Eliana Maria Nigro Rocha


Abstracts - Janeiro a Julho de 2013

Ordem alfabética do título do artigo

Afferent and Efferent Aspects of Mandibular Sensorimotor Control in Adults who Stutter. - PSICOMOTORA
J Speech Lang Hear Res. 2013 Jul 1. [Epub ahead of print]

Daliri A, Prokopenko RA, Max L.
University of Washington, Seattle, WA.

PURPOSE: Individuals who stutter show sensorimotor deficiencies in speech and nonspeech movements. For the mandibular system, we dissociated the sense of kinesthesia from the efferent control component to examine whether kinesthetic integrity itself is compromised in stuttering or whether deficiencies occur only when generating motor commands.
METHOD: We investigated 11 stuttering and 11 nonstuttering adults' kinesthetic sensitivity threshold and kinesthetic accuracy for passive jaw movements as well as their minimal displacement threshold and positioning accuracy for active jaw movements. We also investigated the correlation with an anatomical index of jaw size.
RESULTS: The groups showed no statistically significant differences on sensory measures for passive jaw movements. Although some stuttering individuals performed more poorly than any nonstuttering participants on the active movement tasks, between-group differences for active movements were also not statistically significant. Unlike fluent speakers, however, the stuttering group showed a statistically significant correlation between mandibular size and performance in the active and passive near-threshold tasks.
CONCLUSIONS: Previously reported minimal movement differences were not replicated. Instead, stuttering individuals' performance varied with anatomical properties. These correlational results are consistent with the hypothesis that stuttering participants generate and perceive movements based on less accurate internal models of the involved neuromechanical systems.

PMID: 23816664 [PubMed - as supplied by publisher]


An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions - FARMACOLOGIA
JRSM Short Rep. 2013 Feb;4(2):10. Epub 2013 Feb 12.
Free full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591685/pdf/SHORTS-472115.pdf

Persaud R, Garas G, Silva S, Stamatoglou C, Chatrath P, Patel K.
St Mary's Hospital, Imperial College Healthcare NHS Trust , London , UK.

Botulinum toxin (Botox) is an exotoxin produced from . It works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles or glands innervated. Botox is best known for its beneficial role in facial aesthetics but recent literature has highlighted its usage in multiple non-cosmetic medical and surgical conditions. This article reviews the current evidence pertaining to Botox use in the head and neck. A literature review was conducted using The Cochrane Controlled Trials Register, Medline and EMBASE databases limited to English Language articles published from 1980 to 2012. The findings suggest that there is level 1 evidence supporting the efficacy of Botox in the treatment of spasmodic dysphonia, essential voice tremor, headache, cervical dystonia, masticatory myalgia, sialorrhoea, temporomandibular joint disorders, bruxism, blepharospasm, hemifacial spasm and rhinitis. For chronic neck pain there is level 1 evidence to show that Botox is ineffective. Level 2 evidence exists for vocal tics, trigeminal neuralgia, dysphagia and post-laryngectomy oesophageal speech. For stuttering, 'first bite syndrome', facial nerve paresis, Frey's syndrome, oromandibular dystonia and palatal/stapedial myoclonus the evidence is level 4. Thus, the literature highlights a therapeutic role for Botox in a wide range of non-cosmetic conditions pertaining to the head and neck (mainly level 1 evidence). With ongoing research, the spectrum of clinical applications and number of people receiving Botox will no doubt increase. Botox appears to justify its title as 'the poison that heals'
PMID: 23476731 [PubMed] PMCID: PMC3591685


An exploration of dichotic listening among adults who stutter. - AUDITIVO
Clin Linguist Phon. 2013 Jun 27. [Epub ahead of print]

Robb MP, Lynn WL, O'Beirne GA.
Department of Communication Disorders, University of Canterbury , New Zealand.

A pilot investigation of dichotic listening of CV stimuli was undertaken using seven adults who stutter (AWS) and a comparison group of seven adults who do not stutter (AWNS). The aim of this research was to investigate whether AWS show a difference in the strength of the right ear advantage (REA) in both undirected and directed attention tasks when compared to AWNS. The undirected attention task involved manipulating the interaural intensity difference (IID) of the CV stimuli presented to each ear. The CV stimuli were presented with equal intensity for the directed attention task. The undirected attention results indicated that both AWS and AWNS have a REA for processing speech information, with a primary difference observed between groups in regard to the IID point at which a REA shifts to a LEA. This crossing-over point occurred earlier for AWS, indicating a stronger right hemisphere involvement for the processing of speech compared to AWNS. No differences were found between groups in the directed attention task. The differences and similarities observed in dichotic listening between the two groups are discussed in regard to hemispheric specialization in the processing of speech.
PMID: 23806131 [PubMed - as supplied by publisher]


A preliminary investigation of phonological encoding skills in children who stutter. - FALA
J Fluency Disord. 2013 Mar;38(1):45-58. doi: 10.1016/j.jfludis.2012.12.003. Epub 2013 Jan 3.

Sasisekaran J, Brady A, Stein J.
Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, USA

PURPOSE: The present study investigated phonological encoding skills in children who stutter(CWS) and those who do not (CNS). Participants were 9 CWS (M=11.8 years, SD=1.5) and 9 age and sex matched CNS (M=11.8 years, SD=1.5).
METHOD: Participants monitored target phonemes located at syllable onsets and offsets of bisyllabic words. Performance in the phoneme monitoring task was compared to an auditory tone monitoring task.
RESULTS: Repeated measures analysis of the response time data revealed significant Group×Task×Position interaction with the CWS becoming progressively slower than the CNS in monitoring subsequent phonemes located within the bisyllabic words; differences were not observed in the auditory tone monitoring task. Repeated measures analysis of the error data indicated that the groups were comparable in the percent errors in phoneme vs. tone monitoring. The CWS group was also significantly slower in a picture naming task compared to the CNS.
CONCLUSIONS: Present findings suggest that CWS experience temporal asynchronies in one or more processes leading up to phoneme monitoring. The findings are interpreted within the scope of contemporary theories of stuttering.
EDUCATIONAL OBJECTIVES: At the end of this activity the reader will be able to: (a) discuss the literature on phonological encoding skills in children who stutter, (b) identify theories of phonological encoding in stuttering, (c) define the process of phonological encoding and its implications for fluent speech, (d) suggest future areas of research in the investigation of phonological encoding abilities in children who stutter.
PMID: 23540912 [PubMed - in process]
PMCID: PMC3638240 [Available on 2014/3/1]


A preliminary investigation of segmentation and rhyme abilities of children who stutter. - FALA
J Fluency Disord. 2013 Jun;38(2):222-34. doi: 10.1016/j.jfludis.2012.12.004. Epub 2013 Jan 10.

Sasisekaran J, Byrd CT.
University of Minnesota, United States.

The present study investigated segmentation and rhyme abilities, skills critical for phonological encoding, of children who stutter (CWS) and those who do not (CNS). Participants were 9 CWS (8 males and 1 female, mean age=11.1, SD=2.31) in the age range of 7 and 13 years and 9 age and sex matched CNS (mean age=11.2, SD=2.19). Participants performed two verbal monitoring tasks, phoneme and rhyme monitoring, in silent naming. Performances in the verbal monitoring tasks were compared to a neutral, nonverbal tone monitoring task. Additionally, the complexity of the phoneme monitoring task was varied such that participants had to monitor for singletons vs. consonant clusters. Repeated measures analysis of the response time data did not reveal significant differences between the groups in the three monitoring tasks. Analysis of the complexity data revealed a trend for slower monitoring of the consonant clusters in the CWS group compared to the CNS. Present findings do not support a deficit in segmentation and rhyme abilities in CWS, although there was some preliminary evidence of segmentation difficulties with increasing phonological complexity of the stimuli. Educational objectives: At the end of this activity the reader will be able to: (a) discuss the literature on phonological encoding skills in children who stutter, (b) describe skills underlying the phonological encoding process, (c) summarize whether or not children who stutter differ from those who do not in segmentation and rhyme abilities, (d) suggest future areas of research in the investigation of segmentation and rhyme monitoring abilities in children who stutter.
PMID: 23773673 [PubMed - in process] PMCID: PMC3687361 [Available on 2014/6/1]


Assessment of stigma associated with stuttering: Development and evaluation of the Self-Stigma of Stuttering Scale (4S). - SOCIAL
J Speech Lang Hear Res. 2013 Jul 9. [Epub ahead of print]

Boyle MP.
The Pennsylvania State University.

