Eliana Maria Nigro Rocha


Abstracts - Agosto a Dezembro de 2012

Ordem alfabética do título do artigo

A case of bupropion-induced stuttering - FARMACOLOGIA
Gen Hosp Psychiatry. 2012 Sep 5. [Epub ahead of print].

Fetterolf F, Marceau M.

OBJECTIVE: Stuttering is a frequent side effect of many psychotropic drugs, particularly antidepressants.
METHOD: This is a case report of a woman presenting with stuttering after starting bupropion treatment for her depression.
RESULTS: The patient's stuttering resolved after discontinuing the bupropion.
CONCLUSION: Neuroimaging and pharmacological studies have implicated dopamine in the pathophysiology of stuttering. Bupropion's ability to increase dopamine in the frontal cortex was suspected to have been involved in this patient's stuttering. However, further research is needed before causality can be assured.
PMID: 22959418


Acceptance and Commitment Therapy for adults who stutter: Psychosocial adjustment and speech fluency. - TERAPIA EM GRUPO
J Fluency Disord. 2012 Dec;37(4):289-99. Epub 2012 Jun 6.

Beilby JM, Byrnes ML, Yaruss JS.
School of Psychology and Speech Pathology, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia. Australia.

The aim of the present study was to assess the effectiveness of an Acceptance and Commitment Therapy group intervention program for adults who stutter (N=20). The program consisted of 2-h therapeutic sessions conducted weekly for eight consecutive weeks. It was an integrated program designed to improve: (a) psychosocial functioning, (b) readiness for therapy and change, (c) utilisation of mindfulness skills and psychological flexibility, and (d) frequency of stuttering. The findings provide innovative evidence for Acceptance and Commitment Therapy as an effective intervention with statistically significant improvements in psychosocial functioning, preparation for change and therapy, utilisation of mindfulness skills, and overall speech fluency. Follow-up data collected at three months post-treatment revealed that therapeutic gains were successfully maintained over time. These findings enhance the understanding of the impact of stuttering on psychological wellbeing and offer a new perspective on what might constitute successful stuttering treatment. Further, clinical research support is provided for Acceptance and Commitment Therapy delivered in a group format as a promising and novel intervention for adults who stutter. Educational objectives: The reader will be able to: (a) appreciate the potential for Acceptance and Commitment Therapy for adults who stutter; (b) identify the improvements participants experienced in psychosocial functioning and frequency of stuttered speech; (c) appreciate the six core processes of Acceptance and Commitment Therapy; and (d) appreciate the differences between an ACT model of intervention for adults who stutter compared to a CBT approach.



Autonomic and emotional responses of graduate student clinicians in speech-language pathology to stuttered speech. - SOCIAL
Int J Lang Commun Disord. 2012 Sep;47(5):603-8.

Guntupalli VK, Nanjundeswaran C, Dayalu VN, Kalinowski J.
East Tennessee State University, Johnson City, TN, USA, Seton Hall University, South Orange, NJ, USA, East Carolina University, Greenville, NC, USA.

Background: Fluent speakers and people who stutter manifest alterations in autonomic and emotional responses as they view stuttered relative to fluent speech samples. These reactions are indicative of an aroused autonomic state and are hypothesized to be triggered by the abrupt breakdown in fluency exemplified in stuttered speech. Furthermore, these reactions are assumed to be the basis for the stereotypes held by different communicative partners towards people who stutter. Aims: To examine the autonomic and emotional reactions of graduate student clinicians in speech-language pathology as they viewed fluent and severe stuttered speech samples. Methods & Procedures: Twenty-one female graduate student clinicians in speech-language pathology participated in this study. Each participant viewed four 30-s video samples (two fluent and two stuttered speech samples) while their autonomic responses (skin conductance response (SCR) and heart rate (HR)) were concurrently captured. Furthermore, emotional responses to stuttered and fluent speech samples were captured using the self-assessment manikin (SAM) and a rating scale with nine bipolar adjectives reflecting one's feelings. Outcomes & Results: An increase in SCR and deceleration in HR was observed as graduate clinicians viewed stuttered speech samples versus fluent speech samples and the differences were statistically significant. In addition, results from the self-rating scales showed that participants had negative feelings (e.g., emotionally aroused, unpleasant, embarrassed, uncomfortable, etc.) while viewing stuttered speech. Conclusions & Implications: Findings suggest that graduate student clinicians in speech-language pathology demonstrated altered autonomic and emotional responses similar to those manifested by fluent and stuttered speakers as they viewed stuttered speech samples. Collectively, these findings support the contention that the inherent nature of stuttered speech triggers a visceral reaction in a listener, irrespective of their background and knowledge about the disorder.
PMID: 22938070


Avoidance of eye gaze by adults who stutter. – EMOCIONAL
J Fluency Disord. 2012 Dec;37(4):263-74. doi: 10.1016/j.jfludis.2012.04.004. Epub 2012 May 7.

Lowe R, Guastella AJ, Chen NT, Menzies RG, Packman A, O'Brian S, Onslow M.
The Australian Stuttering Research Centre, The University of Sydney, Australia.

PURPOSE: Adults who stutter are at significant risk of developing social phobia. Cognitive theorists argue that a critical factor maintaining social anxiety is avoidance of social information. This avoidance may impair access to positive feedback from social encounters that could disconfirm fears and negative beliefs. Adults who stutter are known to engage in avoidance behaviours, and may neglect positive social information. This study investigated the gaze behaviour of adults who stutter whilst giving a speech.
METHOD: 16 adults who stutter and 16 matched controls delivered a 3-min speech to a television display of a pre-recorded lecture theatre audience. Participants were told the audience was watching them live from another room. Audience members were trained to display positive, negative and neutral expressions. Participant eye movement was recorded with an eye-tracker.
RESULTS: There was a significant difference between the stuttering and control participants for fixation duration and fixation count towards an audience display. In particular, the stuttering participants, compared to controls, looked for shorter time at positive audience members than at negative and neutral audience members and the background.
CONCLUSIONS: Adults who stutter may neglect positive social cues within social situations that could serve to disconfirm negative beliefs and fears. Educational objectives: The reader will be able to: (a) describe the nature of anxiety experienced by adults who stutter; (b) identify the most common anxiety condition among adults who stutter; (c) understand how information processing biases and the use of safety behaviours contribute to the maintenance of social anxiety; (d) describe how avoiding social information may contribute to the maintenance of social anxiety in people who stutter; and (e) describe the clinical implications of avoidance of social information in people who stutter.


A voxel-based morphometry (VBM) analysis of regional grey and white matter volume abnormalities within the speech production network of children who stutter. - INFANTIL
Cortex. 2012 Sep 17 [Epub ahead of print]

Beal DS, Gracco VL, Brettschneider J, Kroll RM, De Nil LF.
University of Alberta, Edmonton, AB, Canada; Boston University, Boston, MA, United States; Massachusetts Institute of Technology, Cambridge, MA, United States.

It is well documented that neuroanatomical differences exist between adults who stutter and their fluently speaking peers. Specifically, adults who stutter have been found to have more grey matter volume (GMV) in speech relevant regions including inferior frontal gyrus, insula and superior temporal gyrus (Beal et al., 2007; Song et al., 2007). Despite stuttering having its onset in childhood only one study has investigated the neuroanatomical differences between children who do and do not stutter. Chang et al. (2008) reported children who stutter had less GMV in the bilateral inferior frontal gyri and middle temporal gyrus relative to fluently speaking children. Thus it appears that children who stutter present with unique neuroanatomical abnormalities as compared to those of adults who stutter. In order to better understand the neuroanatomical correlates of stuttering earlier in its development, near the time of onset, we used voxel-based morphometry to examine volumetric differences between 11 children who stutter and 11 fluent children. Children who stutter had less GMV in the bilateral inferior frontal gyri and left putamen but more GMV in right Rolandic operculum and superior temporal gyrus relative to fluent children. Children who stutter also had less white matter volume bilaterally in the forceps minor of the corpus callosum. We discuss our findings of widespread anatomic abnormalities throughout the cortical network for speech motor control within the context of the speech motor skill limitations identified in people who stutter (Namasivayam and van Lieshout, 2008; Smits-Bandstra et al., 2006).
pii: S0010-9452(12)00254-7.
doi: 10.1016/j.cortex.2012.08.013.


A welfare economic approach to measure outcomes in stuttering: Comparing willingness to pay and quality adjusted life years. - SUPERFICIAL
J Fluency Disord. 2012 Dec;37(4):300-13. doi: 10.1016/j.jfludis.2012.04.005. Epub 2012 May 10.

Franic DM, Bothe AK, Bramlett RE.
Dept. of Clinical and Administrative Pharmacy, The University of Georgia, Athens, GA, USA.

