win.html). Silent intervals in the speech that ranged from 0.25 to 4s were considered pauses. The pauses were classified as grammatical and non-grammatical, depending on the words that preceded and followed them. Both groups presented grammatical and non-grammatical pauses and the former predominated. The children with Asperger syndrome produced a greater number of pauses than the stutterers. The reader will be able to: (1) characterize the use of pauses in the oral narrative; (2) distinguish a grammatical pause from a non-grammatical pause regarding the use and function; (3) recognize the pattern of pause found in the two populations. Copyright © 2011 Elsevier Inc. All rights reserved.

Characterization of a mutation commonly associated with persistent stuttering: evidence for a founder mutation

PubMed Central

Fedyna, Alison; Drayna, Dennis; Kang, Changsoo

2010-01-01

Stuttering is a disorder which affects the fluency of speech. It has been shown to have high heritability, and has recently been linked to mutations in the GNPTAB gene. One such mutation, Glu1200Lys, has been repeatedly observed in unrelated families and individual cases. Eight unrelated individuals carrying this mutation were analyzed in an effort to distinguish whether these arise from repeated mutation at the same site, or whether they represent a founder mutation with a single origin. Results show that all 12 chromosomes carrying this mutation share a common haplotype in this region, indicating it is a founder mutation. Further analysis estimated the age of this allele to be ~572 generations. Construction of a cladogram tracing the mutation through our study sample also supports the founder mutation hypothesis. PMID:20944643

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.

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.

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

Functional speech disorders: clinical manifestations, diagnosis, and management.

PubMed

Duffy, J R

2016-01-01

Acquired psychogenic or functional speech disorders are a subtype of functional neurologic disorders. They can mimic organic speech disorders and, although any aspect of speech production can be affected, they manifest most often as dysphonia, stuttering, or prosodic abnormalities. This chapter reviews the prevalence of functional speech disorders, the spectrum of their primary clinical characteristics, and the clues that help distinguish them from organic neurologic diseases affecting the sensorimotor networks involved in speech production. Diagnosis of a speech disorder as functional can be supported by sometimes rapidly achieved positive outcomes of symptomatic speech therapy. The general principles of such therapy are reviewed. © 2016 Elsevier B.V. All rights reserved.

Finding Susceptibility Genes for Developmental Disorders of Speech: The Long and Winding Road.

ERIC Educational Resources Information Center

Felsenfeld, Susan

2002-01-01

This article explores the gene-finding process for developmental speech disorders (DSDs), specifically disorders of articulation/phonology and stuttering. It reviews existing behavioral genetic studies of these phenotypes, discusses roadblocks that may impede the molecular study of DSDs, and reviews the findings of the small number of molecular…

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…

Randomized Controlled Trial of Video Self-Modeling Following Speech Restructuring Treatment for Stuttering

ERIC Educational Resources Information Center

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

2010-01-01

Purpose: In this study, the authors investigated the efficacy of video self-modeling (VSM) following speech restructuring treatment to improve the maintenance of treatment effects. Method: The design was an open-plan, parallel-group, randomized controlled trial. Participants were 89 adults and adolescents who undertook intensive speech…

Camperdown Program for Adults Who Stutter: A Student Training Clinic Phase I Trial

ERIC Educational Resources Information Center

Cocomazzo, Nadia; Block, Susan; Carey, Brenda; O'Brian, Sue; Onslow, Mark; Packman, Ann; Iverach, Lisa

2012-01-01

Objectives: During speech pathology professional preparation there is a need for adequate student instruction with speech-restructuring treatments for adults. An important part of that clinical educational experience is to participate in a clinical setting that produces outcomes equivalent to those attained during clinical trials. A previous…

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

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.

Relationship between Speech Production and Perception in People Who Stutter

PubMed Central

Lu, Chunming; Long, Yuhang; Zheng, Lifen; Shi, Guang; Liu, Li; Ding, Guosheng; Howell, Peter

2016-01-01

Speech production difficulties are apparent in people who stutter (PWS). PWS also have difficulties in speech perception compared to controls. It is unclear whether the speech perception difficulties in PWS are independent of, or related to, their speech production difficulties. To investigate this issue, functional MRI data were collected on 13 PWS and 13 controls whilst the participants performed a speech production task and a speech perception task. PWS performed poorer than controls in the perception task and the poorer performance was associated with a functional activity difference in the left anterior insula (part of the speech motor area) compared to controls. PWS also showed a functional activity difference in this and the surrounding area [left inferior frontal cortex (IFC)/anterior insula] in the production task compared to controls. Conjunction analysis showed that the functional activity differences between PWS and controls in the left IFC/anterior insula coincided across the perception and production tasks. Furthermore, Granger Causality Analysis on the resting-state fMRI data of the participants showed that the causal connection from the left IFC/anterior insula to an area in the left primary auditory cortex (Heschl’s gyrus) differed significantly between PWS and controls. The strength of this connection correlated significantly with performance in the perception task. These results suggest that speech perception difficulties in PWS are associated with anomalous functional activity in the speech motor area, and the altered functional connectivity from this area to the auditory area plays a role in the speech perception difficulties of PWS. PMID:27242487

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.