PURPOSE: To create a psychometrically sound scale that measures different levels of internalized stigma (i.e., self-stigma) among adults who stutter and analyze factor structure, reliability, and initial construct validity of the scale.
METHOD: Two-hundred and ninety one adults who stutter were recruited from Board Recognized Specialists in Fluency Disorders and the National Stuttering Association. Participants completed a Web-based survey including an experimental scale called the Self-Stigma of Stuttering Scale (4S), designed to measure different levels of self-stigma in people who stutter, along with a series of established measures of self-esteem, self-efficacy, and life satisfaction.
RESULTS: The experimental scale demonstrated adequate reliability in internal consistency and temporal stability. Factor analysis revealed underlying components supportive of a multidimensional model of stigma. Stigma self-concurrence, and to a lesser extent stereotype agreement and stigma awareness, were negatively correlated with self-esteem, self-efficacy, and life satisfaction, supporting initial construct validity of the scale.
CONCLUSION: Speech-language pathologists can identify the presence of self-stigma in their adult clients who stutter and help them to alter these beliefs. The 4S can be a means for researchers and clinicians to achieve these goals.
PMID: 23838992 [PubMed - as supplied by publisher]

Assessing risk for stuttering in children.
J Fluency Disord. 2013 Jun;38(2):63-5. doi: 10.1016/j.jfludis.2013.03.003. Epub 2013 Mar 21

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

No abstract available.
PMID: 23773661 [PubMed - in process]


Atypical caudate anatomy in children who stutter. - NEUROCIÊNCIAS
Percept Mot Skills. 2013 Apr;116(2):528-43

Foundas AL, Mock JR, Cindass R Jr, Corey DM.
Department of Neurology and Cognitive Neuroscience, University of Missouri-Kansas City, USA.

A temporal motor defect in speech preparation and/or planning may contribute to the development of stuttering. This defect may be linked to a dysfunctional cortical-subcortical network at the level of the striatum. To determine whether structural differences exist and whether group differences are associated with stuttering severity or manual laterality, the caudate was measured in 14 children who stutter (CWS) and in a control group of right-handed boys, ages 8-13 years. There was a statistically significant hemisphere by group effect for caudate volume. CWS had reduced right caudate volume and atypical leftward asymmetry compared to controls. Nine of the 13 CWS with atypical caudate asymmetry had atypical manual laterality. These anomalies may represent a vulnerability that perturbs speech planning/preparation and contributes to inefficiencies in action-perception coupling that may be an indicator of stuttering susceptibility. These results suggest that right-handed boys who stutter may have a defect in the feedforward cortico-striato-thalamo-cortical networks.
PMID: 24032328 [PubMed - in process]


Attention Training in rehabilitation of children with developmental stuttering.- ATENÇÃO
NeuroRehabilitation. 2013 Jan 1;32(2):297-303.

Nejati V, Pouretemad HR, Bahrami H.
Shahid Beheshti University, Evin, Tehran, Iran.

BACKGROUND: Attention and executive function play an important role in fluent speaking. The aim of the present study is to evaluate effect of attention training in rehabilitation of stuttering.
METHOD: In this random clinical trial 30 children with developmental stuttering participate in a random allocation sampling in case or control group. In case group, we trained patient with NEurocognitive Joyful Attentive Training Intervention (NEJATI) in 12 sessions. Riley Stuttering severity instrument-3 (SSI-3), Wisconsin Card Sorting Test (WCST), and Stroop Color Word Test (SCWT) are used for evaluation of executive function before and after intervention. Dependent T-Test was used for analysis.
RESULTS: Comparing case group before and after intervention showed a significant enhancement in executive function and reduced stuttering severity.
CONCLUSION: Attention training propose as a non lingual method of language and speech rehabilitation in developmental stuttering.
PMID: 23535791


Attitudes of Turkish speech and language therapists toward stuttering. - SOCIAL
J Fluency Disord. 2013 Jun;38(2):157-70. Epub 2013 Mar 27.

Maviþ I, St Louis KO, Ozdemir S, Toðram B.
Anadolu University, Eskiþehir, Turkey.

PURPOSE: The study sought to identify clinical beliefs and attitudes of speech and language therapists (SLTs) in Turkey and to compare them to previous research on SLTs in the USA and UK.
METHOD: The Clinician Attitudes Toward Stuttering (CATS) inventory was administered by mail to nearly all-practicing SLTs in Turkey (n=61).
RESULTS: Turkish SLTs, whose caseloads contained a substantial number of people who stutter, agreed with CATS items suggesting psychological causes and problems for those who stutter. They strongly believed therapy should focus on parent counseling for preschoolers who stutter as well as adolescents. They were not optimistic about carrying out stuttering therapy nor about the likelihood that children who stutter could be effectively treated.
CONCLUSION: Attitudes toward stuttering by clinicians who treat them are important considerations in the conduct and outcomes of stuttering therapy. Additionally, SLTs working with stuttering clients should benefit from professional views and clinical experiences of their colleagues from surveys such as this one. Educational objectives: The reader will be able to describe: (a) the components of the CATS, (b) common themes in Turkish speech and language therapists' attitudes toward stuttering, (c) differences between the attitudes of speech and language therapists from Turkey versus the United States and the United Kingdom.
PMID: 23773668 [PubMed - in process]


Behavioral inhibition and childhood stuttering. - EMOCIONAL
J Fluency Disord. 2013 Jun;38(2):171-83. Epub 2013 Mar 16

Choi D, Conture EG, Walden TA, Lambert WE, Tumanova V.
Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States.

PURPOSE: The purpose of this study was to assess the relation of behavioral inhibition to stuttering and speech/language output in preschool-age children who do (CWS) and do not stutter (CWNS).
METHOD: Participants were preschool-age (ages 36-68 months), including 26 CWS (22 males) and 28 CWNS (13 males). Participants' behavioral inhibition (BI) was assessed by measuring the latency to their sixth spontaneous comment during conversation with an unfamiliar experimenter, using methodology developed by Kagan, Reznick, and Gibbons (1989). In addition to these measures of BI, each participant's stuttered and non-stuttered disfluencies and mean length of utterance (in morphemes) were assessed.
RESULTS: Among the more salient findings, it was found that (1) there was no significant difference in BI between preschool-age CWS and CWNS as a group, (2) when extremely high versus low inhibited children were selected, there were more CWS with higher BI and fewer CWS with lower BI when compared to their CWNS peers, and (3) more behaviorally inhibited CWS, when compared to less behaviorally inhibited CWS, exhibited more stuttering.
CONCLUSIONS: Findings are taken to suggest that one aspect of temperament (i.e., behavioral inhibition) is exhibited by some preschool-age CWS and that these children stutter more than CWS with lower behavioral inhibition. The present results seem to support continued study of the association between young children's temperamental characteristics and stuttering, the diagnostic entity (i.e., CWS versus CWNS), as well as stuttering, the behavior (e.g., frequency of stuttered disfluencies).Educational objectives: After reading this article, the reader will be able to: (a) summarize the salient empirical findings in the extant literature with regard to the association between temperament and childhood stuttering; (b) describe the concept of behavioral inhibition (BI) as well as the methods to measure BI; and (c) discuss the association between behavioral inhibition and childhood stuttering in preschool-age children.
PMID: 23773669 [PubMed - in process] PMCID: PMC3686543 [Available on 2014/6/1]


Behavioral treatments for children and adults who stutter: a review. - TERAPIA
Psychol Res Behav Manag. 2013 Jun 10;6:9-19. Print 2013.
Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3682852/pdf/prbm-6-009.pdf

Blomgren M.
Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, UT, USA

This paper provides a brief overview of stuttering followed by a synopsis of current approaches to treat stuttering in children and adults. Treatment is discussed in terms of multifactorial, operant, speech restructuring, and anxiolytic approaches. Multifactorial and operant treatments are designed for young children who stutter. Both of these approaches involve parent training and differ primarily in their focus on reducing demands on the child (multifactorial) or in their use of response contingent stimulation (operant conditioning). Speech restructuring and anxiolytic approaches are used with adults who stutter. Speech restructuring approaches focus on the mechanics of speech production, and anxiolytic treatments tend to focus on the symptoms and social and vocational challenges of stuttering. The evidence base for these different approaches is outlined. Response contingent therapy (for children) and speech restructuring therapy (for adults) have the most robust empirical evidence base. Multifactorial treatments for children and stuttering management approaches for adults are popular but are based on theoretical models of stuttering; the evidence base is not robust and tends to be inferred from work in areas such as cognitive behavior therapy and desensitization. Comprehensive, or holistic, approaches to treating stuttering are also discussed. Comprehensive approaches for treating stuttering in adults address both improved speech fluency and stuttering management.
PMID: 23785248 [PubMed] PMCID: PMC3682852


Breastfeeding may protect against persistent stuttering. - AMBIENTAL
J Commun Disord. 2013 Jun 24. pii: S0021-9924(13)00034-8. [Epub ahead of print]

Mahurin-Smith J, Ambrose NG.
Illinois State University, Box 4720, Normal, IL 61790, United States.