PURPOSE: The purpose of this study was to compare two welfare outcome measures, willingness to pay (WTP) and quality adjusted life years (QALYs) gained, to measure outcomes in stuttering.
METHOD: Seventy-eight adult participants (74 nonstuttering and 4 persons with stuttering) completed one face-to-face structured interview regarding how much they would be willing to pay to alleviate severe stuttering in three interventions of varying impact. These data were compared with QALYs gained as calculated from time trade off (TTO) and standard gamble (SG) data.
RESULTS: Mean (median) WTP bids ranged from US$ 16,875 (8000), for an intervention resulting in improvement from severe stuttering to mild stuttering, to US$ 41,844 (10,000) for an intervention resulting in a cure of severe stuttering. These data were consistent with mean changes in QALYs for the same stuttering interventions ranging from 2.19 (using SG) to 18.42 (using TTO).
CONCLUSIONS: This study presents the first published WTP and QALY data for stuttering. Results were consistent with previous cost-of-illness data for stuttering. Both WTP and QALY measures were able to quantify the reduction in quality of life that occurs in stuttering, and both can be used to compare the gains that might be achieved by different interventions. It is widely believed that stuttering can cause reduced quality of life for some speakers; the introduction into this field of standardized metrics for measuring quality of life is a necessary step for transparently weighing the costs and consequences of stuttering interventions in economic analyses. Educational objectives: The reader will be able to (a) describe the underlying theoretical foundations for willingness to pay and quality adjusted life years, (b) describe the application of willingness to pay and quality adjusted life years for use in economic analyses, (c) compare and contrast the value of willingness to pay and quality adjusted life years in measuring the impact of stuttering treatment on quality of life, (d) interpret quality adjusted life years, and (e) interpret willingness to pay data.


Behavioral Stuttering Interventions for Children and Adolescents: A Systematic Review and Meta-Analysis. - TERAPIA
J Speech Lang Hear Res. 2012 Dec 28. [Epub ahead of print]

Nye C, Vanryckeghem M, Schwartz JB, Herder C, Turner HM 3rd, Howard C.
University of Central Florida.

PURPOSE: The purpose of this systematic review was to evaluate the effectiveness of behavioral interventions designed to treat stuttering in children.
METHOD: Studies were included for review if (1) the treatment was a behavioral intervention, (2) participants were between 2 and 18 years, (3) the design was an experimental or quasi-experimental group design, and (4) the reported outcome measure assessed stuttering. An electronic search of eight databases yielded a total of nine studies representing 327 treated participants across seven different types of intervention. Data were extracted for participant, treatment, and outcome characteristics, and for methodological quality.
RESULTS: An analysis of the treatment effects yielded significant positive effects approaching one standard deviation when a comparison is made to a non-treatment control group. No significant differences emerged for studies comparing two different treatments.
CONCLUSIONS: Conclusions drawn from the extant research suggest that data to support the efficacy of behavioral intervention in children exists for a limited number of intervention strategies, based on a meager number of methodologically acceptable studies.
PMID: 23275413


Coping with a child who stutters: A phenomenological analysis.- SUPERFICIAL
J Fluency Disord. 2012 Dec;37(4):275-88. doi: 10.1016/j.jfludis.2012.06.002. Epub 2012 Jun 23.

Plexico LW, Burrus E.
Auburn University, United States.

Qualitative methods were used in the form of a phenomenological analysis to explore how families cope with having a child who stutters. Twelve participants, 2 men and 10 women, who have children who stutter participated in this study. The participants were asked to consider their experiences with being the parent of a child who stutters. Analysis of these data resulted in 3 primary categories. The results indicate that parents experience and cope with stresses associated with being the parent of a child who stutters. The participants described feelings of uncertainty and concern as well as the desire to do what is best for their children. Results highlight the importance of providing information and avenues of support that will help parents more effectively cope with having a child who stutters. Educational objectives: The reader will be able to: (a) describe, from the perspective of a parent of a child who stutters, the themes associated with the process of coping with a child who stutters, (b) describe types of coping resources, (c) describe the factors that influence the choice to use emotion-focused and problem-focused coping strategies, and (d) describe four specific areas to consider when providing resources for families of children who stutter.


Decreasing Anxiety in Stutterers through the Association between "Purpose in Life/Ikigai" and Emotions.- EMOCIONAL
Glob J Health Sci. 2012 Aug 9;4(5):120-124.

Ishida R.

The human prefrontal lobe is more evolved than those of other mammals. As such, every person has an innate need to establish a meaningful life, often referred to as "Purpose in life (PIL)/ikigai", using the functioning of their prefrontal lobes. PIL/ikigai psychologically, and the prefrontal lobe physiologically, have common functions such as ambition, regulating emotion, and integrating psychological events. PIL/ikigai contributes to a decrease in anxiety influenced by a need for approval from others and stimulates pleasure and comfort, which may be related to the well-balanced secretion of neurotransmitters such as serotonin, dopamine, and ?-endorphin. Thus, a stutterer feels stress, i.e., anxiety, caused by perceived failure when engaging in conversations with others, which may be related to an imbalanced secretion of serotonin and dopamine. Therefore, previous work has suggested that PIL/ikigai may decrease anxiety in stutterers by decreasing the symptoms associated with stuttering.
PMID: 22980384


Differences of articulation rate and utterance length in fluent and disfluent utterances of preschool children who stutter.- FALA
J Commun Disord. 2012 Aug 24. [Epub ahead of print]

Chon H, Sawyer J, Ambrose NG
Division of Speech-Language Pathology, Chosun University, Republic of Korea.

PURPOSE: The purpose of this study was to investigate characteristics of four types of utterances in preschool children who stutter: perceptually fluent, containing normal disfluencies (OD utterance), containing stuttering-like disfluencies (SLD utterance), and containing both normal and stuttering-like disfluencies (SLD+OD utterance). Articulation rate and length of utterance were measured to seek the differences. Because articulation rate may reflect temporal aspects of speech motor control, it was predicted that the articulation rate would be different between perceptually fluent utterances and utterances containing disfluencies. The length of utterance was also expected to show different patterns.
METHOD: Participants were 14 preschool children who stutter. Disfluencies were identified from their spontaneous speech samples, and articulation rate in syllables per second and utterance length in syllables were measured for the four types of utterances.
RESULTS AND DISCUSSION: There was no significant difference in articulation rate between each type of utterance. Significantly longer utterances were found only in SLD+OD utterances compared to fluent utterances, suggesting that utterance length may be related to efforts in executing motor as well as linguistic planning. The SLD utterance revealed a significant negative correlation in that longer utterances tended to be slower in articulation rates. Longer utterances may place more demand on speech motor control due to more linguistic and/or grammatical features, resulting in stuttering-like disfluencies and a decreased rate.
LEARNING OUTCOMES: The reader will learn about and be able to: (a) distinguish the difference between measures of overall speaking rate and articulation rate; (b) explain the theoretical and clinical trends of articulation rate in stuttering; (c) discuss how utterances containing stuttering-like disfluencies, utterances containing other disfluencies, and utterances containing both stuttering-like disfluencies and other disfluencies influence articulation rate; and (d) discuss how the length of utterances is related to disfluencies.
PMID: 22995336


Disfluency patterns and phonological skills near stuttering onset.- FALA
J Commun Disord. 2012 Aug 20. [Epub ahead of print]

Gregg BA, Yairi E.
University of Central Arkansas, Conway, AR, United States.

There is a substantial amount of literature reporting the incidence of phonological difficulties to be higher for children who stutter when compared to normally fluent children, suggesting a link between stuttering and phonology. In view of this, the purpose of the investigation was to determine whether, among children who stutter, there are relationships between phonological skills and the initial characteristics of stuttering. That is, close to the onset of stuttering, there are differences in specific stuttering patterns between children who exhibit minimal and moderate phonological deviations in terms of frequency of stuttering and length of stuttering events? Twenty-nine preschool children near the onset of stuttering, ranging in age from 29 to 49 months, with a mean of 39.17 months, were divided into two groups based on the level of phonological ability: minimal phonological deviations and moderate phonological deviations. The children's level of stuttering-like disfluencies was examined. Results revealed no statistically significant differences in the stuttering characteristics of the two groups near onset, calling into the question the nature of the stuttering-phonology link. Learning outcomes: The reader will learn about and be able to describe the relation between phonological skills and the initial characteristics of stuttering. More specifically, following the completion of this manuscript, the reader should understand whether or not, close to the onset of stuttering, there are differences in frequency of stuttering and length of stuttering moments between children who exhibit minimal and moderate phonological deviations.
PMID: 22939524


Early stuttering, temperament and anxiety: Two hypotheses. - EMOCIONAL
J Fluency Disord. 2012 Sep;37(3):151-63. Epub 2012 Mar 29.

Kefalianos E, Onslow M, Block S, Menzies R, Reilly S.
Murdoch Childrens Research Institute, Australia; Department of Paediatrics, University of Melbourne, Australia.

PURPOSE: The topic of temperament and early stuttering and the extent to which it involves anxiety is theoretically and clinically relevant. The topic can contribute to theory development and clinical practices with early stuttering.
METHOD: We present a review of the empirical literature for this area with a view to determining which of two hypotheses might be true. The first is that, for the population of those who stutter, unusual temperament is a causal factor for the development of the disorder and its later association with anxiety. The second hypothesis is that for the population of those who stutter the developmental manifestation of anxiety is an effect of stuttering. Both hypotheses attempt to account for the well-known association of anxiety with chronic stuttering.
RESULTS: A firm conclusion about the matter would be premature at present because the literature involved is limited and contains some inconsistencies. We suggest some quantitative and qualitative directions for future research. We argue also that the only way to resolve the matter is with longitudinal studies of cohorts ascertained prior to stuttering onset.
CONCLUSION: Conclusive findings about the matter can only emerge when research extends beyond its modest scope of 10 interpretable publications. Educational objectives: The reader will be able to: (a) describe temperament and the role it plays during anxiety development, (b) explain two alternative hypotheses which implicate temperament in early childhood stuttering; (c) describe current knowledge regarding temperament similarities and differences between stuttering and control children, and (d) discuss the theoretical and clinical implications of understand the relationship between temperament, anxiety and early stuttering.
PMID: 22682317


Exchange of disfluency with age from function to content words in Brazilian Portuguese speakers who do and do not stutter. - FALA
Clin Linguist Phon. 2012 Dec;26(11-12):946-61.

