Abstract - Agosto a Dezembro de 2019
2D:4D ratios as an indicator of intrauterine androgen exposure in children who stutter - AVALIAÇÃO
Early Hum Dev. 2019 Aug: 135:27-31. Epub 2019 Jun 19
Yuksel T, Sizer E, Durak H.
Dicle University School of Medicine, Diyarbakir, Turkey
AIM: We aimed to explore whether there is a relationship between stuttering and digit ratio (2D:4D), which is thought to be a marker of prenatal testosterone exposure.
METHODS: We evaluated a total of 90 children who stutter (CWS; n = 40 mild-to-moderate and n = 50 severe stutters) and 40 healthy peers (CWNS) as controls. We used the Clinical Global Impression-Severity (CGIS) scale to measure the severity of stuttering. We measured the lengths of index finger (2D) and ring finger (4D) of both hands directly and divided to calculate 2D:4D ratio. The difference between the right and the left hand 2D:4D ratio (DR-L) was also calculated.
RESULT: Significant difference was found in right 2D:4D and the mean DR-L between the CWS and CWNS groups. Right 2D:4D was significantly lower in stuttering boys than in control boys, and in stuttering girls than control girls. Also, DR-L was significantly lower in stuttering boys than control boys. In ANOVA, there were significant differences between the mild-to-moderate, severe stuttering and control groups in terms of right 2D:4D and DR-L. Right hand 2D:4D and DR-L decreased from controls to severe stutterers.
CONCLUSION: Our results suggest that lower right 2D:4D and DR-L were related to the presence and severity of stuttering in children, i.e. CWS had lower 2D:4D and DR-L than CWNS. Further large-scale prospective studies are needed to clarify the reliability of 2D:4D ratio as an indicator of fetal sex hormone exposure level and its relation with the presence and severity of stuttering in children.
PMID: 31228858 DOI: 10.1016/j.earlhumdev.2019.06.003
A three-arm randomized controlled trial of Lidcombe Program and Westmead Program early stuttering interventions - TERAPIA
J Fluency Disord. 2019 Sep;61:105708.. Epub 2019 May 8
Trajkovski N, O'Brian S, Onslow M, Packman A, Lowe R, Menzies R, Jones M, Reilly S.
The University of Sydney, NSW, Australia; The University of Queensland, QLD, Australia; Griffith University, QLD, Australia; Murdoch Childrens Research Institute, Melbourne, Australia.
PURPOSE: To compare two experimental Westmead Program treatments with a control Lidcombe Program treatment for early stuttering.
METHOD: The design was a three-arm randomized controlled trial with blinded outcome assessments 9 months post-randomization. Participants were 91 pre-school children.
RESULTS: There was no evidence of difference in percentage syllables stuttered at 9 months among groups. Dropout rates were substantive and may have been connected with novel aspects of the trial design: the use of community clinicians, no exclusion criteria, and randomization of children younger than 3 years of age.
CONCLUSION: The substantive dropout rate for all three arms in this trial means that any conclusions about the 9-month stuttering outcomes must be regarded as tentative. However, continued development of the Westmead Program is warranted, and we are currently constructing an internet version.
PMID: 31121476 DOI: 10.1016/j.jfludis.2019.105708
A two-case study of coarticulation in stuttered speech. An articulatory approach - FALA
Clin Linguist Phon. 2019 Sep 3:1-19. [Epub ahead of print]
Didirková I, Hirsch F.
Université Paris 8 , Saint-Denis , France; Université Sorbonne Nouvelle , Paris , France; Université Paul-Valéry Montpellier 3, Praxiling, CNRS , Montpellier , France.
This study aims to describe the coarticulatory behaviour in stuttered speech from an articulatory point of view. Its purpose is to assess the nature of transitions between a stuttered phone and preceding and subsequent phones. Two persons who stutter were recorded by means of an electromagnetic articulograph while reading a text. The vertical movements of upper and lower lips, tongue body, tongue tip and mandible were extracted. They were then analysed during a stuttering moment and linked to the acoustic type of disfluency. Our findings showed several configurations of coarticulatory behaviour in terms of supraglottic articulatory movements. While disfluencies can be the result of a disrupted coarticulatory configuration, no systematicity has been found. Moreover, all acoustic types of disfluencies are represented in several coarticulatory configurations. Therefore, a stuttering-like disfluency is not always due to a coarticulatory disturbance, since correct coarticulatory patterns can be observed both between the disfluent sound and its previous and subsequent sounds. Furthermore, they suggest that the acoustic classification of disfluencies does not seem important for the coarticulatory behaviour.
PMID: 31478388 DOI: 10.1080/02699206.2019.1660913
Abnormal Sensorimotor Integration in Adults Who Stutter: A Behavioral Study by Adaptation of Delayed Auditory Feedback - AUDITIVO
Front Psychol. 2019 Oct 31;10:2440. eCollection 2019.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6834693/pdf/fpsyg-10-02440.pdf
Iimura D, Asakura N, Sasaoka T, Inui T.
University of Tsukuba, Ibaraki, Japan; Japan Society for the Promotion of Science, Tokyo, Japan;Domo-Work (Specified Nonprofit Corporation), Tokyo, Japan; Osaka University, Osaka, Japan; Hiroshima University, Hiroshima, Japan; Otemon Gakuin University, Osaka, Japan.
Stuttering is a fluency disorder, partially alleviated during altered auditory feedback, suggesting abnormal sensorimotor integration in adults who stutter (AWS). As weighting of multiple integrating-information sources would be decided based on their reliabilities, the use of external (auditory feedback) and internal information (prediction of sensory consequences) could correlate with speech processing. We hypothesized that abnormal auditory-feedback processing in AWS could be related to decrease in internal processing precision. We used a perceptual-adaptation experiment of delayed auditory feedback (DAF) to verify the hypothesis. Seventeen AWS and 17 adults who do not stutter (ANS) were required to say "ah" and judge the simultaneity between their motor sensations and vocal sounds in each stimulus onset asynchrony (SOA) (0, 25, 50, 75, 100, 125, or 150 ms) after inducing adaptation of DAF (three conditions with 0-, 66-, or 133-ms delay). While no adaptation occurred during the 0 ms condition, perceptual change in simultaneity judgment (adaptation effect) occurred during the 66 and 133 ms conditions. The simultaneity judgments following exposure in each SOA were fitted to the psychometric function in each condition for the AWS and ANS groups. We calculated the μ (signifying the point of subjective simultaneity and adaptation-effect degree) and σ (signifying the detecting precision) of each function and analyzed them by parametric analyses. For the μ, participant groups and adaptation conditions showed a significant interaction; the adaptation effect was greater in the AWS than in the ANS group. Additionally, the μ and σ were only positively correlated in the AWS group. The point of subjective simultaneity for auditory delay by inducing DAF was higher in AWS than in ANS, indicating that perception of simultaneity in AWS was influenced by DAF to a greater extent. Moreover, the significant positive correlation between the μ and σ in AWS showed that the more imprecise the internal auditory processing, the more AWS relied on auditory feedback. It is suggested that the reliability of internal information differed within the AWS group, and AWS with reduced internal reliability appeared to compensate by relying to a great extent on auditory feedback information.
PMID: 31736833 PMCID: PMC6834693 DOI: 10.3389/fpsyg.2019.02440
Adult stuttering and attentional ability: A meta-analytic review - ATENÇÃO
Int J Speech Lang Pathol. 2019 Oct 7:1-10. [Epub ahead of print]
University of Suffolk , Ipswich , United Kingdom of Great Britain and Northern Ireland.
Purpose: The study presents the first review in which the link between attentional ability and developmental stuttering is explored. The review aimed to summarise the published research literature and provide a more conclusive understanding as to the relationship between stuttering and attention.
Method: To be included in this review, the studies had to compare the attentional performance of adult people who stutter (PWS) and people who do not stutter (PWNS) over the age of 18 years with a validated psychometric instrument for measuring attentional ability. Articles were searched in four electronic databases where each of the following search terms (attention, vigilance, inhibitory, inhibition, interference, executive and processing) was cross-referenced with each of the following terms (stutter, stammer, speech disfluency and speech dysfluency). A total of 21 studies met the inclusion criteria to be submitted into a meta-analysis. Result: The results of the main meta-analysis, which included all selected studies, demonstrated that PWS had a significantly worse attentional performance as compared to PWNS. Two further meta-analyses on selective attention and dual tasking performance confirmed the latter finding. Importantly, however, the effect was not present in all studies. Conclusion: Our findings should be taken as an indication that stuttering sometimes (but not always) manifests together with poorer attentional ability, such that the identified link does not affect all PWS. These results provide support for the notion that there is a close association between stuttering and attentional ability in a subgroup of PWS, highlighting potential practical implications for stuttering treatment.
PMID: 31590580 DOI: 10.1080/17549507.2019.1665710
Adults who stutter and metronome synchronization: evidence for a nonspeech timing deficit - PSICOMOTOR
Ann N Y Acad Sci. 2019 Aug;1449(1):56-69. Epub 2019 May 29.
Sares AG, Deroche MLD, Shiller DM, Gracco VL.
Integrated Program in Neuroscience, Montréal, Quebec, Canada; McGill University, Montréal, Quebec, Canada; School of Communication Sciences and Disorders, Montréal, Quebec, Canada; Université de Montréal, Montréal, Quebec, Canada; Haskins Laboratories, New Haven, Connecticut.
Speech timing deficits have been proposed as a causal factor in the disorder of stuttering. The question of whether individuals who stutter have deficits in nonspeech timing is one that has been revisited often, with conflicting results. Here, we uncover subtle differences in a manual metronome synchronization task that included tempo changes with adults who stutter and fluent speakers. We used sensitive circular statistics to examine both asynchrony and consistency in motor production. While both groups displayed a classic negative mean asynchrony (tapping before the beat), individuals who stutter anticipated the beat even more than their fluent peers, and their consistency was particularly affected at slow tempi. Surprisingly, individuals who stutter did not have problems with interval correction at tempo changes. We also examined the influence of music experience on synchronization behavior in both groups. While music perception and training were related to synchronization behavior in fluent participants, these correlations were not present for the stuttering group; however, one measure of stuttering severity (self-rated severity) was negatively correlated with music training. Overall, we found subtle differences in paced auditory-motor synchronization in individuals who stutter, consistent with a timing problem extending to nonspeech.
PMID: 31144336 PMCID: PMC6687520
Age at onset of training in children with hearing and speech disorders and the analysis of related factors in Turkey - CONCEITO
Ital J Pediatr. 2019 Oct 15;45(1):124.
Free full text - https://ijponline.biomedcentral.com/track/pdf/10.1186/s13052-019-0723-x
Hacettepe University, Sıhhiye, Ankara, Turkey.
BACKGROUND: Early diagnosis and intervention play a vital role in hearing and speech disorders and the effect of intervention varies according to the age at onset of training of children with such disorders. Aim of this study is to investigate the age at onset of training in children admitted to our center with complaints of hearing and speech disorder, and the related factors.
METHODS: In the first phase of the study, data of 473 children admitted to our center between January 2015 and October 2018 with complaints of hearing and speech disorders and no additional disability were retrospectively analyzed. Then, their chronological age, gender, cause of admission, age at onset of training and the effect of factors that may have an impact on the age at onset of training were analyzed statistically. Study data were obtained from patient records.
RESULTS: Of 473 children (350 males and 123 females) admitted to our training center with the complaints of hearing and speech disorders, 252 (53.3%) were presented with speech sound disorders, 90 (19.0%) with stuttering, 87 (18.4%) with delayed speech, 32 (6.8%) with hearing loss and 12 (2.5%) with other causes. Although there was a statistically significant difference between the age at onset of training and the factors; such as cause of admission, parental education level, employment status of the mother, occupation of the father, and socioeconomic status of the family (p < 0.05), no statistically significant difference was found between the age at onset of training and gender (p > 0.05).
CONCLUSIONS: The study revealed that children with hearing loss have the chance of early diagnosis thanks to neonatal hearing screening programs and that they commence their training until the age of 2, which is considered to be a critical period for language and speech development. However, it is an undeniable fact that we have not yet reached the ideal age for the commencement of training (6th month). Similarly, the age of diagnosis and initiation of training is delayed in children with speech disorders due to families' delayed referral to the training centers.
PMID: 31615557 DOI: 10.1186/s13052-019-0723-x
Attention, Speech-Language Dissociations, and Stuttering Chronicity - ATENÇÃO
Am J Speech Lang Pathol. 2019 Dec 16:1-11. [Epub ahead of print]
Singer CM, Walden TA, Jones RM.
Grand Valley State University, Grand Rapids, MI; Vanderbilt University, Nashville, TN.
The purpose of this study was to investigate the singular and joint contributions of speech-language dissociations and attention (i.e., distractibility and attention span) to stuttering chronicity.
Method Participants, aged 3;0-4;11 (years;months) at an initial visit, were classified as persisting (n = 10; 9 boys), recovered (n = 32; 23 boys), and nonstuttering (n = 28; 19 boys) based on multiple speech and language evaluations spread across 2 years. The evaluations included assessments of articulation, receptive and expressive vocabulary, and omnibus receptive and expressive language. These measures were used to identify speech-language dissociations using a correlation-based statistical approach. Attentional characteristics, which included measures of distractibility and attention span, were based on parent report. Analyses investigated between-group differences related to dissociations and attentional characteristics as well as the relation between these indices.
Results There were no significant between-group differences for the persisting and recovered groups on measures of speech-language dissociations; however, the recovered group was found to exhibit less optimal attention span than the persisting group. In addition, children with dissociations exhibited less optimal distractibility and attention spans at the final time point than children without dissociations. Conclusions Present results indicate that attention is related to both stuttering chronicity and the presence of speech-language dissociations; however, they do not support the notion that dissociations are associated with stuttering persistence. These results provide novel insights into the complex nature of the association between developmental stuttering, speech-language dissociations, and attention.
PMID: 31841358 DOI: 10.1044/2019_AJSLP-19-00039
Autonomic Nervous System Response to Speech Production in Stuttering and Normally Fluent Preschool-Age Children - EMOCIONAL
J Speech Lang Hear Res. 2019 Oct 23:1-15. [Epub ahead of print]
Tumanova V, Backes N.
Syracuse University, NY.
Purpose We studied speech-related sympathetic nervous system arousal of preschool-age children who do (CWS) and do not stutter (CWNS) and its association with children's proclivity to experience negative emotions and children's self-reported attitudes toward speaking.
Method Electrodermal activity measures were collected from 32 preschool-age children while they engaged in a picture description and a nonword repetition task. Children's proclivity to experience negative emotions was assessed with a parent report questionnaire. Children's communication attitude was assessed with a self-report questionnaire. Results CWS did not differ from CWNS in their sympathetic arousal during a picture description task. However, during a more challenging nonword repetition task, preschool-age CWS had a higher sympathetic arousal level than CWNS. Although CWS were rated by their caregivers as more fearful and prone to sadness, children's tendency to experience stronger and more frequent negative emotions was not associated with their sympathetic arousal during speaking. Lastly, although CWS had a more negative communication attitude than CWNS, it was not associated with their level of sympathetic arousal during speaking. Conclusions Our findings suggest that age-appropriate social communication tasks are not inherently more stressful for preschool-age CWS and are not associated with state-related stress or anxiety that is often reported for adults who stutter. However, speaking tasks that place a higher demand on children's cognitive-linguistic system may be more taxing and challenging to preschool CWS than CWNS, leading to a higher level of arousal.
PMID: 31644362 DOI: 10.1044/2019_JSLHR-S-19-0121
Behavioral and Neural Correlates of Auditory n-Back Task in Adults With and Without Stuttering - AUDITIVO
Am J Audiol. 2019 Aug 28;28(2S):471-482 Epub 2019 Aug 28.