PURPOSE: This study investigated the hypothesis that breastfeeding in infancy might protect against persistent stuttering in children.
METHOD: We collected new data from the mothers of current and past participants in the Illinois Stuttering Research Program on their children's feeding history during infancy. We obtained 47 usable responses, for 17 children with persistent stuttering and 30 children who recovered naturally after a period of stuttering.
RESULTS: A chi-squared test for linear trend revealed a significant relationship between breastfeeding duration and the likelihood of natural recovery for the boys in the sample. Mothers of children in the persistent group were no more likely to report early feeding difficulties which might have suggested an underlying oral motor deficit in children predisposed toward persistent stuttering.
CONCLUSIONS: Our results offer preliminary support for the idea that breastfeeding may confer a measure of protection against persistent stuttering. The fatty acid profile of human milk, with its potential to affect both gene expression and the composition of neural tissue, may explain this association. Further research is called for. Learning outcomes: The reader will be able to give at least one reason why human milk may make a difference in neurodevelopment generally and with regard to stuttering outcomes specifically. Additionally, the reader will be able to describe the relationship between breastfeeding duration and stuttering recovery observed in this sample.
PMID: 23849886 [PubMed - as supplied by publisher]



Clinicians' management of young children with co-occurring stuttering and speech sound disorder. - TERAPIA
Int J Speech Lang Pathol. 2013 May 22. [Epub ahead of print]

Unicomb R, Hewat S, Spencer E, Harrison E.
The University of Newcastle , Newcastle , Australia.

Speech sound disorders reportedly co-occur in young children who stutter at a substantial rate. Despite this, there is a paucity of scientific research available to support a treatment approach when these disorders co-exist. Similarly, little is known about how clinicians are currently working with this caseload given that best practice for the treatment of both disorders in isolation has evolved in recent years. This study used a qualitative approach to explore current clinical management and rationales when working with children who have co-occurring stuttering and speech sound disorder. Thirteen participant SLPs engaged in semi-structured telephone interviews. Interview data were analysed based on principles derived from grounded theory. Several themes were identified including multi-faceted assessment, workplace challenges, weighing-up the evidence, and direct intervention. The core theme, clinical reasoning, highlighted the participants' main concern, that not enough is known about this caseload on which to base decisions about intervention. There was consensus that little is available in the research literature to guide decisions relating to service delivery. These findings highlight the need for further research to provide evidence-based guidelines for clinical practice with this caseload.
PMID: 23691981 [PubMed - as supplied by publisher]


Computational modeling of stuttering caused by impairments in a basal ganglia thalamo-cortical circuit involved in syllable selection and initiation. - NEUROCIÊNCIAS
Brain Lang. 2013 Jul 18;126(3):263-278. doi: 10.1016/j.bandl.2013.05.016. [Epub ahead of print]

Civier O, Bullock D, Max L, Guenther FH.
Center for Computational Neuroscience and Neural Technology, Boston University, Boston, MA, United States.

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



Description of multilingual participants who stutter. - AVALIAÇÃO
J Fluency Disord. 2013 Jun;38(2):141-56. Epub 2013 Mar 27.

Coalson GA, Peña ED, Byrd CT.
The University of Texas at Austin, 1 University Station A1100, Austin, USA.

PURPOSE: The purpose of this review was to examine the descriptions of multilingual participants provided in stuttering literature to determine how frequently and consistently relevant factors of language profile are reported.
METHOD: We conducted a systematic search of published studies that included multilingual participants who stutter and reviewed the level of detail provided regarding language history, function, proficiency, stability, mode, accent, covert speech, and affective factors.
RESULTS: Twenty-three studies qualified to be included in the systematic review, consisting of 342 different multilingual stuttering participants. Of these 23 studies, the most frequently reported information included language proficiency (70%), history (56%), and function (43%). The specificity of the information used to define these factors was inconsistent. Affect was mentioned in 22% of studies, and language stability, mode, and accent information was included in less than 10% of the studies.
CONCLUSIONS: Results demonstrate that description of multilingual stuttering participants is inadequate and inconsistent. A recommended framework is provided for future studies to facilitate cross-study comparisons and enhance our ability to interpret the manifestation of stuttering in multilingual participants. Educational objectives: The reader will be able to: (a) summarize the current validity of cross-study comparisons in available research of multilingual participants who stutter; (b) describe the range of language factors to be included when providing descriptions of multilingual participants who stutter; (c) discuss the importance of consistency when describing language profiles of multilingual research participants.
PMID: 23773667 [PubMed - in process]


Disfluency: it is not always stuttering.
Clin Genet. 2013 Apr 9. doi: 10.1111/cge.12144. [Epub ahead of print]

Cosyns M, van Zaalen Y, Mortier G, Janssens S, Amez A, Van Damme J, Van Borsel J.
Department of Otorhinolaryngology, Ghent University, Ghent, Belgium

No abstract available.
[PubMed - as supplied by publisher]


Disrupted white matter in language and motor tracts in developmental stuttering. - MEUROCIÊNCIAS
Brain Lang. 2013 Jun 29. [Epub ahead of print]

Connally EL, Ward D, Howell P, Watkins KE.
Department of Experimental Psychology & Oxford Centre, University of Oxford, Oxford , UK.

White matter tracts connecting areas involved in speech and motor control were examined using diffusion-tensor imaging in a sample of people who stutter (n=29) who were heterogeneous with respect to age, sex, handedness and stuttering severity. The goals were to replicate previous findings in developmental stuttering and to extend our knowledge by evaluating the relationship between white matter differences in people who stutter and factors such as age, sex, handedness and stuttering severity. We replicated previous findings that showed reduced integrity in white matter underlying ventral premotor cortex, cerebral peduncles and posterior corpus callosum in people who stutter relative to controls. Tractography analysis additionally revealed significantly reduced white matter integrity in the arcuate fasciculus bilaterally and the left corticospinal tract and significantly reduced connectivity within the left corticobulbar tract in people who stutter. Region-of-interest analyses revealed reduced white matter integrity in people who stutter in the three pairs of cerebellar peduncles that carry the afferent and efferent fibers of the cerebellum. Within the group of people who stutter, the higher the stuttering severity index, the lower the white matter integrity in the left angular gyrus, but the greater the white matter connectivity in the left corticobulbar tract. Also, in people who stutter, handedness and age predicted the integrity of the corticospinal tract and peduncles, respectively. Further studies are needed to determine which of these white matter differences relate to the neural basis of stuttering and which reflect experience-dependent plasticity.
PMID: 23819900 [PubMed - as supplied by publisher]


Distribution of language-related Cntnap2 protein in neural circuits critical for vocal learning.- OUTROS
J Comp Neurol. 2013 Jul 1. [Epub ahead of print]

Condro MC, White SA.
University of California, Los Angeles, CA

Variants of the contactin associated protein-like 2 (Cntnap2) gene are risk factors for language-related disorders including autism spectrum disorder, specific language impairment, and stuttering. Songbirds are useful models for study of human speech disorders due to their shared capacity for vocal learning, which relies on similar cortico-basal ganglia circuitry and genetic factors. Here, we investigate Cntnap2 protein expression in the brain of the zebra finch [tentilhão-zebra, pássaro também conhecido como mandarim], a songbird species in which males, but not females, learn their courtship songs. We hypothesize that Cntnap2 has overlapping functions in vocal learning species, and expect to find protein expression in song-related areas of the zebra finch brain. We further expect that the distribution of this membrane-bound protein may not completely mirror its mRNA distribution due to the distinct subcellular localization of the two molecular species. We find that Cntnap2 protein is enriched in several song control regions relative to surrounding tissues, particularly within the adult male, but not female, robust nucleus of the arcopallium (RA), a cortical song control region analogous to human layer 5 primary motor cortex. The onset of this sexually dimorphic expression coincides with the onset of sensorimotor learning in developing males. Enrichment in male RA appears due to expression in projection neurons within the nucleus, as well as to additional expression in nerve terminals of cortical projections to RA from the lateral magnocellular nucleus of the nidopallium. Cntnap2 protein expression in zebra finch brain supports the hypothesis that this molecule affects neural connectivity critical for vocal learning across taxonomic classes
PMID: 23818387 [PubMed - as supplied by publisher]


Dose dependent stuttering with clozapine: A case report. - FARMACOLOGIA
Asian J Psychiatr. 2013 Apr;6(2):178-9. Epub 2012 Sep 1.

Kumar T, Kathpal A, Longshore CT.
Department of Psychiatry, Mount Sinai School of Medicine, Elmhurst Hospital Center, Elmhurst, NY, USA.

No abstract available
PMID: 23466117
[PubMed - in process]

Early childhood stuttering and electrophysiological indices of language processing. - NEUROCIÊNCIAS
J Fluency Disord. 2013 Jun;38(2):206-21. Epub 2013 Jan 20

Weber-Fox C, Hampton Wray A, Arnold H.
Purdue University, United States. 