Juste FS, Sassi FC, de Andrade CR.
University of São Paulo , São Paulo , Brazil.

The purpose of this study was to investigate the exchange of disfluencies from function words to content words with age in Brazilian Portuguese speakers who do and do not stutter. Ninety stuttering individuals and 90 controls, native speakers of Brazilian Portuguese, were divided into three age groups (children, adolescents and adults). The study method involved analyzing the occurrence of stuttering on content and function words based on spontaneous speech samples. Results indicated that children tend to be more disfluent on function words. With the increase in age, teenagers and adults who stutter presented a higher number of disfluencies on content words. These findings support the current literature, indicating that with the aging process, there is an exchange of disfluencies from function to content words. This shift in the disfluency pattern may account for a more advanced type of stuttering. The study also demonstrated that disfluencies in Portuguese speakers follow the same pattern of shifting from function to content words with age as for English speakers.


Family History Interview of a Broad Phenotype in Specific Language Impairment and Matched Controls - GENÉTICA
Genes Brain Behav. 2012 Aug 28. [Epub ahead of print]

Kalnak N, Peyrard-Janvid M, Sahlén B, Forssberg H.
Dept. of Women's and Children's Health, Astrid Lindgren Children's Hospital, Karolinska Institutet, Stockholm, Sweden.

The aim was to study a broader phenotype of language-related diagnoses and problems in three generations of relatives of children with specific language impairment (SLI). Our study is based on a family history interview of the parents of 59 children with SLI and of 100 matched control children, exploring the prevalence of problems related to language, reading, attention, school achievement, and social communication, as well as diagnoses such as attention deficit hyperactivity disorder (ADHD), autism, Asperger syndrome, dyslexia, mental retardation, cleft palate and stuttering. The results show a spectrum of language-related problems in families of SLI children. In all three generations of SLI relatives, we found significantly higher prevalence rates of language, literacy and social communication problems. The risk of one or both parents having language-related diagnoses or problems was approximately six times higher for the children with SLI (85%) than for the control children (13%), (odds ratio = 37.2). We did not find a significantly higher prevalence of the diagnoses ADHD, autism or Asperger syndrome in the relatives of the children with SLI. However, significantly more parents of the children with SLI had problems with attention/hyperactivity as compared to the parents of controls. Our findings suggest a common genetic influence for problems with language, literacy and social communication, and possibly also for attention/hyperactivity symptoms.
PMID: 22928858


Five analogies between a King's Speech treatment and contemporary play therapies. - TERAPIA
Am J Psychother. 2012;66(3):243-58.

Terr LC.
Department of Psychiatry, University of California San Francisco School of Medicine, San Francisco

OBJECTIVE: Psychiatric patients frequently respond positively to play therapy, which may rely on psychoanalytic, Jungian, cognitive-behavioral, familial, school-based, or other theories. I wished to determine if there were unifying principles that tie together these various types of play treatments.
METHODS: The fact-based film, The King's Speech, vividly illustrates play utilized by Lionel Logue in his speech treatment (1926-1939) of the future King of England. In the film I found five analogies to the play therapy I employ in office practice.
RESULTS: The play scenes in The King's Speech point to five unifying principles among contemporary play therapies: (1) the crucial nature of the relationship, (2) the centrality of having fun, (3) the occasional reliance on others, (4) the interjection of pithy talk, and (5) the usefulness of a little drama.
CONCLUSION: No matter what theory a play therapist ascribes to, these five unifying principles should be kept in mind during treatment.

Gabapentin for treating acquired neurogenic stuttering. - FARMACOLOGIA
Ann Clin Psychiatry. 2012 Aug;24(3):240.

Maguire GA, Bird AA.
University of California, Irvine School of Medicine, Irvine, CA, USA.

No abstract available

Gagueira desenvolvimental persistente familial: perspectivas genéticas /Familial persistent developmental stuttering: genetic perspectives - GENÉTICA
Rev. soc. bras. fonoaudiol. vol.17 no.4 São Paulo Dec. 2012

Free full text: http://www.scielo.br/pdf/rsbf/v17n4/21.pdf

Breila Vilela de Oliveira, Carlos Eduardo Frigério Domingues, Fabíola Staróbole Juste, Claudia Regina Furquim de Andrade, Danilo Moretti-Ferreira

Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP - Botucatu (SP), Brasil; Faculdade de Medicina, Universidade de São Paulo - USP - São Paulo (SP), Brasil 

A gagueira é uma desordem da comunicação oral que tem uma característica multidimensional. A predisposição biológica no desenvolvimento da gagueira ainda não é bem compreendida, mas contribuições genéticas para esta predisposição são reforçadas tanto por referências à agregação familial da gagueira, quanto à gagueira familial, que têm aparecido na literatura há mais de 70 anos. Assim, procuramos estabelecer uma revisão quanto aos prováveis fatores genéticos envolvidos com a manifestação da gagueira desenvolvimental persistente familial. A identificação de genes relacionados à gagueira, bem como de alterações em suas estruturas (por exemplo, mutações), contribuem significativamente para sua compreensão. O modelo exato de transmissão da herança genética para a gagueira ainda não está claramente definida e, provavelmente pode ser diferente entre diferentes famílias e populações. As análises genômicas demonstram, concomitantemente, a relevância dos componentes genéticos envolvidos e sua complexidade, sugerindo assim tratar-se de uma doença poligênica, na qual diversos genes de efeitos variados podem estar envolvidos com o aumento da susceptibilidade de ocorrência da gagueira. O clínico deverá estar alerta ao fato de que uma criança com histórico familial positivo para gagueira poderá ter uma forte tendência a desenvolver o distúrbio de forma crônica. É importante que o clínico esteja atento, de modo a fornecer às famílias orientações precisas sobre o distúrbio. As avaliações objetivas e os tratamentos controlados têm um papel muito importante para o domínio da evolução do distúrbio.


Genetic and environmental effects on stuttering: A twin study from Finland. - GENÉTICA
J Fluency Disord. 2012 Sep;37(3):202-10. Epub 2012 Feb 28

Rautakoski P, Hannus T, Simberg S, Sandnabba NK, Santtila P.
Center of Behavior Genetics, Abo Akademi University, Finland.

The present study explored the prevalence of self-reported stuttering in a Finnish twin population and examined the extent to which the variance in liability to stuttering was attributable to genetic and environmental effects. We analyzed data of 1728 Finnish twins, born between 1961 and 1989. The participants were asked to complete a questionnaire on speech, language, and voice. In two of the questions they were asked to report the occurrence of childhood and present stuttering of their own and that of their sibling. According to the results, 2.3% (52) of the participants were reported to have stuttered as children and 28.8% of them (15) were reported to continue to stutter in adulthood. There was no significant gender difference in the prevalence of stuttering in either childhood or adulthood. For childhood stuttering, the tetrachoric correlation was higher for monozygotic pairs (r=.74) than for dizygotic pairs (r=.27). By means of structural equation modeling it was found that 82% of the variance in liability to childhood stuttering was attributable to additive genetic effects, with the remaining 18% due to non-shared environmental effects. In conclusion, the results of the present study confirm findings from prior studies and support a strong genetic and only a moderate non-shared environmental effect on stuttering. Potential small differences in the prevalence of stuttering in different populations are suggested by our data. Educational objectives: The reader will be able to recognize the contribution of genetic and environmental effects on stuttering.
PMID: 22682321


Improvement in developmental stuttering following deep brain stimulation for Parkinson's disease - GAGUEIRA ADQUIRIDA
Parkinsonism Relat Disord. 2012 Aug 21. [Epub ahead of print]

Thiriez C, Roubeau B, Ouerchefani N, Gurruchaga JM, Palfi S, Fénelon G.Groupe Hospitalier Henri Mondor e Université Paris-est Créteil, Faculté de médecine, Créteil cedex, France.
No abstract available



Individual Variability in Delayed Auditory Feedback Effects on Speech Fluency and Rate in Normally Fluent Adults. – AUDITIVO
J Speech Lang Hear Res. 2012 Sep 19. [Epub ahead of print]

Chon H, Kraft SJ, Zhang J, Loucks T, Ambrose NG.
Division of Speech-Language Pathology, Chosun University, Gwangju, Korea.