Devaraju DS, Kumar UA, Maruthy S.
All India Institute of Speech and Hearing, Mysore.
Purpose Adults with stuttering (AWS) exhibit compromised phonological working memory abilities, poor central auditory processing, and impaired auditory processing especially during overt speech production tasks. However, these tasks are sensitive to language disturbances already found in them. Thus, in this study, monosyllables were used ruling out the language effects, and auditory working memory ability was evaluated in AWS using the n-back task. In specific, the auditory sensory input of the working memory mechanism was evaluated. Method Thirty-two participants, 16 each of AWS and adults with no stuttering (AWNS), performed behavioral auditory 1-back and 2-back tasks. The long latency responses were also recorded during no-back and 2-back conditions from 64 electrode sites. Results Results revealed no significant differences between the groups in any of the behavioral parameters such as reaction time, accuracy, false alarm rate, or d'. N1 amplitude modulation was noted in AWNS, which was absent in AWS. The segmentation analysis showed a left hemisphere-oriented topographical distribution in the N2 region in AWS irrespective of conditions, whereas the scalp topography was right hemisphere-oriented with the involvement of parietal channels in AWNS. The timing differences existed between AWS and AWNS in the intervals that a topographical distribution lasted in all throughout the time window of analysis. Conclusion The results suggest altered neural pathway and hemispheric differences during auditory working memory tasks in AWS.
PMID: 31461331 DOI: 10.1044/2019_AJA-IND50-18-0101
Bilingual children who stutter: Convergence, gaps and directions for research - LINGUAGEM
J Fluency Disord. 2019 Dec 9:105741 [Epub ahead of print]
Choo AL, Smith SA.
Georgia State University, Atlanta, GA, United States; University of South Florida, Tampa, United States.
PURPOSE: The aim of this systematic review is to examine the early interactions between bilingualism and stuttering to synthesize knowledge that could inform diagnosis and treatment for bilingual children who stutter.
METHOD: Scopus, Science Direct, PubMed, ERIC Ebsco, and Google Scholar were searched with no limits placed on the year of publication. Search terms consisted of: ("stuttering" [MeSH] OR "stutter") AND ("child" [MeSH] OR "children") AND ("multilingualism" [MeSH] OR "bilingualism"). Inclusion criteria were children who stutter, bilinguals who stutter, empirical research articles, and published in peer review journals. Exclusion criteria were studies that reported on only adults, only monolinguals, or were not published in English.
RESULTS: A total of 50 articles met the criteria. There was convergence with monolingual studies reporting sexually dimorphic and familial trends in the prevalence of stuttering and rates of recovery. Findings surrounding language proficiency, cross-linguistic stuttering severity, and development were ambivalent. Results point to the difficulty in identifying stuttering in bilingual children, and the need for culturally competent research and interpretations.
CONCLUSION: Current findings offer a fragmented view of bilingual development and echoes a recurring theme, i.e., the current understanding of bilingualism and stuttering is limited and more research is warranted.
PMID: 31883649 DOI: 10.1016/j.jfludis.2019.105741
Bimanual task performance: Adults who do and do not stutter - PSICOMOTOR
J Commun Disord. 2019 Sep - Oct; 81:105911. Epub 2019 May 24.
Werle D, Byrd C, Gkalitsiou Z, Eggers K.
The University of Texas at Austin, Austin, TX, USA; Thomas More University College, Antwerp, Belgium; University of Turku, Turku, Finland.
Research has demonstrated children who stutter score significantly lower than children who do not stutter on the Purdue Pegboard Test. Past data also suggest performance on this task may be associated with stuttering frequency (Choo et al., 2016; Mohammadi et al., 2016). The purpose of this study was to explore whether these performance differences and the relationship to stuttering frequency are present in adults who stutter (AWS). Forty-eight participants (AWS = 24, and AWNS = 24) matched for age, gender, education, and handedness completed all four tasks of the Purdue Pegboard Test. There were no significant between group differences and stuttering frequency did not predict performance. These findings suggest previous differences may only be applicable to subgroups and/or that, with development, the manual tasks unique to the Purdue Pegboard Test may not be sensitive enough to reveal differences.
PMID: 31152880 DOI: 10.1016/j.jcomdis.2019.105911
Clinical Trial for Stuttering Treatment: pilot study about dog participation in the therapy session - TERAPIA
Codas. 2019 Nov 7;31(5):e20180274.
Costa JB, Ichitani T, Juste FS, Cunha MC, Andrade CRF.
Universidade de São Paulo - USP - São Paulo (SP), Brasil; Pontifícia Universidade Católica de São Paulo - PUC-SP- São Paulo (SP), Brasil.
PURPOSE: To verify the effect of dog intervention on the regular session of speech therapy for developmental stuttering in adults.
METHODS: The study involved young adults and adults with developmental stuttering. The study sample was composed of eight participants, six males and two females, ranging in age from 16 to 45 years. Participants were divided into two groups: G1 - those who underwent treatment for stuttering with the presence of a dog-therapist in the therapy room and G2 - those who underwent treatment for stuttering without the presence of the dog therapist. We included a control group, G3, composed of fluent participants, matched in age and sex to G1 and G2 to control the natural variability of speech fluency.
RESULTS: Comparative results between the groups indicated that the group that performed the treatment without the presence of the dog achieved better performance, evolution and efficacy rates.
CONCLUSION: for the population in this study, the dog intervention on speech therapy did not improve treatment.
PMID: 31721913 DOI: 10.1590/2317-1782/20192018274
Disfluencies and phonological revisions in a nonword repetition task in school-age children who stutter - FALA
J Commun Disord. 2019 Sep-Oct; 81: 105917. Epub 2019 Jun 18
Sasisekaran J, Weathers EJ.
University of Minnesota, United States; University of Iowa, United States.
Phonological encoding and associated functions, including monitoring of covert and overt speech, have been attributed relevant roles in stuttering. The aim of this study was to investigate these processes by testing the effects of nonword length in syllables (3-, 4-, 6-syllable), phonotactics, and phonemic/phonetic complexity on disfluencies and phonological revisions in 26 school-age children who stutter (CWS, n = 13) and matched fluent controls (CWNS). Participants repeated nonwords in two sessions separated by an hour. Within-group comparisons of percentage disfluencies using nonparametric tests resulted in significantly more disfluencies for the 6- compared to the 3-syllable nonwords and suggested that nonword length influences disfluencies in the CWS. The groups were comparable in the percentage of disfluencies at all levels of nonword length. The findings failed to provide conclusive evidence that phonological complexity and phonotactic manipulations have a greater effect on disfluencies in CWS compared to CWNS. The findings of significantly fewer phonological revisions and the lack of a significant correlation between disfluencies and revisions in the CWS in Session 1 compared to the CWNS are interpreted to suggest reduced external auditory monitoring. Demands on incremental phonological encoding with increasing task complexity (the Covert Repair Hypothesis, Postma & Kolk, 1993) and reduced external auditory monitoring of stuttered speech can account for the disfluencies, speech errors, and revisions in the speech of school-age CWS.
PMID: 31247507 DOI: 10.1016/j.jcomdis.2019.105917
Ecopipam as a pharmacologic treatment of stuttering - FARMACOLOGIA
Ann Clin Psychiatry. 2019 Aug;31(3):164-168.
Maguire GA, LaSalle L, Hoffmeyer D, Nelson M, Lochhead JD, Davis K, Burris A, Yaruss JS.
University of California, Riverside, School of Medicine, CA. USA.
BACKGROUND: Stuttering, also known as childhood-onset fluency disorder, is a chronic neurodevelopmental disorder that affects 1% of the population and can greatly impact an individual's social, occupational, and academic functioning. Prior research has shown dopamine D2 antagonists are effective in reducing the severity of stuttering symptoms, but these compounds can be associated with metabolic and movement disorder adverse effects. Ecopipam is an investigational medication that acts as a selective dopamine D1 receptor antagonist. This mechanism should reduce the likelihood of metabolic and movement disorder adverse effects of D2 antagonists.
METHOD: This open-label pilot study investigated ecopipam in the treatment of adults who stutter.
RESULTS: The results showed that a majority of participants demonstrated improvement in their stuttering. The medication was well tolerated.
CONCLUSIONS: These positive, preliminary findings suggest that a doubleblind, randomized controlled clinical trial to examine the efficacy of ecopipam in the treatment of stuttering is warranted.
Effect of Different Body Postures on the Severity of Stuttering in Young Adults with Developmental Stuttering - PSICOMOTOR
Biomed Res Int. 2019 Aug 5
Free Full Text : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699346/pdf/BMRI2019-1817906.pdf
Almudhi A, Zafar H, Anwer S, Alghadir A.
King Khalid University, Abha, Saudi Arabia; King Saud University, Riyadh, Saudi Arabia; Hong Kong Polytechnic University, Kowloon, Hong Kong Special Administrative Region, China.
OBJECTIVE: The current study aimed to investigate the effects of body position on the level and severity of stuttering in young adults with developmental stuttering.
METHODS: A total of 24 subjects (male: 17; female: 7; mean age: 24.9 ± 6.2 years) with developmental stuttering participated. The participants were asked to perform oral reading and spontaneous monologue-speaking tasks in different body postures while their speech was recorded. During reading and speaking tasks, the Stuttering Severity Instrument was used to quantify the severity of stuttering. The effects of different body postures on stuttering severity, reading task, and speaking task scores were analyzed.
RESULTS: Significant differences in stuttering severity, reading task, and speaking task scores were found for different body postures. Post hoc analyses revealed a significant difference in stuttering severity, reading task, and speaking task scores when subjects were sitting on a chair with no arm support compared to lying down (p<0.05). Similarly, there were significant differences for two sitting positions (sitting on a chair with no arm support vs sitting on a chair with arm support (p<0.05)).
CONCLUSIONS: Body postures or body segment positions that relax and facilitate the muscles of the neck and shoulders may potentially improve speech fluency in young adults with developmental stuttering.
PMID: 31467870 PMCID: PMC6699346 DOI: 10.1155/2019/1817906
Effect of phonological and morphological factors on speech disfluencies of Kannada speaking preschool children who stutter - FALA
J Fluency Disord. 2019 Sep;61:105707. Epub 2019 May 3.
Seth D, Maruthy S.
All India Institute of Speech and Hearing, Mysore, India.
PURPOSE: Empirical investigations have revealed a strong association between linguistic factors and stuttering, specifically phonological and morphological factors. However, the effect of these factors is suggested to vary across languages owing to the differences in their linguistic structure. Further, the trend is found to vary between AWS and CWS. Literature in this regard is scarce in the Kannada language, particularly in children. Hence, the study was driven by the need to understand the effect of phonological and morphological factors on stuttering in Kannada speaking CWS.
METHOD: Spontaneous speech samples were obtained from twenty Kannada speaking preschool CWS with a confirmed diagnosis of stuttering by an experienced speech-language pathologist. The recorded samples were transcribed, and disfluencies were marked. Further, the stuttered words were analysed for phonological and morphological features. The phonological factors included were phoneme position in a word, phoneme type and word length. Morphological factors consisted of word class and word end inflectional morphology. The percentage of stuttering was calculated with respect to each of the factors mentioned above.
RESULTS: Phoneme in the initial position of a word and words beginning with consonants had a higher rate of stuttering. Word length, word class and word end inflections were found to have no significant effect on the rate of stuttering in CWS.
CONCLUSION: Overall, current findings revealed that stuttering might manifest differently across languages varying in their linguistic structures.
PMID: 31103753 DOI: 10.1016/j.jfludis.2019.105707
Effects of different attention tasks on concurrent speech in adults who stutter and fluent controls - TERAPIA
J Fluency Disord. 2019 Sep;61:105714. doi: 10.1016/j.jfludis.2019.105714. Epub 2019 Aug 21
Eichorn N, Pirutinsky S, Marton K.
The University of Memphis, United States; Touro College School of Social Work, United States; The Graduate School and University Center of the City University of New York, United States; Brooklyn College, CUNY, United States; Bárczi Gusztáv College of Special Education of Eötvös Loránd University, Hungary.
PURPOSE: Motor theories indicate that focusing attention on well-practiced movements interferes with skilled performance; however, specific forms of attention (alerting vs. orienting vs. executive control) associated with this effect are not well understood. The present study explored this question in relation to stuttering, and examined whether dual task conditions that engaged sustained attention or working memory (WM) affected speech fluency in different ways. We also considered whether fluency changes were associated with changes in speech rate and language.
METHODS: Nineteen adults who stutter (AWS) and 20 controls produced spontaneous speech under a baseline condition and two dual task conditions: one involving a sustained attention task, the other involving WM demands.
RESULTS: Both groups produced fewer stutter-like disfluencies under dual task relative to baseline conditions and this reduction did not differ between the two dual tasks (attention vs. WM). Speech rate and language variables, which were potentially influenced by attention conditions, were not affected by dual tasks in the same way as disfluencies, and appeared to be unassociated with fluency results.
CONCLUSIONS: Findings indicate that atypical disfluencies decrease when attention is divided, even when secondary task demands are minimal, as they were in the sustained attention task. For simple secondary tasks, fluency changes do not appear to be a byproduct of slowed rate and are not accompanied by observable changes in language. These results demonstrate that simple manipulations of attention can induce measurable effects on aspects of speech production, and may be a useful tool for facilitating fluency in clinical intervention.
PMID: 31472297 DOI: 10.1016/j.jfludis.2019.105714
Effects of Phantom Electrode Stimulation on Vocal Production in Cochlear Implant Users - AUDITIVO
Ear Hear. 2019 Sep/Oct;40(5):1127-1139
Caldwell MT, Jiradejvong P, Limb CJ.
Vanderbilt University Medical Center; University of California, San Francisco, California, USA.
OBJECTIVES: Cochlear implant (CI) users suffer from a range of speech impairments, such as stuttering and vocal control of pitch and intensity. Though little research has focused on the role of auditory feedback in the speech of CI users, these speech impairments could be due in part to limited access to low-frequency cues inherent in CI-mediated listening. Phantom electrode stimulation (PES) represents a novel application of current steering that extends access to low frequencies for CI recipients. It is important to note that PES transmits frequencies below 300 Hz, whereas Baseline does not. The objective of this study was to explore the effects of PES on multiple frequency-related characteristics of voice production.
DESIGN: Eight postlingually deafened, adult Advanced Bionics CI users underwent a series of vocal production tests including Tone Repetition, Vowel Sound Production, Passage Reading, and Picture Description. Participants completed all of these tests twice: once with PES and once using their program used for everyday listening (Baseline). An additional test, Automatic Modulation, was included to measure acute effects of PES and was completed only once. This test involved switching between PES and Baseline at specific time intervals in real time as participants read a series of short sentences. Finally, a subjective Vocal Effort measurement was also included.
RESULTS: In Tone Repetition, the fundamental frequencies (F0) of tones produced using PES and the size of musical intervals produced using PES were significantly more accurate (closer to the target) compared with Baseline in specific gender, target tone range, and target tone type testing conditions. In the Vowel Sound Production task, vowel formant profiles produced using PES were closer to that of the general population compared with those produced using Baseline. The Passage Reading and Picture Description task results suggest that PES reduces measures of pitch variability (F0 standard deviation and range) in natural speech production. No significant results were found in comparisons of PES and Baseline in the Automatic Modulation task nor in the Vocal Effort task.
CONCLUSIONS: The findings of this study suggest that usage of PES increases accuracy of pitch matching in repeated sung tones and frequency intervals, possibly due to more accurate F0 representation. The results also suggest that PES partially normalizes the vowel formant profiles of select vowel sounds. PES seems to decrease pitch variability of natural speech and appears to have limited acute effects on natural speech production, though this finding may be due in part to paradigm limitations. On average, subjective ratings of vocal effort were unaffected by the usage of PES versus Baseline.