Stuttering: recent developments in theory and in therapy.

PubMed Central

Boberg, E.; Shea, R.

1978-01-01

When parents are concerned about the development of stuttering in their child they often consult their pediatrician or family physician. Theories on the development of stuttering are briefly examined in this article, and guidelines are provided to help the physician determine if the child's dysfluencies are within the normal range. Referral to a speech therapist should be considered when any of the following are noted: excessive repetition of the first syllable of words; tremor of the muscles of mouth or jaw, increase in pitch or loudness, or evidence of fear or emotion as the child struggles with a word; evidence that the child avoids certain words or situations; and excessive concern of parents, teachers or the dysfluent individual. Two approaches to therapy, traditional and behavioural, are described. The latter has resulted in significant gains in fluency among stutterers. PMID:688128

Stuttering in Preschool Children: Direct Versus Indirect Treatment.

PubMed

Nippold, Marilyn A

2018-01-09

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. A hypothetical but realistic case study of a 3-year-old boy who stutters is described. Two contrasting approaches to treatment are presented, the Lidcombe Program (LP) and the demands and capacities model (DCM). Studies published in peer-reviewed research journals that have examined the effectiveness of each approach are summarized and critiqued. The review indicates that the LP is the preferred treatment approach for stuttering in preschool children and that it offers the best opportunity for rapid success. The LP should be carried out by knowledgeable, experienced, and flexible speech-language pathologists who are able to accommodate the individual needs and differences of every child and family.

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.

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.

Transcranial magnetic stimulation in developmental stuttering: Relations with previous neurophysiological research and future perspectives.

PubMed

Busan, P; Battaglini, P P; Sommer, M

2017-06-01

Developmental stuttering (DS) is a disruption of the rhythm of speech, and affected people may be unable to execute fluent voluntary speech. There are still questions about the exact causes of DS. Evidence suggests there are differences in the structure and functioning of motor systems used for preparing, executing, and controlling motor acts, especially when they are speech related. Much research has been obtained using neuroimaging methods, ranging from functional magnetic resonance to diffusion tensor imaging and electroencephalography/magnetoencephalography. Studies using transcranial magnetic stimulation (TMS) in DS have been uncommon until recently. This is surprising considering the relationship between the functionality of the motor system and DS, and the wide use of TMS in motor-related disturbances such as Parkinson's Disease, Tourette's Syndrome, and dystonia. Consequently, TMS could shed further light on motor aspects of DS. The present work aims to investigate the use of TMS for understanding DS neural mechanisms by reviewing TMS papers in the DS field. Until now, TMS has contributed to the understanding of the excitatory/inhibitory ratio of DS motor functioning, also helping to better understand and critically review evidence about stuttering mechanisms obtained from different techniques, which allowed the investigation of cortico-basal-thalamo-cortical and white matter/connection dysfunctions. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

The neurological underpinnings of cluttering: Some initial findings.

PubMed

Ward, David; Connally, Emily L; Pliatsikas, Christos; Bretherton-Furness, Jess; Watkins, Kate E

2015-03-01

Cluttering is a fluency disorder characterised by overly rapid or jerky speech patterns that compromise intelligibility. The neural correlates of cluttering are unknown but theoretical accounts implicate the basal ganglia and medial prefrontal cortex. Dysfunction in these brain areas would be consistent with difficulties in selection and control of speech motor programs that are characteristic of speech disfluencies in cluttering. There is a surprising lack of investigation into this disorder using modern imaging techniques. Here, we used functional MRI to investigate the neural correlates of cluttering. We scanned 17 adults who clutter and 17 normally fluent control speakers matched for age and sex. Brain activity was recorded using sparse-sampling functional MRI while participants viewed scenes and either (i) produced overt speech describing the scene or (ii) read out loud a sentence provided that described the scene. Speech was recorded and analysed off line. Differences in brain activity for each condition compared to a silent resting baseline and between conditions were analysed for each group separately (cluster-forming threshold Z>3.1, extent p<0.05, corrected) and then these differences were further compared between the two groups (voxel threshold p<0.01, extent>30 voxels, uncorrected). In both conditions, the patterns of activation in adults who clutter and control speakers were strikingly similar, particularly at the cortical level. Direct group comparisons revealed greater activity in adults who clutter compared to control speakers in the lateral premotor cortex bilaterally and, as predicted, on the medial surface (pre-supplementary motor area). Subcortically, adults who clutter showed greater activity than control speakers in the basal ganglia. Specifically, the caudate nucleus and putamen were overactive in adults who clutter for the comparison of picture description with sentence reading. In addition, adults who clutter had reduced activity relative to control speakers in the lateral anterior cerebellum bilaterally. Eleven of the 17 adults who clutter also stuttered. This comorbid diagnosis of stuttering was found to contribute to the abnormal overactivity seen in the group of adults who clutter in the right ventral premotor cortex and right anterior cingulate cortex. In the remaining areas of abnormal activity seen in adults who clutter compared to controls, the subgroup who clutter and stutter did not differ from the subgroup who clutter but do not stutter. Our findings were in good agreement with theoretical predictions regarding the neural correlates of cluttering. We found evidence for abnormal function in the basal ganglia and their cortical output target, the medial prefrontal cortex. The findings are discussed in relation to models of cluttering that point to problems with motor control of speech. This paper reports findings on the neural correlates seen in adults who clutter, and offers hypotheses as to how these might map onto the behaviours seen amongst those who clutter. Readers will be able to (a) identify the structures that are implicated in the disorder of cluttering, (b) understand arguments relating these structures to the behavioural expression of the disorder, (c) understand some of the complexities in interpreting data pertaining to recovery from cluttering, (d) understand where future efforts in research into the neurological correlates of cluttering should be focussed. Copyright © 2015. Published by Elsevier Inc.