We examined neural activity mediating semantic and syntactic processing in 27 preschool-age childrenwho stutter (CWS) and 27 preschool-age children who do not stutter (CWNS) matched for age, nonverbal IQ and language abilities. All participants displayed language abilities and nonverbal IQ within the normal range. Event-related brain potentials (ERPs) were elicited while participants watched a cartoon video and heard naturally spoken sentences that were either correct or contained semantic or syntactic (phrase structure) violations. ERPs in CWS, compared to CWNS, were characterized by longer N400 peak latencies elicited by semantic processing. In the CWS, syntactic violations elicited greater negative amplitudes for the early time window (150-350ms) over medial sites compared to CWNS. Additionally, the amplitude of the P600 elicited by syntactic violations relative to control words was significant over the left hemisphere for the CWNS but showed the reverse pattern in CWS, a robust effect only over the right hemisphere. Both groups of preschoolage children demonstrated marked and differential effects for neural processes elicited by semantic and phrase structure violations; however, a significant proportion of young CWS exhibit differences in the neural functions mediating language processing compared to CWNS despite normal language abilities. These results are the first to show that differences in event-related brain potentials reflecting language processing occur as early as the preschool years in CWS and provide the first evidence that atypical lateralization of hemispheric speech/language functions previously observed in the brains of adults who stutter begin to emerge near the onset of developmental stuttering. Educational objectives: The reader will be able to: (1) describe the role of language processing in current theoretical models of developmental stuttering; (2) summarize current evidence regarding language processing differences between individuals who do and do not stutter; (3) describe typical changes in neural indices of semantic and syntactic processing across development; (4) discuss the potential implications of the current findings in relation to theories of developmental stuttering.
PMID: 23773672 [PubMed - in process] PMCID: PMC3687214 [Available on 2014/6/1]


Early-stage chunking of finger tapping sequences by persons who stutter and fluent speakers. – PSICOMOTOR
Clin Linguist Phon. 2013 Jan;27(1):72-84. 

Smits-Bandstra S, De Nil LF.
St Cloud State University , St Cloud, MN , USA.

This research note explored the hypothesis that chunking differences underlie the slow finger-tap sequencing performance reported in the literature for persons who stutter (PWS) relative to fluent speakers (PNS). Early-stage chunking was defined as an immediate and spontaneous tendency to organize a long sequence into pauses, for motor planning, and chunks of fluent motor performance. A previously published study in which 12 PWS and 12 matched PNS practised a 10-item finger tapping sequence 30 times was examined. Both groups significantly decreased the duration of between-chunk intervals (BCIs) and within-chunk intervals (WCIs) over practice. PNS had significantly shorter WCIs relative to PWS, but minimal differences between groups were found for the number of, or duration of, BCI. Results imply that sequencing differences found between PNS and PWS may be due to differences in automatizing movements within chunks or retrieving chunks from memory rather than chunking per se.
PMID: 23237418

Effects of sentence-structure complexity on speech initiation time and disfluency. - LINGUAGEM
J Fluency Disord. 2013 Mar;38(1):30-44. Epub 2013 Jan 5.

Tsiamtsiouris J, Cairns HS.
William Paterson University, United States

There is general agreement that stuttering is caused by a variety of factors, and language formulation and speech motor control are two important factors that have been implicated in previous research, yet the exact nature of their effects is still not well understood. Our goal was to test the hypothesis that sentences of high structural complexity would incur greater processing costs than sentences of low structural complexity and these costs would be higher for adults who stutter than for adults who do not stutter. Fluent adults and adults who stutter participated in an experiment that required memorization of a sentence classified as low or high structural complexity followed by production of that sentence upon a visual cue. Both groups of speakers initiated most sentences significantly faster in the low structural complexity condition than in the high structural complexity condition. Adults who stutter were over-all slower in speech initiation than were fluent speakers, but there were no significant interactions between complexity and group. However, adults who stutter produced significantly more disfluencies in sentences of high structural complexity than in those of low complexity. Educational objectives: After reading this article, the learner will be able to: (a) identify integral parts of all well-known models of adult sentence production; (b) summarize the way that sentence structure might negatively influence the speech production processes; (c) discuss whether sentence structure influences speech initiation time and disfluencies.
PMID: 23540911 [PubMed - in process]


Effectiveness of the Lidcombe Program for early stuttering in Australian community clinics. TERAPIA
Int J Speech Lang Pathol. 2013 May 22. [Epub ahead of print]

O'Brian S, Iverach L, Jones M, Onslow M, Packman A, Menzies R.
The University of Sydney , Australia.

This study explored the effectiveness of the Lidcombe Program for early stuttering in community clinics. Participants were 31 speech-language pathologists (SLPs) using the Lidcombe Program in clinics across Australia, and 57 of their young stuttering clients. Percentage of syllables stuttered (%SS) was collected 9 months after beginning treatment along with information about variables likely to influence outcomes. The mean %SS for the 57 children 9 months after starting treatment was 1.7. The most significant predictor of outcome was Lidcombe Program Trainers Consortium (LPTC) training. The children of trained SLPs (n = 19), compared to the children of untrained SLPs, took 76% more sessions to complete stage 1, but achieved 54% lower %SS scores, 9 months after starting treatment. Results suggest that outcomes for the Lidcombe Program in the general community may be comparable to those obtained in clinical trials when SLPs receive formal training and support.
PMID: 23691980 [PubMed - as supplied by Publisher]


Epidemiology of stuttering: 21st century advances. - CONCEITO
J Fluency Disord. 2013 Jun;38(2):66-87. doi: 10.1016/j.jfludis.2012.11.002. Epub 2012 Nov 27.

Yairi E, Ambrose N.
University of Illinois at Urbana-Champaign, Tel Aviv University, Israel.

Epidemiological advances in stuttering during the current century are reviewed within the perspectives of past knowledge. The review is organized in six sections: (a) onset, (b) incidence, (c) prevalence, (d) developmental paths, (e) genetics and (f) subtypes. It is concluded that: (1) most of the risk for stuttering onset is over by age 5, earlier than has been previously thought, with a male-to-female ratio near onset smaller than what has been thought, (2) there are indications that the lifespan incidence in the general population may be higher than the 5% commonly cited in past work, (3) the average prevalence over the lifespan may be lower than the commonly held 1%, (4) the effects of race, ethnicity, culture, bilingualism, and socioeconomic status on the incidence/prevalence of stuttering remain uncertain, (5) longitudinal, as well as incidence and prevalence studies support high levels of natural recovery from stuttering, (6) advances in biological genetic research have brought within reach the identification of candidate genes that contribute to stuttering in the population at large, (7) subtype-differentiation has attracted growing interest, with most of the accumulated evidence supporting a distinction between persistent and recovered subtypes. Educational objectives: Readers will be exposed to a summary presentation of the most recent data concerning basic epidemiological factors in stuttering. Most of these factors also pertain to children's risks for experiencing stuttering onset, as well as risks for persistency. The article also aims to increase awareness of the implications of the information to research, and professional preparation that meets the epidemiology of the disorder.
PMID: 23773662 [PubMed - in process] PMCID: PMC3687212 [Available on 2014/6/1]


Estudo de caso discutido à luz das diferentes abordagens para a terapia da gagueira - TERAPIA
Rev. CEFAC. 2013 Jan-Fev; 15(1):196-206 - Epub Dec 05, 2011
Free Full Text:http://www.scielo.br/pdf/rcefac/v15n1/16-11.pdf

Larissa Severa da Silva, Maria Inês Dornelles da Costa Ferreira

Tema: na atualidade, a gagueira pode apresentar definições distintas de acordo com a abordagem defendida pelos autores para fundamentar tal distúrbio. O trabalho tem como objetivo discutir tais abordagens na terapia do caso em questão, aplicando suas técnicas terapêuticas e adequando-as conforme o contexto em questão e a aceitação do indivíduo para com as atividades, promovendo o desenvolvimento dos objetivos, procedimentos e técnicas utilizados na terapêutica para a gagueira. Procedimentos: estudo longitudinal de um paciente de 14 anos, atendido em dois momentos: entre 2005/2006, ano em que recebeu alta com indicação de monitoramento, e 2008/2009 época em que retorna ao atendimento devido à recidiva. No estudo, são consideradas as diferentes abordagens: psicolinguística da fluência, neurolinguística e motora da gagueira, vertente contextualizada e abordagem fenomenológica da gagueira. Resultados: na evolução, observou-se a diminuição considerável da gagueira e dos movimentos compensatórios, bem como, comportamento e postura adequados e uma melhor socialização. Conclusão: o estudo das abordagens consideradas na terapia propiciou a realização do atendimento que atingiu os objetivos propostos. Além disso, o paciente contribuiu no direcionamento da terapia conforme sua aceitação e aplicação em sua vida, revelando, dessa forma, quais condutas foram mais efetivas e puderam contribuir de forma mais direta com a sua qualidade de vida e sua evolução.


