www.e-gagueira.com.br - Abstracts 2015 agosto a dezembro

Ordem alfabética do título do artigo

An event-related potential investigation of sentence processing in adults who stutter. - AUDITIVO

Neurosci Res. 2015 Oct 22. pii: S0168-0102(15)00236-9. doi: 10.1016/j.neures.2015.10.004. [Epub ahead of print]

Murase S, Kawashima T, Satake H, Era S.

Gifu University, 1-1 Yanagido, Gifu , Japan; Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu , Japan.

The purpose of this study was to investigate characteristics of the semantic processing of sentences' final verbs in stutterers using event-related potential (ERP). ERPs elicited from semantically violating and non-violating verbs in Japanese sentences were compared between 13 adults who stutter (AWS) and 13 adults who do not stutter (AWNS). The stimulus sentences elicited the N400 and the late positive component (LPC) in both groups. The amplitude of the N400, however, was attenuated in AWS. Regarding the LPC, the LPC in the 450-700ms time window (the early LPC) was evident in both groups, but the LPC in the 700-850 time window (the late LPC) was only apparent in AWS. Because AWS judged sentence congruency as accurately as AWNS did, it is assumed that AWS depended more on the LPC for semantic processing, resulting in the enhancement of the late LPC. We speculate that semantic processing of sentences for AWS is more time consuming than that for AWNS.

PMID: 26477716 [PubMed - as supplied by publisher]

An investigation of the role of parental request for self-correction of stuttering in the Lidcombe Program. - TERAPIA
Int J Speech Lang Pathol. 2015 Mar 12:1-7. [Epub ahead of print]

Donaghy M, Harrison E, O'Brian S, Menzies R, Onslow M, Packman A, Jones M.
Australian Stuttering Research Centre, The University of Sydney , Lidcombe, NSW , Australia.

PURPOSE: 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.
METHOD: 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.
RESULT: No differences were found between groups on primary outcome measures of the number of weeks and clinic visits to 50% reduction in stuttering severity.
CONCLUSION: 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.
PMID: 25763524 [PubMed - as supplied by publisher]

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

Am J Hum Genet. 2015 Nov 5;97(5):715-25. doi: 10.1016/j.ajhg.2015.10.007.

Raza MH, Mattera R, Morell R, Sainz E, Rahn R, Gutierrez J, Paris E, Root J, Solomon B, Brewer C, Basra MA, Khan S, Riazuddin S, Braun A, Bonifacino JS, Drayna D.

National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, MD, USA; Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA; Clinical Center Speech Language Pathology Service, NIH, Bethesda, MD, USA; University of the Punjab, Lahore, Pakistan; Alama Iqbal Medical Research Center, Lahore, Pakistan.

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 [PubMed - in process] PMCID: PMC4667129 [Available on 2016-05-05]

Bupropion-Induced Stuttering.

Prim Care Companion CNS Disord. 2015 Aug 13;17(4). doi: 10.4088/PCC.15l01777. eCollection 2015.

Bhatia MS.

University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India.

Free Full Article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4664569/

No abstract available.

PMID: 26693041 [PubMed] PMCID: PMC4664569

Characteristics Of Fluency And Speech In Two Families With High Incidences Of Stuttering - AVALIAÇÃO

J Speech Lang Hear Res. 2015 Oct;58(5):1440-51. doi: 10.1044/2015_JSLHR-S-14-0080.

Stager SV, Freeman FJ, Braun A.

PURPOSE:This study presents data from two families with high incidence of stuttering, comparing methods of phenotype assignment and exploring the presence of other fluency disorders and corresponding speech characteristics.

METHODS: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 one family were classified by expert consensus. Only 70% of the other family could be similarly categorized. Experts required two other categories, cluttering and other fluency disorders, to fully characterize dysfluency within this family. These two families also demonstrated differences in speech production.

CONCLUSIONS: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 [PubMed - as supplied by publisher]

Children and adolescents who stutter: Further investigation of anxiety - EMOCIONAL

J Fluency Disord. 2015 Aug 8. pii: S0094-730X(15)00062-5. doi: 10.1016/j.jfludis.2015.07.006. [Epub ahead of print]

Messenger M, Packman A, Onslow M, Menzies R, O'Brian S.

Australian Stuttering Research Centre, The University of Sydney, Australia.

PURPOSE: Despite the greatly increased risk of social anxiety disorder in adults who stutter, there is no clear indication of the time of onset of this disorder in childhood and adolescence. The purpose of this study was to explore this issue further using the Revised Children's Manifest Anxiety Scale (RCMAS), so that appropriate interventions can be developed prior to adulthood. This is the first time the RCMAS has been completed by children younger than 11 years. Using the same test for both school-age children and adolescents can potentially identify when anxiety starts to develop from age 6 years through to adulthood.

METHODS: The RCMAS was administered to 18 school-age boys, five school-age girls, 41 adolescent boys and nine adolescent girls who were seeking treatment for their stuttering. Participants also rated the severity of their own stuttering.

RESULTS: All mean scaled scores on the four RCMAS subscales and Total Anxiety scores were within normal limits. However, for both groups of boys, scores on the Lie Scale were significantly higher than scores on the other three subscales.

CONCLUSIONS: Experts suggest high scores on the RCMAS Lie Scale are indicative of participants attempting to present themselves in a positive light and so cast doubt on the veracity of their other responses on the test. One interpretation, then, is that the boys were concealing true levels of anxiety about their stuttering. The results suggest why findings of anxiety studies in children and adolescents to date are equivocal. Clinical implications are discussed.

EDUCATIONAL OBJECTIVES: The reader will be able to: (a) discuss why understanding when anxiety starts in people who stutter is important, (b) describe the function of the RCMAS Lie sub scale and (c) summarize the possible implications of the RCMAS findings in this study.

PMID: 26292910 [PubMed - as supplied by publisher]

Clinical features associated with an early onset in chronic tic disorders.

Psychiatry Res. 2015 Dec 30;230(3):745-8. doi: 10.1016/j.psychres.2015.11.018. Epub 2015 Nov 12.

Richer F, Daghfal R, Rouleau GA, Lespérance P, Chouinard S.

Université du Québec à Montréal, Montreal, QC, Canada; Université de Montréal, Montreal, QC, Canada; McGill University, Montreal, QC, Canada.