Systematic Studies of Modified Vocalization: Effects of Speech Rate and Instatement Style during Metronome Stimulation

ERIC Educational Resources Information Center

Davidow, Jason H.; Bothe, Anne K.; Richardson, Jessica D.; Andreatta, Richard D.

2010-01-01

Purpose: This study introduces a series of systematic investigations intended to clarify the parameters of the fluency-inducing conditions (FICs) in stuttering. Method: Participants included 11 adults, aged 20-63 years, with typical speech-production skills. A repeated measures design was used to examine the relationships between several speech…

Multilingual Aspects of Fluency Disorders. Communication Disorders across Languages

ERIC Educational Resources Information Center

Howell, Peter; Van Borsel, John

2011-01-01

This book contains contributions by scholars working on diverse aspects of speech who bring their findings to bear on the practical issue of how to treat stuttering in different language groups and in multilingual speakers. The book considers classic issues in speech production research, as well as whether regions of the brain that are affected in…

Effects of Sentence-Structure Complexity on Speech Initiation Time and Disfluency

ERIC Educational Resources Information Center

Tsiamtsiouris, Jim; Cairns, Helen Smith

2013-01-01

There is general agreement that stuttering is caused by a variety of factors, and language formulation and speech motor control are two important factors that have been implicated in previous research, yet the exact nature of their effects is still not well understood. Our goal was to test the hypothesis that sentences of high structural…

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.

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.

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.

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.

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

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.

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

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

PubMed

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

2016-10-01

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 stuttering. The design was a parallel, open plan, noninferiority randomized controlled trial of the standard Lidcombe Program treatment and the experimental webcam Lidcombe Program treatment. Participants were 49 children aged 3 years 0 months to 5 years 11 months at the start of treatment. Primary outcomes were the percentage of syllables stuttered at 9 months postrandomization and the number of consultations to complete Stage 1 of the Lidcombe Program. There was insufficient evidence of a posttreatment difference of the percentage of syllables stuttered between the standard and webcam Lidcombe Program treatments. There was insufficient evidence of a difference between the groups for typical stuttering severity measured by parents or the reported clinical relationship with the treating speech-language pathologist. This trial confirmed the viability of the webcam Lidcombe Program intervention. It appears to be as efficacious and economically viable as the standard, clinic Lidcombe Program treatment.

Review of telehealth stuttering management.

PubMed

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

2013-01-01

Telehealth is the use of communication technology to provide health care services by means other than typical in-clinic attendance models. Telehealth is increasingly used for the management of speech, language and communication disorders. The aim of this article is to review telehealth applications to stuttering management. We conducted a search of peer-reviewed literature for the past 20 years using the Institute for Scientific Information Web of Science database, PubMed: The Bibliographic Database and a search for articles by hand. Outcomes for telehealth stuttering treatment were generally positive, but there may be a compromise of treatment efficiency with telehealth treatment of young children. Our search found no studies dealing with stuttering assessment procedures using telehealth models. No economic analyses of this delivery model have been reported. This review highlights the need for continued research about telehealth for stuttering management. Evidence from research is needed to inform the efficacy of assessment procedures using telehealth methods as well as guide the development of improved treatment procedures. Clinical and technical guidelines are urgently needed to ensure that the evolving and continued use of telehealth to manage stuttering does not compromise the standards of care afforded with standard in-clinic models.

Effect of dopaminergic medication on speech dysfluency in Parkinson's disease: a longitudinal study.

PubMed

Tykalová, Tereza; Rusz, Jan; Čmejla, Roman; Klempíř, Jiří; Růžičková, Hana; Roth, Jan; Růžička, Evžen

2015-08-01

Although speech dysfluencies have been hypothesized to be associated with abnormal function of dopaminergic system, the effects of dopaminergic medication on speech fluency in Parkinson's disease (PD) have not been systematically studied. The aim of the present study was, therefore, to investigate the long-term effect of dopaminergic medication on speech fluency in PD. Fourteen de novo PD patients with no history of developmental stuttering and 14 age- and sex-matched healthy controls (HC) were recruited. PD subjects were examined three times; before the initiation of dopaminergic treatment and twice in following 6 years. The percentage of dysfluent words was calculated from reading passage and monolog. The amount of medication was expressed by cumulative doses of L-dopa equivalent. After 3-6 years of dopaminergic therapy, PD patients exhibited significantly more dysfluent events compared to healthy subjects as well as to their own speech performance before the introduction of dopaminergic therapy (p < 0.05). In addition, we found a strong positive correlation between the increased occurrence of dysfluent words and the total cumulative dose of L-dopa equivalent (r = 0.75, p = 0.002). Our findings indicate an adverse effect of prolonged dopaminergic therapy contributing to the development of stuttering-like dysfluencies in PD. These findings may have important implication in clinical practice, where speech fluency should be taken into account to optimize dopaminergic therapy.