Expressão de atitudes na fala com gagueira: Percepção de falantes fluentes - SOCIAL
Alfa – Revista de Linguística - v. 57, n. 1 (2013)
Free full text:https://periodicos.fclar.unesp.br/alfa/article/view/4059/4549

Leticia Correa Celeste, César Reis

O objetivo deste estudo foi verificar como falantes fluentes do português brasileiro percebem a expressão das atitudes de certeza e dúvida em falantes com gagueira. Para tanto, foram coletados dados em dois momentos: 1. material de fala e 2. teste perceptivo. Dois grupos participaram do primeiro momento, sendo 12 indivíduos com gagueira (GE) e 12 sem (GC). Esses participantes gravaram 2 frases em cada uma das três formas estudadas (neutra, expressão de dúvida e expressão de certeza). Para teste perceptivo participaram 60 juízes: 30 julgaram os enunciados do GC e 30 julgaram os enunciados do GE. Foram contabilizadas 1440 respostas para o GC e 1080 respostas para o GE. Foi utilizado o teste de uma afirmativa sobre uma e duas proporções, com significância de 95%. Os resultados mostraram diferença estatisticamente significativa entre os resultados dos juízes do GC e os juízes do GE: os juízes reconhecem melhor as atitudes expressas pelas pessoas sem gagueira do que aquelas expressas pelas pessoas com gagueira.


Fluency patterns in narratives from children with localization related epilepsy. - LINGUAGEM
J Fluency Disord. 2013 Jun;38(2):193-205. doi: 10.1016/j.jfludis.2013.01.003. Epub 2013 Feb 8.

Steinberg ME, Ratner NB, Gaillard W, Berl M.
Department of Hearing and Speech Science, University of Maryland, Lefrak Hall, College Park, MD, USA.

This study assessed the relationship between fluency and language demand in children with epilepsy, a group known to demonstrate depressed language skills. Disfluency type and frequencies were analyzed in elicited narratives from 52 children. Half of these children had localization-related epilepsy (CWE), while the others were age- and gender-matched typically-developing (TD) peers. CWE were found to be significantly more disfluent overall than their matched TD peers during narrative productions, and demonstrated a higher proportion of stutter-like disfluencies, particularly prolongations. The current study adds to an emerging literature that has found depressed language skills and listener perceptions of verbal ability in children with chronic seizure activity, and contributes to the small but growing literature that suggests that disfluency during spoken language tasks may be a subtle marker of expressive language impairment. Educational objectives: The reader will be able to (a) describe why children with epilepsy might be at greater risk for language delays and or increased levels of disfluency; (b) describe profiles of fluency that differentiated children with chronic and recent-onset epilepsy from their age and gender matched peers; and (c) apply this information to monitoring of children with seizure disorder on their caseloads.
PMID: 23773671 [PubMed - in process] PMCID: PMC3687359 [Available on 2014/6/1]


Individual differences in neural regions functionally related to real and imagined stuttering. - NEUROCIÊNCIAS
Brain Lang. 2013 Feb;124(2):153-64. doi: 10.1016/j.bandl.2012.11.013. Epub 2013 Jan 19.

Wymbs NF, Ingham RJ, Ingham JC, Paolini KE, Grafton ST.

Department of Psychological and Brain Sciences, University of California, Santa Barbara, United States.

Recent brain imaging investigations of developmental stuttering show considerable disagreement regarding which regions are related to stuttering. These divergent findings have been mainly derived from group studies. To investigate functional neurophysiology with improved precision, an individual-participant approach (N=4) using event-related functional magnetic resonance imaging and test-retest reliability measures was performed while participants produced fluent and stuttered single words during two separate occasions. A parallel investigation required participants to imaginestuttering or not stuttering on single words. The overt and covert production tasks produced considerable within-subject agreement of activated voxels across occasions, but little within-subject agreement between overt and covert task activations. However, across-subject agreement for regions activated by the overt and covert tasks was minimal. These results suggest that reliable effects of stuttering are participant-specific, an implication that might correspond to individual differences in stuttering severity and functional compensation due to related structural abnormalities.
PMID: 23333668
[PubMed - in process]


Inhibitory control in childhood stuttering. - EMOCIONAL
J Fluency Disord. 2013 Mar;38(1):1-13. doi: 10.1016/j.jfludis.2012.10.001. Epub 2012 Nov 3.

Eggers K, De Nil LF, Van den Bergh BR.
Lessius University College, Belgium; University of Leuven, Belgium.

PURPOSE: The purpose of this study was to investigate whether previously reported parental questionnaire-based differences in inhibitory control (IC; Eggers, De Nil, & Van den Bergh, 2010) would be supported by direct measurement of IC using a computer task.
METHOD: Participants were 30 children who stutter (CWS; mean age=7;05 years) and 30 children who not stutter (CWNS; mean age=7;05 years). Participants were matched on age and gender (±3 months). IC was assessed by the Go/NoGo task of the Amsterdam Neuropsychological Tasks (De Sonneville, 2009).
RESULTS: Results indicated that CWS, compared to CWNS, (a) exhibited more false alarms and premature responses, (b) showed lower reaction times for false alarms, and (c) were less able to adapt their response style after experiencing response errors.
CONCLUSIONS: Our findings provide further support for the hypothesis that CWS and CWNS differ on IC. CWS, as a group, were lower in IC pointing toward a lowered ability to inhibit prepotent response tendencies. The findings were linked to previous IC-related studies and to emerging theoretical frameworks of stuttering development. Educational objectives: The reader will be able to: (1) describe the concept of inhibitory control, and its functional significance; (2) describe the findings on self-regulatory processes, attentional processes, and inhibitory control in CWS; (3) identify which Go/NoGo task variables differentiated between CWS and CWNS; and (4) summarize the theoretical implications for the development of stuttering and the possible clinical implications.
PMID: 23540909 [PubMed - in process]


Logistic regression for risk factor modelling in stuttering research. - AVALIAÇÃO
J Fluency Disord. 2013 Jun;38(2):88-101. doi: 10.1016/j.jfludis.2012.09.003. Epub 2012 Oct 8.

Reed P, Wu Y.
Swansea University, UK. Electronic address: p.reed@swansea.ac.uk.

OBJECTIVES: To outline the uses of logistic regression and other statistical methods for risk factor analysis in the context of research on stuttering.
DESIGN: The principles underlying the application of a logistic regression are illustrated, and the types of questions to which such a technique has been applied in the stuttering field are outlined. The assumptions and limitations of the technique are discussed with respect to existing stuttering research, and with respect to formulating appropriate research strategies to accommodate these considerations. Finally, some alternatives to the approach are briefly discussed.
RESULTS: The way the statistical procedures are employed are demonstrated with some hypothetical data.
CONCLUSION: Research into several practical issues concerning stuttering could benefit if risk factor modelling were used. Important examples are early diagnosis, prognosis (whether a child will recover or persist) and assessment of treatment outcome. Educational objectives: After reading this article you will: (a) Summarize the situations in which logistic regression can be applied to a range of issues about stuttering; (b) Follow the steps in performing a logistic regression analysis; (c) Describe the assumptions of the logistic regression technique and the precautions that need to be checked when it is employed; (d) Be able to summarize its advantages over other techniques like estimation of group differences and simple regression.
PMID: 23773663 [PubMed - in process]


Memantine-induced speech problems in two patients with autistic disorder. - FARMACOLOGIA
Daru. 2013 Jul 2;21(1):54. doi: 10.1186/2008-2231-21-54.

Alaghband-Rad J, Nikvarz N, Tehrani-Doost M, Ghaeli P.
Research Center for Rational Use of Drugs and Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran.

Stuttering is a complex speech disorder. There are two forms of stuttering: developmental stuttering and acquired stuttering. Developmental stuttering is a disorder of early childhood but acquired stuttering can develop at any age. Some medications can induce or deteriorate stuttering as an adverse effect. There are several reports of stuttering due to psychotropic drugs. Memantine, a glutamate antagonist used in the treatment of Alzheimer's disease, has also been studied for the treatment of autism spectrum disorders. This report presents deterioration of stuttering and speech problem in two children with autistic disorder who were receiving memantine. Based on our knowledge, this is the first time these adverse drug reactions have been attributed to memantine. In conclusion clinicians should consider that speech problems including stuttering may be due to the consumption of memantine, especially, in children may be a side effect of memantine especially in children.
PMID: 23819879 [PubMed] PMCID: PMC3711986 Free PMC Article


Neural anomaly and reorganization in speakers who stutter: A short-term intervention study.
Neurology. 2013 Apr 16;80(16):1538. doi: 10.1212/WNL.0b013e31828fa475.

Rosenfield DB.
No abstract available.