PMID: 30601240 DOI: 10.1097/AUD.0000000000000690
Efficacy of aripiprazole in severe, persistent, socially- and occupationally-impairing developmental stuttering.
Asian J Psychiatr. 2019 Oct 31;48:101861. [Epub ahead of print]
Bharadwaj A, Andrade C.
National Institute of Mental Health and Neurosciences, Bangalore, India.
No abstract available
Eliciting Stuttering in Laboratory Contexts - AVALIAÇÃO
J Speech Lang Hear Res. 2019 Dec 13:1-8. [Epub ahead of print]
Jackson ES, Gracco V, Zebrowski PM.
New York University, New York City; Haskins Laboratories, New Haven, CT; The University of Iowa, Iowa City.
Purpose The contextual variability of stuttering events makes it difficult to reliably elicit stuttered speech in laboratory settings. As a result, studies that compare stuttered versus fluent speech are difficult to conduct and, thus, are limited in the literature. The purpose of the current study is to describe a novel approach to elicit stuttering during laboratory testing.
Method A semistructured clinical interview leveraging the phenomenon of stuttering anticipation was administered to 22 adults who stutter (1st visit). The interview was used to generate participant-specific anticipated and unanticipated word lists, which were used as stimuli during a 2nd visit so that the validity of the method could be tested.
Results The method yielded a near-equal distribution of unambiguously stuttered and fluent utterances (43.6% and 43.5%, respectively). Moreover, 12.9% of the utterances were judged to be ambiguous, that is, not unambiguously stuttered or fluent.
Conclusion This approach outperformed previous attempts to elicit stuttering during laboratory testing. It could be implemented in future studies that compare neural, physiological, or behavioral correlates of fluent versus stuttered speech.
PMID: 31835000 DOI: 10.1044/2019_JSLHR-S-19-0173
Estimates of functional cerebral hemispheric differences in monolingual and bilingual people who stutter: dichotic listening paradigm - AUDITIVO
Clin Linguist Phon. 2019 Dec 3:1-16. [Epub ahead of print]
Kornisch M, Robb MP, Jones RD.
University of Canterbury, Christchurch, New Zealand; University of Mississippi, Oxford, Mississippi, USA; Pennsylvania State University, University Park, Pennsylvania, USA.
Recent studies indicate functional cerebral hemispheric processing differences between monolinguals and bilinguals who stutter, as well as monolinguals and bilinguals who do not stutter. Eighty native German speakers, half of whom were also proficient speakers of English as a second language (L2), were assessed on a dichotic listening paradigm using CV syllables as stimuli. The participants were organised into four different groups according to speech status and language ability: 20 monolinguals who stutter, 20 bilinguals who stutter, 20 monolinguals who do not stutter, and 20 bilinguals who do not stutter. A right ear advantage (REA) was observed across all groups with no significant group differences in regard to hemispheric asymmetry. Although MWS (18 dB) and BWS (16 dB) crossed over to an LEA at an earlier point compared to the MWNS (5 dB) and BWNS (2 dB), the difference between groups was minor and not significant. Thus, a significant difference in REA resistance, as proposed by other researchers, was not reflected in the current study neither for people who stutter nor for bilinguals. In addition, no meaningful relationship was found between dichotic listening and stuttering severity, as well as the four language modalities (listening, speaking, reading, writing). Thus, we contend that neither stuttering nor bilingualism has any non-trivial effect on functional cerebral hemispheric differences in language processing in dichotic listening.
PMID: 31795770 DOI: 10.1080/02699206.2019.1697372
Group Experiences and Individual Differences in Stuttering - TERAPIA EM GRUPO
J Speech Lang Hear Res. 2019 Nov 18;62(12):4335-4350. Epub 2019 Dec 12.
Tichenor SE, Yaruss JS.
Michigan State University, East Lansing.
Purpose This study explored group experiences and individual differences in the behaviors, thoughts, and feelings perceived by adults who stutter. Respondents' goals when speaking and prior participation in self-help/support groups were used to predict individual differences in reported behaviors, thoughts, and feelings.
Method In this study, 502 adults who stutter completed a survey examining their behaviors, thoughts, and feelings in and around moments of stuttering. Data were analyzed to determine distributions of group and individual experiences.
Results Speakers reported experiencing a wide range of both overt behaviors (e.g., repetitions) and covert behaviors (e.g., remaining silent, choosing not to speak). Having the goal of not stuttering when speaking was significantly associated with more covert behaviors and more negative cognitive and affective states, whereas a history of self-help/support group participation was significantly associated with a decreased probability of these behaviors and states.
Conclusion Data from this survey suggest that participating in self-help/support groups and having a goal of communicating freely (as opposed to trying not to stutter) are associated with less negative life outcomes due to stuttering. Results further indicate that the behaviors, thoughts, and experiences most commonly reported by speakers may not be those that are most readily observed by listeners.
PMID: 31830852 DOI: 10.1044/2019_JSLHR-19-00138
Hand Motor Cortex Excitability During Speaking in Persistent Developmental Stuttering. - PSICOMOTOR
Front Hum Neurosci. 2019 Oct 4;13:349.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788188/pdf/fnhum-13-00349.pdf
Sommer M, Omer S, Wolff von Gudenberg A, Paulus W.
University of Göttingen, Göttingen, Germany; PARLO Institute for Research and Training in Speech Therapy, Calden, Germany.
Persistent developmental stuttering (PDS) is a speech fluency disorder characterized by intermittent involuntary breakdowns of speech motor control, possibly related to motor cortex excitability. Whether motor cortex dysfunction extends into hand representations is unclear. We here studied task-dependent modulations of hand motor cortex excitability in 10 right-handed adults who stutter (AWS) and 13 age- and sex-matched fluent speaking control participants (ANS), covering a wide range of tasks in an exploratory study. Before, during and after a null speech/rest task, spontaneous speech, solo reading, chorus reading, singing, and non-verbal orofacial movements, transcranial magnetic stimulation was applied over the primary motor cortex and motor evoked potentials (MEPs) were recorded from the abductor digiti minimi muscle of either hand. In both groups, motor threshold was lower in the left than in the right motor cortex. During task performance, MEP amplitudes increased in both groups. A post hoc comparison of spontaneous speech and non-verbal orofacial movements yielded an interaction of group by task with AWS showing larger than ANS MEP amplitude increase in spontaneous speech, but a smaller than ANS MEP amplitude increase in non-verbal orofacial movements. We conclude that hemispheric specialization of hand motor representation is similar for both groups. Spontaneous speech as well as non-verbal orofacial movements are the orofacial tasks that merit further study. The excessive motor cortex facilitation could be reflecting a stronger activation of non-speech muscles during AWS's speech.
PMID: 31636556 PMCID: PMC6788188 DOI: 10.3389/fnhum.2019.00349
Human GNPTAB stuttering mutations engineered into mice cause vocalization deficits and astrocyte pathology in the corpus callosum - GENÉTICA
Proc Natl Acad Sci U S A. 2019 Aug 27;116(35):17515-17524. Epub 2019 Aug 12.
Han TU, Root J, Reyes LD, Huchinson EB, Hoffmann JD, Lee WS, Barnes TD, Drayna D.
National Institutes of Health, Bethesda, MD 20892; Washington University School of Medicine in St. Louis, St. Louis.
Stuttering is a common neurodevelopmental disorder that has been associated with mutations in genes involved in intracellular trafficking. However, the cellular mechanisms leading to stuttering remain unknown. Engineering a mutation in N-acetylglucosamine-1-phosphate transferase subunits α and β (GNPTAB) found in humans who stutter into the mouse Gnptab gene resulted in deficits in the flow of ultrasonic vocalizations similar to speech deficits of humans who stutter. Here we show that other human stuttering mutations introduced into this mouse gene, Gnptab Ser321Gly and Ala455Ser, produce the same vocalization deficit in 8-day-old pup isolation calls and do not affect other nonvocal behaviors. Immunohistochemistry showed a marked decrease in staining of astrocytes, particularly in the corpus callosum of the Gnptab Ser321Gly homozygote mice compared to wild-type littermates, while the staining of cerebellar Purkinje cells, oligodendrocytes, microglial cells, and dopaminergic neurons was not significantly different. Diffusion tensor imaging also detected deficits in the corpus callosum of the Gnptab Ser321Gly mice. Using a range of cell type-specific Cre-drivers and a Gnptab conditional knockout line, we found that only astrocyte-specific Gnptab-deficient mice displayed a similar vocalization deficit. These data suggest that vocalization defects in mice carrying human stuttering mutations in Gnptab derive from abnormalities in astrocytes, particularly in the corpus callosum, and provide support for hypotheses that focus on deficits in interhemispheric communication in stuttering.
PMID: 31405983 DOI: 10.1073/pnas.1901480116
Idiopathic Normal Pressure Hydrocephalus with Stuttering: Report of Two Cases and Review of the Literature - GAGUEIRA ADQUIRIDA
World Neurosurg. 2019 Dec 2. [Epub ahead of print]
Mathew P, Chiu L, Lee C, Carroll R, Johnson MD.
University of Massachusetts Medical School, Worcester, Massachusetts; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Idiopathic normal pressure hydrocephalus (iNPH) is a disorder of aging that is characterized by enlarged cerebral ventricles, gait apraxia, dementia, and urinary incontinence. iNPH is frequently misdiagnosed, in part because the symptoms resemble other neurological disorders, and because other associated symptoms have not been fully characterized. Importantly, iNPH has not previously been associated with stuttering, and shunting has not been shown to alleviate the symptom of stuttering. Here, the authors report two cases of patients with iNPH presenting with stuttering that resolved after ventriculoperitoneal (VP) shunt placement. Each patient presented with gait difficulty, incontinence, cognitive impairment and stuttering. Lasting improvements of the symptoms (including stuttering) were seen in both patients after CSF drainage procedures that included lumbar puncture, extended lumbar CSF drainage, placement of a VP shunt, and VP shunt revision. These findings suggest that iNPH can present with stuttering or dysarthria. The significant improvement in stuttering and dysarthria, along with the improvements in gait difficulty, incontinence, and cognitive impairment that occurred after CSF drainage, suggests that the motor apraxia observed in NPH can affect speech production. Practitioners should be aware that iNPH can present with stuttering, and that CSF drainage can improve stuttering in select circumstances.
PMID: 31805405 DOI: 10.1016/j.wneu.2019.11.152
Impact of auditory feedback alterations in individuals with stuttering - AUDITIVO
Braz J Otorhinolaryngol. 2019 Oct 3. [Epub ahead of print]
Free full text: https://www.sciencedirect.com/science/article/pii/S1808869419301120?via%3Dihub
Fiorin M, Marconato E, Palharini TA, Picoloto LA, Frizzo ACF, Cardoso ACV, Oliveira CMC.
Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP)
INTRODUCTION: Electrophysiological evidence has reinforced the hypothesis that stuttering is associated with a deficit in modulation of the cortical auditory system during speech planning, contributing to an inefficient auditory feedback monitoring and, consequently, resulting in disfluencies.
OBJECTIVE: To verify the impact of auditory feedback modifications on the spontaneous speech of individuals with stuttering.
METHODS: Sixteen individuals, of both genders, aged 8-17 years and 11 months, with a diagnosis of persistent neurodevelopmental stuttering, were divided into two groups: Moderate Stuttering Group and Severe Stuttering Group. The testing procedures consisted of three stages: collection of identification data, audiological assessment and fluency evaluation of spontaneous speech in four auditory feedback conditions (non-altered, delayed, masked and amplified). The speech sample obtained in the non-altered feedback was considered the control; the others were considered as modified listening conditions.
RESULTS: Regarding the stuttering-like disfluencies, a statistically significant difference was observed in the intragroup analysis of the Moderate Stuttering Group between non-altered and masked auditory feedback (p = 0.042), as well as between non-altered and amplified (p = 0.042). There was a statistically significant difference in the Severe Stuttering Group for all auditory feedback modifications in relation to the non-altered (delayed p = 0.012, masked p = 0.025 and amplified p = 0.042). There was also a reduction in flows of syllables and words-per-minute in the Moderate Stuttering Group for the delayed auditory feedback, as compared to non-altered (p = 0.017 and p = 0.025, respectively).
CONCLUSION: The effect of delayed auditory feedback was favorable for the Severe Stuttering Group, promoting speech fluency. The conditions of masked and amplified auditory feedback resulted in speech benefits in both groups, decreasing the number of stuttering-like disfluencies. The speech rate was not impaired by any listening condition analyzed.
PMID: 31648949 DOI: 10.1016/j.bjorl.2019.08.005
Is there an association between age at first words and speech sound disorders among 4- to 5-year-old children? An epidemiological cross-sectional study based on parental reports - LINIGUAGEM
Int J Pediatr Otorhinolaryngol. 2019 Nov; 126:109602. Epub 2019 Jul 26
Salvago P, Gorgone E, Giaimo S, Battaglia E, Dispenza F, Ferrara S, Martines F.
Università degli Studi di Palermo, Palermo, Italy; Azienda Sanitaria Provinciale 2, Caltanissetta, Italy; U.O.C. Otorinolaringoiatria AOUP P, Giaccone, Palermo, Italy.
OBJECTIVE: To investigate the role of the period of emergence of the first words and its interactions with other risk factors in predicting the development of speech sound disorder (SSD) among 4- to 5-year-old children.
METHODS: After 373 children underwent otolaryngology and speech pathology examinations, their parents answered a questionnaire about potential risk factors for speech impairment. The presence of SSD was identified by a speech pathologist who administered Fanzago's Articulation Test to each child. Multivariate logistic analysis was used to explore the relationships between variables and outcomes.
RESULTS: Mean age at first words was 17.8 ± 6.5 months of life; 25.7% of patients suffered from SSD, and 3.7% from stuttering. A family history of language impairment was found in 12.9% of the sample, whereas a family history of reading difficulty was reported in only 5.4% of cases. No differences in terms of mean age (p = 0.3) or gestational age (p = 0.16) were found between children affected by SSD and those who were not. Multivariate logistic analysis revealed that male sex (p < 0.001), a family history of language impairment (p < 0.001) and stuttering (p = 0.001) were significantly associated to SSD. Age at first words did not result a predictor of speech impairment.
CONCLUSION: In contrast to male sex (p < 0.001), family history of language impairment (p < 0.001) and stuttering (p = 0.001) which resulted significantly associated to SSD, age at first words does not seem to be a predictor of SSD (p = 0.11); however, it remains a useful indicator of language delay and, when considered in association with other language milestones, can be a reason of concern for parents and caregivers about their children's developmental and speech therapy needs.
PMID: 31374388 DOI: 10.1016/j.ijporl.2019.109602
Is what I think I think really what I think? Implicit and explicit attitudes toward stuttering among practicing speech-language pathologists - AVALIAÇÃO
J Commun Disord. 2019 Nov 13;83:105965. [Epub ahead of print]
Walden TA, Lesner TA, Jones RM.
Vanderbilt University, Nashville, United States.
PURPOSE: Two studies assessed implicit (Study 1) and explicit (Study 2) attitudes toward stuttering and those who stutter among speech-language pathologists (SLPs).
METHOD: In Study 1, 15 SLPs completed the Stuttering Implicit Association Test, a measure of implicit attitudes toward stuttered speech. In Study 2, 40 SLPs provided explicit attitudes about individuals who stutter, assessed via self-report ratings of an adult who stutters and one who does not. Participants also completed measures of experience with stuttering.
RESULTS: As a group, clinicians displayed negative implicit attitudes toward stuttering. Explicit attitudes toward a person who stutters were positive, albeit less positive than attitudes toward a person who does not stutter. Amount of prior exposure to stuttering among these experienced SLPs was not significantly associated with either implicit or explicit attitudes.