PURPOSE: Delayed auditory feedback (DAF) is known to induce stuttering-like disfluencies and cause speech rate reductions in normally fluent adults, but the reason for speech disruptions is not fully known and individual variation has not been well characterized. Studying individual variation in susceptibility to DAF may identify factors that predispose an individual to be more or less dependent on auditory feedback.
METHOD: Participants were 62 normally fluent adults. Each participant performed a spontaneous speech task under 250 ms DAF and under amplified non-delayed auditory feedback (NAF). Stuttering-like disfluencies (SLD), other disfluencies (OD), speech errors (SE), and articulation rate (AR) were measured under each condition.
RESULTS: SLD and SE significantly increased and AR decreased under DAF. Sex had a limited effect in that males exhibited more OD and faster AR than females. More importantly, parametric cluster analysis identified that two and three subgroup solutions reveal important variation that differentiates tendencies towards disfluency changes and rate reduction under DAF, which are theoretically and empirically preferred to a single group solution.
CONCLUSION: Individual variability in response to DAF may be accounted for by subgroups of individuals. This suggests that certain normally fluent individuals could be more dependent on intact feedback to maintain fluency.
PMID: 22992711

Language and motor abilities of preschool children who stutter: Evidence from behavioral and kinematic indices of nonword repetition performance. – FALA
J Fluency Disord. 2012 Dec;37(4):344-58. doi: 10.1016/j.jfludis.2012.06.001. Epub 2012 Jul 24.

Smith A, Goffman L, Sasisekaran J, Weber-Fox C.
Speech, Language, and Hearing Sciences, Purdue University, United States. Electronic address: asmith@purdue.edu.

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



Linkage analysis of a large African family segregating stuttering suggests polygenic inheritance. - GENÉTICA
Hum Genet. 2012 Dec 13. [Epub ahead of print]

Raza MH, Gertz EM, Mundorff J, Lukong J, Kuster J, Schäffer AA, Drayna D.
National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA.

We describe a pedigree of 71 individuals from the Republic of Cameroon in which at least 33 individuals have a clinical diagnosis of persistent stuttering. The high concentration of stuttering individuals suggests that the pedigree either contains a single highly penetrant gene variant or that assortative mating led to multiple stuttering-associated variants being transmitted in different parts of the pedigree. No single locus displayed significant linkage to stuttering in initial genome-wide scans with microsatellite and SNP markers. By dividing the pedigree into five subpedigrees, we found evidence for linkage to previously reported loci on 3q and 15q, and to novel loci on 2p, 3p, 14q, and a different region of 15q. Using the two-locus mode of Superlink, we showed that combining the recessive locus on 2p and a single-locus additive representation of the 15q loci is sufficient to achieve a two-locus score over 6 on the entire pedigree. For this 2p + 15q analysis, we show LOD scores ranging from 4.69 to 6.57, and the scores are sensitive to which marker is chosen for 15q. Our findings provide strong evidence for linkage at several loci.
PMID: 23239121


Long-term effectiveness of the SpeechEasy fluency-enhancement device. – DAF
J Fluency Disord. 2012 Dec;37(4):334-43. doi: 10.1016/j.jfludis.2012.07.001. Epub 2012 Jul 20.

Gallop RF, Runyan CM.
Loyola University Maryland, 4501 N. Charles Street, Baltimore, MD, United States.

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


Management of childhood stuttering. - TERAPIA
J Paediatr Child Health. 2012 Dec 18. doi: 10.1111/jpc.12034. [Epub ahead of print]

Onslow M, O'Brian S.
Australian Stuttering Research Centre, The University of Sydney, Sydney, New South Wales, Australia.

Stuttering is a speech disorder that begins during the first years of life and is among the most prevalent of developmental disorders. It appears to be a problem with neural processing of speech involving genetics. Onset typically occurs during the first years of life, shortly after language development begins. Clinical presentation during childhood is interrupted and effortful speech production, often with rapid onset. If not corrected during early childhood, it becomes intractable and can cause psychological, social, educational and occupational problems. There is evidence from replicated clinical trials to support early intervention during the pre-school years. Meta-analysis of studies indicates that children who receive early intervention during the pre-school years are 7.7 times more likely to have resolution of their stuttering. Early intervention is recommended with a speech pathologist. Some children who begin to stutter will recover without such intervention. However, the number of such recoveries is currently not known, and it is not possible to predict which children are likely to recover naturally. Consequently, the current best practice is for speech pathologists to monitor children for signs of natural recovery for up to 1 year before beginning treatment.

Mental imagery of speech: linking motor and perceptual systems through internal simulation and estimation. - PSICOMOTOR
Front Hum Neurosci. 2012;6:314. doi: 10.3389/fnhum.2012.00314. Epub 2012 Nov 28.
Free Full Text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3508402/pdf/fnhum-06-00314.pdf.

Tian X, Poeppel D.
Poeppel Lab, Department of Psychology, New York University New York, NY, USA.

The neural basis of mental imagery has been investigated by localizing the underlying neural networks, mostly in motor and perceptual systems, separately. However, how modality-specific representations are top-down induced and how the action and perception systems interact in the context of mental imagery is not well understood. Imagined speech production ("articulation imagery"), which induces the kinesthetic feeling of articulator movement and its auditory consequences, provides a new angle because of the concurrent involvement of motor and perceptual systems. On the basis of previous findings in mental imagery of speech, we argue for the following regarding the induction mechanisms of mental imagery and the interaction between motor and perceptual systems: (1) Two distinct top-down mechanisms, memory retrieval and motor simulation, exist to induce estimation in perceptual systems. (2) Motor simulation is sufficient to internally induce the representation of perceptual changes that would be caused by actual movement (perceptual associations); however, this simulation process only has modulatory effects on the perception of external stimuli, which critically depends on context and task demands. Considering the proposed simulation-estimation processes as common mechanisms for interaction between motor and perceptual systems, we outline how mental imagery (of speech) relates to perception and production, and how these hypothesized mechanisms might underpin certain neural disorders.
PMID: 23226121 [PubMed] PMCID: PMC3508402


Methylphenidate as a treatment for stuttering: a case report.- FARMACOLOGIA
Eur Rev Med Pharmacol Sci. 2012 Oct;16 Suppl 4:66-9.

Devroey D, Beerens G, Van De Vijver E.
Department of Family Medicine, Vrije Universiteit Brussel, Brussels, Belgium.

INTRODUCTION: A randomized placebo controlled trial with methylphenidate (MPH) was set up to identify the effects of MPH on cognition in healthy young adults (ea. without attention deficit hyperactivity disorder, ADHD). Subjects repeatedly performed tests of the immediate and delayed memory and vigilance tasks after administration of placebo or 20 mg MPH.
CASE PRESENTATION: We report the case of an 18 year old man who participated in the study. He suffered from stuttering since childhood. During the study phase he reported a remarkable relief of the stuttering after the intake of 20 mg MPH.
CONCLUSIONS: For D-amphetamine the beneficial effect on stuttering has been demonstrated but it was never implemented in clinical practice because of important adverse events. MPH, an amphetamine analogue, doesn't present these side effects. For this reason, MPH seems to merit further investigation in a randomized-controlled trial as a possible agent in the treatment of stuttering.Methylphenidate, Stuttering.

Neural anomaly and reorganization in speakers who stutter: A short-term intervention study. - NEUROLOGIA
Neurology. 2012 Aug 8. [Epub ahead of print]

Lu C, Chen C, Peng D, You W, Zhang X, Ding G, Deng X, Yan Q, Howell P.
Beijing Normal University, Beijing, PR China; University of California, Irvine; Chinese Academy of Science, Beijing; Stuttering Therapy Center, Beijing, PR China, University College London, UK.

OBJECTIVES: The aim of the current study was to differentiate between neural activity that represents neural anomalies that are responsible for persistent developmental stuttering (PDS) from the activity that is a result of compensating for stuttering. This was done by investigating alterations to the intrinsic functional architecture of speech-language processes of patients with PDS before and after a short-term intervention.
METHODS: The resting-state functional connectivity (RSFC) and cortical thickness were examined before and after the intervention. The structural data were used to validate the functional results. Fifteen stuttering patients who received intervention (PDS+), 13 stuttering patients who did not receive intervention (PDS-), and 13 fluent controls participated.
RESULTS: Before the intervention, both groups of PDS patients showed significant RSFC and cortical thickness reductions in the left pars-opercularis (PO) and RSFC increases in the cerebellum, as compared to fluent controls. The intervention was effective in reducing stuttering in PDS+ patients and lowering their RSFC in the cerebellum to the level of fluent controls. The intervention effect was specific to the PDS+ group (it was not evident in the PDS- group). The intervention did not change RSFC and cortical thickness in the left PO, which remained at its preintervention level.
CONCLUSIONS: The results suggest that the left PO is a locus where the intrinsic functional architecture of speech-language processes is altered in PDS patients, suggesting an etiologic role of this region in PDS. The cerebellum showed intervention-induced neural reorganization, suggesting a compensatory response when stuttering occurs.
PMID: 22875083

Neural control of rising and falling tones in Mandarin speakers who stutter. - NEUROLOGIA
Brain Lang. 2012 Dec;123(3):211-21. doi: 10.1016/j.bandl.2012.09.010. Epub 2012 Nov 2.

Howell P, Jiang J, Peng D, Lu C.
Division of Psychology and Language Sciences, University College London, UK.

Neural control of rising and falling tones in Mandarin people who stutter (PWS) was examined by comparing with that which occurs in fluent speakers [Howell, Jiang, Peng, and Lu (2012). Neural control of fundamental frequency rise and fall in Mandarin tones. Brain and Language, 121(1), 35-46]. Nine PWS and nine controls were scanned. Functional connectivity analysis showed that the connections between the insula and LMC and between the LMC and the putamen differed significantly between PWS and fluent speakers during both rising and falling tones. The connection between the insula and the brainstem differed between PWS and fluent speakers only during the falling tone. These results indicated the neural control for the rising tone and the falling tone are affected in PWS. Moreover, whilst both rising and falling tones were affected in PWS, falling-tone control appeared to be affected more.