Comment on
• Neural anomaly and reorganization in speakers who stutter: a short-term intervention study.[Neurology. 2012]
• Resting-state MRI: a peek through the keyhole on therapy for stuttering. [Neurology. 2012]
PMID: 23589641
[PubMed - indexed for MEDLINE]


Olanzapine versus haloperidol: which can control stuttering better? - FARMACOLOGIA
Int J Prev Med. 2013 May;4(Suppl 2):S270-3.
Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678230/?report=printable

Shaygannejad V, Khatoonabadi SA, Shafiei B, Ghasemi M, Fatehi F, Meamar R, Dehghani L.
Department of Neurology, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

BACKGROUND: The aim of this study was to compare the effects of olanzapine versus haloperidol to control the signs and symptoms of stuttering.
METHODS: Ninety-three patients were recruited in a 12-week single-blind randomized clinical trial, which was held between October 2009 and October 2010. Forty-three patients received olanzapine (5 mg/day) and 50 patients, haloperidol (2.5 mg/day). Before and after the study, they were evaluated by a speech pathologist by Van Riper's questionnaire. The data were analyzed using the SPSS version 16. T-test was used to compare the data between the two groups.
RESULTS: Mean of stuttering score (SD) before treatment was 4.67 (0.81) and 4.40 (1.14) in haloperidol and olanzapine groups, respectively (P > 0.05). After treatment, the mean (SD) score was 2.87 (1.32) and 1.56 (0.71) in haloperidol and olanzapine groups, respectively (P = 0.000).
CONCLUSIONS: It seems that olanzapine does have better impact in controlling stuttering, and it may be recommended to prescribe olanzapine for stutters as the first choice to control the stuttering under a careful follow-up.
PMID: 23776736 [PubMed] PMCID: PMC3678230


Oral EMG Activation Patterns for Speech Are Similar in Preschoolers Who Do and Do Not Stutter. - FALA
J Speech Lang Hear Res. 2013 Jul 9. [Epub ahead of print]

Walsh B, Smith A.
Purdue University, West Lafayette, Indiana.

PURPOSE: We determined whether basic patterns of muscle activation for speech were similar in preschool children who stutter and their fluent peers.
METHOD: We recorded right and left lower lip muscle activity during conversational speech and sentence repetition in 64 preschool children (CWS) diagnosed as stuttering and in 40 children who do not stutter (CWNS). Measures of EMG amplitude, right/left asymmetry, and bilateral coordination were computed for fluent speech. The potential presence of tremor-like oscillations during disfluencies of CWS was assessed, and EMG amplitudes of fluent and disfluent speech were compared in CWS.
RESULTS: Across both speaking tasks lip muscle activation was similar in CWS and CWNS in overall amplitude, bilateral synchrony, and degree of right/left asymmetry. EMG amplitude was reduced during disfluent compared to fluent conversational speech of CWS, and there was no evidence of tremor in the disfluencies of CWS.
CONCLUSION: These results support the assertion that stuttering in young children arises not from basic features of muscle contraction, but rather from the command signals that control the timing and amplitude of muscle activity. Our results indicate that no frank abnormality is present in muscle activation patterns in preschoolers who stutter.
PMID: 23838991 [PubMed - as supplied by publisher]


Personality dysfunction in adults who stutter: Another look. - EMOCIONAL
J Fluency Disord. 2013 Jun;38(2):184-92. doi: 10.1016/j.jfludis.2013.02.001. Epub 2013 Feb 20.

Manning W, Beck JG.
School of Communication Sciences and Disorders, The University of Memphis, Memphis, TN, United States.

PURPOSE: Given reports of the frequent occurrence of personality disorders (PD) among individuals who stutter, this investigation was designed to determine the presence of personality disorders (PD) for individuals seeking treatment for stuttering, using a different self-report measure.
METHOD: The sample included 50 adults who were undergoing treatment for stuttering. The participants also completed a self-report measure (Assessment of the DSM-IV Personality Disorders, ADP-IV) that is known to have good differential validity in the assessment of personality disorders as well as good convergent validity with a structured interview administered by a skilled mental health professional.
RESULTS: Four participants met threshold values for one personality disorder (PD) and one participant met criteria for two personality disorders. The remaining 45 participants (90%) did not meet criteria for a PD.
CONCLUSION: Rates of observed PDs in this sample approximated rates that have been observed in general community samples using structured clinical interviews and trained interviewers. Related reports which have claimed high levels of personality disorders among adults who stutter appear to be inflated by the use of self-report devices that overestimate the occurrence and co-morbidity of these conditions. Implications for the treatment of adults who stutter are discussed. Educational objectives: The reader will be able to (a) summarize two basic perspectives of how individuals who stutter are influenced by the possibility of personality dysfunction (b) describe the factors that influence the detection of personality dysfunction using self-report procedures, discuss the important (c) theoretical and (d) clinical implications of accurately identifying personality dysfunction for adults who stutter.
PMID: 23773670 [PubMed - in process]


Procedures used for assessment of stuttering frequency and stuttering duration. - AVALIAÇÃO
Clin Linguist Phon. 2013 Jul 12. [Epub ahead of print]

Jani L, Huckvale M, Howell P.
Department of Cognitive, Perceptual and Brain Sciences, University College London , London , UK.

Frequency of stuttered syllables and their durations were assessed using different procedures. The experiment examined overall syllable counts, counts of stuttered syllables and measures of stutter durations when they were made simultaneously or successively. Samples of speech with associated syllable, stuttered syllable and duration measurements of stuttering events were employed in reference transcriptions. Samples contained a minimum of 200 syllables. Ten participants assessed these samples for syllables, stuttered syllables and duration in an experiment. The responses of these participants were stored in alignment with the speech recordings for analysis. Performance was significantly more accurate (relative to transcriptions) for measures other than duration when the successive procedure was used as opposed to the simultaneous procedure. Although the successive method was more accurate, accuracy of stutter event identification was low for most participants. The procedure that allowed listeners to replay a speech sample and count the syllables, stuttered syllables and durations in three passes yielded more accurate syllable and stuttered syllable counts than procedures that required these judgments to be made in one pass.
PMID: 23848369 [PubMed - as supplied by publisher]


Psychosocial morbidities in school going adolescent girls: a study from a South Indian city. - SOCIAL
J Clin Diagn Res. 2013 Apr;7(4):684-6. doi: 10.7860/JCDR/2013/5029.2881. Epub 2013 Apr 1.
Free Full Text:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3644444/pdf/jcdr-7-684.pdf

Aradhya GH.
Associate Professor, Department of Paediatrics, J.J.M. Medical college , Karnataka, India .

Introduction: Adolescents form about 20-30% of our population. Like the children of any other ages, adolescents have the so called usual problems and problems which are specific for their age and developmental peculiarities. The present study was undertaken to assess the prevalence of the psycho-social problems of adolescent girls and to counsel the girls with problems or those who were problem prone. Methods: This was a cross-sectional study in which 500 adolescent girls from 6 higher secondary schools were selected via a simple random sampling method. A psychiatrist was consulted before the study was undertaken. A pre-designed profoma was given to be filled up and the data was analyzed later. Results: Sixty percent of the girls were in the age group of 14 to 15 years. Depression was noted in 10 girls (2%), symptoms of anxiety were noted in 5 girls (1%), stuttering and a poor concentration were observed in 10 girls ( 1% each), 2 girls (0.4%) came from broken families, 5 girls (1%) were suffering from anorexia nervosa, 3 girls (0.6%) were suffering from bulimia nervosa and 10 girls (2%) had pychosomatic symptoms. 5 girls (1%) reported interpersonal violence among their hostelmates. Conclusion: Finding out the prevalence of the psychosocial problems among adolescent girls and counselling them appropriately can decrease the major psychosocial morbidities which are prevalent in the community.
PMID: 23730646 [PubMed] PMCID: PMC3644444


Revisiting Bloodstein's Anticipatory Struggle Hypothesis from a psycholinguistic perspective: A Variable Release Threshold hypothesis of stuttering. - FALA / LINGUAGEM
J Commun Disord.2013 May-Jun;46(3):217-37.doi:10.1016/j.jcomdis.2013.04.002.

Brocklehurst PH, Lickley RJ, Corley M.
University of Edinburgh, Edinburgh, Scotland, UK; Stammering Self-Empowerment Programme, England, UK.