CONCLUSIONS: These findings highlight the importance of evaluating both implicit and explicit attitudes toward stuttering. The finding of positive explicit attitudes but negative implicit attitudes among similar samples of SLPs underscores the need to study implicit attitudes toward stuttering. Considering only explicit attitudes could lead to incomplete conclusions about the complex nature of attitudes toward stuttering.
PMID: 31759231 DOI: 10.1016/j.jcomdis.2019.105965
Limited Pre-Speech Auditory Modulation in Individuals Who Stutter: Data and Hypotheses - AUDITIVO
J Speech Lang Hear Res. 2019 Aug 29;62(8S):3071-3084. Epub 2019 Aug 29.
Max L, Daliri A.
University of Washington, Seattle; Haskins Laboratories, New Haven, CT; Arizona State University, Tempe, AZ.
Purpose We review and interpret our recent series of studies investigating motor-to-auditory influences during speech movement planning in fluent speakers and speakers who stutter. In those studies, we recorded auditory evoked potentials in response to probe tones presented immediately prior to speaking or at the equivalent time in no-speaking control conditions. As a measure of pre-speech auditory modulation (PSAM), we calculated changes in auditory evoked potential amplitude in the speaking conditions relative to the no-speaking conditions. Whereas adults who do not stutter consistently showed PSAM, this phenomenon was greatly reduced or absent in adults who stutter. The same between-group difference was observed in conditions where participants expected to hear their prerecorded speech played back without actively producing it, suggesting that the speakers who stutter use inefficient forward modeling processes rather than inefficient motor command generation processes. Compared with fluent participants, adults who stutter showed both less PSAM and less auditory-motor adaptation when producing speech while exposed to formant-shifted auditory feedback. Across individual participants, however, PSAM and auditory-motor adaptation did not correlate in the typically fluent group, and they were negatively correlated in the stuttering group. Interestingly, speaking with a consistent 100-ms delay added to the auditory feedback signal-normalized PSAM in speakers who stutter, and there no longer was a between-group difference in this condition. Conclusions Combining our own data with human and animal neurophysiological evidence from other laboratories, we interpret the overall findings as suggesting that (a) speech movement planning modulates auditory processing in a manner that may optimize its tuning characteristics for monitoring feedback during speech production and, (b) in conditions with typical auditory feedback, adults who stutter do not appropriately modulate the auditory system prior to speech onset. Lack of modulation of speakers who stutter may lead to maladaptive feedback-driven movement corrections that manifest themselves as repetitive movements or postural fixations.
PMID: 31465711 DOI: 10.1044/2019_JSLHR-S-CSMC7-18-0358
Methylphenidate and stuttering - FARMACOLOGIA
Br J Clin Pharmacol. 2019 Nov 85(11) 2634-2637. Epub 2019 Sep 12
Trenque T, Claustre G, Herlem E, Djerada Z, Trenque A, Morel A, Azzouz B
Reims University Hospitals; University of Reims Champagne-Ardenne, Faculty of Medicine, Reims, France.
Methylphenidate (MPH) is a piperidine similar to amphetamines, and is indicated for Attention Deficit Hyperactivity Disorder. Studies concerning stuttering occurring with methylphenidate are contradictory. We investigated the association between methylphenidate and stuttering. We analyzed reports in the World Health Organization global individual case safety reports database, Vigibase, up to 31 December 2018, with the MedDRA Preferred Term "dysphemia" and the Lower Level Terms "stutter" and "stuttering". The association between exposure to MPH and occurrence of the adverse drug reaction was estimated by disproportionality analysis. Reporting Odds Ratios (ROR) were calculated with 95% Confidence Intervals (CIs). In total, 2,975 cases of dysphemia were reported, of which 46 reports were associated with MPH. For the PT "dysphemia", the ROR was 7.3 (95% CI: 5.4-9.8). With the LLT "stuttering", 584 cases were registered in the database of which 17 involved MPH. The ROR was 13.9 (95% CI: 8.6-22.5). This study found a signal for stuttering with methylphenidate.
PMID: 31418914 DOI: 10.1111/bcp.14097
Movement kinematics and speech accuracy in a nonword repetition task in school-age children who stutter - FALA
J Commun Disord. 2019 Sep - Oct;81:105916. Epub 2019 Jun 18.
Sasisekaran J, Basu S, Weathers EJ.
University of Minnesota, United States; University of Iowa, United States.
We investigated sensorimotor processes in school-age children who do (CWS) and do not stutter (CWNS) in a nonword repetition (NWR) task and evaluated changes in behavioral (percent speech accuracy) and speech kinematics measures (lip aperture variability, movement duration) with practice and retention. Thirteen CWS and 13 CWNS divided into two age groups (younger, 8-12 years; n = 6, older, 13-15 years, n = 7) repeated nonwords varying in phonological properties over two sessions separated by an hour. Participants in both groups also completed several baseline measures, including tests of digit span and nonword repetition (NRT). A marginal trend for lower speech accuracy was noted in the CWS compared to the CWNS in the NWR task. The younger CWS also performed poorly compared to the older CWS and age-matched CWNS in the NRT. Findings provided weak support for limitations in initial encoding and subsequent retrieval of phonemic information. The CWS demonstrated significantly reduced inter-articulatory coordination for the 3-syllable nonwords. While both groups demonstrated significantly slower movements with increase in nonword complexity at the 3-syllable level, such differences were enhanced in the CWS group and influenced further by participant age. Additionally, digit span influenced movement coordination in both groups with only the CWNS showing a significant negative correlation between the digit span scores and movement variability at the onset of practice in Session 1. The findings offer limited support for a sensorimotor integration deficit in CWS and the contributions of cognitive mechanisms to performance in NWR.
PMID: 31325632 DOI: 10.1016/j.jcomdis.2019.105916
Neuroanatomical Correlates of Childhood Stuttering: MRI Indices of White and Gray Matter Development That Differentiate Persistence Versus Recovery - INFANTIL
J Speech Lang Hear Res. 2019 Aug 29;62(8S):2986-2998.Epub 2019 Aug 29.
Garnett EO, Chow HM, Chang SE.
University of Michigan, Ann Arbor; Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; Michigan State University, East Lansing.
Purpose We review two recent neuroanatomical studies of children who stutter (CWS), one that examines white matter integrity and the other that focuses on cortical gray matter morphology. In both studies, we sought to examine differences between children whose stuttering persists ("persistent"), children who recovered from stuttering ("recovered"), and their nonstuttering peers ("controls"). Method Both of the reviewed studies use data from a large pediatric sample spanning preschool- to school-age children (3-10 years old at initial testing). Study 1 focused on surface-based measures of cortical size (thickness) and shape (gyrification) using structural magnetic resonance imaging, whereas Study 2 utilized diffusion tensor imaging to examine white matter integrity. Results In both studies, the main difference that emerged between CWS and fluent peers encompassed left hemisphere speech motor areas that are interconnected via the arcuate fasciculus. In the case of white matter integrity, the temporoparietal junction and posterior superior temporal gyrus, both connected via the left arcuate fasciculus, and regions along the corpus callosum that contain fibers connecting bilateral motor regions were significantly decreased in white matter integrity in CWS compared to controls. In the morphometric study, children who would go on to have persistent stuttering specifically had lower cortical thickness in ventral motor and premotor areas of the left hemisphere. Conclusion These results point to aberrant development of cortical areas involved in integrating sensory feedback with speech movements in CWS and differences in interhemispheric connectivity between the two motor cortices. Furthermore, developmental trajectories in these areas seem to diverge between persistent and recovered cases.
PMID: 31465710 DOI: 10.1044/2019_JSLHR-S-CSMC7-18-0356
Neurofilament-Lysosomal Genetic Intersections in the Cortical Network of Stuttering - GENÉTICA
Prog Neurobiol. 2019 Oct 24:101718 [Epub ahead of print]
Benito-Aragón C, Gonzalez-Sarmiento R, Liddell T, Diez I, d'Oleire Uquillas F, Ortiz-Terán L, Bueichekú E, Chow HM, Chang SE, Sepulcre J.
Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; University of Navarra, Pamplona, Navarra, Spain; University of Exeter, Exeter, England, UK; Tecnalia Health Department, Tecnalia, Derio, Basque Country, Spain; Universitat Jaume I, Castellón, Spain; University of Michigan, Michigan, USA; Alfred I. du Pont Hospital for Children, Wilmington, DE, USA; Michigan State University, East Lansing, MI, USA.
The neurobiological underpinnings of stuttering, a speech disorder characterized by disrupted speech fluency, remain unclear. While recent developments in the field have afforded researchers with the ability to pinpoint several genetic profiles associated with stuttering, how these specific genetic backgrounds impact neuronal circuits and how they generate or facilitate the emergence of stuttered speech remains unknown. In this study we identified the large-scale cortical network that characterizes stuttering using functional connectivity MRI and graph theory. We performed a spatial similarity analysis that examines whether the topology of the stuttering cortical network intersects with genetic expression levels of previously reported genes for stuttering from the protein-coding transcriptome data of the Allen Human Brain Atlas. We found that GNPTG - a gene involved in the mannose-6-phosphate lysosomal targeting pathways - was significantly co-localized with the stuttering cortical network. An enrichment analysis demonstrated that the genes identified with the stuttering cortical network shared a significantly overrepresented biological functionality of Neurofilament Cytoskeleton Organization (NEFH, NEFL and INA). The relationship between lysosomal pathways, cytoskeleton organization, and stuttering, was investigated by comparing the genetic interactome between GNPTG and the neurofilament genes implicated in the current study. We found that genes of the interactome network, including CDK5, SNCA, and ACTB, act as functional links between lysosomal and neurofilament genes. These findings support stuttering is due to a lysosomal dysfunction that impart deleterious effects on the neurofilament organization of the speech neuronal circuits. They help in solving the intriguing unsolved link between lysosomal mutations and the presence of stuttering.
PMID: 31669185 DOI: 10.1016/j.pneurobio.2019.101718
Neuromagnetic Oscillations in the Human Sensory Systems: A Mini Review of Our Series and Literature - AUDITIVO
Neurosci Res. 2019 Dec 21. [Epub ahead of print]
Kyushu University, Fukuoka, Japan.
Oscillatory neuronal (electrical) activity in defined frequency ranges supports synchronous interactions between anatomically distinct regions of the human brain during cognitive tasks. Here, the author reviews our previous studies that focused on the neuromagnetic oscillations in the sensory systems in response to the external stimuli in normal healthy subjects and neurological disorders. A magnetoencephalo- graphy was applied to evaluate the neuromagnetic oscillations in humans. We have demonstrated that the oscillatory gamma synchronization binds the primary and secondary somatosensory areas (S1 and S2) in humans. This functional coupling is modulated by aging. In people who stutter, functional and structural reorganization of the right auditory cortex appears to be a compensatory mechanism for impaired left auditory cortex function. This may be partly caused by increased right hemispheric local phase synchronization and increased inter-hemispheric phase synchronization. We have also found that the hippocampus modulates auditory processing differently under normal conditions and in epileptic patients with hippocampal sclerosis. This indicates that altered neural synchronization may provide useful information about possible functional deterioration in patients with unilateral mesial temporal lobe epilepsy. Finally, supraspinal (cortical) mechanism is responsible for pain perception and pain relief via neural oscillations. Together, neuronal synchronization plays an important role in distributed cortico-cortical processing.
PMID: 31874215 DOI: 10.1016/j.neures.2019.12.007
Newly Recognized Stuttering in Three Young Children Following the Hojedk Earthquake in Iran - EMOCIONAL
Prehosp Disaster Med. 2019 Aug ;34(4):456-457. Epub 2019 Jun 25
Jafari H, Mohamadi M, Haghjoo A, Heidari M.
Iran University of Medical Sciences, Tehran, Iran; Isfahan University of Medical Sciences, Isfahan, Iran; State Welfare Organization of Kerman, Rehabilitation Branch, Kerman, Iran; Shahrekord University of Medical Sciences, Shahrekord, Iran.
Natural disasters, particularly earthquakes, in addition to physical complications, have always had psychological consequences for those affected by them. Stuttering is one of the psychological consequences of shocking events. After a 6.6 magnitude earthquake in Hojedk, Kerman, Iran, two 5-year-old children and a 4-year-old child with symptoms of discontinuous speech (including repeated sound, syllable, and words) were referred to the Kerman Welfare Organization's rehabilitation center (Kerman, Iran). After history-taking, it became clear that the children had begun to stutter after the earthquake due to fear and stress. Considering the importance of negative emotional experiences in the onset of stuttering, it cannot really be said with certainty that the negative experience of the earthquake initiated the stuttering. Rather, the stuttering had not been present before the earthquake and appeared after the event. These cases indicate the importance of psychosocial support and speech therapy after disasters, especially for children that have higher psychological vulnerability than other age groups.
PMID: 31237226 DOI: 10.1017/S1049023X19004497
No Evidence for Dystonia-Like Sensory Overflow of Tongue Representations in Adults Who Stutter - NEUROCIÊNCIAS
Front Hum Neurosci. 2019 Oct 4;13:336.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6787140/pdf/fnhum-13-00336.pdf
Vreeswijk SME, Hoang TNL, Korzeczek A, Neef NE, Wolff von Gudenberg A, Paulus W, Sommer M.
University Medical Center Göttingen, Georg-August-University, Göttingen, Germany; Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Institut der Kasseler Stottertherapie, Bad Emstal, Germany.
Persistent developmental stuttering (PDS) disrupts speech fluency in about 1% of adults. Although many models of speech production assume an intact sensory feedback from the speech organs to the brain, very little is actually known about the integrity of their sensory representation in PDS. Here, we studied somatosensory evoked potentials (SEPs) in adults who stutter (AWS), with the aim of probing the integrity of sensory pathways. In addition, we tested the processing of dual sensory input to address a putative link between stuttering and focal dystonia. In 15 AWS (aged 15-55 years; three females) and 14 matched fluent speaking adults (ANS), we recorded SEPs at C5' and C6' induced by stimulating separately or simultaneously the tongue or the cheek at the corner of the mouth. We determined latencies (N13, P19, and N27) and peak-to-peak amplitudes (N13-P19, P19-N27). We divided amplitudes from simultaneous stimulation by the sum of those from separate stimulation. Amplitude ratios did not differ between groups, indicating normal processing of dual sensory input. This does not support a clinical analogy between focal dystonia and persistent stuttering. SEP latencies as a measure of transmission speed in sensory pathways were significantly shorter in stuttering subjects than in fluent speaking participants, however, this might have been related to a trend for a height difference between groups, and was not confirmed in a replication dataset. In summary, we did not find evidence for dystonia-like sensory overflow of tongue representations in AWS.
PMID: 31636553 PMCID: PMC6787140 DOI: 10.3389/fnhum.2019.00336
Nonword repetition and identification skills in Kannada speaking school-aged children who do and do not stutter - FALA
J Fluency Disord. 2019 Dec 19:105745. [Epub ahead of print]
Sugathan N, Maruthy S.
All India Institute of Speech and Hearing, Mysuru, Karnataka, India.
PURPOSE: The present study employed nonword repetition and nonword identification tasks to explore the phonological working memory (PWM) abilities and its interaction with speech motor control in school-aged children who do and do not stutter.
METHOD: Participants were 17 children who stutter (CWS) (Age range = 7-12) and 17 age and gender-matched children who do not stutter (CWNS). For the nonword repetition task, the participants repeated sets of 2-, 3-, and 4-syllable nonwords (n = 12 per set). The participants silently identified a target nonword from a subsequent set of three nonwords (n = 12 per 2-, 3- and 4-syllable length) for the nonword identification task. The performance of CWS on the nonword repetition task was compared with the CWNS for the mean number of accurate repetitions, number of trials taken, number of accurate repetitions on initial trial, and number of fluent repetitions across the three-syllable conditions for the tasks. For the nonword identification task, the number of nonwords identified accurately by the two groups were subjected to analysis.
