Eliana Maria Nigro Rocha



Abstract  - Janeiro a Julho de 2021


A Case of Acute Stuttering Resulting after a Sports-related Concussion - GAGUEIRA ADQUIRIDA

Curr Sports Med Rep. 2021 Jan 1;20(1):10-12


James Toldi , Jared Jones

Johns Hopkins All Children's Hospital, St. Petersburg, FL; University of South Alabama, Mobile, AL.


No abstract available



A Case Report of Clozapine-Associated Stuttering and Amisulpride-Associated Stuttering and Seizure in an Adult on Concurrent Fluoxetine Therapy

J Clin Psychopharmacol. 2021 Mar 5. Online ahead of print.


Rahul Mathur , Jawahar Singh, Mamta Sood

All India Institute of Medical Sciences (AIIMS) New Delhi, India.


No abstract available.

PMID: 33675589 DOI: 10.1097/JCP.0000000000001376




A comparison of the performance of Persian speaking children who do and do not stutter on three nonwords repetition tasks - INFANTIL / FALA

J Fluency Disord. 2021 Jan 5;67:105825. Online ahead of print.


Farhad Sakhai, Akbar Darouie, Julie D Anderson, Mahdi Dastjerdi-Kazemi, Golnoosh Golmohammadi, Enayatollah Bakhshi

University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Indiana University, United States; Allameh Tabataba'i University, Tehran, Iran.


Purpose: The purpose of the study was to examine the performance of Persian speaking children who stutter (CWS) and children who do not stutter (CWNS) on three nonword repetition tasks, while also focusing on which task and scoring method best differentiates the two groups of children.

Method: Thirty CWS and 30 CWNS between the ages of 5;0 to 6;6 completed three nonword repetition tasks that varied in complexity. Each task was scored using two methods: nonwords correct and phonemes correct. Between-group differences in performance on each task were examined, along with disfluencies for CWS and the task and scoring method that best differentiated the CWS and CWNS.

Results: The findings revealed that, across all three nonword repetition tasks, the CWS consistently produced fewer nonwords correct and phonemes correct than the CWNS group at virtually all syllable lengths. The CWS produced more disfluencies on longer nonwords than shorter nonwords in all three nonword repetition tasks. The nonword repetition task with lower wordlikeness and more phonologically complex items best differentiated the two groups of children. Findings further revealed that discriminative accuracy was highest for scoring based on the number of phonemes produced correctly.

Conclusion: Findings provide further evidence to suggest that CWS may have difficulty with phonological working memory and/or phonological processing.

PMID: 33395124 DOI: 10.1249/JSR.0000000000000795




A Preliminary Investigation of Attention-Deficit/Hyperactivity Disorder Characteristics in Adults Who Stutter - ATENÇÃO

J Speech Lang Hear Res. 2021 Mar 1;1-15. Online ahead of print.


Seth E Tichenor, Chelsea A Johnson, J Scott Yaruss

Michigan State University, East Lansing.


Purpose Recent studies have shown that many children who stutter may have elevated characteristics of attention-deficit/hyperactivity disorder (ADHD). Although childhood ADHD commonly persists into adulthood, it is unclear how many adults who stutter experience aspects of ADHD (e.g., inattention or hyperactivity /impulsivity). This study sought to increase understanding of how ADHD characteristics might affect individuals who stutter by evaluating (a) whether elevated ADHD characteristics are common in adults who stutter, (b) whether elevated ADHD characteristics in adults who stutter were significantly associated with greater adverse impact related to stuttering, and (c) whether individual differences in Repetitive Negative Thinking (RNT) and Effortful Control influenced this relationship.
Method Two hundred fifty-four adults who stutter completed the Adult ADHD Self-Report Scale, the Perseverative Thinking Questionnaire, the Adult Temperament Questionnaire short form, and the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed via multiple linear regression to determine whether the number of inattention or hyperactivity/impulsivity characteristics was significantly associated with RNT, Effortful Control, or Adverse Impact related to stuttering.
Results Almost one quarter of participants (23.2%; 60/254) self-reported experiencing six or more inattention characteristics, while fewer participants (8.3%; 21/254) self-reported experiencing six or more hyperactivity/impulsivity characteristics. Participants with lower Effortful Control and higher levels of both RNT and Adverse Impact were significantly more likely to self-report experiencing more inattention characteristics.

Discussion Many adults who stutter may exhibit previously unaccounted for characteristics of ADHD, especially inattention. Results highlight the value of continued research on the intersectionality of stuttering, ADHD, and attention, and the importance of individualizing therapy to the needs of each unique person who stutters.

PMID: 33647218 DOI: 10.1044/2020_JSLHR-20-00237





A Questionnaire Survey About Support Requests From School-Age Children and Adolescents Who Stutter - AMBIENTE

Lang Speech Hear Serv Sch. 2021 Jan 26;1-11. Online ahead of print.


Daichi Iimura, Osamu Ishida, Saburo Takahashi, Hideaki Yokoi, Shoko Miyamoto

Kawasaki University of Medical Welfare, Okayama, Japan; University of Tsukuba, Ibaraki, Japan; Saitama Municipal Nakamoto Elementary School, Saitama, Japan; Dai-nana Elementary School, Tokyo, Japan; Japan Stuttering Genyukai Association, Tokyo, Japan; Narumi Stuttering Consultation Room, Aichi, Japan.