In chronic tic disorders such as Tourette syndrome (TS), tics often appear between 4 and 8 years but they can also appear in early childhood, a period in which symptom expression may be affected by early brain development. The present study examined whether symptom expression in early-onset TS was distinct from that observed in TS with a later onset. We compared the clinical characteristics in children with TS who developed tics before age 4 or after age 6. Early-onset TS was significantly associated with an increased rate of stuttering and other speech disfluencies as well as an increased rate of oppositional defiant disorder, symptoms that often appear before age 4. Early-onset TS was also linked to maternal transmission of tics. Early-onset TS was not significantly associated with tic severity, obsessive-compulsive behavior or attention-deficit hyperactivity disorder. The results suggest that an early onset affects symptom expression in tic disorders.

PMID: 26596364 [PubMed - in process]

Clozapine-induced stuttering: an estimate of prevalence in the west of Ireland - FARMACOLOGIA

Ther Adv Psychopharmacol. 2015 Aug;5(4):232-6. doi: 10.1177/2045125315590060.

Free Full Text -http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4535049/pdf/10.1177_2045125315590060.pdf

Murphy R, Gallagher A, Sharma K, Ali T, Lewis E, Murray I, Hallahan B.

National University of Ireland Galway, Newcastle Road, Galway; University Hospital Galway, Galway; Letterkenny General Hospital, Letterkenny; Sligo General Hospital, Sligo, Ireland.

OBJECTIVES: Clozapine is the most effective treatment available for treatment-resistant schizophrenia; however, it is also associated with a large array of adverse effects that limits its tolerability. A number of previous case reports have noted an association between clozapine and stuttering, however the rate of this possible adverse effect is yet to be established.

METHODS: In this paper, we present six cases of patients treated with clozapine who developed stuttering.

RESULTS: Clozapine was associated with stuttering in 0.92% of individuals treated with clozapine in the region. Clozapine-induced stuttering was associated with an increase in treatment dose or with dose titration at initiation of clozapine in five individuals, with dose reduction or slower dose titration associated with a cessation of stuttering in these cases.

CONCLUSIONS: This is the largest case series to date examining clozapine-induced stuttering and indicates that clozapine-induced stuttering is a relatively common adverse effect that can be managed by a slower titration of clozapine dosage or a modest reduction in dose in most cases.

PMID: 26301079 [PubMed] PMCID: PMC4535049

Communication attitudes in children who stutter: A meta-analytic review. - SOCIAL

J Fluency Disord. 2015 Sep 2. pii: S0094-730X(15)00076-5. doi: 10.1016/j.jfludis.2015.08.001. [Epub ahead of print]

Guttormsen LS, Kefalianos E, Næss KB.

University of Oslo, Norway; Murdoch Childrens Research Institute, Australia; University of Melbourne, Australia; University of Oslo, Norway.

BACKGROUND: This article presents a meta-analytic review of differences in communication attitudes between children who stutter (CWS) and children who do not stutter (CWNS).

METHOD: 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.

RESULTS: 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.

CONCLUSION: 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.

EDUCATIONAL OBJECTIVES: 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.

PMID: 26365773 [PubMed - as supplied by publisher]

Electrophysiological evidence for a general auditory prediction deficit in adults who stutter - AUDITIVO

Brain Lang. 2015 Aug 31;150:37-44. doi: 10.1016/j.bandl.2015.08.008. [Epub ahead of print]

Daliri A, Max L.

University of Washington, Seattle, WA; Haskins Laboratories, New Haven, CT, United States

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 [PubMed - as supplied by publisher]

Economic evaluation of stuttering treatment in preschool children: The RESTART-study. - TERAPIA INFANTIL

J Commun Disord. 2015 Nov-Dec;58:106-18. doi: 10.1016/j.jcomdis.2015.10.006. Epub 2015 Oct 24.

de Sonneville-Koedoot C, Bouwmans C, Franken MC, Stolk E.

Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus University Medical Center, Rotterdam, The Netherlands.

PURPOSE: The purpose of this study was to evaluate the incremental cost-effectiveness and cost-utility of the Lidcombe Program (LP) compared with treatment based on the Demands and Capacities Model (RESTART-DCM) for preschool children who stutter.

METHOD: A cost-effectiveness and cost-utility analysis were carried out alongside a Randomized Clinical Trial (the RESTART-study). In total, 199 children in 20 speech clinics participated. Outcome measures included the number needed to treat, based on the percentage of children who did not stutter at 18 months, and Health-related Quality of Life (EQ-VAS and HUI3) at 3, 6, 12 and 18 months. Health-related Quality of Life scores were used to calculate quality adjusted life years (V-QALYs for the EQ-VAS and U-QALYs for the HUI3). Direct and indirect costs were measured by cost questionnaires. Missing data were multiply imputed. Percentages of children who did not stutter in both groups were compared by a chi-square test. Between-group differences in mean QALYs and costs, as well as cost effectiveness and cost-utility ratios, were evaluated by applying bootstrapping techniques.

RESULTS: After 18 months, health outcomes were slightly better in the LP group, although only the difference in V-QALYs was statistical significant (0.018; 95% CI: 0.008 to 0.027) with a small effect size (Cohen's d=0.17). Mean costs for the LP group were significantly higher compared to the RESTART-DCM group (€3199 versus €3032), again with a small effect size (Cohen's d=0.14). The incremental cost-effectiveness ratio was €3360 for one additional child who did not stutter with the LP, and the estimated cost-utility ratios were €10,413 (extra cost per extra V-QALY) and €18,617 (extra cost per extra U-QALY). The results indicated a high probability that the LP is cost-effective compared to RESTART-DCM treatment given a threshold for willingness-to-pay of €20,000 per QALY.

CONCLUSIONS: Differences in effects and costs between the LP and RESTART-DCM treatment were small. Cost-effectiveness and cost-utility ratios were in favor of the LP. The LP is considered a good alternative to RESTART-DCM treatment in Dutch primary care.

PMID: 26524414 [PubMed - in process]

Electrophysiological evidence for a general auditory prediction deficit in adults who stutter. - AUDITIVO

Brain Lang. 2015 Nov;150:37-44. doi: 10.1016/j.bandl.2015.08.008. Epub 2015 Aug 31.

Daliri A, Max L.

University of Washington, Seattle, WA, United States; Haskins Laboratories, New Haven, CT, United States.

PMID: 26335995 [PubMed - in process] PMCID: PMC4663101 [Available on 2016-11-01]

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

J Fluency Disord. 2015 Sep;45:1-11. doi: 10.1016/j.jfludis.2015.06.001. Epub 2015 Jun 28.