RESULTS: CWS were significantly less accurate on the initial production of nonwords and required significantly more number of attempts to repeat the nonword accurately. Further for the nonword identification task, CWS were significantly less accurate than CWNS in correctly identifying the target nonword.
CONCLUSIONS: The present findings suggest that, in addition to limitations in PWM capacity, an unstable speech motor control system in CWS may lead to dysfluent speech.
PMID: 31889560 DOI: 10.1016/j.jfludis.2019.105745
Parent perceptions of an integrated stuttering treatment and behavioral self-regulation program for early developmental stuttering - INFANTIL
J Fluency Disord. 2019 Nov 6;62:105726. [Epub ahead of print]
Druker K, Mazzucchelli T, Hennessey N, Beilby J.
Curtin University, Western Australia, Australia.
PURPOSE: Recent research has identified approximately half of children who stutter present with self-regulation challenges. These manifest in elevated inattentive and/or impulsive behaviours, aligned with attention deficit hyperactivity disorder (ADHD) symptoms. These symptoms have been found to influence the child's responsiveness to their stuttering treatment, and may exacerbate the psychosocial consequences of stuttering for them and their families. Early stuttering intervention identifies parents as key agents of change in the management of their children's stuttering. This study sought feedback from parents regarding their experiences with an integrated stuttering treatment and behavioral self-regulation program for early developmental stuttering, addressing the child's self-regulation challenges.
METHOD: Eight parents of children who stutter who had co-occurring self-regulation challenges completed the integrated program. This incorporated the Triple P--Positive Parenting Program adapted for the developmental stuttering population, and the Curtin University Stuttering Program (CUSP). Semi-structured qualitative interviews were conducted to capture parents' reflections on, and experiences with, the integrated program.
RESULTS: Thematic analysis identified several major themes regarding the parents' experiences with the integrated program: emotional impact on parents, child self-regulation, link between stuttering and behaviour, parent self-regulation, impact on family dynamics, and overall positive perceptions of the integrated program. All of the parents indicated they would recommend the program to future parents of children who stutter.
CONCLUSION: This study provides insights into parents' perceptions regarding an integrated intervention approach for early stuttering and behavior management. It also indicates how adopting a holistic approach to stuttering intervention is positive and has social validity.
PMID: 31756581 DOI: 10.1016/j.jfludis.2019.105726
Phase I trial of a standalone internet social anxiety treatment for adolescents who stutter: iBroadway - EMOCIONAL
Int J Lang Commun Disord. 2019 Nov: 54(6): 927-939. Epub 2019 Jul 30
Gunn A, Menzies RG, Onslow M, O'Brian S, Packman A, Lowe R, Helgadóttir FD, Jones M.
The University of Sydney, Lidcombe, Sydney, NSW, Australia; University of Queensland, Herston, Australia.
BACKGROUND: iGlebe is a fully automated internet treatment program for adults who stutter that has been shown, in some cases, to reduce anxiety and effectively manage social anxiety disorder for many participants. No such automated internet treatment program exists for adolescents who stutter.
AIMS: The present paper reports a Phase I trial of an adolescent version of the adult program: iBroadway.
METHODS & PROCEDURES: Participants were 29 adolescents in the age range 12-17 years who were seeking cognitive-behaviour therapy (CBT) for anxiety associated with stuttering. The design was a non-randomized Phase I trial with outcome assessments at pre-treatment and immediately post-treatment after 5 months of access to the program. No contact by a clinical psychologist occurred during participant use of the program. Outcomes were a range of psychological, quality-of-life and stuttering severity measures.
OUTCOMES & RESULTS: The compliance rate for the seven iBroadway modules over 5 months was extremely favourable for internet CBT, at 52.4%. There was evidence of treatment effects for (1) the number of DSM-IV mental health diagnoses with the Diagnostic Interview Schedule for Children; (2) the Unhelpful Thoughts and Beliefs About Stuttering scale; (3) the Subjective Units of Distress Scale; and (4) parent-reported speech satisfaction.
CONCLUSIONS & IMPLICATIONS: Further development of iBroadway, the adolescent version of iGlebe, with Phase II trialling is warranted.
PMID: 31364252 DOI: 10.1111/1460-6984.12496
Phonological Abilities in Persian Speaking Preschool Children with Stuttering and Fluent Peers. - FALA
Iran J Child Neurol. 2019 Fall;13(4):75-82.
Tahmasebi N, Ahmadi A, Zamani P, Nourafshan M, Salehimanesh F.
University of Medical Sciences, Ahvaz, Iran; Babol University of Medical Sciences, Babol, IR Iran; Ferdowsi University of Mashhad, Mashhad, Iran.
OBJECTIVES: Speech sound production is poorer in stutterers than normally fluent peers. This study was performed to compare speech sound production abilities in Persian speaking children with developmental stuttering.
MATERIALS & METHODS: Overall, 34 children with stuttering and 60 children without stuttering aged from 3 to 6 yr old were enrolled from Ahvaz City, Khuzestan Province, southern Iran in 2016. The phonetic information test was used to assess speech sound production in this study and 30-minute mother-child conversations were utilized for calculation of Percentage Consonant Correct. Phonological abilities of these two groups were compared against each other and a correlation between stuttering severity and speech sound articulation was calculated.
RESULTS: There was significant difference between children with stuttering and normal peers for articulation error total percentage but not significant difference was found for percentage consonant correct (P=0.16). Moreover, no significant correlation between stuttering severity and speech sound production in this population was found.
CONCLUSION: No association seems to exist between stuttering severity and speech sound production abilities in this population. This study may lead to the notion that there was significant difference between the two groups in speech sound production assessment.
PMID: 31645868 PMCID: PMC6789087 [Available on 2020-01-01]
Physiological Correlates of Fluent and Stuttered Speech Production in Preschool Children Who Stutter - INFANTIL
J Speech Lang Hear Res. 2019 Dec 5:1-15. [Epub ahead of print]
Walsh B, Usler E.
Michigan State University, East Lansing; University of Delaware, Newark.
Purpose The purpose of this study was to compare physiological indices of sympathetic nervous system arousal recorded during fluent and stuttered utterances in a preschool children who stutter (CWS).
Method Twenty-two 4- to 5-year-old CWS participated in the experiment. We recorded children's skin conductance response amplitude and frequency, blood pulse volume amplitude, and pulse rate as they completed a picture description task. We then compared indices of phasic sympathetic arousal recorded during stuttered versus fluent utterances. In addition, children's communication attitudes were evaluated with a self-report measure.
Results We detected significantly higher sympathetic arousal during stuttered utterances compared to fluent utterances. Specifically, we found larger skin conductance responses occurring at an increased frequency and decreased blood pulse volume amplitudes during stuttered speech. The behavioral measure indicated a negative communication attitude in only one-third of the participants.
Conclusion Our findings suggest that preschool CWS may exhibit higher levels of sympathetic arousal during stuttered speech compared to when they are speaking fluently. We discuss the potential impact of increased sympathetic arousal on speech regulatory mechanisms in early childhood stuttering and present questions to guide future research.
PMID: 31805242 DOI: 10.1044/2019_JSLHR-S-19-0018
Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009-2017 - CONCEITO
Pediatrics. 2019 Oct; 144(4).
Zablotsky B, Black LI, Maenner MJ, Schieve LA, Danielson ML, Bitsko RH, Blumberg SJ, Kogan MD, Boyle CA.
Centers for Disease Control and Prevention, Hyattsville, Maryland; Maternal and Child Health Bureau, Rockville, Maryland.
OBJECTIVES: To study the national prevalence of 10 developmental disabilities in US children aged 3 to 17 years and explore changes over time by associated demographic and socioeconomic characteristics, using the National Health Interview Survey.
METHODS: Data come from the 2009 to 2017 National Health Interview Survey, a nationally representative survey of the civilian noninstitutionalized population. Parents reported physician or other health care professional diagnoses of attention-deficit/hyperactivity disorder; autism spectrum disorder; blindness; cerebral palsy; moderate to profound hearing loss; learning disability; intellectual disability; seizures; stuttering or stammering; and other developmental delays. Weighted percentages for each of the selected developmental disabilities and any developmental disability were calculated and stratified by demographic and socioeconomic characteristics.
RESULTS: From 2009 to 2011 and 2015 to 2017, there were overall significant increases in the prevalence of any developmental disability (16.2%-17.8%, P < .001), attention-deficit/hyperactivity disorder (8.5%-9.5%, P < .01), autism spectrum disorder (1.1%-2.5%, P < .001), and intellectual disability (0.9%-1.2%, P < .05), but a significant decrease for any other developmental delay (4.7%-4.1%, P < .05). The prevalence of any developmental disability increased among boys, older children, non-Hispanic white and Hispanic children, children with private insurance only, children with birth weight ≥2500 g, and children living in urban areas and with less-educated mothers.
CONCLUSIONS: The prevalence of developmental disability among US children aged 3 to 17 years increased between 2009 and 2017. Changes by demographic and socioeconomic subgroups may be related to improvements in awareness and access to health care.
PMID: 31558576 DOI: 10.1542/peds.2019-0811
Primarily depression manifestation of Wilson's disease-Case report
Clin Neurol Neurosurg. 2019 Dec 26;190:105651. [Epub ahead of print]
Kułak-Bejda A, Waszkiewicz N, Galińska-Skok B, Zajkowska A, Kułakowska A, Kochanowicz J.
Medical University of Białystok, Choroszcz, Poland;
Wilson's disease is an inherited autosomal-recessive disorder of biliary copper excretion. It is characterized by hepatic, neurological and ophthalmic manifestations related to the accumulation of copper in the liver, the lenticular nuclei of brain and cornea. The authors present the case of a 29-year-old female with primarily depression manifestation of Wilson's disease. The patient also reported agitation, difficulties with concentration, slowdown of speech, and stuttering. In magnetic resonance imaging, in putamen, the globus pallidus, claustrum, the heads of caudate nucleus and thalamus areas demonstrated the increased signal in T2. A high copper content was obtained in daily urine collection and reduced level in serum. Similarly, ceruloplasmin level was decreased. Despite the antidepressant treatment with venlafaxine, no improvement was observed. Within a week of psychomotor slowdown, symptoms such as Parkinson's syndrome appeared. Due to the rapid progression of the disease symptoms, the patient was referred for further treatment at a specialistic center. After six month, despite the treatment, the progress of disease was so advanced that patient was transferred to the hospice. Two weeks later patient died. Wilson's disease might be consider in differential diagnosis of depression in young patients, especially if they present additional extrapyramidal symptoms and unspecific changes in magnetic resonance imaging.
PMID: 31896489 DOI: 10.1016/j.clineuro.2019.105651
Psychological correlates of biological and non-biological explanations for stuttering - CONCEITO
Int J Speech Lang Pathol. 2019 Oct 1:1-9 [Epub ahead of print]
Montclair State University , Bloomfield , NJ , USA.
Purpose: This study examined whether people who stutter would associate biological and non-biological explanations of stuttering with the endorsement of stereotypes about people who stutter, prognostic expectations for the reduction of stuttering, feelings of guilt, self-blame, and shame about stuttering, and agency for speech modification.
Method: This was a cross-sectional study including 372 adults who stutter. Participants completed a web survey with scales that measured their agreement with biological and non-biological models of stuttering; their endorsement of common stereotypes for people who stutter; prognostic expectations for reduced stuttering; feelings of guilt, self-blame, and shame about stuttering; and feelings of agency in their ability to modify their speech.
Result: Biological explanations for stuttering were significantly correlated with reduced stereotype endorsement about people who stutter, lower prognostic expectations for reducing stuttering, and reduced feelings of guilt and self-blame regarding stuttering. Non-biological explanations for stuttering were significantly correlated with increased endorsement of negative stereotypes about people who stutter, increased prognostic expectations for reducing stuttering, and increased feelings of guilt, self-blame, and shame about stuttering.
Conclusion: It is concluded that the implications of biological framing of stuttering among people who stutter are complex and should be well thought out by professionals. Explaining stuttering as biological, but responsive to personal and environmental influences, may lead to reduced guilt and self-blame, while at the same time fostering feelings of agency for speech modification.
PMID: 31575286 DOI: 10.1080/17549507.2019.1663931
Qualitative investigation of the speech-language therapy experiences of individuals who covertly stutter - TERAPIA
J Fluency Disord. 2019 Set 61:105713. Epub 2019 Aug 20
Douglass JE, Constantino C, Alvarado J, Verrastro K, Smith K.
Sacred Heart University, Fairfield, CT, United States; Florida State University, Tallahassee, FL, United States.
PURPOSE: Individuals who covertly stutter have a unique experience of stuttering that involves concealing the core behaviors of stuttering (e.g., repetitions, prolongations, and blocks). From the listener's perspective, covert stuttering results in minimum typical, overt stuttering behaviors. However, from the speaker's perspective, covert stuttering often increases the cognitive and emotional impact of stuttering. This study explores the speech-language therapy experiences of individuals who covertly stutter in order to improve treatment recommendations and best practice.
METHODS: This investigation is a qualitative analysis of individuals' speech-language therapy experiences as persons who covertly stutter. Real-time video interviews were conducted with the use of open-ended phenomenological interview questions. Interviews were transcribed and thematic analysis of interview transcripts was conducted to investigate the speech-language therapy experiences of the participants.
RESULTS: The participants indicated that stuttering therapy was most impactful when it included explicit goals and activities, personalized selection of therapy techniques or strategies beyond fluency techniques, encouraged self-education, and educated those in the person's environment.
CONCLUSION: The evidence suggests individualized therapy based on each client's unique manifestation of covert stuttering is beneficial; while, fluency-focused stuttering therapy is often incongruent with the needs of persons who covertly stutter. Therapeutic implications and recommendations for speech-language pathologists are discussed.
PMID: 31451301 DOI: 10.1016/j.jfludis.2019.105713
Repetitive Negative Thinking, Temperament, and Adverse Impact in Adults Who Stutter - EMOCIONAL
Am J Speech Lang Pathol. 2019 Dec 17:1-15. [Epub ahead of print]
Tichenor S, Yaruss JS.
Michigan State University, East Lansing.
Purpose Prior research has explored how repetitive negative thinking (RNT) contributes to both the increased persistence and severity of various disorders, such as depression, anxiety, and eating disorders. This study explored the potential role of RNT in the experience of stuttering, with a particular focus on the relationship between RNT, adverse impact, and certain temperament profiles.
Method Three hundred thirteen adults who stutter completed a measurement of the frequency/severity of RNT (Perseverative Thinking Questionnaire; Ehring et al., 2011), 207 completed a temperament profile (Adult Temperament Questionnaire; Evans & Rothbart, 2007), and 205 completed a measurement of adverse stuttering impact (Overall Assessment of the Speaker's Experience of Stuttering; Yaruss & Quesal, 2016). Analyses were conducted within and across instruments to ascertain how RNT, temperament markers, and adverse impact interrelate within individuals.
Results Results indicated that RNT significantly predicts Overall Assessment of the Speaker's Experience of Stuttering impact scores with great effect and that certain temperament markers (specifically, Effortful Control and Negative Affectivity) moderate this relationship for specific sections of the Overall Assessment of the Speaker's Experience of Stuttering.
Conclusion By assessing RNT in people who stutter, clinicians can better understand individual differences in their clients, and this will allow them to make targeted diagnoses and develop more tailored intervention plans.
PMID: 31846585 DOI: 10.1044/2019_AJSLP-19-00077
Rhyme Production Strategies Distinguish Stuttering Recovery and Persistence - AUDITIVO
J Speech Lang Hear Res. 2019 Sep 20;62(9):3302-3319. Epub 2019 Sep 15.