Nonword repetition and phoneme elision in adults who do and do not stutter. - FALA
J Fluency Disord. 2012 Sep;37(3):188-201. Epub 2012 Mar 29.

Byrd CT, Vallely M, Anderson JD, Sussman H.
Department of Communication Sciences and Disorders, The University of Texas at Austin

The purpose of the present study was to explore the phonological working memory of adults who stutter through the use of a non-word repetition and a phoneme elision task. Participants were 14 adults who stutter (M=28 years) and 14 age/gender matched adults who do not stutter (M=28 years). For the non-word repetition task, the participants had to repeat a set of 12 non-words across four syllable lengths (2-, 3-, 4-, and 7-syllables) (N=48 total non-words). For the phoneme elision task, the participants repeated the same set of non-words at each syllable length, but with a designated target phoneme eliminated. Adults who stutter were significantly less accurate than adults who do not stutter in their initial attempts to produce the longest non-words (i.e., 7-syllable). Adults who stutter also required a significantly higher mean number of attempts to accurately produce 7-syllable non-words than adults who do not stutter. For the phoneme elision task, both groups demonstrated a significant reduction in accuracy as the non-words increased in length; however, there was no significant interaction between group and syllable length. Thus, although there appear to be advancements in the phonological working memory for adults who stutter relative to children who stutter, preliminary data from the present study suggest that the advancements may not be comparable to those demonstrated by adults who do not stutter. EDUCATIONAL OBJECTIVES: At the end of this activity the reader will be able to (a) summarize the nonword repetition data that have been published thus far with children and adults who stutter; (b) describe the subvocal rehearsal system, an aspect of the phonological working memory that is critical to nonword repetition accuracy; (c) employ an alternative means to explore the phonological working memory in adults who stutter, the phoneme elision task; and (d) discuss both phonological and motoric implications of deficits in the phonological working memory.
Copyright © 2012 Elsevier Inc. All rights reserved.

Novel tactile feedback to reduce overt stuttering. - OUTRAS ÁREAS
Neuroreport. 2012 Aug 22;23(12):727-30.

Waddell DE, Goggans PM, Snyder GJ.
University of Mississippi, Mississippi, USA.

Stuttering is generally considered to be a speech disorder that affects ∼1% of the global population. Various forms of speech feedback have been shown to reduce overt stuttered speaking, and in particular, second speech signal through speech feedback has drastically reduced utterances of stuttered speech in adults with persistent stuttering. This study reports data for increased overt fluency of speech in an adult stuttering population, whereby the vocalization of the speaker is captured by a microphone or an accelerometer, signal processed, and returned as mechanical tactile speech feedback to the speaker's skin. A repeated measures analysis of variance was used to show that both the microphone and the accelerometer speaking conditions were significantly more fluent than a control (no feedback) condition, with the microphone-driven tactile feedback reducing instances of stuttering by 71% and the accelerometer-driven tactile feedback reducing instances of stuttering by 80%. It is apparent that self-generated tactile feedback can be used to enhance fluency significantly in those who stutter.

O efeito do processo terapêutico para problemas de fluência de fala no discurso de pais - AMBIENTE
Distúrb. comun; 24(2)ago. 2012. ilus, tab.
Free full text: https://revistas.pucsp.br/dic/article/view/11970

Mestrado: https://tede2.pucsp.br/bitstream/handle/11923/1/Thais%20Inocencio%20Pires.pdf

Pires, Thais I; Friedman, Silvia.

Objetivo: Estudar, por intermédio do discurso de pais, os efeitos e a efetividade de um processo terapêutico para problemas de fluência de fala baseado em uma abordagem dialético-histórica. Método: Trata-se de pesquisa qualitativa para a qual foram feitas entrevistas semi-estruturadas a três famílias em atendimento terapêutico com a pesquisadora. A entrevista iniciou-se com a frase: Fale-me sobre o processo terapêutico de seu filho. O entrevistador interferiu de modo a garantir que os entrevistados falassem sobre a visão que tinham e tem de seus filhos e de sua fala e das mudanças que observaram. As entrevistas transcritas, foram categorizadas de acordo com a Análise de Conteúdo de Bardin em 4 categorias: Abordagem Terapêutica; Vivências e Afetos; Causas e Visão que os Pais têm do Filho, da Linguagem e da Gagueira, esta última estruturada em 3 sub-categorias: Sentimentos/Pensamentos sobre a Gagueira/Linguagem; Situações Sociais e Características da Comunicação. Resultados/Discussão: Os efeitos terapêuticos observados a partir da analise das categorias foram: em Abordagem Terapêutica relatos dos pais de que, diferentemente de outras abordagens, na abordagem dialético histórica sentiram--se parte integrante do processo terapêutico. Na categoria Vivências e Afetos relatos de que momentos de fala antes sentidos como aflitivos e exaustivos, passaram a ser compartilhados e apreendidos como parte integrante do processo de produção de fala e de que compreenderam que os seus sentimentos tem efeitos sobre a fala das crianças. Na categoria Causas relatos que relacionaram o surgimento da gagueira a algum evento importante de suas vidas. Na categoria Visão que os Pais têm do Filho, da Linguagem e da Gagueira relatos sobre como era a fala de seus filhos; sobre as mudanças observadas nessa fala; sobre o estigma que eles e seus filhos carregavam e sobre sua compreensão de que os contextos sociais intensificavam a gagueira. Conclusão: esses efeitos indicam que o processo terapêutico apoiado na vertente dialético histórica foi efetivo para os participantes desta pesquisa. Indicam também que essa efetividade não se avalia apenas pela diminuição da gagueira e da disfluência das crianças mas, principalmente, pela mudança da atitude dos pais em relação a esta forma de fala, que permitiu tal diminuição. Tal resultado aponta para a necessidade e importância de realizar outros estudos a respeito desse tipo de abordagem terapêutica.(AU)(AU)
LILACS-Express | ID: 655171 | Pt


Optimal intervention intensity in speech-language pathology: Discoveries, challenges, and unchartered territories. - TERAPIA
Int J Speech Lang Pathol. 2012 Oct;14(5):478-85.

Baker E.
The University of Sydney , Australia.

This article is the final response in a scientific forum on the optimal intensity of intervention in speech-language pathology. It is a reflection on the state of knowledge offered by the 13 commentaries in this issue, addressing the areas of early communication and language impairment, speech sound disorders in children, emergent literacy, reading, aphasia, dysphagia, stuttering, motor speech disorders, voice disorders, and traumatic brain injury. Although more intense intervention can lead to better outcomes, the relationship between intensity and outcome is not always linear. More is not always better. Non-intense and intense schedules can yield similar outcomes. Intensity can also reach a point of diminishing return. The insights offered by the authors illustrate the challenges involved in studying this complex issue. To establish the optimal intensity of interventions in speech-language pathology our field needs to: identify active ingredients of interventions; better understand how principles of motor learning and neural plasticity facilitate learning; appreciate the contribution of individuals characteristics, values, and preferences; discover the effect of specific combinations of intensity (including dose, dose form, dose frequency, session duration, and total intervention duration) on treatment outcomes, and find practical solutions when disparities exist between research recommendations and workplace limitations.
PMID: 22974107

Past tense marking in the spontaneous speech of preschool children who do and do not stutter.- LINGUAGEM
J Fluency Disord. 2012 Dec;37(4):314-24. doi: 10.1016/j.jfludis.2012.04.003. Epub 2012 Apr 26.

Bauman J, Hall NE, Wagovich SA, Weber-Fox CM, Ratner NB.
Department of Hearing and Speech Sciences, University of Maryland - College Park, United States.

PURPOSE: The aim of this study was to identify whether different patterns of errors exist in irregular past-tense verbs in children who stutter (CWS) and children who do not stutter (CWNS).
METHOD: Spontaneous language samples of thirty-one age- and gender-matched pairs of children (total N=62) between the ages of 24 months and 59 months were analyzed.
RESULTS: Results indicated that children who do and do not stutter over-regularize irregular past-tense verbs (i.e., saying runned for ran) with comparable frequency. However, two nonsignificant trends which suggest possible intra-group differences were noted. First, irregular past tense verbs represented a greater portion of total verbs for CWS than for CWNS. Second, CWS appeared to double-mark (i.e., say ranned for ran) more often than CWNS. Results are discussed in light of theories about the acquisition of the irregular past-tense and about differences in language skills between CWS and CWNS. Educational objectives: After reading this article, the reader will be able to: (a) summarize previous findings about connections between stuttering and language in CWS and CWNS; (b) describe similarities and differences between irregular past-tense verb use and errors in CWS and CWNS; (c) discuss possible connections between the declarative-procedural model and stuttering.
PMID: 23218214

Phonetically governed voicing onset and offset in preschool children who stutter. – FALA
J Fluency Disord. 2012 Sep;37(3):179-87. Epub 2012 Apr 21.

Arenas RM, Zebrowski PM, Moon JB.
University of Iowa, Department of Communication Sciences and Disorders, Iowa City, United States.