Panico J, Healey EC, Knopik J.

Southern Illinois University Edwardsville, Edwardsville, IL, USA. University of Nebraska-Lincoln, NE, USA.

PURPOSE: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSION: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.

EDUCATIONAL OBJECTIVES: 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.

PMID: 26144598 [PubMed - as supplied by publisher]

Factors involved in the identification of stuttering severity in a foreign language - AVALIAÇÃO

Clin Linguist Phon. 2015 Aug 26:1-13. [Epub ahead of print]

Cosyns M, Einarsdóttir JT, Van Borsel J.

Department of Speech, Language, and Hearing Sciences , Ghent University , Ghent , Belgium

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

PMID: 26308390 [PubMed - as supplied by publisher]

How Does GPi-DBS Affect Speech in Primary Dystonia? - GAGUEIRA "ADQUIRIDA"

Brain Stimul. 2015 Sep-Oct;8(5):875-80. doi: 10.1016/j.brs.2015.04.009. Epub 2015 Apr 25.

Risch V, Staiger A, Ziegler W, Ott K, Schölderle T, Pelykh O, Bötzel K.

Clinical Neuropsychology Research Group (EKN), Städtisches Klinikum München GmbH, Klinikum Schwabing, München, Germany;Ludwig-Maximilians-University Munich, Klinikum Großhadern, Munich, Germany.

BACKGROUND:Globus pallidus internus deep brain stimulation (GPi-DBS) can be an effective treatment for primary dystonia. However, speech disorders have previously been reported as a common possible side effect of the treatment.

OBJECTIVES:To study possible deterioration of speech after GPi-DBS and describe this in different dimensions.

METHODS:Speech was systematically evaluated in 15 patients with predominant torticollis and GPi-DBS. Each patient was tested twice within one day in two stimulation conditions: ON-DBS vs. OFF-DBS. Speech analyses comprised both function-oriented (perceptual scales, acoustic analyses) and communication-related measures (intelligibility, naturalness). A control sample of 15 healthy speakers underwent the same speech assessment.

RESULTS:On the group level, patients with dystonia showed mild but significant impairment on the overall dysarthria scale, the intelligibility score, and the naturalness ratings in both stimulation conditions (Mann-Whitney, P < .05). No stimulation-induced deterioration was found. A slight increase in articulation rate was measured in the ON condition. On the single-case level, effects of GPi-DBS on speech were heterogenous. In one patient we observed a deterioration of speech (dysarthria), in a second patient with a history of childhood stuttering we found an aggravation of dysfluency. Impressive benefits could be documented in another patient who also suffered from spasmodic dysphonia.

CONCLUSIONS:The study provides evidence that speech impairment is not a necessary side-effect of GPi-DBS in primary dystonia. Both, recurring of stuttering and a worsening of dysarthria may be seen in individual patients. The positive effects of GPi-DBS on the symptoms of spasmodic dysphonia merits further research as DBS is not commonly applied in this population.

PMID: 26002621 [PubMed - as supplied by publisher]

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

Clin Linguist Phon. 2015 Nov 23:1-21. [Epub ahead of print]

Heyde CJ, Scobbie JM, Lickley R, Drake EK.

Queen Margaret University , Edinburgh , Scotland; University of Edinburgh , Edinburgh , Scotland.

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).

PMID: 26596188 [PubMed - as supplied by publisher]

Human mutant huntingtin disrupts vocal learning in transgenic songbirds. - OUTRAS ÁREAS

Nat Neurosci. 2015 Nov;18(11):1617-22. doi: 10.1038/nn.4133. Epub 2015 Oct 5.

Liu WC, Kohn J, Szwed SK, Pariser E, Sepe S, Haripal B, Oshimori N,Marsala M, Miyanohara A, Lee R.

The Rockefeller University, New York, New York, USA; University of California, San Diego, La Jolla, California, USA; UCSD School of Medicine, La Jolla, California, USA; CHDI Management Inc., New York, New York, USA.

Speech and vocal impairments characterize many neurological disorders. However, the neurogenetic mechanisms of these disorders are not well understood, and current animal models do not have the necessary circuitry to recapitulate vocal learning deficits. We developed germline transgenic songbirds, zebra finches (Taneiopygia guttata) expressing human mutant huntingtin (mHTT), a protein responsible for the progressive deterioration of motor and cognitive function in Huntington's disease (HD). Although generally healthy, the mutant songbirds had severe vocal disorders, including poor vocal imitation, stuttering, and progressive syntax and syllable degradation. Their song abnormalities were associated with HD-related neuropathology and dysfunction of the cortical-basal ganglia (CBG) song circuit. These transgenics are, to the best of our knowledge, the first experimentally created, functional mutant songbirds. Their progressive and quantifiable vocal disorder, combined with circuit dysfunction in the CBG song system, offers a model for genetic manipulation and the development of therapeutic strategies for CBG-related vocal and motor disorders.

PMID: 26436900 [PubMed - in process]

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

J Commun Disord. 2015 Nov-Dec;58:43-57. doi: 10.1016/j.jcomdis.2015.10.003. Epub 2015 Oct 22.

Adriaensens S, Beyers W, Struyf E.

University of Antwerp, Belgium; Ghent University, Belgium.

PURPOSE: The theory that self-esteem is substantially constructed based on social interactions implies that having a stutter could have a negative impact on self-esteem. Specifically, self-esteem during adolescence, a period of life characterized by increased self-consciousness, could be at risk. In addition to studying mean differences between stuttering and non-stuttering adolescents, this article concentrates on the influence of stuttering severity on domain-specific and general self-esteem. Subsequently, we investigate if covert processes on negative communication attitudes, experienced stigma, non-disclosure of stuttering, and (mal)adaptive perfectionism mediate the relationship between stuttering severity and self-esteem.

METHODS: Our sample comprised 55 stuttering and 76 non-stuttering adolescents. They were asked to fill in a battery of questionnaires, consisting of: Subjective Screening of Stuttering, Self-Perception Profile for Adolescents, Erickson S-24, Multidimensional Perfectionism Scale, and the Stigmatization and Disclosure in Adolescents Who Stutter Scale.

RESULTS: SEM (structural equation modeling) analyses showed that stuttering severity negatively influences adolescents' evaluations of social acceptance, school competence, the competence to experience a close friendship, and global self-esteem. Maladaptive perfectionism and especially negative communication attitudes fully mediate the negative influence of stuttering severity on self-esteem. Group comparison showed that the mediation model applies to both stuttering and non-stuttering adolescents.