Purpose Children who stutter (CWS) face communication difficulties in school activities and at home. Although the importance of receiving support from their surroundings has been documented, few studies have investigated potential requests of CWS from their surroundings. This study aimed to elucidate such requests.
Method A total of 43 school-age children and 25 adolescents who stutter completed a free-description questionnaire, including questions such as "what you want your classmates/your classroom teacher/your family to do about your stuttering?" Their descriptions were summarized and categorized based on similarity. Results The results indicate that 90.6% of the participants had more than one request for their classmates, classroom teacher, or family. A total of 197 items were extracted and categorized into seven themes. In particular, the responses included "listen attentively," "treat us naturally," and "make arrangements." While participants tended to hope for classmates or family to "listen attentively" and "treat us naturally," the request to "make arrangements" was higher for their teacher. Their potential requests varied by age: While school-age CWS wanted people around them to "listen carefully," the hope of adolescents who stutter was "treat us naturally."
Conclusions The various potential requests of CWS were categorized, and the responses shed light on the importance of increasing knowledge of stuttering. The difference between the requests could reflect psychosocial differences between school-age children and adolescents who stutter. In addition, social interaction among peers is more developed in adolescents, and they could harbor fear of being excluded within their community.

PMID: 33497578 DOI: 10.1044/2020_LSHSS-20-00069




A systematic review on the role of language-related factors in the manifestation of stuttering in bilinguals - LINGUAGEM

Review J Fluency Disord. 2021 Jan 23;68:105829 Online ahead of print.


Chanchal Chaudhary, Santosh Maruthy, Vasudeva Guddattu, Gopee Krishnan

Manipal Academy of Higher Education, Manipal, Karnataka, India; All India Institute of Speech and Hearing, Manasgangothri, Mysore, India.


Purpose: Bilingual(s) who stutter (BWS) provide an opportunity to explore the link between stuttering and language. Unlike in monolinguals, stuttering in bilinguals could be influenced by both speaker-related language (e.gs. dominance & proficiency) and linguistic typology-related factors (e.g., structure of languages). However, the available literature is largely inconclusive on these factors. In this context, we systematically reviewed the literature to compile evidence on the influence of such factors on BWS.

Method: We followed the conventional systematic review process that included five databases. Further, the quality of the included articles was assessed using Newcastle-Ottawa Scale (NOS) for quality rating.

Result: Thirteen articles passed the selection criteria. Review of these articles revealed that language proficiency and dominance are the important factors that affect stuttering frequency in BWS. Though the linguistic typology is portrayed as a factor on the differential manifestation of dysfluencies in both languages of the BWS, the literature does not provide substantiating data for this. Further, the lack of uniformity in assessing and reporting language dominance and proficiency are the major drawbacks in the existing literature on stuttering in BWS.

Conclusion: This review identifies proficiency and dominance as the major factors that influence the stuttering frequency in BWS. Currently, the evidence for the influence of typological differences between languages of the BWS on stuttering largely remains whimsical. Future research shall employ the recommended tasks and metrics while assessing the dysfluencies in BWS so that findings across centres become comparable, which in turn, could yield valid inferences.

PMID: 33556665




Acquired stuttering after pediatric concussion - GAGUEIRA ADQUIRIDA

Acta Neurol Belg. 2021 Mar 20. Online ahead of print.


Sean C Rose, David L Weldy, Svitlana Zhukivska, Thomas L Pommering

Nationwide Children's Hospital, Columbus, OH, USA; The Ohio State University College of Medicine, Columbus, OH, USA; University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.


No abstract available

PMID: 33743164 DOI: 10.1007/s13760-021-01653-x




Association Between Gray Matter Volume Variations and Energy Utilization in the Brain: Implications for Developmental Stuttering - INFANTIL / CONCEITO

J Speech Lang Hear Res. 2021 Mar 9;1-8. Online ahead of print.


Nathaniel Boley, Sanath Patil, Emily O Garnett, Hua Li, Diane C Chugani 5, Soo-Eun Chang, Ho Ming Chow

The George Washington University, Washington, DC; Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE; Eberly College of Science, The Pennsylvania State University, University Park; University of Michigan Medical School, Ann Arbor; University of Delaware, Newark; Michigan State University, East Lansing.


Purpose The biological mechanisms underlying developmental stuttering remain unclear. In a previous investigation, we showed that there is significant spatial correspondence between regional gray matter structural anomalies and the expression of genes linked to energy metabolism. In the current study, we sought to further examine the relationship between structural anomalies in the brain in children with persistent stuttering and brain regional energy metabolism.
Method High-resolution structural MRI scans were acquired from 26 persistent stuttering and 44 typically developing children. Voxel-based morphometry was used to quantify the between-group gray matter volume (GMV) differences across the whole brain. Group differences in GMV were then compared with published values for the pattern of glucose metabolism measured via F18 fluorodeoxyglucose uptake in the brains of 29 healthy volunteers using positron emission tomography.

Results A significant positive correlation between GMV differences and F18 fluorodeoxyglucose uptake was found in the left hemisphere (ρ = .36, p < .01), where speech-motor and language processing are typically localized. No such correlation was observed in the right hemisphere (ρ = .05, p = .70).

Conclusions Corroborating our previous gene expression studies, the results of the current study suggest a potential connection between energy metabolism and stuttering. Brain regions with high energy utilization may be particularly vulnerable to anatomical changes associated with stuttering. Such changes may be further exacerbated when there are sharp increases in brain energy utilization, which coincides with the developmental period of rapid speech/language acquisition and the onset of stuttering during childhood.
PMID: 33719533 DOI: 10.1044/2020_JSLHR-20-00325



Case Report: Deep Brain Stimulation to the Ventral Internal Capsule/Ventral Striatum Induces Repeated Transient Episodes of Voltage-Dependent Tourette-Like Behaviors - OUTRAS ÁREAS

Front Hum Neurosci. 2021 Jan 25;14:590379. eCollection 2020.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869408/pdf/fnhum-14-590379.pdf


Joan A Camprodon, Tina Chou, Abigail A Testo, Thilo Deckersbach, Jeremiah M Scharf, Darin D Dougherty

Harvard Medical School, Boston, MA, United States.