Phonetically governed changes in the fundamental frequency (F(0)) of vowels that immediately precede and follow voiceless stop plosives have been found to follow consistent patterns in adults and children as young as four years of age. In the present study, F(0) onset and offset patterns in 14 children who stutter (CWS) and 14 children who do not stutter (CWNS) were investigated to evaluate differences in speech production. Participants produced utterances containing two VCV sequences. F(0) patterns in the last ten vocal cycles in the preceding vowel (voicing offset) and the first ten vocal cycles in the subsequent vowel (voicing onset) were analyzed. A repeated measures ANOVA revealed no group differences between the CWS and CWNS in either voicing onset or offset gestures. Both groups showed patterns of F(0) onset and offset that were consistent with the mature patterns seen in children and adults in previous studies. These findings suggest that in both CWS and CWNS, a mature pattern of voicing onset and offset is present by age 3;6. This study suggests that there is no difference between CWS and CWNS in the coordination of respiratory and laryngeal systems during voicing onset or offset. Educational objectives: The reader will be able to: (a) discuss the importance of investigating children who stutter close to the onset of stuttering; (b) describe the typical change in F(0) during voicing onset; (c) discuss the potential implications of these results with regard to future research.
PMID: 22682319

Quando a posição fluente se perde: desarmonia entre fala e língua - CONCEITO
Distúrb Comun, São Paulo, 24(3): 309-321, dezembro, 2012
Free full text:http://revistas.pucsp.br/index.php/dic/article/view/13147/9682

Wladimir A.P. de L. Damasceno e Silvia Friedman
Pontifícia Universidade Católica de São Paulo – PUC-SP.

Objetivo: Desenvolver compreensão sobre a desarmonia entre fala e língua a partir do discurso de pessoas adultas com gagueira.
Métodos: Foram realizadas entrevistas semi-estruturadas com 6 adultos que gaguejam, a partir de perguntas-chave. Após a transcrição dos discursos, a noção de práticas discursivas e produção de sentidos permitiu que se defi nissem três categorias analíticas.
Resultados: As categorias foram: Sentido da Fala (Positivo e Negativo); Contexto de Fala (Efeito Outro e Efeito Sozinho) e Antecipação da Gagueira. Em Sentido da Fala – Positivo os entrevistados relataram os modos de se sentir relacionados a fluir melhor na fala e a permitir-se gaguejar. Em Sentido da Fala – Negativo os entrevistados relataram sentir-se dessemelhantes e marginalizados por seu modo de falar. Em Contexto de Fala – Efeito Outro, os entrevistados mostraram que ao ocuparem a posição de falantes gagos imaginam o outro como aquele que fiscalizará seu dizer. Em Contexto de Fala – Efeito Sozinho, os entrevistados reiteram a gagueira como uma manifestação fortemente atrelada à presença do outro. Em Antecipação da Gagueira os entrevistados revelam os modos como a gagueira é prevista subjetivamente antes de materializar-se na fala. Conclusão: a desarmonia entre fala e língua, no discurso gaguejante, relaciona-se a um falante que se sente estigmatizado em certas condições de produção discursiva; a desarmonia entre fala e língua se materializa com a finalidade de evitar a gagueira prevista. Tais características assinalam alguns elementos que parecem importantes ao direcionamento de uma abordagem terapêutica fonoaudiológica da gagueira que pretenda superar o modo de funcionamento subjetivo/discursivo que a sustenta.
Article em Pt | LILACS-Express | ID: 663180


Reduced activation of left orbitofrontal cortex precedes blocked vocalization: A magnetoencephalographic study. - NEUROLOGIA
J Fluency Disord. 2012 Dec;37(4):359-65. doi: 10.1016/j.jfludis.2012.05.001. Epub 2012 May 19.

Sowman PF, Crain S, Harrison E, Johnson BW.
ARC Centre of Excellence in Cognition and its Disorders, and Department of Cognitive Science, Macquarie University, Australia.

While stuttering is known to be characterized by anomalous brain activations during speech, very little data is available describing brain activations during stuttering. To our knowledge there are no reports describing brain activations that precede blocking. In this case report we present magnetoencephalographic data from a person who stutters who had significant instances of blocking whilst performing a vowel production task. This unique data set has allowed us to compare the brain activations leading up to a block with those leading up to successful production. Surprisingly, the results are very consistent with data comparing fluent production in stutterers to controls. We show here that preceding a block there is significantly less activation of the left orbitofrontal and inferiorfrontal cortices. Furthermore, there is significant extra activation in the right orbitofrontal and inferiorfrontal cortices, and the sensorimotor and auditory areas bilaterally. This data adds weight to the argument forwarded by Kell et al. (2009) that the best functional sign of optimal repair in stutterering is activation of the left BA 47/12 in the orbitofrontal cortex. Educational objectives: At the end of this activity the reader will be able to (a) identify brain regions associated with blocked vocalization, (b) discuss the functions of the orbitofrontal and inferior frontal cortices in regard to speech production and (c) describe the usefulness and limitations of magnetoencephalography (MEG) in stuttering research.
PMID: 23218218

Reducing anxiety in stutterers through the association between "purpose in life/Ikigai" and emotions. - EMOCIONAL
Glob J Health Sci. 2012 Aug 9;4(5):120-4. doi: 10.5539/gjhs.v4n5p120

Ishida R.

The human prefrontal lobe is more evolved than those of other mammals. As such, every person has an innate need to establish a meaningful life, often referred to as "Purpose in life (PIL)/ikigai", using the functioning of their prefrontal lobes. PIL/ikigai psychologically, and the prefrontal lobe physiologically, have common functions such as ambition, regulating emotion, and integrating psychological events. PIL/ikigai contributes to a decrease in anxiety influenced by a need for approval from others and stimulates pleasure and comfort, which may be related to the well-balanced secretion of neurotransmitters such as serotonin, dopamine, and ?-endorphin. Thus, a stutterer feels stress, i.e., anxiety, caused by perceived failure when engaging in conversations with others, which may be related to an imbalanced secretion of serotonin and dopamine. Therefore, previous work has suggested that PIL/ikigai may decrease anxiety in stutterers by decreasing the symptoms associated with stuttering.

Relationships between personality characteristics of people who stutter and the impact of stuttering on everyday life. – AVALIAÇÃO
J Fluency Disord. 2012 Dec;37(4):325-33. doi: 10.1016/j.jfludis.2012.07.003. Epub 2012 Aug 11.

Bleek B, Reuter M, Yaruss JS, Cook S, Faber J, Montag C.
Department of Psychology, University of Bonn, Bonn, Germany.

OBJECTIVE: This study investigates the association between the five-factor model of personality measured by the NEO Five-Factor Inventory (NEO-FFI) and the Overall Assessment of the Speaker's Experience of Stuttering (OASES). The OASES measures the adverse impact of stuttering on a person's life.
DESIGN: Participants in the present study were 112 persons who stutter from Germany.
METHODS: All participants filled in both the NEO-FFI and the OASES questionnaires.
RESULTS: Results revealed a strong positive correlation between the personality trait Neuroticism and scores on the OASES. Moreover, Extraversion was negatively correlated with the OASES scores.
CONCLUSIONS: The findings suggest that people with higher Neuroticism and lower Extraversion scores experience a greater impact of stuttering on their daily life. The results underscore the importance of considering personality as a potential moderator or mediator factor in future stuttering research and, potentially, also in treatment. Educational objectives: The reader will learn (a) about the different personality dimensions reflected by the NEO-FFI, (b) why it is important to consider the impact of stuttering on everyday life from the perspective of the people who stutter and (c) how personality is linked to the Overall Assessment of the Speaker's Experience of Stuttering (OASES).
PMID: 23218215

Resting-state MRI: A peek through the keyhole on therapy for stuttering.- NEUROLOGIA
Neurology. 2012 Aug 8. [Epub ahead of print]
Comment on: Neural anomaly and reorganization in speakers who stutter: a short-term intervention study. [Neurology. 2012]

Kell CA.
Department of Neurology, Goethe University, Frankfurt, Germany.

In many neurologic conditions, clinicians rely on nonpharmaceutical treatments that aim at restoring function or enabling compensation strategies. Most of these therapeutic interventions are based on empirical observations on the behavioral level. Yet knowledge about the mechanisms underlying the behavioral amelioration of symptoms could help improve therapies and deepen our understanding of the pathologic condition per se. In this issue of Neurology(®), Lu et al.(1) report changes in functional connectivity of the speech network induced by 1 week of efficient therapy for stuttering. The innovative aspect of this fMRI study is that this measure of engagement of a given brain region in the speech network is acquired while participants are at rest and thus not speaking.

Special edition of the Oxford Dysfluency Conference.
Fluency Disord. 2012 Dec;37(4):213. doi: 10.1016/j.jfludis.2012.11.001.

Millard S.

No abstract available
PMID: 23218204 [PubMed - indexed for MEDLINE]

Speech Impairment in Down Syndrome: A Review. - OUTRAS ÁREAS
J Speech Lang Hear Res. 2012 Dec 28. [Epub ahead of print]

Kent RD, Vorperian HK.
Waisman Center, University of Wisconsin-Madison.