CONCLUSION: We acknowledge the impact of having a stutter on those domains of the self in which social interactions and communication matter most. We then accentuate that negative attitudes about communication situations and excessive worries about saying things in ways they perceive as wrong are important processes to consider with regard to the self-esteem of adolescents who stutter. Moreover, we provide evidence that these covert processes also need to be addressed when helping adolescents who are insecure about their fluency in general.

PMID: 26484722 [PubMed - in process]

Increased motor preparation activity during fluent single word production in DS: A correlate for stuttering frequency and severity.- NEUROCIÊNCIAS
Neuropsychologia. 2015 Aug;75:1-10. doi: 10.1016/j.neuropsychologia.2015.05.013. Epub 2015 May 21

Vanhoutte S, Santens P, Cosyns M, van Mierlo P, Batens K, Corthals P, De Letter M, Van Borsel J.
Ghent University Hospital, Ghent, Belgium

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.
PMID: 26004061 [PubMed - as supplied by publisher]

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

Ann Pharmacother. 2015 Oct;49(10):1096-104. doi: 10.1177/1060028015596415. Epub 2015 Jul 30.

Rabaeys H, Bijleveld HA, Devroey D.

Vrije Universiteit Brussel, Brussels, Belgium; Université Libre de Bruxelles, Brussels, Belgium.

BACKGROUND: Recently, a case report described a decrease in frequency of stuttering after intake of methylphenidate (MPH).

OBJECTIVE: This study was undertaken to investigate if this effect could again be reproduced in a population of young healthy male adult persons with developmental stuttering.

METHODS: A double-blind randomized crossover trial, with a 2-week washout period, including 15 Dutch-speaking young healthy persons with developmental stuttering, assessed the effects of a single dose of 20 mg MPH compared with placebo on stuttering. Dependent and 1-sample t tests were used to detect significant differences. The end point was the number of stutter moments and self-perceived improvement.

RESULTS: MPH yielded a significant decrease in the number of stutter moments when reading and speaking (P = 0.002), which was not the case with placebo (P = 0.090). There was a significant improvement from baseline after intake of MPH as compared with placebo (P = 0.003). Self-perceived improvement with MPH was not significantly better as compared with placebo (P = 0.28).

CONCLUSIONS: This study showed that the participants had an objective statistically significant decrease in the frequency of stuttering with MPH, and this was not the case with placebo. This was also the case for a reduction in stutter moments when reading out loud and speaking spontaneously. However, this result was not subjectively perceived by the participants.

PMID: 26228939 [PubMed - indexed for MEDLINE]

Neural systems mediating processing of sound units of language distinguish recovery versus persistence in stuttering. - INFANTIL

J Neurodev Disord. 2015;7(1):28. doi: 10.1186/s11689-015-9124-7. Epub 2015 Aug 18.

Free Full Text:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4538747/pdf/11689_2015_Article_9124.pdf

Mohan R, Weber C.

Purdue University, West Lafayette, IN USA.

BACKGROUND: Developmental stuttering is a multi-factorial disorder. Measures of neural activity while children processed the phonological (language sound unit) properties of words have revealed neurodevelopmental differences between fluent children and those who stutter. However, there is limited evidence to show whether the neural bases of phonological processing can be used to identify stuttering recovery status. As an initial step, we aimed to determine if differences in neural activity during phonological processing could aid in distinguishing children who had recovered from stuttering and those whose stuttering persisted.

METHODS: We examined neural activity mediating phonological processing in forty-three 7-8 year old children. Groups included children who had recovered from stuttering (CWS-Rec), those whose stuttering persisted (CWS-Per), and children who did not stutter (CWNS). All children demonstrated normal non-verbal intelligence and language skills. Electroencephalograms were recorded as the children listened to pairs of pseudo-words (primes-targets) that either rhymed or did not. Behavioral rhyme judgments along with peak latency and mean amplitude of the N400s elicited by prime and target stimuli were examined.

RESULTS: All the groups were very accurate in their rhyme judgments and displayed a typical ERP rhyme effect, characterized by increased N400 amplitudes over central parietal sites for nonrhyming targets compared to rhyming targets. However, over anterior electrode sites, an earlier onset of the N400 for rhyming compared to non-rhyming targets, indexing phonological segmentation and rehearsal, was observed in the CWNS and CWS-Rec groups. This effect occurred bilaterally for the CWNS, was greater over the right hemisphere in the CWS-Rec, and was absent in the CWS-Per.

CONCLUSIONS: These results are the first to show that differences in ERPs reflecting phonological processing are marked by atypical lateralization in childhood even after stuttering recovery and more pronounced atypical neural patterns for the children whose stuttering persisted. Despite comparable language and phonological skills as revealed by standardized tests, the neural activity mediating phonological segmentation and rehearsal differentiated 7-8 year old children whose stuttering persisted from those who had recovered from stuttering and typically developing peers.

PMID: 26284147 [PubMed] PMCID: PMC4538747

Neurogenic speech sequelae following suicide attempt by hanging: a case report. GAGUEIRA ADQUIRIDA

Int J Adolesc Med Health. 2015 Sep 11. pii: /j/ijamh.ahead-of-print/ijamh-2015-0039/ijamh-2015-0039.xml. doi: 10.1515/ijamh-2015-0039. [Epub ahead of print]

Wazeer MM, John S, Rajashekhar B.

BACKGROUND: Attempting suicide by hanging has become one of the most preferred means among adolescents. Individuals who survive a suicide attempt by hanging have a range of deficits, including neuropsychological, neuropsychiatric, pulmonary and even speech and language deficits. Literature regarding speech and language deficits in cases of near hanging is especially limited.

OBJECTIVE: This study aimed to demonstrate the sequelae of neurogenic speech deficits following a suicide attempt by hanging, the treatment strategies, and prognostic issues in one such case.

METHODS: We report of Patient X who attempted suicide by hanging. The patient was admitted and a detailed speech and language evaluation was completed.

RESULTS: Patient X was diagnosed with hypoxic-ischemic encephalopathy with organic amnesic syndrome. Consequent to the neurogenic insult, the patient demonstrated speech deficits that were characterized by moderate flaccid dysarthria and neurogenic stuttering. Patient X underwent a week of treatment, subsequent to which there was an improvement in certain speech subsystems. However, the neurogenic stuttering symptoms did not resolve completely even post therapy.