Deep Brain Stimulation (DBS) is an invasive device-based neuromodulation technique that allows the therapeutic direct stimulation of subcortical and deep cortical structures following the surgical placement of stimulating electrodes. DBS is approved by the U.S. Federal Drug Administration for the treatment of movement disorders and obsessive-compulsive disorder, while new indications, including Major Depressive Disorder (MDD), are in experimental development. We report the case of a patient with MDD who received DBS to the ventral internal capsule and ventral striatum bilaterally and presented with 2 weeks of voltage-dependent Tourette-like symptoms including brief transient episodes of abrupt-onset and progressively louder coprolalia and stuttered speech; tic-like motor behavior in his right arm and leg; rushes of anxiety, angry prosody, angry affect; and moderate amnesia without confusion. We describe the results of the inpatient neuropsychiatric workup leading to the diagnosis of iatrogenic voltage-dependent activation of cortico-subcortical circuits and discuss insights into the pathophysiology of Tourette as well as safety considerations raised by the case.

PMID: 33568978 PMCID: PMC7869408 DOI: 10.3389/fnhum.2020.590379




Cognitive control of action naming in adults who stutter - LINGUAGEM

J Fluency Disord. 2021 Feb 27;70:105841. Online ahead of print.


Nathan D Maxfield

University of South Florida, Tampa, FL, United States.


Purpose: Based on previous evidence that cognitive control of lexical selection in object (noun) naming operates differently in adults who stutter (AWS) versus typically-fluent adults (TFA), the aim was to investigate cognitive control of lexical selection in action (verb) naming in AWS.

Method: 12 AWS and 12 TFA named line drawings depicting actions using verbs. Half of the pictures had high-agreement action names and the other half low-agreement action names. Naming accuracy and reaction times (RT), and event-related potentials (ERPs) time-locked to picture onset, were compared between groups.

Results: Naming RTs were slower for low- versus high-agreement trials, and the magnitude of this effect was larger in AWS versus TFA. Delta-plot analysis of naming RTs revealed that individual differences in selective inhibition were associated with the agreement effect on naming RTs in AWS but not TFA. Action naming elicited frontal-central N2 activity in both agreement conditions in TFA but not AWS. Additionally, a later, posterior P3b component was affected by agreement in TFA only. In AWS, low-agreement action naming elicited frontal P3a activation.

Conclusions: Results suggest that cognitive control of action name selection was qualitatively different between groups. In TFA, cognitive control of lexical selection in action naming involved nonselective inhibition, as well as more efficient working memory updating on high- versus low-agreement trials. In AWS, cognitive control of low-agreement action naming involved increased focal attention. Individual differences in selective inhibition may have moderated cognitive control of action naming in AWS.

PMID: 33667938 DOI: 10.1016/j.jfludis.2021.105841




Cognitive Flexibility and Effortful Control in School-Age Children With and Without Stuttering Disorders - INFANTIL / ATENÇÃO

J Speech Lang Hear Res. 2021 Feb 25;1-16. Online ahead of print.


Naomi Eichorn, Steven Pirutinsky

The University of Memphis, TN; Touro College School of Social Work, New York, NY.


Purpose This study compared attention control and flexibility in school-age children who stutter (CWS) and children who do not stutter (CWNS) based on their performance on a behavioral task and parent report. We used a classic attention-shifting paradigm that included manipulations of task goals and timing to test effects of varying demands for flexibility on switching accuracy and speed. We also examined associations between task performance, group, and relevant aspects of temperament.

Method Participants included 33 children (15 CWS, 18 CWNS) between 8 and 11 years of age. Children sorted stimuli that differed on two dimensions (color and shape) based on sorting rules that varied from block to block or trial to trial. Timing manipulations included intervals of 200-, 600-, or 1,200-ms durations for critical trial components. Temperament data were obtained via the Children's Behavior Questionnaire.

Results All children showed expected performance costs in response to block and trial manipulations; however, CWS were more affected by task conditions that increased demands for cognitive flexibility. Effects of interval durations also differed by group. Factor scores on the Children's Behavior Questionnaire indicated differences in effortful control between groups; however, this aspect of temperament did not mediate between-groups differences in switching performance.

Conclusions Findings suggest that stuttering continues to be associated with differences in attention control and flexibility beyond the preschool years. Further research is needed to clarify how these cognitive processes shape the development of stuttering throughout childhood.

PMID: 33630654 DOI: 10.1044/2020_JSLHR-20-00440




Comprehensive Review of Factors Influencing the Use of Telepractice in Stuttering Treatment - TERAPIA

Healthc Inform Res. 2021 Jan;27(1):57-66. Epub 2021 Jan 31.


Baran Bayati, Haleh Ayatollahi

Iran University of Medical Sciences, Tehran, Iran.


Objectives: Stuttering is a speech disorder characterized by the repetition of sounds, syllables, or words; prolongation of sounds; and interruptions in speech. Telepractice allows speech services to be delivered to patients regardless of their location. This review investigated factors influencing the use of telepractice in stuttering treatment.