Classification of Types of Stuttering Symptoms Based on Brain Activity

PubMed Central

Jiang, Jing; Lu, Chunming; Peng, Danling; Zhu, Chaozhe; Howell, Peter

2012-01-01

Among the non-fluencies seen in speech, some are more typical (MT) of stuttering speakers, whereas others are less typical (LT) and are common to both stuttering and fluent speakers. No neuroimaging work has evaluated the neural basis for grouping these symptom types. Another long-debated issue is which type (LT, MT) whole-word repetitions (WWR) should be placed in. In this study, a sentence completion task was performed by twenty stuttering patients who were scanned using an event-related design. This task elicited stuttering in these patients. Each stuttered trial from each patient was sorted into the MT or LT types with WWR put aside. Pattern classification was employed to train a patient-specific single trial model to automatically classify each trial as MT or LT using the corresponding fMRI data. This model was then validated by using test data that were independent of the training data. In a subsequent analysis, the classification model, just established, was used to determine which type the WWR should be placed in. The results showed that the LT and the MT could be separated with high accuracy based on their brain activity. The brain regions that made most contribution to the separation of the types were: the left inferior frontal cortex and bilateral precuneus, both of which showed higher activity in the MT than in the LT; and the left putamen and right cerebellum which showed the opposite activity pattern. The results also showed that the brain activity for WWR was more similar to that of the LT and fluent speech than to that of the MT. These findings provide a neurological basis for separating the MT and the LT types, and support the widely-used MT/LT symptom grouping scheme. In addition, WWR play a similar role as the LT, and thus should be placed in the LT type. PMID:22761887

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

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…

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.

[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.

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.

Somnolence and Stuttering as the Primary Manifestations of a Midbrain Stroke

PubMed Central

Karakis, Ioannis; Ellenstein, Aviva; Roselló, Gemma R; Romero, José R

2008-01-01

Background: Stroke can occasionally manifest with non-lateralizing findings such as somnolence and stuttering. We describe a case and discuss the anatomical and physiological implications of this rare combination of symptoms. Case report: A 51-year-old woman presented with 3 days of “feeling drunk”. She could further specify her symptoms as blurry vision, slurred speech, and gait instability. She had a history of hypertension and hyperlipidemia. Her examination at presentation was remarkable only for marked somnolence. Over the next several hours she developed mild upgaze limitation and vertical nystagmus. Non-enhanced computed tomography of the brain was normal. Brain magnetic resonance imaging (MRI) revealed a 5 mm acute infarct in the caudal midbrain. The first week the patient remained somnolent and manifested marked stuttering. The patient improved gradually with speech therapy. Conclusion: Strokes affecting the diencephalic-mesencephalic junction can manifest with stuttering. Defective projections of the reticular formation to the supplementary motor area, damaged extrapyramidal circuits, and/or aberrant propioceptive feedback due to involvement of the mesencephalic nucleus of the trigeminal nerve are the proposed pathophysiological mechanisms. Somnolence can also be part of the presentation and is likely due to disruptions of sleep pathways subserved by the reticular activating system. The accurate diagnosis of these cases depends on careful clinical assessment and high index of suspicion for stroke, especially in lieu of preexisting vascular risk factors and lack of an alternative explanation such as toxic-metabolic encephalopathy. PMID:22518226

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.

Common Speech Problems Encountered in General Practice

PubMed Central

Godfrey, Charles M.; Ward, Jean F.

1962-01-01

The authors consider speech and communication in the light of whole patient care and point out that defects may be signs and symptoms of underlying organic disease. They describe the four classifications of speech disorders—articulation, rhythm, voice and language, with an indication of the speech therapy required and duration of treatment. Special emphasis has been given to those speech problems which are seen by the family physician; these are usually of the articulation group. A short discussion of stuttering and aphasia is given. Emphasis is put on the direction of treatment by the physician and the use of well-qualified personnel as members of the rehabilitation team. PMID:13963265

A Comparative Investigation of the BigCAT and Erickson S-24 Measures of Speech-Associated Attitude

ERIC Educational Resources Information Center

Vanryckeghem, Martine; Brutten, Gene J.