CONCLUSION: Individuals who survive a suicide attempt by hanging have a range of deficits, including speech deficits that need to be addressed by a speech language pathologist. This case report is an eye opener for speech language pathologists regarding their role in such cases.

PMID: 26360492 [PubMed - as supplied by publisher]

Observer perspective imagery with stuttering - EMOCIONAL
Int J Speech Lang Pathol. 2015 Oct;17(5):481-8. doi: 10.3109/17549507.2015.1010580. Epub 2015 Mar 5.
Lowe R, Menzies R, Packman A, O'Brian S, Onslow M.
Australian Stuttering Research Centre, The University of Sydney , Lidcombe, NSW Australia.

Purpose: Adults who stutter are at risk of developing a range of psychological conditions. Social anxiety disorder is the most common anxiety disorder associated with stuttering. Observer perspective imagery is one cognitive process involved in the maintenance of some anxiety disorders. This involves viewing images as if looking at the self from the perspective of another. In contrast, the field perspective involves looking out from the self at the surrounding environment. The purpose of this study was to assess the presence of observer perspective imagery with stuttering. Method: The authors administered the Hackmann, Surawy and Clark (1998) semi-structured interview to 30 adults who stutter and 30 controls. Group images and impressions were compared for frequency, perspective recalled and emotional valence. Result: The stuttering group was significantly more likely than controls to recall images and impressions from an observer rather than a field perspective for anxious situations. Conclusion: It is possible the present results could reflect the same attentional processing bias that occurs with anxiety disorders in the non-stuttering population. These preliminary results provide an explanation for the persistence of conditions such as social anxiety disorder with stuttering. Clinical implications are discussed.
PMID: 25740627 [PubMed - as supplied by publisher]

Neural systems mediating processing of sound units of language distinguish recovery versus persistence in stuttering - INFANTIL

J Neurodev Disord. 2015;7(1):28. doi: 10.1186/s11689-015-9124-7. Epub 2015 Aug 18.

Free Full Text -

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4538747/pdf/11689_2015_Article_9124.pdf

Mohan R, Weber C.

Department of Speech Language and Hearing Science, Purdue University, West Lafayette, IN USA.

PMID: 26284147 [PubMed]

Neurogenic speech sequelae following suicide attempt by hanging: a case report. - GAGUEIRA ADQUIRIDA

Int J Adolesc Med Health. 2015 Sep 11. pii: /j/ijamh.ahead-of-print/ijamh-2015-0039/ijamh-2015-0039.xml. doi: 10.1515/ijamh-2015-0039. [Epub ahead of print]

Wazeer MM, John S, Rajashekhar B.

OBJECTIVE: This study aimed to demonstrate the sequelae of neurogenic speech deficits following a suicide attempt by hanging, the treatment strategies, and prognostic issues in one such case.

METHODS: We report of Patient X who attempted suicide by hanging. The patient was admitted and a detailed speech and language evaluation was completed.

PMID: 26360492 [PubMed - as supplied by publisher]

Origin and Pawn scaling for adults who do and do not stutter: A preliminary comparison. - NEUROCIÊNCIAS
J Fluency Disord. 2015 Sep;45:73-81. doi: 10.1016/j.jfludis.2015.05.001. Epub 2015 May 16.

Lee K, Manning WH, Herder C.
Catholic University of Daegu, Hyang-Eup, Gyungsan-si, Kyungsangbuk-do, South Korea; The University of Memphis, Memphis, TN, USA; American Institute for Stuttering, New York, USA.

PURPOSE:In order to determine whether adults who stutter (AWS) would show changes in locus of causality during stuttering treatment and approximate those of adults who do not stutter (AWNS) this preliminary study compared the locus of causality as indicated by Origin and Pawn scaling procedures from two groups of young adults who do and do not stutter.
METHOD:A total of 20 age- and gender-matched undergraduate and graduate students who did (n=10) and did not (n=10) stutter participated. The AWS took part in a three week intensive stuttering treatment provided by the American Institute for Stuttering (AIS). Along with measures of treatment outcome, writing samples were analyzed for Origin and Pawn statements that indicated the participant's locus of causality.
RESULTS:At the outset of treatment the AWS showed significantly greater Pawn scores than the control group of AWNS and similar occurrences of Origin statements. The AWS showed a statistically significant increase in pre- to post-treatment Origin scores and a statistically significant decrease in Pawn scores. Following treatment the AWS showed the Origin and Pawn score ratios similar to those of AWNS.
CONCLUSION:A pattern of increasing Origin and decreasing Pawn scores may indicate a pattern of increasing agency during successful stuttering treatment. Moreover the post-treatment Origin and Pawn score ratios of AWS, which were not significantly different from those of AWNS, may indicate a change trend toward normalization. Further research will determine whether such change patterns are predictive of long-term maintenance.
EDUCATIONAL OBJECTIVES:By reading this article the reader will be able to: (a) describe advantages of content analysis measure such as the Origin and Pawn Scales; (b) discuss the purposes and procedures of the Origin and Pawn Scales; (c) describe typical change pattern of Origin and Pawn scores of adults who stutter while receiving treatment; (d) discuss how successful treatment for stuttering can result in the normalization of one's locus of causality.
PMID: 26026504 [PubMed - as supplied by publisher]

Personality attributes of Iranian people who stutter. - EMOCIONAL

J Commun Disord. 2015 Nov-Dec;58:119-25. doi: 10.1016/j.jcomdis.2015.10.001. Epub 2015 Oct 17.

Jafari R, Baziar M, Bleek B, Reuter M, Montag C.

Tehran University of Medical Sciences, Tehran, Iran; Iran University of Medical Sciences, Tehran, Iran; University of Bonn, Bonn, Germany; Ulm University, Ulm, Germany.

Two recent studies from Australia and Germany have both shown that people who stutter (PWS) have elevated Neuroticism scores on the widely used NEO Five Factor Inventory (NEO-FFI) compared to individuals in a control sample. The two studies showed opposite results, however, for the personality traits Agreeableness and Conscientiousness. One reason for these opposing findings could be that the two studies were conducted in different cultural settings. Given that the effect of different cultural background on the relationship between the NEO-FFI and stuttering remains an open question, we investigated the NEO-FFI scores from 98 PWS and an age- and sex-matched control-group from a less widely studied cultural background (Iran). Overall, the present study showed, in line with a study from Germany, higher Agreeableness, but not Neuroticism, in PWS compared to normally fluent controls. To get further insights into these findings, we also contrasted both samples from Iran with a healthy matched sample from Germany. The resulting cross-cultural differences from these analyses are also discussed in the present paper. Although the present study is limited by a cross-sectional design, and so no causal conclusions can be drawn, the authors discuss whether the replicated elevated Agreeableness scores in PWS might represent a self-defense mechanism to cope with one's own speech handicap.