Methods: Articles related to the application of telepractice in stuttering were searched using the Scopus, Web of Science, PubMed, Cochrane, and ProQuest databases without consideration of any time limit. Initially, 79 articles were found and after application of the inclusion and exclusion criteria, 15 articles were selected for the review study. Data were analyzed by using the content analysis method and synthesized narratively.

Results: Factors influencing the use of telepractice in stuttering treatment were categorized into individual, technical, clinical, and economic factors. Providing access to healthcare services, maintaining personal privacy, and allowing flexibility in arranging appointments were among individual factors. In terms of the technical factors, technical problems and Internet speed were addressed. Clinical factors were divided into positive and negative outcomes, and economic factors were mainly related to time and cost savings.

Conclusions: Although patients may benefit from using telepractice, the widespread adoption of this technology can be hindered by some technical and non-technical factors. Because telepractice can be employed as a complementary method to treat stuttering, more attention should be paid to the required infrastructure and factors that may negatively impact the use of this technology.
PMID: 33611877 DOI: 10.4258/hir.2021.27.1.57




Cultural difference in attitudes towards stuttering among British, Arab and Chinese students: Considering home and host cultures - SOCIAL

Int J Lang Commun Disord. 2021 Apr 5. Online ahead of print.


Meryem S Üstün-Yavuz, Meesha Warmington, Hope Gerlach, Kenneth O St Louis

University of Sheffield, Sheffield, UK; Western Michigan University, Kalamazoo, MI, USA; West Virginia University, Morgantown, WV, USA.


Background: Geographical and cultural differences have been shown to affect public attitudes towards stuttering. However, increasingly for many individuals in the world one's birthplace culture (or home culture) and culture in their local geographical environment (or host culture) are not the same.

Aims: The effects of home culture and host culture in shaping the attitudes towards stuttering among students with British, Arab and Chinese home cultures attending one British university were explored. The effects of host culture were investigated by considering the time lived in the UK for Arab and Chinese students.

Methods & procedures: The study used a descriptive survey design that included a standardized self-delivered questionnaire: the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S). Purposive sampling was carried out thorough volunteer mailing lists, student societies and personal contact. The final sample of 156 university students included 51 British, 52 Arab and 53 Chinese students.

Outcomes & results: Overall stuttering score (OSS), which is indicative of attitudes towards stuttering, was highest for British participants (mean = 30) and lowest for Chinese participants (mean = 13), with Arab participants falling in the middle (mean = 21). The differences in attitudes between the three groups were statistically significant, suggesting that home culture is a contributor to attitudes towards stuttering. A post-hoc item analysis of the POSHA-S revealed numerous specific differences in attitudes towards stuttering between the three groups, including differences in the attribution of the aetiology of stuttering, their role in helping people who stutter (PWS) and sympathy toward PWS. Time lived in the UK-a proxy measure for the role of host culture-did not significantly influence the attitudes of Arab and Chinese respondents.

Conclusions & implications: To varying degrees, all three groups had evidence of stereotypical stuttering attitudes. Nevertheless, given similar ages and student status in the same university, observed respondent differences confirm previous research documenting geographical influences on stuttering attitudes in Western versus East Asian and Middle Eastern samples. The study also provides evidence that home culture was influential in shaping attitudes towards stuttering, but host culture was not a significant contributor. 

What this paper adds What is already known on the subject Public stereotypical beliefs towards stuttering are found across the world and hinder the quality of life among PWS. Different cultures have unique stereotypical beliefs towards PWS.
What this study adds to existing knowledge To the best of our knowledge, no other study has investigated specifically if individuals who live in the same geographical location but have different home cultures, have similar or differing attitudes towards PWS. Results provide preliminary evidence that the home culture of an individual was influential in shaping attitudes towards PWS, but host culture, measured as the length of time living in the current geographical location, did not have a significant relationship with attitudes towards stuttering.
What are the potential or actual clinical implications of this work This study highlights that culturally sensitive clinical practice should not be based on just the culture of the region but should take home culture into consideration as well, and clinicians should discuss cultural perceptions of stuttering with clients in clinical practice.

PMID: 33818900 DOI: 10.1111/1460-6984.12617




Do dyslexia and stuttering share a processing deficit? - AVALIAÇÃO

J Fluency Disord. 2021 Jan 6;67:105827. Online ahead of print.


Mahmoud M Elsherif, Linda R Wheeldon, Steven Frisson

University of Birmingham, Birmingham, UK; University of Agder, Kristiansand, Norway.


This study assessed the prevalence of childhood stuttering in adults with dyslexia (AWD) and the prevalence of dyslexia in adults who stutter (AWS). In addition, the linguistic profiles of 50 AWD, 30 AWS and 84 neurotypical adults were measured. We found that 17 out of 50 AWD (34 %) reported stuttering during childhood compared to 1 % of the neurotypical population. This was moderated by the severity of dyslexia: People with mild dyslexia showed a lower prevalence rate (15 %) of childhood stuttering than those with severe dyslexia (47 %). In addition, we observed that 50 % of the AWS (n = 30) fulfilled the diagnostic criteria of dyslexia, even though they had never been diagnosed as dyslexic. Compared to neurotypical adults, phonological working memory, awareness, and retrieval were similarly reduced in AWS and AWD. The findings supports the view that stuttering and dyslexia may share a phonological deficit.

PMID: 33444937 DOI: 10.1016/j.jfludis.2020.105827




Does the clinical utility of self-disclosure of stuttering transcend culturally and linguistically diverse populations? - TERAPIA

Int J Speech Lang Pathol. 2021 Feb 5;1-18. Online ahead of print.


Robyn L Croft , Courtney T Byrd

The University of Texas at Austin, Austin, USA.