This paper reviews Bloodstein's (1975) Anticipatory Struggle Hypothesis of stuttering, identifies its weaknesses, and proposes modifications to bring it into line with recent advances in psycholinguistic theory. The review concludes that the Anticipatory Struggle Hypothesis provides a plausible explanation for the variation in the severity of stuttered disfluencies across speaking situations and conversation partners. However, it fails to explain the forms that stuttered disfluencies characteristically take or the subjective experience of loss of control that accompanies them. The paper then describes how the forms and subjective experiences of persistent stuttering can be accounted for by a threshold-based regulatory mechanism of the kind described in Howell's (2003) revision of the EXPLAN hypothesis. It then proposes that shortcomings of both the Anticipatory Struggle and EXPLAN hypotheses can be addressed by combining them together to create a 'Variable Release Threshold' hypothesis whereby the anticipation of upcoming difficulty leads to the setting of an excessively high threshold for the release of speech plans for motor execution. The paper also reconsiders the possibility that two stuttering subtypes exist: one related to formulation difficulty and other to difficulty initiating motor execution. It concludes that research findings that relate to the one may not necessarily apply to the other. Learning outcomes: After reading this article, the reader will be able to: (1) summarize the key strengths and weaknesses of Bloodstein's Anticipatory Struggle Hypothesis; (2) describe two hypothesized mechanisms behind the production of stuttered disfluencies (tension and fragmentation & release threshold mechanisms); and (3) discuss why the notion of anticipation is relevant to current hypotheses of stuttering.
PMID: 23631932
[PubMed - in process]


Risk factors and stuttering: Evaluating the evidence for clinicians. - AVALIAÇÃO
J Fluency Disord. 2013 Jun;38(2):134-40. doi: 10.1016/j.jfludis.2013.02.007. Epub 2013 Mar 1.

Ward D.
The University of Reading, United Kingdom; The Apple House Centre for Stammering, The Warneford Hospital, Oxford, United Kingdom.

This paper summarizes and discusses some of the key issues raised in the other four manuscripts in this special edition of Journal of Fluency Disorders. All the four pieces examine risk factors in developmental stuttering from different perspectives and all provide stand-alone contributions to knowledge on the subject. Thus, rather than review, the focus of the present paper is to highlight those matters, which, from a clinical perspective might be seen as either (a) of the greatest contention, (b) of particular relevance to clinicians, or (c) requiring greater emphasis in future research, on the basis of the conclusions from the authors involved. Educational objectives: This paper provides an overview of points of particular clinical interest arising from the four contributions to this special edition. Readers will be able to (a) understand arguments for and against whole word repetitions being included as moments of stuttering in the SSI-3 assessment, (b) understand arguments relating to psychological components in early onset stuttering, (c) understand some of the complexities in interpreting data pertaining to recovery from stuttering, (d) understand where future efforts in research into risk of stuttering should be placed.
PMID: 23773666 [PubMed - in process]



Screening school-aged children for risk of stuttering. - AVALIAÇÃO
J Fluency Disord. 2013 Jun;38(2):102-23. doi: 10.1016/j.jfludis.2012.09.002. Epub 2012 Oct 24.

Howell P.
Division of Psychology and Language Science, University College London, London, England, United Kingdom

OBJECTIVES: Howell and Davis's (2011) model that predicts whether stuttering in eight-year old children will persist or recover by teenage was adapted for screening school-aged children for risk of stuttering. Stuttering-severity scores were used to predict whether children belonged to fluent or stuttering groups. Predicted group assignments were compared for models in which severity measures were made with whole-word repetitions excluded or included. The best model for distinguishing children who stutter (CWS) from fluent children was validated across a wide range of ages.
DESIGN: Stuttering-severity scores from CWS (222 for development, and 272 for validation, of the models) and fluent children (103 for development, and 25 for validation, of the models) were employed. Models were developed that predicted prognosis and screened CWS and fluent children. All these analyses were conducted both with whole-word repetitions excluded and included in the stuttering-severity scores. The model that screened fluent children from all CWS which excluded whole-word repetitions was validated for children across a range of ages.
RESULTS: All models achieved around 80% specificity and sensitivity. Models in which whole-word repetitions were excluded were always better than those which included them. Validation of the screening for fluency with whole-word repetitions excluded classified 84.4% of fluent children, and 88.0% of CWS, correctly. Some of these children differed in age from those used to develop the model.
CONCLUSION: Howell and Davis's risk factor model for predicting persistence/recovery can be extended to screen school-aged children for fluency. Educational objectives: After reading this article, participants will be able to: (1) describe the difference between finding group differences and risk factor modeling in stuttering research; (2) summarize the strengths and weaknesses of stuttering severity instrument version three; (3) discuss how validation of diagnostic and screening models for fluency can be performed; (4) see how risk models have potential applications for screening for communication disorders in general.
PMID: 23773664 [PubMed - in process]


Simulating the neural correlates of stuttering. - NEUROCIÊNCIAS
Neurocase. 2013 May 22. [Epub ahead of print]

den Ouden DB, Montgomery A, Adams C.
Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.

For functional neuroimaging studies of stuttering, two challenges are (1) the elicitation of naturally stuttered versus fluent speech and (2) the separation of activation associated with abnormal motor execution from activation that reflects the cognitive substrates of stuttering. This paper reports on a proof-of-concept study, in which a single-subject approach was applied to address these two issues. A stuttering speaker used his insight into his own stuttering behavior to create a list of stutter-prone words versus a list of "fluent" words. He was then matched to a non-stuttering speaker, who imitated the specific articulatory and orofacial motor pattern of the stuttering speaker. Both study participants performed a functional MRI experiment of single word reading, each being presented with the same lexical items. Results suggest that the generally observed right-hemisphere lateralization appears to reflect a true neural correlate of stuttering. Some of the classically reported activation associated with stuttering appears to be driven more by nonspecific motor patterns than by cognitive substrates of stuttering, while anterior cingulate activation may reflect awareness of (upcoming) dysfluencies. This study shows that it is feasible to match stuttering speakers' utterances more closely to simulated stutters for the investigation of neural correlates of real stuttering. Significant main effects and contrast effects were obtained for the differences between fluent and stuttered speech, and right-hemisphere lateralization associated with real stuttered speech was shown in a single subject.
PMID: 23697790 [PubMed - as supplied by publisher]


Socioeconomic status, parental education, vocabulary and language skills of children who stutter. -AMBIENTAL
J Commun Disord. 2013 Jul 11. pii: S0021-9924(13)00036-1. doi: 10.1016/j.jcomdis.2013.07.002. [Epub ahead of print]

Richels CG, Johnson KN, Walden TA, Conture EG.
Old Dominion University, Norfolk, VA, United States.

PURPOSE: The purpose of this project was to investigate the possible relation between standardized measures of vocabulary/language, mother and father education, and a composite measure of socioeconomic status (SES) for children who do not stutter (CWNS) and children who stutter (CWS).
METHODS: Participants were 138 CWNS and 159 CWS between the ages of 2;6 and 6;3 and their families. The Hollingshead Four Factor Index of Social Position (i.e., Family SES) was used to calculate SES based on a composite score consisting of weighted values for paternal and maternal education and occupation. Statistical regression analyses were conducted to investigate the relation between parental education and language and vocabulary scores for both the CWNS and CWS. Correlations were calculated between parent education, Family SES, and stuttering severity (e.g., SSI-3 score, % words stuttered).
RESULTS: Results indicated that maternal education contributed the greatest amount of variance in vocabulary and language scores for the CWNS and for participants from both groups whose Family SES was in the lowest quartile of the distribution. However, paternal education generally contributed the greatest amount of variance in vocabulary and language scores for the CWS. Higher levels of maternal education were associated with more severe stuttering in the CWS.
CONCLUSION: Results are generally consistent with existing literature on normal language development that indicates maternal education is a robust predictor of the vocabulary and language skills of preschool children. Thus, both father and mothers' education may impact the association between vocabulary/language skills and childhood stuttering, leading investigators who empirically study this association to possibly re-assess their participant selection (e.g., a priori control of parental education) and/or data analyses (e.g., post hoc covariation of parental education). Learning outcomes: The reader will learn about and be able to: (a) describe the influence of socioeconomic status on the development of vocabulary and language for children who do and do not stutter; (b) discuss the contribution of maternal education on vocabulary and language development; (c) describe possible reasons why paternal education contributes in unique ways to the vocabulary and language development of children who stutter as well as stuttering severity; and (d) explain possible reasons why socioeconomic status is an important variable for describing language related findings in young children.
PMID: 23906898 [PubMed - as supplied by publisher]


Stuttering severity, psychosocial impact and lexical diversity as predictors of outcome for treatment of stuttering. - AVALIAÇÃO
J Fluency Disord. 2013 Jun;38(2):124-33. doi: 10.1016/j.jfludis.2012.08.001. Epub 2012 Aug 14.

Cook S, Donlan C, Howell P.
Division of Psychology and Language Science, University College London, England, United Kingdom.