PURPOSE: This review summarizes research on disorders of speech production in Down Syndrome (DS) for the purposes of informing clinical services and guiding future research.
METHOD: Review of the literature was based on searches using Medline, Google Scholar, Psychinfo, and HighWire Press, as well as consideration of reference lists in retrieved documents (including online sources). Search terms emphasized functions related to voice, articulation, phonology, prosody, fluency and intelligibility.
CONCLUSIONS: The following conclusions pertain to four major areas of review: (a) Voice. Although a number of studies have been reported on vocal abnormalities in DS, major questions remain about the nature and frequency of the phonatory disorder. Results of perceptual and acoustic studies have been mixed, making it difficult to draw firm conclusions or even to identify sensitive measures for future study. (b) Speech sounds. Articulatory and phonological studies show that speech patterns in DS are a combination of delayed development and errors not seen in typical development. Delayed (i.e., developmental) and disordered (i.e., nondevelopmental) patterns are evident by the age of about 3 years, although DS-related abnormalities possibly appear earlier, even in infant babbling. (c) Fluency and prosody. Stuttering and/or cluttering occur in DS at rates of 10 to 45%, compared to about 1% in the general population. Research also points to significant disturbances in prosody. (d) Intelligibility. Studies consistently show marked limitations in this area but it is only recently that research goes beyond simple rating scales.
PMID: 23275397

Stuttering and language ability in children: questioning the connection. - LINGUAGEM
Am J Speech Lang Pathol. 2012 Aug;21(3):183-96. doi: 10.1044/1058-0360(2012/11-0078). Epub 2012 Mar 21

Nippold MA.
University of Oregon, Eugene, USA.

PURPOSE: This article explains why it is reasonable to question the view that stuttering and language ability in children are linked-the so-called "stuttering-language connection."
METHOD:Studies that focused on syntactic, morphologic, and lexical development in children who stutter (CWS) are examined for evidence to support the following claims: (a) that CWS, as a group, are more likely to have disordered or weak language skills ("language deficits") than children who do not stutter (CWNS); (b) that language deficits play a causal role in the onset of stuttering; and (c) that stuttering, over time, restricts children's language development.
RESULTS: Analysis of the evidence suggests that CWS, like CWNS, show the full range of language abilities (high, average, low); that language deficits are not associated with stuttering onset or persistence; and that stuttering has little or no impact on language development.
CONCLUSIONS: A connection between stuttering and language ability was not supported. An alternative perspective is that CWS have a compromised motor control system that makes it difficult for them to move forward in speech and that the tie to language lies not in a deficient linguistic system but in difficulty expressing the intended meaning via a fully functional speech system.
PMID: 22442282 [PubMed - indexed for MEDLINE]


Stuttering attitudes in Hong Kong and adjacent Mainland China.- SOCIAL
Int J Speech Lang Pathol. 2012 Sep 14. [Epub ahead of print]

Ip ML, St Louis KO, Myers FL, Xue SA.
University of Hong Kong , Hong Kong.

The present study aims at studying the public attitudes towards stuttering in Hong Kong and Mainland China. Translated Chinese versions of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) were distributed to convenience samples in Hong Kong and Mainland China, with a total number of 175 completed questionnaires returned in each sampling region (n 5 350). Mean ratings of respondents from Hong Kong and Mainland China were similar in most comparisons; yet, a few differences were noted. Larger but idiosyncratic differences characterized the Chinese respondents compared to more than 4000 respondents from numerous countries and languages around the world in the POSHA-S database archive. Overall, they documented aspects of stereotypes and potential stigma with respect to people who stutter. While premature to provide unambiguous conclusions, results suggest that Chinese respondents have unique stuttering attitudes.
PMID: 22974072

Stuttering in school-age children: a comprehensive approach to treatment. - TERAPIA
Lang Speech Hear Serv Sch. 2012 Oct;43(4):536-48. .

Yaruss JS, Coleman CE, Quesal RW.

PURPOSE: This letter, prepared through a close collaboration between the authors and more than 100 colleagues, responds to a paper by the editor of Language, Speech, and Hearing Services in Schools that highlighted the need for research on treatment for stuttering in school-age children.
METHOD: Our response addresses 3 themes: First, we offer agreement with the editor's call for research because more evidence about treatment for children who stutter is certainly needed. Second, we provide an overview of recent literature, demonstrating that the majority of current treatments include strategies for helping children improve speech fluency in addition to helping them increase acceptance of their stuttering and diminish the negative consequences of the disorder. Third, we present several strategies designed to help clinicians respond to the individual needs of children who stutter in a data-based, comprehensive manner that focuses on minimizing the adverse impact of stuttering on children's educational endeavors, and on their lives as a whole.
CONCLUSION: Much has been learned about the factors that contribute to the successful treatment of stuttering in school-age children, and evidence will continue to accumulate. Meanwhile, speech-language pathologists can help children increase their fluency while simultaneously minimizing the adverse impact of their speaking difficulties and helping them improve their overall communication.

Stuttering treatment for a school-age child with Down syndrome: A descriptive case report. - OUTRAS ÁREAS
J Fluency Disord. 2012 Dec;37(4):253-62. Epub 2012 May 29

Harasym J, Langevin M.
Institute for Stuttering Treatment & Research (ISTAR), Faculty of Rehabilitation Medicine, University of Alberta, Canada.

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

Temperament, speech and language: An overview. - EMOCIONAL
J Commun Disord. 2012 Nov 19. pii: S0021-9924(12)00122-0. [Epub ahead of print]

Conture EG, Kelly EM, Walden TA.
Department of Hearing and Speech Sciences, Vanderbilt University, United States.

The purpose of this article is to discuss definitional and measurement issues as well as empirical evidence regarding temperament, especially with regard to children's (a)typical speech and language development. Although all ages are considered, there is a predominant focus on children. Evidence from considerable empirical research lends support to the association between temperament, childhood development and social competence. With regard to communication disorders, extant literature suggests that at least certain elements of temperament (e.g., attention regulation, inhibitory control) are associated with the presence of certain communication disorders. However, the precise nature of this association remains unclear. Three possible accounts of the association between temperament and speech-language disorder are presented. One, the disability model (i.e., certain disorders impact psychological processes leading to changes in these processes, personality, etc., Roy & Bless, 2000a) suggests speech-language disorders may lead to or cause changes in psychological or temperamental characteristics. The disability account cannot be categorically refuted based on currently available research findings. The (pre)dispositional or vulnerability model (i.e., certain psychological processes directly cause the disorder or indirectly modify the course or expression of the disorder, Roy & Bless, 2000a) suggests that psychological or temperamental characteristics may lead to or cause changes in speech-language disorders. The vulnerability account has received some empirical support with regard to stuttering and voice disorders but has not received widespread empirical testing for most speech-language disorders. A third, interaction account, suggests that "disability" and "vulnerability" may both impact communication disorders in a complex, dynamically changing manner, a possibility that must await further empirical study. Suggestions for future research directions are provided. Learning outcomes: After reading this article, the reader will be able to (1) better understand the concept of temperament as well as theories of and means to measure/study temperament, (2) better understand the possible association of temperament to children's speech-language, in general, and children's speech-language disorders, in specific, and (3) be able to describe the disability, dispositional and interaction accounts of the association of temperament to speech-language disorders.

The effect of speech rate on stuttering frequency, phonated intervals, speech effort, and speech naturalness during chorus reading. - FALA
J Commun Disord. 2012 Dec 1.  [Epub ahead of print]

Davidow JH, Ingham RJ.
Hofstra University, United States..

PURPOSE: This study examined the effect of speech rate on phonated intervals (PIs), in order to test whether a reduction in the frequency of short PIs is an important part of the fluency-inducing mechanism of chorus reading. The influence of speech rate on stuttering frequency, speaker-judged speech effort, and listener-judged naturalness was also examined. An added purpose was to determine if chorus reading could be further refined so as to provide a perceptual guide for gauging the level of physical effort exerted during speech production.
METHODS: A repeated-measures design was used to compare data obtained during control reading conditions and during several chorus reading conditions produced at different speech rates. Participants included 8 persons who stutter (PWS) between the ages of 16 and 32years.
RESULTS: There were significant reductions in the frequency of short PIs from the habitual reading condition during slower chorus conditions, no change when speech rates were matched between habitual reading and chorus conditions, and an increase in the frequency of short PIs during chorus reading produced at a faster rate than the habitual condition. Speech rate did not have an effect on stuttering frequency during chorus reading. In general, speech effort ratings improved and naturalness ratings worsened as speech rate decreased.
CONCLUSION: These results provide evidence that (a) a reduction in the frequency of short PIs is not necessary for fluency improvement during chorus reading, and (b) speech rate may be altered to provide PWS with a more appropriate reference for how physically effortful normally fluent speech production should be. Future investigations should examine the necessity of changes in the activation of neural regions during chorus reading, the possibility of defining individualized units on a 9-point effort scale, and if there are upper and lower speech rate boundaries for receiving ratings of "highly natural sounding" speech during chorus reading. Learning outcomes: The reader will be able to: (1) describe the effect of changes in speech rate on the frequency of short phonated intervals during chorus reading, (2) describe changes to speaker-judged speech effort as speech rate changes during chorus reading, (3) and describe the effect of changes in speech rate on listener-judged naturalness ratings during chorus reading.
PMID: 23273708

The long term effectiveness of intensive stuttering therapy: A mixed methods study. - TERAPIA
J Fluency Disord. 2012 Sep;37(3):164-78. Epub 2012 Apr 21.