Purpose: Research suggests that self-disclosure can improve listeners' perceptions of stuttering; however, it is unknown whether the effectiveness of self-disclosure transcends culture and language. This study examined the clinical utility of self-disclosure in a culturally and linguistically diverse population: Hebrew-speaking people who stutter in Israel.
Method: The experimental protocol replicated Byrd, Croft et al. Participants (N = 92 adults in Israel) viewed a video of either a male or female Hebrew-speaking person who simulated stuttering and self-disclosed informatively, apologetically, or not at all. Participants then rated the speaker on ten traits (i.e. friendly, outgoing, intelligent, confident, engaging, distracting, unfriendly, shy, unintelligent, insecure) using a bipolar likert scale.
Result: Results indicated that participants rated the speaker who self-disclosed in a neutral and informative manner as significantly more outgoing compared to the speaker who did not self-disclose at all, supporting the results from Byrd, Croft et al. Additionally, the male speaker was rated as significantly more friendly and outgoing than the female speaker.
Conclusion: This study suggests that self-disclosing in a neutral and informative manner can improve listeners' perceptions of people who stutter similarly across culture and language.

PMID: 33544005 DOI: 10.1080/17549507.2020.1861326




Drug induced stuttering: pharmacovigilance data - FARMACOLOGIA

Expert Opin Drug Saf. 2020 Dec 27;1-5. Online ahead of print.


Thierry Trenque, Aurore Morel, Agathe Trenque, Brahim Azzouz

Reims University Hospitals, Reims, France; University of Reims Champagne-Ardenne , Reims, France.


Background: Stuttering is a speech disorder characterized by poor fluency of speech despite the speech production organs being normal. Numerous factors contribute to stuttering, and it may also be an iatrogenic effect of certain drugs. The aim of this study was to investigate the association between stuttering and drug exposure.

Research design and methods: We investigated the association between drugs and stuttering. We analyzed reports in the World Health Organization global individual case safety reports database (Vigibase) up to 31 May 2020 with the MedDRA lower level terms 'stutter' and 'stuttering.' The association between a drug and the occurrence of the adverse drug reaction was estimated by disproportionality analysis. Reporting odds ratios (ROR) were calculated with 95% confidence intervals.

Results: In total, 724 notifications were identified using the MedDRA terms selected. The main drugs implicated were methylphenidate (ROR = 19.58; 95% CI: 13.3-28.8), topiramate (ROR = 12.5; 95% CI: 7.1-22.1), olanzapine (ROR = 12; 95% CI: 8-17.9) and golimumab (ROR = 10.2; 95% CI: 5.5-19.1).

Conclusions: When stuttering occurs in a patient treated by drugs affecting neurotransmission, a drug-induced origin of the stutter should be considered.

PMID: 33337944 DOI: 10.1080/14740338.2021.1867101




Effect of Maximally Relaxed Lying Posture on the Severity of Stuttering in Young Adults Who Stutter - PSICOMOTOR

Motor Control. 2021 Mar 15;1-11. Online ahead of print.


Abdulaziz Almudhi , Hamayun Zafar

King Khalid University; King Saud University; Umea University.


The current study was carried out with the aim of investigating the effect of maximally relaxed lying posture on disfluencies in young adults who stutter. A total of 24 participants (17 males, seven females; mean age = 24.9 ± 6.2 years) with developmental stuttering were a part of the study. The participants were asked to perform spontaneous speaking and reading aloud tasks in standard sitting and maximally relaxed lying postures. The severity of stuttering for the studied postures was estimated by using the Stuttering Severity Instrument. The results on the Stuttering Severity Instrument showed that stuttering parameters improved during the maximally relaxed lying posture compared with the standard sitting position. The results are discussed in the light of motor control concepts. It is concluded that the maximally relaxed lying posture can facilitate improvement in stuttering scores during spontaneous speaking as well as reading aloud in young adults who stutter. Reduced stuttering scores in the maximally relaxed lying posture suggest that speech therapists can position participants in this position while treating people who stutter.

PMID: 33721838 DOI: 10.1123/mc.2020-0063




Effects of tDCS on Sound Duration in Patients with Apraxia of Speech in Primary Progressive Aphasia - OUTRAS ÁREAS

Brain Sci. 2021 Mar 6;11(3):335.


Charalambos Themistocleous, Kimberly Webster, Kyrana Tsapkini

Johns Hopkins School of Medicine, Baltimore, USA.


Transcranial direct current stimulation (tDCS) over the left inferior frontal gyrus (IFG) was found to improve oral and written naming in post-stroke and primary progressive aphasia (PPA), speech fluency in stuttering, a developmental speech-motor disorder, and apraxia of speech (AOS) symptoms in post-stroke aphasia. This paper addressed the question of whether tDCS over the left IFG coupled with speech therapy may improve sound duration in patients with apraxia of speech (AOS) symptoms in non-fluent PPA (nfvPPA/AOS) more than sham. Eight patients with non-fluent PPA/AOS received either active or sham tDCS, along with speech therapy for 15 sessions. Speech therapy involved repeating words of increasing syllable-length. Evaluations took place before, immediately after, and two months post-intervention. Words were segmented into vowels and consonants and the duration of each vowel and consonant was measured. Segmental duration was significantly shorter after tDCS compared to sham and tDCS gains generalized to untrained words. The effects of tDCS sustained over two months post-treatment in trained and untrained sounds. Taken together, these results demonstrate that tDCS over the left IFG may facilitate speech production by reducing segmental duration. The results provide preliminary evidence that tDCS may maximize efficacy of speech therapy in patients with nfvPPA/AOS.