2012-01-01

The BigCAT and the Erickson S-24, self-report measures of communication attitude, were administered in a randomly determined order to 72 adults who stuttered (PWS) and 72 who did not (PWNS). The two groups of participants differed from each other to a statistically significant extent on both of these measures of speech-associated attitude,…

PubMed Central

Getty, Louise; de Courval, Louise Poulin

1981-01-01

The Speech and Hearing Department of the University of Montréal, in conjunction with ‘l'Unité de médecine familiale de Verdun’ set up a pilot project grouping family doctors, audiologists and speech pathologists. Information was exchanged on speech and language problems in children, stuttering, voice disorders, aphasia and hearing problems in children and adults. We emphasized the importance of early detection of these problems, of adequate information to the patient and his family and referral to the speech pathologist or to the audiologist. The results of this experience showed the importance of close collaboration between family doctors and communication specialists. PMID:21289800

On token reinforcement and stuttering therapy: another view on findings reported by Howie and Woods (1982).

PubMed

Ingham, R J

1983-01-01

Howie and Woods (1982) have provided data that, they claim, indicate that a token reinforcement system is redundant in instating and shaping fluent speech within a stuttering treatment program developed by Ingham and Andrews (1973a, b). However, there were substantial procedural differences between the treatment programs referred to in both studies, as well as methodological weaknesses in Howie and Woods' study. These factors provide ample sources of explanation for Howie and Woods' failure to demonstrate benefits from their token reinforcement system.

Identification of neural structures involved in stuttering using vibrotactile feedback.

PubMed

Cheadle, Oliver; Sorger, Clarissa; Howell, Peter

Feedback delivered over auditory and vibratory afferent pathways has different effects on the fluency of people who stutter (PWS). These features were exploited to investigate the neural structures involved in stuttering. The speech signal vibrated locations on the body (vibrotactile feedback, VTF). Eleven PWS read passages under VTF and control (no-VTF) conditions. All combinations of vibration amplitude, synchronous or delayed VTF and vibrator position (hand, sternum or forehead) were presented. Control conditions were performed at the beginning, middle and end of test sessions. Stuttering rate, but not speaking rate, differed between the control and VTF conditions. Notably, speaking rate did not change between when VTF was delayed versus when it was synchronous in contrast with what happens with auditory feedback. This showed that cerebellar mechanisms, which are affected when auditory feedback is delayed, were not implicated in the fluency-enhancing effects of VTF, suggesting that there is a second fluency-enhancing mechanism. Copyright © 2018 Elsevier Inc. All rights reserved.

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.

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.

How fluent is the fluent speech of people who stutter? A new approach to measuring kinematics with ultrasound.

PubMed

Heyde, Cornelia J; Scobbie, James M; Lickley, Robin; Drake, Eleanor K E

2016-01-01

We present a new approach to the investigation of dynamic ultrasound tongue imaging (UTI) data, applied here to analyse the subtle aspects of the fluency of people who stutter (PWS). Fluent productions of CV syllables (C = /k/; V = /ɑ, i, ə/) from three PWS and three control speakers (PNS) were analysed for duration and peak velocity relative to articulatory movement towards (onset) and away from (offset) the consonantal closure. The objective was to apply a replicable methodology for kinematic investigation to speech of PWS in order to test Wingate's Fault-Line hypothesis. As was hypothesised, results show comparable onset behaviours for both groups. Regarding offsets, groups differ in peak velocity. Results suggest that PWS do not struggle initiating consonantal closure (onset). In transition from consonantal closure into the vowel, however, groups appear to employ different strategies expressed in increased variation (PNS) versus decreased mean peak velocity (PWS).

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

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.

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

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.

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.

Association between Rare Variants in AP4E1, a Component of Intracellular Trafficking, and Persistent Stuttering.

PubMed

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

2015-11-05

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. Copyright © 2015 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

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,…

Subtyping stuttering I: a review.

PubMed

Yairi, Ehud

2007-01-01

A reliable and practical subtype system of stuttering should enhance all related scientific work concerned with this disorder. Although a fair number of classification systems have been offered, to date, none has received wide recognition or has been routinely applied in research or clinical spheres. Whereas progress has been made in understanding and treating the disorder, for the most part stuttering continues to be viewed and addressed as a unitary problem. The objectives of the current article are to (a) highlight the motivation for identifying sub-types of stuttering, (b) outline the issues involved in researching subtypes, and (c) address the question of whether or not subtyping is plausible for this disorder. Toward these ends, a broad-based review of past concepts regarding subtypes of stuttering and stutterers is presented according to seven categories that reflect the various authors' conceptual or experimental approaches. Selected studies for each category are also presented to illustrate the research problems and challenges. It is concluded that islands of progress can be identified in subtype research, particularly in studies of children. It is recommended that future studies include multiple factors or domains in the data collection process, especially with young children during the formative years of the disorder, when substantial overlap in the development of several speech/language domains occurs. (a) Readers will be able to describe the theory and research concerning the numerous attempts to subtype stuttering, particularly during the past 50 years; (b) Readers will be able to explain the general issues that need to be resolved in order to identify subtypes as well as current and future research strategies aimed at achieving these goals.

Fluency disorders in genetic syndromes.