Gerwin K, Brosseau-Lapré F, Brown B, Christ S, Weber C.
Purdue University, West Lafayette, IN.
Purpose The primary aim of the current study was to examine the developing phonological awareness of 4- to 5-year-old children who stutter (CWS) in relation to eventual recovery (CWS-eRec) or persistance (CWS-ePer) in stuttering, accounting for the presence of typical speech (TS) production or speech sound disorder (SSD).
Method In the 1st year of a 5-year longitudinal study, 37 children who do not stutter (CWNS) and 48 CWS completed a rhyme discrimination and a rhyme production task from the Phonological Awareness Test-Second Edition (Robertson & Salter, 2007). Using data from their last year of participation, CWS were classified into CWS-ePer and CWS-eRec. Each CWS group was further divided into TS and SSD groups based on speech production abilities at the time of the rhyme tasks. Accuracy on the rhyme tasks was compared. Groups were also compared on strategies used to generate correct and incorrect responses for the rhyme production task (e.g., real-word correct, nonword correct, semantic association, repeated cues). Results All groups performed similarly on the rhyme discrimination task. On the rhyme production task, CWS-ePer-SSD and CWS-eRec-SSD performed with less accuracy than CWNS, but CWS-ePer-TS, CWS-eRec-TS, and CWNS achieved similar task accuracy. On correct rhyme production trials, CWS-ePer-TS created more nonword rhymes than real-word rhymes. CWS-ePer-TS used the nonword strategy at 1.88 times the CWNS rate. CWS-eRec-TS fell between CWS-ePer-TS and CWNS in use of the nonword strategy. Conclusions Reliance on a nonword strategy for rhyme production in CWS-ePer-TS may reflect differences in underlying phonological representations and ease of phonological access to the lexicon compared to CWNS.
PMID: 31525133 DOI: 10.1044/2019_JSLHR-S-18-0294
Sex Differences in Functional Brain Networks for Language - NEUROCIÊNCIAS
Cereb Cortex. 2019 Sep 12. [Epub ahead of print]
Xu M, Liang X, Ou J, Li H, Luo YJ, Tan LH.
Shenzhen University, Shenzhen, China; Shenzhen Institute of Neuroscience, Shenzhen, China; Shenzhen University Health Science Center, Shenzhen, China.
Men and women process language differently, but how the brain functions to support this difference is poorly understood. A few studies reported sex influences on brain activation for language, whereas others failed to detect the difference at the functional level. Recent advances of brain network analysis have shown great promise in picking up brain connectivity differences between sexes, leading us to hypothesize that the functional connections among distinct brain regions for language may differ in males and females. To test this hypothesis, we scanned 58 participants' brain activities (28 males and 30 females) in a semantic decision task using functional magnetic resonance imaging. We found marked sex differences in dynamic interactions among language regions, as well as in functional segregation and integration of brain networks during language processing. The brain network differences were further supported by a machine learning analysis that accurately discriminated males from females using the multivariate patterns of functional connectivity. The sex-specific functional brain connectivity may constitute an essential neural basis for the long-held notion that men and women process language in different ways. Our finding also provides important implications for sex differences in the prevalence of language disorders, such as dyslexia and stuttering.
PMID: 31512720 DOI: 10.1093/cercor/bhz184
Sleep problems in children who stutter: Evidence from population data.- AMBIENTE
J Commun Disord. 2019 Nov- Dec; 82:105935. Epub 2019 Sep 4
Merlo S, Briley PM.
Brazilian Fluency Institute; East Carolina University, United States.
Purpose Previous research has identified seizures, intellectual disability, learning disability, pervasive developmental disorder, and attention deficit hyperactivity disorder as coexisting disabilities frequently seen in children who stutter (CWS). The observation that those conditions are affected by sleep has incited the present study, which aimed to explore if sleep problems are also more frequent in CWS.
Method Data was obtained from the 2012 National Health Interview Survey. Children included in the analysis were those whose caregivers answered definitively whether or not the sample child stuttered in the last 12 months and whose caregivers definitively answered questions regarding insomnia or trouble sleeping, sleepiness during the day, and fatigue during the day in the last 12 months. This sample included 203 CWS and 10,005 children who do not stutter (CWNS).
Results CWS were at greater odds of presenting insomnia or trouble sleeping (OR = 3.72, p < .001), sleepiness during the day (OR = 2.20, p < .001), and fatigue during the day (OR = 2.87, p < .001) when compared to CWNS. Moreover, CWS with coexisting disabilities were at greater odds of presenting with sleep problems when compared to CWS without coexisting disabilities. Finally, CWS without coexisting disabilities were at greater odds of presenting insomnia when compared to CWNS without coexisting disabilities. Conclusion CWS are at risk for presenting with sleep problems. Additionally, sleep problems persist from early childhood to adolescence. The implications of these findings are unclear, though future studies should look to explore the impact of sleep problems on stuttering.
PMID: 31522013 DOI: 10.1016/j.jcomdis.2019.105935
Social Judgments of Digitally Manipulated Stuttered Speech: An Evaluation of Self-Disclosure on Cognition - SOCIAL
J Speech Lang Hear Res. 2019 Nov 22;62(11):3986-4000. Epub 2019 Nov 7.
Ferguson AM, Roche JM, Arnold HS.
Kent State University, OH.
Purpose Persons who stutter (PWS) may be susceptible to discrimination because of negative judgments made by listeners. The current study sought to determine how the cognitive system's explicit (i.e., conscious) and implicit (i.e., nonconscious) biases about PWS are impacted by self-disclosure.
Method A computer mouse-tracking paradigm was used to evaluate categorical social judgments about PWS. Computer mouse trajectories, which have been shown to reveal underlying cognitive pull or competition between opposing concepts, were used to measure implicit bias (i.e., nonconscious stereotypes). Participants were asked to explicitly categorize the speaker as either intelligent or unintelligent before and after listening to a speaker self-disclose. Mouse cursor trajectories during the explicit response categorization were used to evaluate implicit bias associated with the decision-making process.
Results Results indicated that participants chose "intelligent" for a higher proportion of the trials in the disclosure condition compared to baseline, showing that listeners' explicit biases changed after listening to a self-disclosure that the speaker stutters. Results also indicated listeners exhibited a more negative implicit bias, based on computer mouse trajectories, when rating the PWS relative to the "persons who do not stutter" talker, but this negative implicit bias did seem to reduce over time after the disclosure was made. Conclusions These findings indicate that, even though explicit and implicit biases were evident when listeners heard stuttering, both explicit and implicit biases seemed to extinguish over time after a self-disclosure. Although the bias was not completely extinguished, these results provide promising evidence toward developing methods to reduce negative beliefs and reactions toward PWS. Supplemental Material http://osf.io/mwrp7/.
PMID: 31697574 DOI: 10.1044/2019_JSLHR-S-19-0088
Speech disfluencies in bilingual Yiddish-Dutch speaking children - LINGUAGEM
Clin Linguist Phon. 2019 Oct 23:1-17 [Epub ahead of print]
Eggers K, Van Eerdenbrugh S, Byrd CT.
Thomas More University College , Antwerp , Belgium; University of Turku , Turku , Finland; University of Texas at Austin , Austin , USA.
In this study, we investigated the frequency and types of stuttering-like (SLD) and other (OD) disfluencies in 59 typically developing bilingual Yiddish-Dutch (YD) speaking children. Participants were divided in two age categories: 6.01-7.07 and 9.00-10.04-year-olds. All children (1) were successive, bilingual YD speaking, (2) had Yiddish as their dominant language and (3) were sufficiently intelligible in both languages. A conversation sample of at least 300 syllables was collected in each of the two languages. The main findings in this study were (a) the total amount of SLD as well as OD were significantly higher in the non-dominant language. For the SLD, this was mainly caused by the higher frequency of monosyllabic word and syllable repetitions. For the OD, almost all disfluency types seem to have contributed to this. (b) The total amount of OD was significantly higher in the older group of bilingual YD children than in the younger group. This was primarily due to higher frequencies of phrase repetitions, lexical revisions and unfinished words. (c) The monolingual diagnostic guideline of three SLD per 100 words as a means to label stuttering cannot be used in this bilingual population. The majority of the non-stuttering children scored higher than the standard 3% SLD in both languages. In the dominant Yiddish language, 27 children (46%) scored above this percentage, in the non-dominant Dutch language, 46 children (78%). We conclude that bilingual YD-speaking children have a higher frequency of speech disfluencies in comparison to monolingual children. Consequently, monolingual stuttering guidelines cannot be used in this bilingual population.
PMID: 31645140 DOI: 10.1080/02699206.2019.1678670
"Spontaneous" late recovery from stuttering: Dimensions of reported techniques and causal attributions - TERAPIA
J Commun Disord. 2019 Sep - Oct;81:105915. Epub 2019 Jun 28.
Free Full Text: https://www.sciencedirect.com/science/article/pii/S0021992418300789
Neumann K, Euler HA, Zens R, Piskernik B, Packman A, St Louis KO, Kell CA, Amir O, Blomgren M, Boucand VA, Eggers K, Fibiger S, Fourches A, Franken MJP, Finn P.
Ruhr University Bochum, Germany; Goethe University Frankfurt, Frankfurt/Main, Germany; University of Vienna, Austria; University of Technology Sydney, Australia; West Virginia University, Morgantown, WV, USA; Goethe University Frankfurt, Frankfurt/Main, Germany; Tel Aviv University, Tel Aviv, Israel; The University of Utah, Salt Lake City, UT, USA; University of Paris, Paris, France; Thomas More University College, Antwerp, Belgium; University of Turku, Finland; University Library of Southern Denmark, Odense, Denmark; Aulnay-sous-Bois, France; Erasmus Medical University Centre, Sophia Children's Hospital, KNO/Gehoor- en Spraakcentrum, Rotterdam, Netherlands; University of Georgia, Athens, GA, USA.
PURPOSE: (1) To survey the employed techniques and the reasons/occasions which adults who had recovered from stuttering after age 11 without previous treatment reported as causal to overcome stuttering, (2) to investigate whether the techniques and causal attributions can be reduced to coherent (inherently consistent) dimensions, and (3) whether these dimensions reflect common therapy components.
METHODS: 124 recovered persons from 8 countries responded by SurveyMonkey or paper-and-pencil to rating scale questions about 49 possible techniques and 15 causal attributions.
RESULTS: A Principal Component Analysis of 110 questionnaires identified 6 components (dimensions) for self-assisted techniques (Speech Restructuring; Relaxed/Monitored Speech; Elocution; Stage Performance; Sought Speech Demands; Reassurance; 63.7% variance explained), and 3 components of perceived causal attributions of recovery (Life Change, Attitude Change, Social Support; 58.0% variance explained).
DISCUSSION: Two components for self-assisted techniques (Speech Restructuring; Elocution) reflect treatment methods. Another component (Relaxed/Monitored Speech) consists mainly of items that reflect a common, non-professional understanding of effective management of stuttering. The components of the various perceived reasons for recovery reflect differing implicit theories of causes for recovery from stuttering. These theories are considered susceptible to various biases. This identification of components of reported techniques and of causal attributions is novel compared to previous studies who just list techniques and attributions.
CONCLUSION: The identified dimensions of self-assisted techniques and causal attributions to reduce stuttering as extracted from self-reports of a large, international sample of recovered formerly stuttering adults may guide the application of behavioral stuttering therapies.
PMID: 31301534 DOI: 10.1016/j.jcomdis.2019.105915
Student clinicians' and clients' perceptions of the therapeutic alliance and outcomes in stuttering treatment - TERAPIA
J Fluency Disord. 2019 Sep;61:105709. Epub 2019 Aug 14.
Croft RL, Watson J.
The University of Texas at Austin, Austin, TX. United States; Texas Christian University, United States.
PURPOSE: The purpose of this study was to examine how the therapeutic alliances (TA) of graduate student clinicians and adult clients who stutter relate to perceived treatment outcomes.
METHODS: Student clinicians (N = 42) and adult clients who stutter (N = 22) completed a survey assessing their TA strength and perception of treatment outcomes. Responses were analyzed to determine similarities and differences in how clinicians and clients relate the TA to perceptions of treatment effectiveness, progress, and outcome satisfaction.
RESULTS: Results suggest that clinicians and clients who stutter both relate the TA to treatment outcome, but in different ways. While clinicians associate the TA most with treatment effectiveness and client progress, clients relate the TA most to outcome satisfaction.
CONCLUSION: Clinicians should be aware that for adult clients who stutter, outcome satisfaction is related to the degree of shared understanding, agreement on daily tasks, and bond they experience with their clinician. To ensure a strong TA and client satisfaction, clinicians should actively seek their clients' perspective regarding TA status.
PMID: 31445437 DOI: 10.1016/j.jfludis.2019.105709
Studying stuttering mice.
Lab Anim (NY). 2019 Oct;48(10):298. doi: 10.1038/s41684-019-0411-x.
No abstract available.
PMID: 31537935 DOI: 10.1038/s41684-019-0411-x
Stuttering as Defined by Adults Who Stutter - CONCEITO
J Speech Lang Hear Res. 2019 Nov 18;62(12):4356-4369. Epub 2019 Dec 12.
Tichenor SE, Yaruss JS.
Michigan State University, East Lansing.
Purpose Numerous frameworks and definitions have sought to differentiate what behaviors and experiences should be considered as a part of stuttering. Nearly all of these efforts have been based on the perspectives and beliefs of conversational partners and listeners. This outside-in approach to defining stuttering lacks validation from people who live with the condition.
Method In this study, 430 adults who stutter participated in a qualitative exploration of the term stuttering. Data were analyzed thematically to determine speakers' perspectives about moment of stuttering and the overall experience of stuttering in their lives.
Results To adults who stutter, the term stuttering signifies a constellation of experiences beyond the observable speech disfluency behaviors that are typically defined as stuttering by listeners. Participants reported that the moment of stuttering often begins with a sensation of anticipation, feeling stuck, or losing control. This sensation may lead speakers to react in various ways, including affective, behavioral, and cognitive reactions that can become deeply ingrained as people deal with difficulties in saying what they want to say. These reactions can be associated with adverse impact on people's lives. This interrelated chain of events can be exacerbated by outside environmental factors, such as the reactions of listeners.
Discussion Data from this survey provide novel evidence regarding what stuttering means to adults who stutter. These data are used to update the adaptation of the World Health Organization's International Classification of Functioning, Disability and Health as it applies to stuttering (Yaruss & Quesal, 2004) to better account for the complex and individualized phenotype of stuttering and to develop a definition of the experience of stuttering that is based not only on the observations of listeners but also on the impact of stuttering on the lives of adults who stutter.
PMID: 31830837 DOI: 10.1044/2019_JSLHR-19-00137
Stuttering Impact: A Shared Perception for Parents and Children? - INFANTIL
Folia Phoniatr Logop. 2019 Dec 10:1-9. [Epub ahead of print]
Rocha M, Yaruss JS, Rato JR.
Universidade Católica Portuguesa, Lisbon, Portugal; Michigan State University, East Lansing, Michigan, USA.
BACKGROUND/AIMS: Previous research has provided information about how school-aged children perceive their own stuttering; however, less is known about how stuttering is perceived by their parents. The ways that parents view their children's stuttering could influence how the children themselves react to it. This study proceeds to assess how parents' perceptions of the impact of stuttering relate to the perceptions of children.
METHOD: Participants were 50 children who stutter aged 7-12 years (mean = 9.10; SD = 1.7) and their parents, recruited from different cities in Portugal. The European Portuguese version of the Overall Assessment of the Speaker's Experience of Stuttering was administered to the children, and an adapted version of the tool was administered to their parents.