PMID: 33800933 DOI: 10.3390/brainsci11030335




Enlarged Area of Mesencephalic Iron Deposits in Adults Who Stutter - INFANTIL / CONCEITO

Front Hum Neurosci. 2021 Feb 11;15:639269.


Jan Liman, Alexander Wolff von Gudenberg, Mathias Baehr, Walter Paulus, Nicole E Neef, Martin Sommer

University Medical Center Göttingen, Göttingen, Germany; Institut der Kasseler Stottertherapie (KST), Bad Emstal, Germany.


Purpose: Childhood onset speech fluency disorder (stuttering) is possibly related to dopaminergic dysfunction. Mesencephalic hyperechogenicity (ME) detected by transcranial ultrasound (TCS) might be seen as an indirect marker of dopaminergic dysfunction. We here determined whether adults who stutter since childhood (AWS) show ME.

Methods: We performed TCS in ten AWS and ten matched adults who never stuttered. We also assessed motor performance in finger tapping and in the 25 Foot Walking test.

Results: Compared to controls, AWS showed enlarged ME on either side. Finger tapping was slower in AWS. Walking cadence, i.e., the ratio of number of steps by time, tended to be higher in AWS than in control participants.

Discussion: The results demonstrate a motor deficit in AWS linked to dopaminergic dysfunction and extending beyond speech. Since iron deposits evolve in childhood and shrink thereafter, ME might serve as an easily quantifiable biomarker helping to predict the risk of persistency in children who stutter.

PMID: 33643015 PMCID: PMC7904683 DOI: 10.3389/fnhum.2021.639269




Evaluating adaptation effect in real versus virtual reality environments with people who stutter - TERAPIA

Expert Rev Med Devices. 2021 Mar 8;1-7. Online ahead of print.


Abdulaziz Almudhi

King Khalid University, Saudi Arabia.


Methods: This research aimed at measuring the adaptation effect in real and virtual reality (VR) environments for spontaneous-speech and reading. The objectives were divided into two categories. The first objective aimed at comparing the adaption effect for the real and VR environments on the reading task, while the second objective addressed the same objective, but for the spontaneous-speech task. The study involved 24 participants in the age range of 19-33 years. SSI-4 was administered on the participants.

Conclusion: The reduction in dysfluencies was seen for both real and VR testing environments. The reduction in the dysfluency was more marked for reading-task compared to spontaneous-speech task. The results shed light on the relationship between adaptation effect and the test environment.

PMID: 33678105 DOI: 10.1080/17434440.2021.1894124




Evolution in technology and changes in the perspective of stuttering therapy: A review study - TERAPIA

Review Saudi J Biol Sci. 2021 Jan;28(1):623-627. Epub 2020 Nov 4.

Free PMC article : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7783783/pdf/main.pdf


Abdulaziz Almudhi

King Khalid University, Abha, Saudi Arabia.


Technology has been revolutionizing health care. The current article is split into three parts, the first portion discusses the usage of technological devices in stuttering treatment, the scan of technical devices may be used specifically in treatment or can be used to offer guidance and thereby improve the pace of expression. They will even help to create physiological improvements. The second section of the article refers to telehealth as a means of providing services to people with stuttering. This approach has become a simple benevolence of technology and has managed to enter the unreached. Teletherapy can also be utilized for individuals who are robbed of treatment owing to isolation from financial restrictions. The third part of the analysis is regarding the apps. Apps may be used as an adjunct to speech language training or can be used during the repair process.

PMID: 33424348 PMCID: PMC7783783 DOI: 10.1016/j.sjbs.2020.10.051




Interventions for children and adolescence who stutter: A systematic review, meta-analysis, and evidence map - iNFANTIL / TERAPIA

J Fluency Disord. 2021 Mar 11;70:105843. Online ahead of print.


Amanda Brignell, Michelle Krahe, Martin Downes, Elaina Kefalianos, Sheena Reilly, Angela Morgan

Murdoch Children's Research Institute, Victoria, Australia; Griffith University, Queensland, Australia; University of Melbourne, Victoria, Australia.


Purpose: This systematic review critically appraises and maps the evidence for stuttering interventions in childhood and adolescence. We examine the effectiveness of speech-focused treatments, the efficacy of alternative treatment delivery methods and identify gaps in the research evidence.

Methods: Nine electronic databases and three clinical trial registries were searched for systematic reviews, randomised controlled trials (RCTs) and studies that applied an intervention with children (2-18 years) who stutter. Pharmacological interventions were excluded. Primary outcomes were a measure of stuttering severity and quality assessments were conducted on all included studies.

Results: Eight RCTs met inclusion criteria and were analysed. Intervention approaches included direct (i.e. Lidcombe Program; LP) and indirect treatments (e.g. Demands and Capacities Model; DCM). All studies had moderate risk of bias. Treatment delivery methods included individual face-to-face, telehealth and group-based therapy. Both LP and DCM approaches were effective in reducing stuttering in preschool aged children. LP had the highest level of evidence (pooled effect size=-3.8, CI -7.3 to -0.3 for LP). There was no high-level evidence for interventions with school-aged children or adolescents. Alternative methods of delivery were as effective as individual face-to-face intervention.

Conclusion: The findings of this systematic review and evidence mapping are useful for clinicians, researchers and service providers seeking to understand the existing research to support the advancement of interventions for children and adolescence who stutter. Findings could be used to inform further research and support clinical decision-making.

PMID: 33743406 DOI: 10.1016/j.jfludis.2021.105843





Investigation of Risperidone Treatment Associated With Enhanced Brain Activity in Patients Who Stutter - FARMACOLOGIA

Front Neurosci. 2021 Feb 12;15:598949. eCollection 2021.