OBJECTIVE: This study assessed factors that predicted therapy outcome for children and adolescents who stuttered after attendance at an intensive therapy course. The factors examined were stuttering severity, lexical diversity measured by Type Token Ratio, and psychosocial impact of stuttering on the child's life.
DESIGN:Fifty-four children who stuttered (CWS) participated in the study. The hypotheses were: (1) CWS with high initial stuttering severity would be more likely to persist than those with low initial severity; (2) lexical diversity before treatment should be related to therapy outcome; (3) psychosocial factors would affect therapy outcome. The predictions were assessed by linear and logistic regression analyses.
RESULTS: Initial stuttering severity was the only significant predictor for stuttering severity after therapy. However, psychosocial impact correlated with improvement in fluency, and lexical diversity correlated with therapy outcome.
CONCLUSIONS: Only initial stuttering severity was a significant predictor of therapy outcome after an intensive therapy intervention. This is in agreement with the study of Howell and Davis (2011). Educational objectives: Readers will get an overview of the literature on risk factors that are considered to predict therapy outcomes for CWS. They will be able to (a) identify what variable represent potential risk factors, (b) describe the psychosocial impact of stuttering, (c) explain how lexical diversity is measured, and (d) describe different assessment instruments used to decide on the outcome of therapy.
PMID: 23773665 [PubMed - in process]


The impact of adolescent stuttering and other speech problems on psychological well-being in adulthood: evidence from a birth cohort study. - EMOCIONAL
Int J Lang Commun Disord. 2013 Jul;48(4):458-68. doi: 10.1111/1460-6984.12021. Epub 2013 May 3.

McAllister J, Collier J, Shepstone L.
School of Allied Health Professions, University of East Anglia.

BACKGROUND: Developmental stuttering is associated with increased risk of psychological distress and mental health difficulties. Less is known about the impact of other developmental speech problems on psychological outcomes, or the impact of stuttering and speech problems once other predictors have been adjusted for.
AIMS: To determine the impact of parent-reported adolescent stuttering and other speech difficulties on psychological distress and associated symptoms as measured by the Rutter Malaise Inventory.
METHOD & PROCEDURES: A British birth cohort dataset provided information about 217 cohort members who stuttered and 301 cohort members who had other kinds of speech problem at age 16 according to parental report, and 15,694 cohort members who had experienced neither stuttering nor other speech difficulties. The main analyses concerned associations between adolescent stuttering or speech difficulty and score on the Rutter Malaise Inventory at age 42. Other factors that had previously been shown to be associated with score on the Malaise Inventory were also included in the analyses.
OUTCOMES & RESULTS: In the adjusted analyses that controlled for other predictors, cohort members who were reported to stutter had higher malaise scores than controls overall, indicating a higher level of psychological distress, but they were not at significantly more likely to have malaise scores in the range indicating a risk of serious mental health difficulties. Cohort members who were reported to have other speech difficulties during adolescence had malaise scores that overall did not differ significantly from those of controls in the adjusted analyses, but they were at significantly greater risk of serious mental health difficulties.
CONCLUSIONS & IMPLICATIONS: These findings support those of other studies that indicate an association between stuttering and psychological distress. This study is the first to have shown that adolescents who experience speech difficulties other than stuttering are more likely than controls to be at risk of poorer mental health in adulthood. The results suggest a need for therapeutic provision to address psychosocial issues for both stuttering and other developmental speech disorders in adulthood, as well as further research into the consequences in adulthood of stuttering and other developmental speech disorders.
PMID: 23889841 [PubMed - in process]


The impact of stuttering on adults who stutter and their partners. - SOCIAL
J Fluency Disord. 2013 Mar;38(1):14-29 . Epub 2012 Dec 13.

Beilby JM, Byrnes ML, Meagher EL, Yaruss JS.
School of Psychology and Speech Pathology, Curtin University, Perth, Australia.

This study explored the impact of the stuttering disorder on perceived quality of life, with emphasis on the individual's relationship with their partner or spouse. Specifically, the purposes were: (a) to investigate what personal experiences and themes exist for both members of a couple dyad when one member of the couple stutters and (b) to examine whether the partners have different experiences with respect to the impact of stuttering on their lives. A mixed method research design was used. Participant dyads (adults who stutter and their fluent life partner) each completed one semi-structured qualitative interview and two questionnaires: the Overall Assessment of Speakers' Experience of Stuttering (OASES), and the Medical Short Form 36 (SF-36). Interviews were analysed qualitatively and significant themes evaluated. Quantitative results of the OASES and SF-36 were analysed, and scores correlated to determine the strength of any clinically significant relationships. Results indicated that people who stutter and their fluent partners reported similar experiences in reactions to stuttering and perceived difficulties in communication. However, no relationship was seen between the two groups in perceived impact on quality of life. Qualitative results indicated that the participants shared life experiences including reactions to stuttering, treatment undertaken and support. Such findings lend support to a broad-based clinical programme for adults who stutter that includes the fluent partner as an agent of change in their treatment. Findings also support the utilisation of qualitative and quantitative research techniques to elucidate relevant psychosocial life themes and experiences for those who live with a stutter. Educational objectives The reader will be able to: (a) identify the life themes associated with having a partner who stutters; (b) identify the perceived impact of stuttering for adults who stutter compared to their partners; and (c) discuss the clinical implications of the results with regards to working with adults who stutter.
PMID: 23540910
[PubMed - in process]


The SpeechEasy device in stuttering and nonstuttering adults: Fluency effects while speaking and reading. - AUDITIVO
Brain Lang. 2013 May 24;126(2):141-150. doi: 10.1016/j.bandl.2013.04.004. [Epub ahead of print]

Foundas AL, Mock JR, Corey DM, Golob EJ, Conture EG.
Brain and Behavior Program at Children's Hospital, New Orleans; Department of Neurology and Cognitive Neuroscience, University of Missouri - Kansas City, United States.

The SpeechEasy is an electronic device designed to alleviate stuttering by manipulating auditory feedback via time delays and frequency shifts. Device settings (control, default, custom), ear-placement (left, right), speaking task, and cognitive variables were examined in people who stutter (PWS) (n=14) compared to controls (n=10). Among the PWS there was a significantly greater reduction in stuttering (compared to baseline) with custom device settings compared to the non-altered feedback (control) condition. Stuttering was reduced the most during reading, followed by narrative and conversation. For the conversation task, stuttering was reduced more when the device was worn in the left ear. Those individuals with a more severe stuttering rate at baseline had a greater benefit from the use of the device compared to individuals with less severe stuttering. Our results support the view that overt stuttering is associated with defective speech-language monitoring that can be influenced by manipulating auditory feedback.
PMID: 23712191 [PubMed - as supplied by publisher]


Unscheduled telephone calls to measure percent syllables stuttered during clinical trials. - AVALIAÇÃO
J Speech Lang Hear Res. 2013 Jun 19. [Epub ahead of print]

Karimi H, O'Brian S, Onslow M, Jones M.
Australian Stuttering Research Centre, The University of Sydney.

PURPOSE: Researchers have used unscheduled telephone calls for many years during clinical trials to measure stuttering severity before and after adult stuttering treatment. Since variability is one of the hallmarks of stuttering severity with adults, an issue is whether an unscheduled telephone call is truly representative of their everyday speech.
METHOD: We studied the speech of nine men and one woman for a 12-hour day during different speaking activities. On that day, and 1week prior to that day, participants received an unscheduled 10-minute telephone call from a person unknown to them. We compared the percent syllables stuttered (%SS) for the unscheduled telephone call on the day to the %SS of the unscheduled telephone call 1 week prior to the day and to the %SS during the entire day.
RESULTS: No significant differences were found, and all confidence intervals with t-tests included zero. The concordance correlation test also showed a strong positive correlation between %SS scores for the entire day and for the unscheduled 10-minute telephone call.
CONCLUSION: We conclude that there is no reason to doubt that 10-minute unscheduled telephone calls are a representative speech sample for %SS during clinical trials of stuttering treatments.
PMID: 23785177 [PubMed - as supplied by publisher]


Verbal Implicit Sequence Learning in Persons Who Stutter and Persons With Parkinson's Disease. - FALA
J Mot Behav. 2013 Jul 11. [Epub ahead of print]

Smits-Bandstra S, Gracco V.
Department of Communication Sciences and Disorders , St. Cloud State University , St. Cloud , Minnesota.

The authors investigated the integrity of implicit learning systems in 14 persons with Parkinson's disease (PPD), 14 persons who stutter (PWS), and 14 control participants. In a 120-min session participants completed a verbal serial reaction time task, naming aloud 4 syllables in response to 4 visual stimuli. Unbeknownst to participants, the syllables formed a repeating 8-item sequence. PWS and PPD demonstrated slower reaction times for early but not late learning trials relative to controls reflecting delays but not deficiencies in general learning. PPD also demonstrated less accuracy in general learning relative to controls. All groups demonstrated similar limited explicit sequence knowledge. Both PWS and PPD demonstrated significantly less implicit sequence learning relative to controls, suggesting that stuttering may be associated with compromised functional integrity of the cortico-striato-thalamo-cortical loop.
PMID: 23844763 [PubMed - as supplied by publisher]




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