PMID: 26547120 [PubMed - in process]

Perspectives of Clinicians Involved in the RESTART-Study: Outcomes of a Focus Group. - TERAPIA

Am J Speech Lang Pathol. 2015 Nov;24(4):708-16. doi: 10.1044/2015_AJSLP-14-0215.

de Sonneville-Koedoot C, Adams SA, Stolk EA, Franken MC.

PURPOSE: The purpose of this study was to explore the attitudes and beliefs of speech-language pathologists (SLPs) with regard to the Lidcombe Program and Demands and Capacities-based treatment and to examine how these attitudes and beliefs might have changed as a result of participating in the RESTART-study.

METHOD: A focus group meeting with 13 SLPs was organized. The discussion was structured using questions on therapy preference, attitudes about and explicit comparison of both treatments and treatment manuals, and learnings of trial participation.

RESULTS: Four main themes were identified. First, a change in attitude toward treatment choice was observed. Second, this change was related to a change in beliefs about the potential of both treatments. Third, aspects of the treatments regarded as success factors were considered. Last, learning outcomes and increased professionalism as a result of participating in the RESTART-trial were discussed.

CONCLUSIONS: This study showed how attitudes and beliefs of SLPs with regard to the Lidcombe Program and Demands and Capacities-based treatment evolved during a randomized trial. This work increases our understanding of the role of attitudes and beliefs in the uptake and utilization of therapies and demonstrates the importance of collecting qualitative data. Results and recommendations should prove of value in implementing the RESTART-trial results and in training SLPs.

PMID: 26363127 DOI: 10.1044/2015_AJSLP-14-0215

Predicting Treatment Time and Long-Term Outcome of the Lidcombe Program: A Replication and Reanalysis - INFANTIL

Am J Speech Lang Pathol. 2015 Aug;24(3):533-44. doi: 10.1044/2015_AJSLP-13-0156.

Guitar B, Kazenski D, Howard A, Cousins SF, Fader E, Haskell P.

PURPOSE:The present study presents treatment duration and outcome data on 14 children who stutter (CWS) recently treated by the Lidcombe Program (LP). These data were then combined with data from a previous LP treatment study (Miller and Guitar, 2009) to examine predictor variables for treatment duration and outcome. The present study also provides evidence of the effectiveness of LP from researchers who are independent of the developers of the program.

METHOD:Fourteen preschool CWS were assessed on stuttering severity variables and participant characteristics prior to treatment, given LP treatment, and reassessed two years after the children achieved stable fluency. These children's data were added to the data of 15 previously-treated CWS to examine predictors of treatment duration and long-term outcome. Preliminary analysis lead to the identification of two predictors that were tested in a generalized linear model.

RESULTS:For the new group of 14 CWS, median treatment duration was 15 clinic visits and resulted in near-zero stuttering long-term for most of the children and substantial reductions in stuttering for all of the children. For the combined group of 29 children, pre-treatment stuttering frequency and severity were the best predictors of treatment duration in both clinic visits and weeks.

CONCLUSIONS:Children with more frequent and more severe stuttering may take longer in LP treatment. Long-term outcome may be best be predicted by pre-treatment stuttering and sex.

PMID: 26125134 [PubMed - as supplied by publisher]

Relation of motor, linguistic and temperament factors in epidemiologic subtypes of persistent and recovered stuttering: Initial findings. - INFANTIL

J Fluency Disord. 2015 Sep;45:12-26. doi: 10.1016/j.jfludis.2015.05.004. Epub 2015 Jun 1.

Ambrose NG, Yairi E, Loucks TM, Seery CH, Throneburg R.

University of Illinois at Urbana-Champaign; University of Wisconsin-Milwaukee; Eastern Illinois University, United States.

PURPOSE:The purpose of this study was to determine the presence of any patterns reflecting underlying subtypes of persistence and recovery across epidemiologic, motor, language, and temperament domains in the same group of children beginning to stutter and followed for several years.

METHODS:Participants were 58 2-4-year-old CWS and 40 age and gender matched NFC from four different sites in the Midwest. At the end of the multi-year study, stuttering children were classified as Persistent or Recovered. The same protocol obtaining data to measure stuttering, motor, language and temperament characteristics was used at each site. They have not been included in previous reports.

RESULTS:The Persistent group performed consistently differently from the Recovered and Control groups. They performed lower on standardized language tests and in phonological accuracy, had greater kinematic variability, and were judged by their parents to be more negative in temperament.

CONCLUSIONS:The present study provides data supporting the hypothesis that subtypes of stuttering can be identified along persistency/recovery lines, but results were not definitive.

EDUCATIONAL OBJECTIVES:Readers will be able to (a) describe the current state of subtypes of stuttering research; (b) summarize possible contributions of epidemiologic, motoric, linguistic and temperament to such subtyping with regard to persistency and recovery.

PMID: 26117417 [PubMed - as supplied by publisher]

Responses of adults who stutter to the anticipation of stuttering. - TERAPIA

J Fluency Disord. 2015 September ; 45: 38–51. doi:10.1016/j.jfludis.2015.05.002.

Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728710/pdf/nihms694161.pdf

Jackson ES, Yaruss JS, Quesal RW, Terranova V, Whalen DH.
The Graduate Center of the City University of New York; University of Pittsburgh; Western Illinois University; Hunter College of the City University of New York; Haskins Laboratories, United States.

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.
EDUCATIONAL OBJECTIVES: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.
PMID: 26065618 [PubMed - as supplied by publisher]

Screening for Speech and Language Delay in Children 5 Years Old and Younger: A Systematic Review - INFANTIL

Pediatrics. 2015 Aug;136(2):e448-62. doi: 10.1542/peds.2014-3889. Epub 2015 Jul 7.

Wallace IF, Berkman ND, Watson LR, Coyne-Beasley T, Wood CT, Cullen K, Lohr KN.

RTI International, Research Triangle Park, North Carolina; University of North Carolina, Chapel Hill, North Carolina.