Gerald A Maguire, Bo Ram Yoo, Shahriar SheikhBahaei

University of California, Riverside, Riverside, CA, United States; National Institute of Neurological Disorders and Stroke/National Institutes of Health, Bethesda, MD, United States.


Stuttering is a childhood onset fluency disorder that leads to impairment in speech. A randomized, double-blinded placebo-controlled study was conducted with 10 adult subjects to observe the effects of risperidone (a dopamine receptor 2/serotonin receptor 2 antagonist) on brain metabolism, using [18F] deoxyglucose as the marker. At baseline and after 6 weeks of taking risperidone (0.5-2.0 mg/day) or a placebo pill, participants were assigned to a solo reading aloud task for 30 min and subsequently underwent a 90-min positron emission tomography scan. Paired t-tests were performed to compare the pre-treatment vs. post-treatment in groups. After imaging and analysis, the blind was broken, which revealed an equal number of subjects of those on risperidone and those on placebo. There were no significant differences in the baseline scans taken before medication randomization. However, scans taken after active treatment demonstrated higher glucose uptake in the specific regions of the brain for those in the risperidone treatment group (p < 0.05). Risperidone treatment was associated with increased metabolism in the left striatum, which consists of the caudate and putamen, and the Broca's area. The current study strengthens previous research that suggests the role of elevated dopamine activity and striatal hypometabolism in stuttering. We propose that the mechanism of risperidone's action in stuttering, in part, involves increased metabolism of striatal astrocytes. We conclude that using neuroimaging techniques to visualize changes in the brain of those who stutter can provide valuable insights into the pathophysiology of the disorder and guide the development of future interventions.
PMID: 33642973 PMCID: PMC7906995




Is social distancing a boon or bane for persons who stutter during COVID-19 pandemic? - SOCIAL

Saudi J Biol Sci. 2021 Feb 22. Online ahead of print.

Free full text: https://pubmed.ncbi.nlm.nih.gov/33642895/


Abdulaziz Almudhi

King Khalid University, Abha, Saudi Arabia.


The Covid-19 pandemic is an ongoing crisis and is colloquially known as the corona virus pandemic. As no specific treatment protocol are available for this viral infection, social distancing is considered as one of the remedies to prevent the infection. This study aimed to investigate the anxiety issues in persons who stutter (PWS). A total of 110 (55 PWS and 55 Neuro-typical Adults) were enrolled for the study. A questionnaire comprising of two parts on social anxiety and consequences of social distancing was administered on the participants. The results showed that PWS felt more socially anxious. PWS opined that they were comfortable during the corona virus lockdown period, as the situation demanded them to speak minimally to strangers. Neuro-typical adults, on the other hand, reported that they did not observe any change with respect to the social communication skills during lockdown.

PMID: 33642895 PMCID: PMC7899021 DOI: 10.1016/j.sjbs.2021.02.055




Latent Class Analysis Reveals Distinct Groups Based on Executive Function and Socioemotional Traits, Developmental Conditions, and Stuttering: A Population Study - CONCEITO


Sara Ashley Smith, Ai Leen Choo, Matthew E Foster

University of South Florida, Tampa, FL, 33620, USA; Georgia State University, Atlanta, GA, USA.


A growing body of research has reported associations between weaker Executive Functions (EF), the set capacities that are needed to manage and allocate one's cognitive resources during cognitively challenging activities and various neurodevelopmental conditions, including stuttering. The majority of this research has been based on variable-centered approaches, which have the potential to obscure within-population heterogeneity. Person-centered analyses are essential to understanding multifactorial disorders where relationships between indicators have been elusive, such as stuttering. The current study addressed gaps in the literature by using latent class analysis (LCA), a person-centered approach, to identify homogenous subgroups within the National Health Interview Survey (2004-2018) publicly available data set. Using this exploratory approach, we examined the hypothesis that there exist distinct classes (or subgroups) of children based on parent reports of EF, Socioemotional (SE) traits, developmental atypicality, and stuttering. Our analyses revealed distinct subgroups with substantially different likelihoods of parent-reported stuttering behaviors and developmental atypicality. For children with both EF and SE difficulties, the likelihood of parental report of stuttering and atypical development was even higher, in fact this likelihood (of stuttering and not-typically developing) was highest among all subgroups. In contrast, children without difficulties were the least likely to be reported with stuttering or not-typically developing. Our findings are consistent with theoretical frameworks for stuttering, which cite EF as a crucial component in the disorder. Additionally, our findings suggest within-population heterogeneity among children with EF difficulties and, specifically, EF and SE heterogeneity among children who stutter.

PMID: 33782821 DOI: 10.1007/s10578-021-01160-3




Lexical Planning in People Who Stutter: A Defect in Lexical Encoding or the Planning Scope? - LINGUAGEM

Front Psychol. 2021 Feb 23;12:581304.
Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940678/pdf/fpsyg-12-581304.pdf


Liming Zhao, Miaoqing Lian

Tianjin Normal University, Tianjin, China; Center of Collaborative Innovation for Assessment and Promotion of Mental Health, Tianjin, China.