RESULTS: Both parents and children showed generally similar overall impact ratings, typically falling in the mild and moderate ranges. Differences were observed in families with a history of stuttering: for those families, a comparison of parents' and children's scores revealed, in some domains, that parents perceived the impact of stuttering to be greater than the children did, especially related with children's reactions to stuttering and their quality of life.
CONCLUSION: Knowledge about how parents perceive the impact of stuttering on their children is important because families can play a key role in helping children cope with stuttering. These findings highlight the benefits of using an individualized treatment approach for each child that focuses on their perceptions, as well as on those of the parents, in order to address negative attitudes toward children's stuttering.
PMID: 31821996 DOI: 10.1159/000504221
Stuttering Severity Modulates Effects of Non-invasive Brain Stimulation in Adults Who Stutter - NEUROCIÊNCIAS
Front Hum Neurosci. 2019 Nov 21;13:411.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6881273/pdf/fnhum-13-00411.pdf
Garnett EO, Chow HM, Choo AL, Chang SE.
University of Michigan, Ann Arbor, MI, United States; Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE, United States; University of Delaware, Newark, DE, United States; University, Atlanta, GA, United States.
Stuttering is a neurodevelopmental disorder that manifests as frequent disruptions in the flow of speech, affecting 1% of adults. Treatments are limited to behavioral interventions with variable success and high relapse rates, particularly in adults. However, even in severe cases, fluency can be temporarily induced during conditions in which the speaker synchronizes his speech with external rhythmic cues, such as when reading in unison (choral speech) or with a metronome. Non-invasive neuromodulation techniques such as transcranial direct current stimulation (tDCS) have shown promise in augmenting the effects of behavioral treatment during motor and speech/language rehabilitation, but only one study to date has examined behavioral modulatory effects of tDCS in the context of stuttering. Using high-definition (HD)-tDCS electrodes, which improves focality of stimulation relative to conventional tDCS, we investigated the effects of tDCS on speech fluency and brain activation in 14 adults who stutter (AWS). Either anodal or sham stimulation was delivered on separate days over left supplementary motor area (SMA). During stimulation, participants read aloud in sync with a metronome. Measures of speech fluency and brain activity functional magnetic resonance imaging (fMRI) were collected before and after stimulation. No significant differences in brain activity or speech fluency were found when comparing active and sham stimulation. However, stuttering severity significantly modulated the effect of stimulation: active stimulation attenuated the atypically strong association between stuttering severity and right thalamocortical network activity, especially in more severe speakers. These preliminary results warrant additional research into potential application of HD-tDCS to modulate speech motor networks to enhance fluency in stuttering.
PMID: 31824276 PMCID: PMC6881273 DOI: 10.3389/fnhum.2019.00411
Stuttering: Understanding and Treating a Common Disability - CONCEITO
Am Fam Physician. 2019 Nov 1;100(9):556-560.
Sander RW, Osborne CA.
Medical College of Wisconsin-Central Wisconsin, Wausau, WI, USA; University of Wisconsin, Stevens Point, WI, USA.
Childhood-onset fluency disorder, the most common form of stuttering, is a neurologic disability resulting from an underlying brain abnormality that causes disfluent speech. Stuttering can lead to significant secondary effects, including negative self-perception and negative perception by others, anxiety, and occasionally depression. Childhood-onset fluency disorder affects 5% to 10% of preschoolers. Early identification of stuttering is important so that therapy can begin while compensatory changes to the brain can still occur and to minimize the chances of the patient developing social anxiety, impaired social skills, maladaptive compensatory behaviors, and negative attitudes toward communication. However, stuttering may be persistent, even with early intervention, and affects about 1% of adults. In patients with persistent stuttering, speech therapy focuses on developing effective compensatory techniques and eliminating ineffective secondary behaviors. The role of family physicians includes facilitating early identification of children who stutter, arranging appropriate speech therapy, and providing support and therapy for patients experiencing psychosocial effects from stuttering. Finally, physicians can serve as advocates by making the clinic setting more comfortable for people who stutter and by educating teachers, coaches, employers, and others in the patient's life about the etiology of stuttering and the specific challenges patients face.
Subthalamic deep brain stimulation aggravates speech problems in Parkinson's disease: Objective and subjective analysis of the influence of stimulation frequency and electrode contact location - OUTRAS ÁREAS
Parkinsonism Relat Disord. 2019 Sep;66:110-116. Epub 2019 Jul 16
Phokaewvarangkul O, Boonpang K, Bhidayasiri R.
Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
BACKGROUND: Speech disorders, including stuttering and hypophonia, have been reported in patients with Parkinson's disease (PD) after subthalamic deep brain stimulation (STN-DBS).
OBJECTIVE: To evaluate the effect of stimulation frequency or electrode contact location on speech disorders in PD patients with STN-DBS.
METHOD: In this case-controlled study, we enrolled 50 PD patients with, and 100 PD patients without STN-DBS to compare their vocal intensities, measured by a sound pressure meter, and perceptual speech ratings, obtained from the speech sections of the United Parkinson's Disease Rating Scale (UPDRS) and subjective ratings regarding the impediment of functional communication by stuttering. For patients with STN-DBS, comparisons were made between high-frequency (HFS; 130 Hz), low-frequency (LFS; 80 Hz), and off-stimulation. We also evaluated the effect of electrode contact locations on speech function.
RESULTS: Patients with STN-DBS had decreased vocal intensities and UPDRS scores compared to those without (p < 0.05). Vocal intensity was significantly lower during HFS than during LFS and off-stimulation (both, p < 0.05). Stuttering impeded STN-DBS patients' communication to greater extent than for those without (p < 0.001). Vocal intensity was lower when active contacts were in the dorsal zone compared to those in the ventral zone (p < 0.05). Only STN-DBS treatment was a predictive factor for low vocal intensity (OR = 9.53, p = 0.04).
CONCLUSION: High-frequency STN-DBS with dorsal zone contacts can aggravate certain speech problems in PD patients. Therefore, it is important to balance between motor control and speech impairments in these patients.
PMID: 31327627 DOI: 10.1016/j.parkreldis.2019.07.020
Success in changing stuttering attitudes: A retrospective analysis of 29 intervention studies - TERAPIA
J Commun Disord. 2019 Dec 28;84:105972. [Epub ahead of print]
St Louis KO, Węsierska K, Przepiórka A, Błachnio A, Beucher C, Abdalla F, Flynn T, Reichel I, Beste-Guldborg A, Junuzović-Žunić L, Gottwald S, Hartley J, Eisert S, Johnson KN, Bolton B, Sangani MT, Rezai H, Abdi S, Pushpavathi M, Hudock D, Spears S, Aliveto E.
West Virginia University, Morgantown, WV, USA; University of Silesia, Katowice, Poland; The John Paul II Catholic University of Lublin, Lublin, Poland; Sava Senior Care, Palisade, CO, USA; Kuwait University, Kuwait City, Kuwait; EBS Healthcare, Alexandria, VA, USA; Touro College, New York City, NY, USA; Minot State University, Minot, ND, USA; University of Tuzla, Tuzla, Bosnia and Herzegovina; University of New Hampshire, Durham, NH, USA; Boothby Therapy Services, Laconia, NH, USA; Children's Therapy of Woodinville, Woodinville, WA, USA; University of Houston, Houston, TX, USA; Leeds Community Health Care and Leeds Beckett University, Leeds, UK; Iran University of Medical Science, Tehran, Iran; Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; All India Institute of Speech and Hearing (AIISH), Mysuru, India; Idaho State University, Pocatello, ID, USA; Oceanside Unified School District, Oceanside, CA, USA; Loudoun County Public Schools, Ashburn, VA, USA.
BACKGROUND: Against the backdrop of hundreds of studies documenting negative stereotypes and stigma held by the public regarding people who stutter, a substantial number of investigations have attempted to improve public attitudes and measure their results with a standard instrument, the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S). Although the majority of interventions have been moderately to quite successful, a substantial minority have been unsuccessful.
PURPOSE: This study sought to determine what properties of interventions and demographic variables were predictive of least to most successful interventions. Preliminary to that, however, it required the division of samples into clearly differentiated categories of success.
METHOD: Twenty-nine different study samples containing 934 participants were categorized into four levels of success of interventions according to pre versus post POSHA-S summary mean ratings. Intervention properties and demographic characteristics and for each success category were analyzed for their predictive potential of successful attitude improvement.
RESULTS: Interventions characterized by high interest or involvement, meaningful material, and content that respondents found to be relevant, but not excessive, tended to be associated with more successful interventions. In contrast, demographic variables were weak predictors of intervention success.
CONCLUSION: The authors hypothesize that maximally effective interventions reflect optimal matches between participant characteristics and intervention features, although the critical variables in each are not yet apparent.
PMID: 32114184 DOI: 10.1016/j.jcomdis.2019.105972
Swedish outcomes of the Overall Assessment of the Speaker's Experience of Stuttering in an international perspective - SOCIAL
Logoped Phoniatr Vocol. 2019 Nov 27:1-9.[Epub ahead of print]
Lindström E, Nilsson E, Nilsson J, Schödin I, Strömberg N, Österberg S, Yaruss JS, Samson I.
Åbo Akademi University, Turku, Finland; Karolinska Institutet, Stockholm, Sweden; Michigan State University, East Lansing, MI, USA; Danderyd Hospital, Stockholm, Sweden.
Aim: The purpose of the present project was to translate the Overall Assessment of the Speaker's Experience of Stuttering (OASES) to Swedish, and to compare the results with available international data.
Method: The Swedish versions of OASES-A, OASES-T and OASES-S were administered to 80 adults, 27 teenagers and 32 children who stutter, respectively. The overall impact scores and the impact scores for each of the four sections of the instrument were analyzed in relation to other studies involving the OASES.
Results: The results revealed that all three Swedish versions of OASES had normally distributed outcomes and that they were reliable and valid. The overall impact scores for adults (2.33), teenagers (2.60) and children (2.28) all fell within Impact Rating Moderate. The mean overall impact score for OASES-A-S was significantly lower than corresponding data from USA, Australia and Japan (p < .01). There was no difference between Swedish and American teenagers, or between Swedish and American or Dutch schoolchildren.
Conclusion: There seems to be cultural differences in the experience of negative consequences associated with stuttering. This suggests that cultural aspects should be carefully considered in assessment, treatment, and research involving individuals who stutter.
PMID: 31771383 DOI: 10.1080/14015439.2019.1695930
Sympathetic Nervous System Activity in Preschoolers Who Stutter - INFANTIL
Front Hum Neurosci. 2019 Oct 9;13:356.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795148/pdf/fnhum-13-00356.pdf
Walsh B, Smith A, Christ SL, Weber C.
Michigan State University, East Lansing, MI, United States; Purdue University, West Lafayette, IN, United States.
BACKGROUND: In our Dynamic Pathways, account, we hypothesized that childhood stuttering reflects an impairment in speech sensorimotor control that is conditioned by cognitive, linguistic, and emotional factors. The purpose of this study was to investigate potential differences in levels of sympathetic arousal during performance of speech and non-speech tasks between children who do and do not stutter.
METHODS: Seventy-two preschool-aged children participated in the study, 47 children who stutter (CWS; 38 boys) and 25 children who do not stutter (CWNS; 18 boys). We recorded skin conductance and blood pulse volume (BPV) signals, indices of sympathetic arousal, during higher/lower load speech tasks (structured sentence production and picture description) and non-speech tasks (jaw wagging and forceful blowing). We included a measure that reflects children's attitudes about their communication skills and a parent-report assessment of temperament.
RESULTS: We found no significant differences between preschool CWS and CWNS in phasic skin conductance response amplitude or frequency, BPV, and pulse rate for any of the experimental tasks. However, compared to CWNS, CWS had, on average, significantly higher skin conductance levels (SCL), indexing slowly changing tonic sympathetic activity, across both speech and non-speech experimental conditions. We found distinctive task-related profiles of sympathetic arousal in both groups of preschool children. Most children produced the highest levels of sympathetic arousal in the physically demanding blowing task rather than in speech, as seen in previous studies of adults. We did not find differences in temperament between the two groups of preschool children nor a relationship among behavioral indices of temperament and communication attitude and physiological measures of sympathetic arousal.
CONCLUSION: We did not find that atypically high, speech-related sympathetic arousal is a significant factor in early childhood stuttering. Rather, CWS had higher, on average, task-related tonic SCLs across speech and non-speech tasks. A relationship among behavioral measures of temperament and physiological measures of sympathetic arousal was not confirmed. Key questions for future experiments are how the typical coupling of sympathetic and speech sensorimotor systems develops over childhood and adolescence and whether task related developmental profiles follow a different course in children who continue to stutter.
PMID: 31649519 PMCID: PMC6795148
Temperament, Executive Functioning, and Anxiety in School-Age Children Who Stutter - INFANTIL
Front Psychol. 2019 Oct 4;10:2244.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788391/pdf/fpsyg-10-02244.pdf
Rocha MS, Yaruss JS, Rato JR.
Catholic University of Portugal, Lisbon, Portugal; Michigan State University, East Lansing, MI, United States.
The purpose of this study was to examine temperament dimensions, executive functioning ability, and anxiety levels in school-age children who stutter and their non-stuttering peers. Participants were 100 Portuguese children aged 7 to 12 years (M = 9.13; SD = 1.70), including 50 children who stutter and 50 children who do not stutter. Analyses, which were performed separately for younger and older participants, sought to identify correlations between key variables. Temperament was evaluated through a parent questionnaire, executive functioning was evaluated through children's responses on a performance test, and anxiety level was assessed through a self-perception scale. On the temperament measure, comparisons between children who stutter and their non-stuttering peers revealed that older children who stutter exhibited significantly higher scores on the Anger/Frustration, Impulsivity, and Sadness subscales, and lower averages on the Attention/Focusing, Perceptual sensitivity, and Soothability/Falling Reactivity subscales. On the executive functioning task, comparisons revealed that the group of younger children who stutter exhibited significantly higher average execution times than their non-stuttering peers. There were no statistically significant differences in anxiety between children who stutter and children who do not stutter, and there were no statistically significant correlations between temperament factors and measures of executive functioning. Children who stutter experienced lower ability to orient attention and greater emotional reactivity compared with their non-stuttering peers. Significant correlations were found between executive functioning and age and among the temperament factors themselves. These results, which support the need for a multidimensional view of stuttering, were interpreted in the context of the Dual Diathesis - Stressor model. Findings indicate that temperament and executive functioning abilities may contribute to the development of stuttering.
Temperament in Adults Who Stutter and Its Association With Stuttering Frequency and Quality-of-Life Impacts - EMOCIONAL
J Speech Lang Hear Res. 2019 Aug 15;62(8):2691-2702. Epub 2019 Jul 17.
Lucey J, Evans D, Maxfield ND.
University of South Florida, Tampa; Tobacco Research & Intervention Program, Tampa, FL.
Purpose The study aim was to determine whether self-reported temperament traits differentiate adults who stutter (AWS) from adults who do not stutter (AWNS). Additionally, associations between temperament and stuttering frequency, and between temperament and quality of life impacts of stuttering, were investigated in AWS. Method Self-reported temperament traits were documented for 33 AWS and 43 AWNS using the Adult Temperament Questionnaire (ATQ; Evans & Rothbart, 2007). Quality-of-life impacts of stuttering were assessed using the Overall Assessment of the Speaker's Experience with Stuttering (Yaruss & Quesal, 2010). Stuttering frequency was calculated from 100-word monologue and reading samples. Results A between-groups difference in scores on the ATQ Positive Affect subscale was nominally significant (i.e., before correcting for multiple tests) and also approached statistical significance after Bonferroni correction. Positive Affect scores were lower for AWS, and the size of this trending effect was moderate. Within AWS, a statistically significant positive correlation was found between impact scores on the General Information section of the Overall Assessment of the Speaker's Experience with Stuttering and ATQ Frustration subscale scores after Bonferroni correction. No associations were detected between temperament traits and stuttering frequency. Conclusions Results reveal a nontrivial tendency for AWS to experience decreased positive affect compared to AWNS. In addition, increased frustration was found to be associated with reduced general knowledge about stuttering in AWS. Neither effect has been previously reported for adults or children who stutter. Finally, self-reported temperament traits were not found to vary with stuttering frequency in adults, consistent with previous results for AWS.