PubMed

Van Borsel, John; Tetnowski, John A

2007-01-01

The characteristics of various genetic syndromes have included "stuttering" as a primary symptom associated with that syndrome. Specifically, Down syndrome, fragile X syndrome, Prader-Willi syndrome, Tourette syndrome, Neurofibromatosis type I, and Turner syndrome all list "stuttering" as a characteristic of that syndrome. An extensive review of these syndromes indicated clients diagnosed with these syndromes do show evidence of nonfluency patterns, but not all would be considered stuttering. Many of the syndromes are marked by degrees of mental retardation that probably contribute to a higher than average prevalence of stuttering, as well as a higher than average prevalence of other fluency disorders (when compared to the population at large). An in-depth analysis of the available data indicates that some of these genetic syndromes show patterns of stuttering that may be indicative of only that syndrome (or similar syndromes) that can be differentially diagnosed from developmental stuttering. Among these patterns are the word-final nonfluencies noted in Prader-Willi syndrome; the presence of stuttering in the absence of secondary behaviors noted in Prader-Willi syndrome and; the presence of palilalia, word-final and word-medial nonfluencies, and word-medial and word-final nonfluencies in Tourette syndrome. Implications for future research are discussed in light of these findings. The reader will be able to: (1) describe the various different genetic syndromes that are associated with fluency disorders; (2) describe the types of nonfluencies that are associated with the major types of genetic syndromes that have fluency disorders; (3) describe the behaviors that may assist in differentially diagnosing different types of speech characteristics associated with various genetic syndromes.

Communication attitudes of Japanese school-age children who stutter.

PubMed

Kawai, Norimune; Healey, E Charles; Nagasawa, Taiko; Vanryckeghem, Martine

2012-01-01

Past research with the Communication Attitude Test (CAT) has shown it to be a valid and reliable instrument for assessing speech-associated attitude of children who stutter (CWS). However, in Japan, the CAT has not been used extensively to examine the communication attitude of CWS. The purpose of this study was to determine if a Japanese version of the CAT could differentiate between the communication attitude of Japanese elementary school CWS and children who do not stutter (CWNS). A Japanese translation of the 1991 version of the Communication Attitude Test-Revised (CAT-R) was used in this study. Eighty Japanese CWS and 80 gender- and grade level-matched CWNS participated in the study. The results showed that CWS had a significantly more negative communication attitude than CWNS. Both CWS and CWNS in 1st grade showed significantly more positive communication attitudes than children in 2nd, 3rd, 4th, 5th, and 6th grades. Furthermore, a link between stuttering severity and CWS' communication attitude was found. Additional research is needed to confirm the results of the current study, which indicate that the communication attitude of Japanese CWS becomes more negative as they get older. The reader will be able to: (1) Describe the process that was used to develop a Japanese version of the Communication Attitude Test (CAT-J). (2) Discuss attitude differences between Japanese children who stutter and those who do not and how grade level impacts a negative attitude toward communication. (3) Explain the link between stuttering severity and attitudes of Japanese children who stutter. Copyright © 2012 Elsevier Inc. All rights reserved.

Using the OASES-A to illustrate how network analysis can be applied to understand the experience of stuttering.

PubMed

Siew, Cynthia S Q; Pelczarski, Kristin M; Yaruss, J Scott; Vitevitch, Michael S

Network science uses mathematical and computational techniques to examine how individual entities in a system, represented by nodes, interact, as represented by connections between nodes. This approach has been used by Cramer et al. (2010) to make "symptom networks" to examine various psychological disorders. In the present analysis we examined a network created from the items in the Overall Assessment of the Speaker's Experience of Stuttering-Adult (OASES-A), a commonly used measure for evaluating adverse impact in the lives of people who stutter. The items of the OASES-A were represented as nodes in the network. Connections between nodes were placed if responses to those two items in the OASES-A had a correlation coefficient greater than ±0.5. Several network analyses revealed which nodes were "important" in the network. Several centrally located nodes and "key players" in the network were identified. A community detection analysis found groupings of nodes that differed slightly from the subheadings of the OASES-A. Centrally located nodes and "key players" in the network may help clinicians prioritize treatment. The different community structure found for people who stutter suggests that the way people who stutter view stuttering may differ from the way that scientists and clinicians view stuttering. Finally, the present analyses illustrate how the network approach might be applied to other speech, language, and hearing disorders to better understand how those disorders are experienced and to provide insights for their treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Reducing Anxiety in Stutterers through the Association between “Purpose in Life/Ikigai” and Emotions

PubMed Central

Ishida, Riichiro

2012-01-01

The prefrontal lobe is more evolved in humans than in other mammals. The functioning of human prefrontal lobes promotes an innate need to establish a meaningful life, often referred to as “Purpose in life (PIL)/ikigai.” PIL/ikigai and the prefrontal lobe psychologically and physiologically, respectively, shape ambition, regulate the development of emotions and integrate psychological events. PIL/ikigai contributes to both a reduction in the anxiety caused by a need for approval from others and the stimulation of pleasure and comfort, which may be related to the well-balanced secretion of neurotransmitters such as serotonin, dopamine, and β-endorphin. Thus, if a stutterer aware that articulate speech is advantageous in communication feels a need for social desirability (SD) based on a need for approval from others, they may develop stress and anxiety caused by their perceived failure when engaging in conversations. This feeling of failure may be related to an imbalanced secretion of serotonin and dopamine. Therefore, previous work has suggested that PIL/ikigai may reduce anxiety in stutterers who seek SD by reducing the symptoms associated with stuttering. PMID:22980384

ARTICULATION DISORDERS IN SERBIAN LANGUAGE IN CHILDREN WITH SPEECH PATHOLOGY.