Developmental stuttering is a widely discussed speech fluency disorder. Research on its mechanism has focused on an atypical interface between the planning (PLAN) and execution (EX) processes, known collectively as the EXPLAN model. However, it remains unclear how this atypical interface influences people who stutter. A straightforward assumption is that stuttering speakers adopt a smaller scope of speech planning, whereas a defect in word retrieval can be confounding. To shed light on this issue, we took the semantic blocking effect as an index to examine lexical planning in word and phrase production. In Experiment 1, for word production, pictures from the same semantic category were combined to form homogeneous blocks, and pictures from different categories were combined to form heterogeneous blocks. A typical effect of semantic blocking showing longer naming latencies for homogeneous blocks than heterogeneous ones was observed for both stuttering and fluent speakers. However, this effect was smaller for stuttering speakers, when it was subject to lexical defects in stuttering. In Experiment 2, for a conjoined noun phrase production task, the pictures referring to the first noun were manipulated into homogeneous and heterogeneous conditions. The semantic blocking effect was also much smaller for stuttering speakers, indicating a smaller scope of lexical planning. Therefore, the results provided more evidence in support of the EXPLAN model and indicated that a smaller scope of lexical planning rather than lexical defects causes the atypical interface for stuttering. Moreover, a comparison between these two tasks showed that the study findings have implications for syntactic defects in stuttering.

PMID: 33708156 PMCID: PMC7940678 DOI: 10.3389/fpsyg.2021.581304




Linguistic features of dysfluencies in Parkinson Disease - OUTRAS ÁREAS

J Fluency Disord. 2021 Mar 19;70:105845. Online ahead of print.


Angela E Reif, Alexander M Goberman

The University of Akron, United States; Bowling Green State University, United States.


Purpose: The purpose of this study was to examine dysfluency characteristics of individuals with Parkinson Disease (PD) relative to linguistic features of grammatical class and position within word. Few studies have reported dysfluency characteristics of PD relative to these characteristics. Those that do report on these characteristics include one case study and a study of six individuals with PD. No previous research is known to have examined dysfluency related to grammatical class and position within words for a large sample of individuals with PD.

Method: Dysfluencies from 32 individuals with PD were analyzed according to position within a word and grammatical class.

Results: Participants produced significantly more dysfluencies in the initial position of words compared to medial or final positions, and a significantly higher percent dysfluency for content words versus function words.

Conclusion: Effects of linguistic features of grammatical class and position within a word on dysfluencies are present within a population with PD and are similar to the linguistic features associated with developmental stuttering. Clinical implications of the effect of linguistic features on speech dysfluencies in PD are discussed.

PMID: 33780692 DOI: 10.1016/j.jfludis.2021.105845




Migraine and adult-onset stuttering: A proposed autoimmune phenomenon

Ann Clin Psychiatry. 2021 Feb;33(1):56-57.


Stephanie M Wong, Joyce Y Kim, Gerald A Maguire

Riverside, CA 92521, USA. Cite


No abstract available

PMID: 33529288 DOI: 10.12788/acp.0016




Phonetic complexity and stuttering in Turkish-speaking children who stutter - FALA

Clin Linguist Phon. 2021 Jan 4;1-14. Online ahead of print.


Ayse Aydin Uysal, Dilek Fidan, Feda Yousef Al-Tamimi, Peter Howell

Kocaeli University , Kocaeli, Turkey; Jordan University of Science and Technology , Irbid, Jordan; University College London , London, UK.


The relationship between stuttering and phonetic complexity for words spoken by Turkish children who stutter was investigated. The research questions were: (1) Do Turkish-speaking children stutter more on unbound content words than on unbound function words? (2) Do Turkish-speaking children stutter more on words with higher phonetic complexity scores? Twenty-one monolingual children aged 6-11 years who had a clinical diagnosis of stuttering participated. Speech samples were transcribed and lexical categories determined. Phonetic complexity was assessed by an adaptation of Index of Phonetic Complexity (IPC) for Turkish. Results revealed that the mean rank of unbound content words differed significantly from the mean rank of unbound function words and that stuttering frequency for unbound content words was significantly higher than for unbound function words.

PMID: 33393379 DOI: 10.1080/02699206.2020.1866674




Public attitudes towards people who stutter in South Egypt - SOCIAL

PLoS One. 2021 Feb 4;16(2):e0245673 eCollection 2021.

Free article: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245673


Ahmed Arafa, Shaimaa Senosy, Haytham A Sheerah, Kenneth St Louis

Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt; Osaka University, Osaka, Japan; West Virginia University, Morgantown, West Virginia, United States of America.


Purpose: Stuttering is a multifactorial speech disorder with significant social and psychological consequences. There is a lack of knowledge about public attitudes towards people who stutter (PWS) and the factors that can determine such attitudes in underprivileged communities. This study aimed to assess the public attitudes in South Egypt towards PWS and compare our results with those stored in a reference database representing 180 different samples.

Methods: A multi-stage random sampling approach was used to recruit 650 people from Beni-Suef City in South Egypt. All participants were interviewed using the Arabic version of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) after getting their informed consent. This instrument assesses people's Beliefs and Self Reactions towards PWS in addition to their sociodemographic characteristics.

Results: The Beliefs and Self Reactions subscores in addition to the Overall Stuttering Score of the Egyptian sample were remarkably lower than the median values of the reference database (12 versus 34), (-4 versus 2), and (4 versus 18), respectively. TV, radio, and films were the main sources of knowledge about stuttering. Egyptian participants who reported average to high income were more likely to have a positive attitude (≥50% of Overall Stuttering Score) towards PWS than their counterparts with low income (Odds Ratio = 1.57, 95% Confidence Interval: 1.08-2.28).

Conclusion: People in South Egypt showed a less positive attitude towards PWS compared with other populations worldwide. Further studies should focus on changing the public attitudes towards PWS through awareness programs that consider the cultural perspectives of the society.

PMID: 33539373 DOI: 10.1371/journal.pone.0245673