Irani F, Gabel R, Daniels D, Hughes S.
Department of Communication Disorders, Texas State University - San Marcos, San Marcos, TX, USA.

PURPOSE: The purpose of this study was to gain a deeper understanding of client perceptions of an intensive stuttering therapy program that utilizes a multi-faceted approach to therapy. The study also proposed to gain a deeper understanding about the process involved in long-term maintenance of meaningful changes made in therapy.
METHODS: The study used a mixed methods design. The core method was a phenomenological approach using semi-structured interviews. Objective clinical data was gathered concurrently. This included archival records and current measures on a variety of assessments to evaluate stuttering severity and attitudes toward communication.
RESULTS: The major themes generated from participants' transcripts included (1) the positive effects of the Duration and Nature of the Program; (2) Speech Techniques Learned; (3) Attitude Change and Counseling; and (4) activities related to Desensitization and Transfer. The participants also reported positive effects of their personal motivation and clinician attitudes. Clinical data indicated that the participants made measurable clinical gains on all measures of stuttering severity and attitude change following the intensive clinic and these changes were maintained long after the program was completed.
CONCLUSIONS: It appears that this intensive stuttering therapy program is effective for making positive changes in behavioral measures of speech disfluencies, and attitudes. Clients reported multiple factors directly related to the program and personal factors that contributed to treatment effectiveness. Hence, future studies should explore and report on a variety of factors related to communication attitudes and overall quality of life in addition to behavioral measures of speech. Educational objectives: After reading this article, the learner will be able to: (a) identify the basic tenets of evidence-based practice; (b) summarize what we currently know about the effectiveness of behavioral treatments of stuttering; (c) identify factors that client report as important to treatment effectiveness.

Theory and therapy in stuttering: A complex relationship. –TERAPIA
J Fluency Disord. 2012 Dec;37(4):225-33. 2012.05.004.

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

There are many treatments currently available for stuttering, for both children and adults. These range from direct interventions intended to reduce the severity and/or frequency of the speech behaviors of stuttering, to those intended to alleviate the anxiety and other mental health issues that can accompany the disorder. However, as there are little supporting data for many of these treatments, there is little consensus about which to use. Another way to evaluate stuttering treatments is to explore the extent to which they address the cause of the disorder. However, the cause of stuttering is not yet known. In this theoretical paper, a 3-factor causal model is presented, to which the mechanisms thought to be driving different treatments are then aligned. The model is innovative, in that it attempts to explain moments of stuttering. It is argued that all causal factors must be operating at each moment of stuttering. The model is intended as a new way of looking at cause, and how treatments may address cause. It is hoped this will stimulate discussion and lead to further lines of inquiry. Educational objectives: The reader will be able to: (a) describe the P&A 3-factor causal model of moments of stuttering; (b) state how indirect direct stuttering treatments relate to cause, according to the P&A model; (c) describe how direct stuttering treatments relate to cause, according to the P&A model; (d) state the purpose of cognitive behavior therapy; and (e) describe at least one suggestion for further research arising from the P&A model.

Traits of attention deficit/hyperactivity disorder in school-age children who stutter. - ATENÇÃO
J Fluency Disord. 2012 Dec;37(4):242-52. Epub 2012 Aug 21.

Donaher J, Richels C.
The Center for Childhood Communication, The Children's Hospital of Philadelphia, Philadelphia, PA United States.

PURPOSE: The purpose of this study was to explore whether parents of CWS reported the presence of ADHD symptoms that would warrant a referral to a psychologist to rule out the disorder. This study also aimed to describe the characteristics of the sample in terms of gender, family history of stuttering, presence of neurological impairment, concomitant diagnoses, and stuttering severity. Finally, this study sought to explore the possible statistical relations among these same variables.
METHODS: Participants were 36 school-age CWS (32 males and 4 females) between the ages of 3.9 and 17.2 years (M=10.4, SD=4.0). Parent responses on the ADHD Rating Scale (Power et al., 2001) were collected via a retrospective chart review.
RESULTS: For this sample 58% (n=21), of the participants met criteria for needing referral for additional evaluation for symptoms related to ADHD. A strong positive relation (r=.720, p<.001) was found between a reported family history of recovered stuttering and the presence of a concomitant diagnosis.
CONCLUSION: The results of the present study demonstrate the need for further training and education for SLPs working with CWS regarding ADHD. Educational objectives: The reader will be able to (1) describe the main characteristics of ADHD, (2) discuss the evidence suggesting a possible relationship between ADHD and stuttering and (3) discuss how ADHD characteristics could impact clinical outcomes for CWS.

Two-Year Follow-Up of the Lidcombe Program in Ten Swedish-Speaking Children. - TERAPIA
Folia Phoniatr Logop. 2012 Oct 12;64(5):248-253. [Epub ahead of print]

Femrell L, Avall M, Lindström E.
Department of Communication Disorders, Danderyd University Hospital, Stockholm, Sweden.

Purpose: The purpose of this semicontrolled prospective study was to report on the outcomes of 10 Swedish-speaking children treated with the Lidcombe Program and how the parents viewed the treatment. Method: Ten children at an age from 2:9 to 5:8 (years:months) referred to two clinics for communication disorders were consecutively included in the study. The children had been stuttering for 0:9 to 3:3 with a mean stuttering frequency of 10.1% syllables stuttered (%SS; 0.8-33.9) before treatment. Parents and teachers filled out questionnaires concerning the children's speech and the parents also answered questions on their views on the program. Results: Eight children completed the program and were reassessed upon completion of the program, about 2 years after progressing to stage 2. There was a significant decrease in mean %SS before and after treatment (7.6 vs. 0.1%, respectively) with a large Cohen effect size (d = 2.9). Parents and teachers found that the treatment had a positive effect on the children's stuttering and all parents would recommend the Lidcombe Program to other families. Conclusion: The results of this preliminary study suggest that the Lidcombe Program can be an effective treatment for Swedish-speaking preschool children who stutter.

When a School-Age Child Stutters, Let's Focus on the Primary Problem. - INFANTIL
Lang Speech Hear Serv Sch. 2012 Oct;43(4):549-51.

Nippold MA.

PURPOSE: In this reply to Yaruss, Coleman, and Quesal (2012), I explain why it is reasonable for speech-language pathologists to focus their attention on helping school-age children who stutter (CWS) achieve natural-sounding fluent speech. I also emphasize the necessity for clinical researchers to conduct high-quality treatment efficacy studies of school-age CWS.

Witnessing stories: Definitional Ceremonies in Narrative Therapy with adults who stutter. - TERAPIA
J Fluency Disord. 2012 Dec;37(4):234-41. Epub 2012 Mar 9.

Leahy MM, O'Dwyer M, Ryan F.
Dept. of Clinical Speech & Language Studies, Trinity College Dublin 2, Ireland.

BACKGROUND: Narrative therapy (White & Epston, 1990) was developed as an approach to counselling, as a response to the power relations that influence people's lives. Its use with people who stutter has been documented. A basic tenet of narrative therapy is that the dominant problem-saturated narrative is challenged by externalizing the problem, in due course facilitating development of an alternative narrative. Within this process, the definitional ceremony involving outsider witnesses is a key procedure used to influence change.
AIMS: This paper describes definitional ceremonies, and their application within a narrative approach to therapy for stuttering. The analysis of a specific definitional ceremony is presented, leading to an exploration of identity as a public and social achievement.
METHODS: A definitional ceremony involving a woman who stutters and family members was recorded and analysed using two methods: interpretative phenomenological analysis and Heideggerian hermeneutic phenomenological analysis. Details of the clinical application of definitional ceremonies with this client are described.
RESULTS AND CONCLUSIONS: Results from both methods of analysis were found to be similar. Notable results include the fact that the stuttering per se was not presented as the problem; rather, the impact of stuttering, especially the experience of bullying, was a dominant theme. This paper shows how definitional ceremonies can open opportunities for clients to present themselves in a preferred way, forming the basis for a new story and revised identity. Emerging themes can be identified for reflection and discussion with the client for therapeutic benefit. Educational objectives: (1) to describe and explain to readers the process of narrative therapy, with special attention to the use of definitional ceremonies; (2) to provide detail regarding the clinical processes involved with a specific definitional ceremony with one client; (3) to have the reader appreciate the specific importance of involving outsider witnesses in the therapy process; (4) to discuss the outcomes of the use of this particular definitional ceremony.


Voltar para Abstracts



Veja os abstracts de janeiro a julho de 2023

                                    agosto a dezembro de 2023


                                    janeiro a julho de 2022

                                    agosto a dezembro de 2022


                                    janeiro a julho de 2021

                                    agosto a dezembro de 2021


                                    janeiro a julho de 2020

                                   agosto a dezembro de 2020


                                    janeiro a julho de 2019

                                   agosto a dezembro de 2019


                                    janeiro a julho de 2018

                                    agosto a dezembro de 2018


                                    janeiro a julho de 2017

                                    agosto a dezembro de 2017


                                    janeiro a julho de 2016

                                    agosto a dezembro de 2016


                                    janeiro a julho de 2015

                                    agosto a dezembro de 2015


                                    janeiro a julho de 2014
                                    agosto a dezembro de 2014


                                     janeiro a julho de 2013

                                     agosto a dezembro de 2013


                                      janeiro a julho de 2012

                                      agosto a dezembro de 2012