PMID: 31318628 DOI: 10.1044/2019_JSLHR-S-18-0225
The experiences of migrants to Australia who stutter - SOCIAL
J Fluency Disord. 2019 Nov 3;62:105723. [Epub ahead of print]
Nang C, Reynolds V, Hersh D, Andrews C, Humphries O.
Edith Cowan University, Perth, Australia; State University of New York at Plattsburgh, New York, United States of America; Edith Cowan University, Perth, Australia.
PURPOSE: Migration is a contemporary, global matter. With the number of international migrants doubling over the past four decades, speech-language pathologists will likely work with migrants who have childhood-onset stuttering. However, combined migration and stuttering experiences have never been investigated specifically. This study is the first to investigate the experiences of migrants to Australia who stutter.
METHODS: Three women and six men, aged 23 to 66 years old, participated. Data from individual interviews were analysed using Interpretative Phenomenological Analysis to examine the 'lived experience' of participants, as well as with NVivo 12 software for the management of coding. Participants also completed The Overall Assessment of the Speaker's Experience of Stuttering (OASES™).
RESULTS: The stress experienced from migration interacted and compounded the existing stress of stuttering. Central themes emerged pertaining to the impact of increased stress on self-identity, the interactions of the stresses, as well as the coping strategies/facilitators. Stuttering and other personal factors, such as language(s) spoken and accent, had a negative impact on communication skills.
CONCLUSION: Migration cannot be experienced independently of a stutter, as both are intrinsically linked to self-identity. The combined stress of migration with stuttering amplified the perception of feeling abnormal and resulted in difficulties with establishing a stable self-identity and a sense of belonging in the new context. Participants found strength in the company of others and considered Australia to be accepting of stuttering.
PMID: 31711011 DOI: 10.1016/j.jfludis.2019.105723
The influence of workplace discrimination and vigilance on job satisfaction with people who stutter - SOCIAL
J Fluency Disord. 2019 Oct 30;62:105725. [Epub ahead of print]
Plexico LW, Hamilton MB, Hawkins H, Erath S.
Auburn University, United States; University of Alabama, United States.
Purpose The purpose of the present study is to examine the association between workplace discrimination, vigilance, and job satisfaction in people who stutter and compare this with people who do not stutter.
Method Seventy-two people who stutter (PWS) and 92 people who do not stutter (PWNS) participated in an online survey. Participants completed a survey assessing 6 different areas: (a) background information, (b) job satisfaction, (c) everyday discrimination, and (d) heightened vigilance. Mediation analyses were conducted to evaluate the relationship between the independent variables and dependent variable.
Results There was a relationship between being a PWS and job satisfaction, discrimination, and vigilance. PWS were found to experience higher discrimination as well as be more vigilant. Discrimination and vigilance were found to mediate the relationship between stuttering and job satisfaction.
Conclusion Results of this study indicate that the participants who stutter differ from PWNS in their job satisfaction, discrimination, and vigilance. Clinicians can prepare PWS with self-advocacy strategies, legal knowledge of what their rights are as an employee who identifies as a person who stutters with a disability, a legal understanding of workplace discrimination, and counseling on the impact of vigilance on workplace experiences.
PMID: 31756582 DOI: 10.1016/j.jfludis.2019.105725
The relationship between prenatal testosterone and developmental stuttering in boys - CONCEITO
Turk J Pediatr. 2019;61(2):193-199.
Free full text: http://www.turkishjournalpediatrics.org/uploads/pdf_TJP_1958.pdf
Dönmez YE, Özcan Ö, Bilgiç A, Miniksar DY.
Malatya Training and Research Hospital, Malatya, Turkey; İnönü University Faculty of Medicine, Malatya, Turkey; Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey.
Stuttering is a multi-factorial speech disorder characterized by various dysfluencies in the beginning and/or smooth flow of speech. Its incidence is about 1% in the general population, with 80% of stuttering cases seen in children aged three to eight years. The etiology of developmental stuttering has not been precisely explained. Several researchers report that neurological factors, especially atypical lateralization of the speech and language processes, play an important role in the etiology of stuttering. Various hypotheses suggest that prenatal testosterone causes atypical hemispheric lateralization. The aim of this study was to investigate the role of prenatal testosterone in the etiology of developmental stuttering by the use of the ratio of secondand fourth-digit lengths (2D:4D). Totally 133 boys (49 boys who stutter and 84 boys who do not stutter) were included in the study. The age range of children participating in the study was determined as 2-12 years. In the comparative evaluation conducted between the stuttering group and the control group in terms of their right 2D:4D and left 2D:4D ratios, it was found that the left 2D:4D ratio of the patients was significantly higher than that of the control group. We are of the opinion that prenatal testosterone may play a role in the etiology of developmental stuttering. The present study is the first study in the literature to reveal a relationship between prenatal testosterone and developmental stuttering.
PMID: 32077645 DOI: 10.24953/turkjped.2019.02.007
The Role of Executive Function in Developmental Stuttering - CONCEITO
Semin Speech Lang. 2019 Aug;40(4):305-319. Epub 2019 Jul 16.
Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910129/pdf/nihms-1062016.pdf
Anderson JD, Ofoe LC.
Indiana University, Bloomington, Indiana.
Developmental stuttering is a complex disorder and children who stutter form a heterogeneous group. Most contemporary researchers would agree that multiple factors, including those associated with linguistic, motor, sensory, and emotional processes, are likely involved in its development and/or maintenance. There is growing evidence, however, that cognitive processes also play a role. In this article, we briefly review behavioral and parent-report studies of executive function in children who stutter, the findings of which have generally suggested that these skills may be challenging for at least some children who stutter. We then consider how deficits in executive function could provide an explanatory account for not only the multifactorial nature of developmental stuttering but also the considerable amount of variability that exists among individuals who stutter.
PMID: 31311055 DOI: 10.1055/s-0039-1692965
Theta Modulated Neural Phase Coherence Facilitates Speech Fluency in Adults Who Stutter - NEUROCIÊNCIAS
Front Hum Neurosci. 2019 Nov 19;13:394.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6878001/pdf/fnhum-13-00394.pdf
Sengupta R, Yaruss JS, Loucks TM, Gracco VL, Pelczarski K, Nasir SM.
Northwestern University, Evanston, IL, United States; Michigan State University, East Lansing, MI, United States; University of Alberta, Edmonton, AB, Canada; Haskins Laboratories, New Haven, CT, United States; Kansas State University, Manhattan, KS, United States; Ball State University, Muncie, IN, United States.
Adults who stutter (AWS) display altered patterns of neural phase coherence within the speech motor system preceding disfluencies. These altered patterns may distinguish fluent speech episodes from disfluent ones. Phase coherence is relevant to the study of stuttering because it reflects neural communication within brain networks. In this follow-up study, the oscillatory cortical dynamics preceding fluent speech in AWS and adults who do not stutter (AWNS) were examined during a single-word delayed reading task using electroencephalographic (EEG) techniques. Compared to AWNS, fluent speech preparation in AWS was characterized by a decrease in theta-gamma phase coherence and a corresponding increase in theta-beta coherence level. Higher spectral powers in the beta and gamma bands were also observed preceding fluent utterances by AWS. Overall, there was altered neural communication during speech planning in AWS that provides novel evidence for atypical allocation of feedforward control by AWS even before fluent utterances.
PMID: 31798431 PMCID: PMC6878001 DOI: 10.3389/fnhum.2019.00394
The utility of stuttering support organization conventions for young people who stutter.
J Fluency Disord. 2019 Dec;62:105724. Epub 2019 Oct 5.
Gerlach H, Hollister J, Caggiano L, Zebrowski PM.
The University of Iowa, Iowa City, IA, United States; Western Michigan University, Kalamazoo, MI , United States; Loma Linda University, , Loma Linda, CA, United States; FRIENDS: The National Association of Young People Who Stutter, United States.
BACKGROUND: Stuttering Support Organizations (SSOs) are places where people who stutter can share their experiences with stuttering and lend support to each other. There is evidence that SSO participation may be helpful in reducing the negative impact of stuttering and promoting positive cognitive and affective changes in adults who stutter. The benefits of participating in SSO organizations for young people, however, are currently unknown.
PURPOSE: This study investigated the relationship between attending a multi-day SSO convention and cognitive and affective changes among young people who stutter (YPWS).
METHODS: Twenty-two YPWS (ages 10 to 18) were recruited from the 2016 FRIENDS annual convention to participate in this study. FRIENDS is the National Association of Young People Who Stutter. A mixed methods approach was used to collect and analyze quantitative and qualitative data. The Overall Assessment of the Speaker's Experience with Stuttering (OASES) was administered at three times points: pre-convention, post-convention, and three months following the convention. Semi-structured interviews were conducted with seven participants to further explain the quantitative results.
RESULTS: Analysis of OASES scores across the three time points indicated that there were significant decreases in the negative impact of stuttering between pre-convention and post-convention measures. Qualitative analysis of semi-structured interview transcripts revealed five themes related to community building, collaborative learning, cognitive and communicative changes, self-acceptance, and normalizing stuttering.
CONCLUSION: SSOs may be beneficial in reducing the negative impact of stuttering and should be considered a potentially valuable addition to traditional therapy for stuttering.
PMID: 31634790 DOI: 10.1016/j.jfludis.2019.105724
Three Lidcombe program clinic visit options: a phase II trial - TERAPIA
J Commun Disord. 2019 Nov- Dec ;82:105919.. Epub 2019 Jul 2
Koushik S, Hewat S, Onslow M, Shenker R, Jones M, O'Brian S, Packman A, Menzies R, Harrison E, Wilson L.
University of Newcastle, Newcastle, Australia; University of Technology Sydney, Australia; Montreal Fluency Centre, Montreal, Canada; Bond University, Brisbane, Australia; Macquarie University, Sydney, Australia;
Charles Sturt University, Albury, Australia.
PURPOSE: Weekly clinic visits are recommended in the Lidcombe Program Treatment Guide (Packman et al., 2015). That specification is based on traditional speech-language pathology practices rather than empirical research, and two studies have suggested that such a format does not always occur in clinical communities. This research was conducted to determine the relative efficacy of different Lidcombe Program models of clinic visits.
METHOD: Thirty-one children were randomized to three different service delivery models: twice-weekly, weekly and fortnightly (once every two weeks) clinic visits. All children were treated with the Lidcombe Program following manualised procedures. Measures of percentage syllables stuttered were obtained from beyond clinic audio recordings pre- and post-randomization.
RESULTS: Results showed that the twice-weekly and fortnightly treatment formats were not suitable for all families. However, the fortnightly outcomes at 9 months post-randomization were comparable with those attained during weekly clinic visits.
CONCLUSIONS: These results justify further, large-scale clinical trialling to compare weekly Lidcombe Program clinic visits with schedules involving less frequent clinic visits.
PMID: 31351345 DOI: 10.1016/j.jcomdis.2019.105919
Understanding and Treating Childhood-Onset Stuttering.
Am Fam Physician. 2019 Nov 1;100(9):Online.
[No authors listed]
No abstract available.
Violent crime against children with disabilities: A nationwide prospective birth cohort-study - SOCIAL
Child Abuse Negl. 2019 Dec ;98:104150. Epub 2019 Sep 24
The Danish Center for Social Science Research, Copenhagen K, Denmark.
BACKGROUND: The rate of violent victimization against children with disabilities is thought to be lower than the rate for children without disabilities but several studies shows otherwise.
OBJECTIVE: The study focuses on examining violent crime against children with disabilities and explaining differences in victimization, in order to elucidate to what extent types of disability, family disadvantages, gender, high-risk behavior, location and indicator of ethnic minority (e.g. non-Danish citizens) influence adolescents' risk of violent victimization. Previous population studies in this area lack scientifically sound research methodology and results are weak or inconclusive.
METHOD: Data is based on a national study of reported violent crime against children in Denmark aged between 7 and 18 years, using total birth cohorts (N = 678,000). Data on types of disability were collected from the Danish national inpatient register. Violent-crime data were extracted from Danish police records. Within the birth cohorts studied, 3.5% of children had experienced a violent crime. A discrete-time Cox model was used for the statistical analysis, which included an extended list of potential risk factors to adjust for confounding.
RESULTS: Children with disabilities are more likely to be victims of a reported violent crime than non-disabled children - ADHD odds ratio: 2.7 (2.6-2.8), mental retardation: 2.7 (2.6-2.7), autism 2.6 (2.5-2.7), loss of hearing 1.4 (1.2-1.5), brain injury: 1.8 (1.7-1.9), physical disabilities 1.4 (1.2-1.5), and blindness 2.0 (1.4-2.8). Speech disability, epilepsy, stuttering, and dyslexia were not associated with increased risk of violent victimization, when adjusted for confounding risk factors and age.
CONCLUSIONS: The results of our study provide empirical insight into the first-time prevalence of victimization among children with disability, and into the predicative association between family disadvantages and victimization.
PMID: 31561190 DOI: 10.1016/j.chiabu.2019.104150
What do people search for in stuttering therapy: Personal goal-setting as a gold standard? - TERAPIA
J Commun Disord. 2019 Oct 1:105944. [Epub ahead of print]
Sønsterud H, Feragen KB, Kirmess M, Halvorsen MS, Ward D.
University of Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Reading, Speech Research Laboratory, England, United Kingdom.
PURPOSE: Stuttering affects people in individual ways, and there are multiple factors which may influence a person's goals when seeking therapy. Even though there is a common consensus that speech-language pathologists should discuss the individual's goals and expectations for stuttering therapy and outcomes, few studies have systematically investigated this issue. The aims of the present study were to investigate individual motivations and goal-setting related factors in stuttering therapy. The associations between self-reported impact of stuttering and the participants' perceptions of stuttering interference in communication, speaking abilities, and relationships with other people were also investigated.
METHOD: This study is part of a wider-ranging treatment study of individualized stuttering management tailored to the participants' personal goals and preferences. A mixed method, multiple single-case design was used to address the research questions. Twenty-one adults, age 21-61 years, took part in a pretherapy interview, which also included two quantitative measures: the Client Preferences for Stuttering Therapy-Extended version (CPST-E) and the Overall Assessment of Speakers' Experience of Stuttering-Adult version (OASES-A). Findings from the study sample was compared with a Norwegian reference group, in order to check for the representativeness of the study sample.
RESULTS: Quantitative data showed that most participants wanted to focus on both physical and psychological aspects of therapy, and that 95% considered 'to gain a sense of control over the stuttering' as important. Participants' perspectives on their speaking ability and stuttering interference in communication were identified as central factors, particularly in social and professional settings. These outcomes aligned well with the finding of avoidance behaviors, such as avoiding words and speaking situations. Qualitative data identified four main areas that the participants wanted to improve: speech fluency, emotional functioning, activity and participation, and understanding of their stuttering.
CONCLUSION: The study confirms that multiple and individual factors may influence the person's goals for therapy. Goals were mainly anchored in participants' wish of better coping in real world settings. A high degree of avoidance behavior was reported, suggesting that anxiety, and in particular linguistic-related anxiety needs to be taken into account when addressing social anxiety in fluency disorders.
PMID: 31607438 DOI: 10.1016/j.jcomdis.2019.105944