BACKGROUND AND OBJECTIVES: No recommendation exists for or against routine use of brief, formal screening instruments in primary care to detect speech and language delay in children through 5 years of age. This review aimed to update the evidence on screening and treating children for speech and language since the 2006 US Preventive Services Task Force systematic review.

METHODS: Medline, the Cochrane Library, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, ClinicalTrials.gov, and reference lists. We included studies reporting diagnostic accuracy of screening tools and randomized controlled trials reporting benefits and harms of treatment of speech and language. Two independent reviewers extracted data, checked accuracy, and assigned quality ratings using predefined criteria.

RESULTS: We found no evidence for the impact of screening on speech and language outcomes. In 23 studies evaluating the accuracy of screening tools, sensitivity ranged between 50% and 94%, and specificity ranged between 45% and 96%. Twelve treatment studies improved various outcomes in language, articulation, and stuttering; little evidence emerged for interventions improving other outcomes or for adverse effects of treatment. Risk factors associated with speech and language delay were male gender, family history, and low parental education. A limitation of this review is the lack of well-designed, well-conducted studies addressing whether screening for speech and language delay or disorders improves outcomes.

CONCLUSIONS: Several screening tools can accurately identify children for diagnostic evaluations and interventions, but evidence is inadequate regarding applicability in primary care settings. Some treatments for young children identified with speech and language delays and disorders may be effective.

PMID: 26152671 [PubMed - in process]

Speech and voice disorders in patients with psychogenic movement disorders - EMOCIONAL

J Neurol. 2015 Nov;262(11):2420-4. doi: 10.1007/s00415-015-7856-7. Epub 2015 Jul 21.

Baizabal-Carvallo JF, Jankovic J.

Baylor College of Medicine, Cambridge

Psychogenic speech and voice disorders (PSVDs) may occur in isolation but more typically are encountered in the setting of other psychogenic disorders. We aimed to characterize the phenomenology, frequency, and correlates of PSVDs in a cohort of patients with psychogenic movement disorders (PMDs). We studied 182 consecutive patients with PMDs, 30 of whom (16.5 %) also exhibited PSVD. Stuttering was the most common speech abnormality (n = 16, 53.3 %), followed by speech arrests (n = 4, 13.3 %), foreign accent syndrome (n = 2, 6.6 %), hypophonia (n = 2, 6.6 %), and dysphonia (n = 2, 6.6 %). Four patients (13.2 %) had more complex presentations with different combinations of these patterns. No differences in gender, age at onset, and distribution of PMDs were observed between patients with and without PSVD. PSVDs are relatively frequent in patients with PMDs and are manifested by a wide variety of abnormal speech and voice phenomena, with stuttering being the most common presentation. Speech therapy and insight-oriented counseling may be helpful to some patients.

PMID: 26194199 [PubMed - as supplied by publisher]

Speech-Language Dissociations, Distractibility, and Childhood Stuttering - ATENÇÃO
Am J Speech Lang Pathol. 2015 Aug;24(3):480-503. doi: 10.1044/2015_AJSLP-14-0198.

Clark CE, Conture EG, Walden TA, Lambert WE.

PURPOSE:This study investigated the relation among speech-language dissociations, attentional distractibility, and childhood stuttering.
METHOD:Participants were 82 preschool-age children who do (CWS) and 120 who do not stutter (CWNS). Correlation-based statistics (Bates, E., Appelbaum, Salcedo, Saygin, & Pizzamiglio, 2003) identified dissociations across five norm-based speech-language (sub)tests. The Behavioral Style Questionnaire (BSQ) distractibility subscale measured attentional distractibility. Analyses addressed: (1) between-group differences in the number of children exhibiting speech-language dissociations; (2) between-group distractibility differences; (3) the relation between distractibility and speech-language dissociations; and (4) whether interactions between distractibility and dissociations predicted the frequency of total, stuttered, and non-stuttered disfluencies.
RESULTS:More preschool-age CWS exhibited speech-language dissociations than CWNS, and more boys exhibited dissociations than girls. Additionally,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. Lastly, interactions between distractibility and dissociations did not predict CWS's or CWNS's speech disfluencies.
CONCLUSIONS: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 [PubMed - as supplied by publisher]

Speech motor planning and execution deficits in early childhood stuttering. - FALA INFANTIL

J Neurodev Disord. 2015;7(1):27. doi: 10.1186/s11689-015-9123-8. Epub 2015 Aug 20.

Free Full Text

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4545974/pdf/11689_2015_Article_9123.pdf

Walsh B, Mettel KM, Smith A.

Purdue University, IN USA; University of Colorado Hospital, CO USA.

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.

PMID: 26300988 [PubMed] PMCID: PMC4545974 Free PMC Article

Speech preparation in adults with persistent developmental stuttering. - NEUROCIÊNCIAS

Brain Lang. 2015 Oct;149:97-105. doi: 10.1016/j.bandl.2015.05.009. Epub 2015 Jul 17.

Mock JR, Foundas AL, Golob EJ.

Tulane University; University of Missouri, Kansas City School of Medicine, United States;

Motor efference copy conveys movement information to sensory areas before and during vocalization. We hypothesized speech preparation would modulate auditory processing, via motor efference copy, differently in men who stutter (MWS) vs. fluent adults. Participants (n=12/group) had EEG recorded during a cue-target paradigm with two conditions: speech which allowed for speech preparation, while a control condition did not. Acoustic stimuli probed auditory responsiveness between the cue and target. MWS had longer vocal reaction times (p<0.01) when the cue-target differed (10% of trials), suggesting a difficulty of rapidly updating their speech plans. Acoustic probes elicited a negative slow wave indexing motor efference copy that was smaller in MWS vs. fluent adults (p<0.03). Current density responses in MWS showed smaller left prefrontal responses and auditory responses that were delayed and correlated to stuttering rate. Taken together, the results provide insight into the cortical mechanisms underlying atypical speech planning and dysfluencies in MWS.

PMID: 26197258 [PubMed - as supplied by publisher]

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

Int J Speech Lang Pathol. 2015 Nov 7:1-12. [Epub ahead of print]

Erickson S, Block S, Menzies R, O'Brian S, Packman A, Onslow M.

La Trobe University , Melbourne , Australia and The University of Sydney , Lidcombe , Australia.

PURPOSE: 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.

METHOD: 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.

RESULT: 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.

CONCLUSION: 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.