PubMed

Dmitrić, Tanja; Veselinović, Mila; Mitrović, Slobodan M

2015-01-01

Articulation is the result of speech organs and it means clean, clear and distinct pronunciation of voices in words. A prospective study included 24 children between 5 and 15 years of age, of both sexes. All children were monolingual, Serbian being their native language. The quality of articulation was tested with Triage articulation test. Neither omission nor distortion of plosives was observed in any of them, whereas substitution of plosives occurred in 12% of patients. Omission of affricates was not observed in any of the subjects, but substitution and distortion occurred in 29%, and 76% of subjects, respectively. Omission of fricatives was found in 29% subjects, substitution in 52%, and distortion in 82% of subjects. Omission and distortion of nasals was not recorded in any of the subjects, and substitution occurred in 6% of children. Omission of laterals was observed in 6%, substitution in 46% and distortion in 52% of subjects with articulation disorders. Discussion and Articulation disorders were observed not only in children diagnosed with dyslalia but in those with dysphasia and stuttering as well. Children with speech disorders articulate vowels best, then nasals and plosives. Articulation of fricatives and laterals was found to be most severely deviated, including all three disorders, i.e. substitution, omission and distortion. Spasms of speech muscles and vegetative reactions were also observed in this study, but only in children with stuttering.

Speech Research

NASA Astrophysics Data System (ADS)

Several articles addressing topics in speech research are presented. The topics include: exploring the functional significance of physiological tremor: A biospectroscopic approach; differences between experienced and inexperienced listeners to deaf speech; a language-oriented view of reading and its disabilities; Phonetic factors in letter detection; categorical perception; Short-term recall by deaf signers of American sign language; a common basis for auditory sensory storage in perception and immediate memory; phonological awareness and verbal short-term memory; initiation versus execution time during manual and oral counting by stutterers; trading relations in the perception of speech by five-year-old children; the role of the strap muscles in pitch lowering; phonetic validation of distinctive features; consonants and syllable boundaires; and vowel information in postvocalic frictions.

Axis I anxiety and mental health disorders among stuttering adolescents.

PubMed

Gunn, Anthony; Menzies, Ross G; O'Brian, Sue; Onslow, Mark; Packman, Ann; Lowe, Robyn; Iverach, Lisa; Heard, Robert; Block, Susan

2014-06-01

The purpose of this study was to evaluate anxiety and psychological functioning among adolescents seeking speech therapy for stuttering using a structured, diagnostic interview and psychological questionnaires. This study also sought to determine whether any differences in psychological status were evident between younger and older adolescents. Participants were 37 stuttering adolescents seeking stuttering treatment. We administered the Computerized Voice Version of the Diagnostic Interview Schedule for Children, and five psychometric tests. Participants were classified into younger (12-14 years; n=20) and older adolescents (15-17 years; n=17). Thirty-eight percent of participants attained at least one diagnosis of a mental disorder, according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA, 2000), with the majority of these diagnoses involving anxiety. This figure is double current estimates for general adolescent populations, and is consistent with our finding of moderate and moderate-severe quality of life impairment. Although many of the scores on psychological measures fell within the normal range, older adolescents (15-17 years) reported significantly higher anxiety, depression, reactions to stuttering, and emotional/behavioral problems, than younger adolescents (12-14 years). There was scant evidence that self-reported stuttering severity is correlated with mental health issues. There are good reasons to believe these results are conservative because many participants gave socially desirable responses about their mental health status. These results reveal a need for large-scale, statistically powerful assessments of anxiety and other mental disorders among stuttering adolescents with reference to control populations. The reader will be able to: (a) explain the clinical importance of assessing for mental health with stuttering adolescents, (b) state the superior method for adolescent mental health assessment and (c) state a major issue with determining the genuineness of stuttering adolescent responses to psychological assessment. Copyright © 2013 Elsevier Inc. All rights reserved.

Disappearance of a stutter shortly before death.

PubMed

Duong, Phuc H; Zulian, Gilbert B

2007-01-01

A patient with a stutter caused by the trauma of the death of a loved one was able to recover normal speech 1 week before her death, which resulted from intestinal obstruction caused by ovarian cancer. The stutter appeared to have been overcome using a combination therapy of sophrology, self-regulation, and drug therapy. During a genuine resilience process, the patient was able to overcome an earlier existential fracture. In this final phase of life, health professionals and the family fully respected the patient's independence to remain in control of events. She repeatedly refused to have a nasogastric tube inserted to extract fecal matter from the stomach. This patient consequently repossessed her own language of expression in a body that was shattered by cancerous illness and the consequences of treatments. She thus managed to find a successful balance between the body, the spirit, and the brain.