PMID: 27063674 [PubMed - as supplied by publisher]

"Stuttering" after minor head trauma.

Am J Emerg Med. 2015 Jul 29. pii: S0735-6757(15)00612-9. doi: 10.1016/j.ajem.2015.07.056. [Epub ahead of print]

Strasberg S, Johnson EJ, Parry T.

Lincoln Medical and Mental Health Center, Bronx, NY;

No abstract available

PMID: 26371830 [PubMed - as supplied by publisher]

Stuttering Associated With the Use of Short-Acting Oral Methylphenidate. - FARMACOLOGIA

J Clin Psychopharmacol. 2015 Oct 2. [Epub ahead of print]

Alpaslan AH, Coşkun KŞ, Kocak U, Gorücü Y.

Faculty of Medicine, Afyonkarahisar, Turkey

No abstract available.

PMID: 26436866 [PubMed - as supplied by publisher]

Sympathetic arousal of young children who stutter during a stressful picture naming task - EMOCIONAL INFANTIL

Fluency Disord. 2015 Aug 6. pii: S0094-730X(15)00061-3. doi: 10.1016/j.jfludis.2015.07.005. [Epub ahead of print]

Zengin-Bolatkale H, Conture EG, Walden TA.

Vanderbilt University, Nashville, TN , United States.

PURPOSE: The purpose of the current study was to investigate sympathetic arousal of young children who do and do not stutter during a stressful picture-naming task under instructions to name pictures as rapidly as possible.

METHOD: Thirty-seven young children who stutter (CWS) and 39 young children who do not stutter (CWNS) served as participants. Dependent measures consisted of tonic skin conductance during a pretask baseline, a stress-inducing rapid picture-naming task, and post-picture-naming task condition.

RESULTS: Findings indicated that, when chronological age was not taken into account, there was no between-group difference in tonic skin conductance level. When age was taken into account, however, there was a significant talker group×age group interaction, with follow-up analyses indicating that 3-year-old CWS exhibited significantly higher sympathetic arousal than their CWNS peers, and their 4-year-old CWNS peers.

CONCLUSIONS: Findings were taken to be consistent with non-physiological results indicating an association between emotional processes and childhood stuttering. This association, at least for this cross-sectional study of tonic skin conductance level (SCL) during a picture-naming task, was moderated by children's chronological age. Such developmental differences may be associated with various processes, for example, attention, cognition, or physiology, or some combination of two or more of these processes. Future empirical study of these processes in young CWS and CWNS may profit from longitudinal measurement of converging lines of evidence from behavioral, parent and psychophysiological indexes of emotional reactivity and regulation.

EDUCATIONAL OBJECTIVES: After reading this article, the reader will be able to: (a) discuss salient findings in the literature regarding the association between emotional processes and childhood stuttering; (b) discuss sympathetic arousal, and how skin conductance is used to measure it; and (c) discuss the role of chronological age in the association between emotion and stuttering in young children.

PMID: 26296616 [PubMed - as supplied by publisher]

The Neurobiological Grounding of Persistent Stuttering: from Structure to Function - NEUROCIÊNCIAS

Curr Neurol Neurosci Rep. 2015 Sep;15(9):579. doi: 10.1007/s11910-015-0579-4.

Neef NE, Anwander A, Friederici AD.

Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany

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.

PMID: 26228377 [PubMed - in process]

The prevalence of anti-Toxoplasma gondii antibodies in stutterers is higher than in the control group.

Folia Parasitol (Praha). 2015 Dec 16;62. pii: 2015.066. doi: 10.14411/fp.2015.066.

Celik T, Gokcen C, Aytas O, Ozcelik A, Celik M, Coban N.

Faculty of Medicine, Adiyaman University, Adiyaman, Turkey; Medicine Faculty of Gaziantep University, Gaziantep, Turkey; Malatya State Hospital, Malatya, Turkey;

No abstract available.

PMID: 26726750 [PubMed - in process]

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

J Fluency Disord. 2015 Aug 1. pii: S0094-730X(15)00057-1. doi: 10.1016/j.jfludis.2015.07.001. [Epub ahead of print]

Park J, Logan KJ.

Chungnam National University, Daejeon, Republic of Korea;, University of Florida, Gainesville, FL, USA.

PURPOSE: 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.

METHOD: 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.

RESULTS: 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.

CONCLUSIONS: 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.

EDUCATIONAL OBJECTIVES: 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.

PMID: 26296615 [PubMed - as supplied by publisher]

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

Int J Lang Commun Disord. 2015 Sep-Oct;50(5):676-718. doi: 10.1111/1460-6984.12171. Epub2015 Jun 30.

Baxter S, Johnson M, Blank L, Cantrell A, Brumfitt S, Enderby P, Goyder E.

University of Sheffield, Sheffield, UK

BACKGROUND:The growing range of available treatment options for people who stutter presents a challenge for clinicians, service managers and commissioners, who need to have access to the best available treatment evidence to guide them in providing the most appropriate interventions. While a number of reviews of interventions for specific populations or a specific type of intervention have been carried out, a broad-based systematic review across all forms of intervention for adults and children was needed to provide evidence to underpin future guidelines, inform the implementation of effective treatments and identify future research priorities.

AIMS:To identify and synthesize the published research evidence on the clinical effectiveness of the broad range of non-pharmacological interventions for the management of developmental stuttering.

METHODS & PROCEDURES:A systematic review of the literature reporting interventions for developmental stuttering was carried out between August 2013 and April 2014. Searches were not limited by language or location, but were restricted by date to studies published from 1990 onwards. Methods for the identification of relevant studies included electronic database searching, reference list checking, citation searching and hand searching of key journals. Appraisal of study quality was performed using a tool based on established criteria for considering risk of bias. Due to heterogeneity in intervention content and outcomes, a narrative synthesis was completed.

MAIN CONTRIBUTION:The review included all available types of intervention and found that most may be of benefit to at least some people who stutter. There was evidence, however, of considerable individual variation in response to these interventions. The review indicated that effects could be maintained following all types of interventions (although this was weakest with regard to feedback and technology interventions).

CONCLUSIONS:This review highlights a need for greater consensus with regard to the key outcomes used to evaluate stuttering interventions, and also a need for enhanced understanding of the process whereby interventions effect change. Further analysis of the variation in effectiveness for different individuals or groups is needed in order to identify who may benefit most from which intervention.

PMID: 26123259 [PubMed - as supplied by publisher]

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