Qualitative analysis of bibliotherapy as a tool for adults who stutter and graduate students.

PubMed

Gerlach, Hope; Subramanian, Anu

2016-03-01

The purpose of this study was to investigate the use of bibliotherapy as a therapeutic tool for adults who stutter (AWS) and as an educational tool for graduate students in speech-language pathology. Bibliotherapy refers to the process of reading, reflecting upon, and discussing literature, often first person illness or disability narratives, to promote cognitive shifts in the way clients and clinicians conceptualize the experience of disability. Five AWS and six graduate students participated in supervised bibliotherapy using a stuttering memoir during therapy sessions. An inductive, qualitative analysis was utilized to analyze data collected from questionnaires and interviews. An additional deductive qualitative approach was utilized to explore how client data fit into an existing five-outcome model of bibliotherapy from the psychology literature. Graduate students reported developing essential clinical skills for working with clients who stutter, including an improved understanding of the experience of people who stutter and an increased ability to form and strengthen the therapeutic alliance. Clients reported experiencing shifts in the cognitive and affective components of the disorder. Imposing the five-outcome model on client data indicates that at least two clients in the current study experienced all five outcomes of bibliotherapy. These include client experiences of involvement, identification, catharsis, insight and universalism. Both graduate students and clients reported benefits from reading and discussing a memoir about stuttering. Bibliotherapy can be an effective tool in therapy and clinical education when used appropriately. Copyright © 2015 Elsevier Inc. All rights reserved.

Spontaneous regulation of emotions in preschool children who stutter: preliminary findings.

PubMed

Johnson, Kia N; Walden, Tedra A; Conture, Edward G; Karrass, Jan

2010-12-01

Emotional regulation of preschool children who stutter (CWS) and children who do not stutter (CWNS) was assessed through use of a disappointing gift (DG) procedure (P. M. Cole, 1986; C. Saarni, 1984, 1992). Participants consisted of 16 CWS and CWNS (11 boys and 5 girls in each talker group) who were 3 to 5 years of age. After assessing each child's knowledge of display rules about socially appropriate expression of emotions, the authors asked the children to participate in a DG procedure. The children received a desirable gift preceding the first free-play task and a disappointing gift preceding a second free-play task. Dependent variables consisted of participants' positive and negative expressive nonverbal behaviors exhibited during receipt of a desirable gift and disappointing gift as well as conversational speech disfluencies exhibited following receipt of each gift. Findings indicated that CWS and CWNS exhibited no significant differences in amount of positive emotional expressions after receiving the desired gift; however, CWS--when compared with CWNS--exhibited more negative emotional expressions after receiving the undesirable gift. Furthermore, CWS were more disfluent after receiving the desired gift than after receiving the disappointing gift. Ancillary findings also indicated that CWS and CWNS had equivalent knowledge of display rules. Findings suggest that efforts to concurrently regulate emotional behaviors and that speech disfluencies may be problematic for preschool-age CWS.

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…

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.

Sensorimotor Integration in Speech Processing: Computational Basis and Neural Organization

PubMed Central

Hickok, Gregory; Houde, John; Rong, Feng

2011-01-01

Sensorimotor integration is an active domain of speech research and is characterized by two main ideas, that the auditory system is critically involved in speech production, and that the motor system is critically involved in speech perception. Despite the complementarity of these ideas, there is little crosstalk between these literatures. We propose an integrative model of the speech-related “dorsal stream” in which sensorimotor interaction primarily supports speech production, in the form of a state feedback control architecture. A critical component of this control system is forward sensory prediction, which affords a natural mechanism for limited motor influence on perception, as recent perceptual research has suggested. Evidence shows that this influence is modulatory but not necessary for speech perception. The neuroanatomy of the proposed circuit is discussed as well as some probable clinical correlates including conduction aphasia, stuttering, and aspects of schizophrenia. PMID:21315253

A Program of Behavioral Objectives for the Students.

ERIC Educational Resources Information Center

McDowell, Thomas, Comp.; Sharbaugh, Marilyn, Comp.

Provided is a program of behavioral objectives for use with speech handicapped preschool and elementary level children in the areas of articulation disorders, language disorders, stuttering, tongue thrust, and voice. Communication disorders are defined as substandard behaviors which interfere with the student's ability to perform acceptably for…

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.

Safety Behaviors and Speech Treatment for Adults Who Stutter

ERIC Educational Resources Information Center

Helgadottir, Fjola Dogg; Menzies, Ross G.; Onslow, Mark; Packman, Ann; O'Brian, Sue

2014-01-01

Purpose: Those with anxiety use safety behaviors when attempting to prevent negative outcomes. There is evidence that these behaviors contribute to the persistence of anxiety disorders. Safety behaviors have been prominent in the cognitive behavior therapy literature during the last decade, particularly with social phobia management. However,…