Abnormal time course of low beta modulation in non-fluent preschool children: A magnetoencephalographic study of rhythm tracking. - AUDITIVO
Neuroimage. 2016 Jan 15;125:953-63. doi: 10.1016/j.neuroimage.2015.10.086. Epub 2015 Nov 3.
Etchell AC, Ryan M, Martin E, Johnson BW, Sowman PF.
ARC Centre of Excellence in Cognition and Its Disorders, Australia; Perception in Action Research Centre (PARC), Australia; Department of Cognitive Science, Australia.
Stuttering is a disorder of speech affecting millions of people around the world. Whilst the exact aetiology of stuttering remains unknown, it has been hypothesised that it is a disorder of the neural mechanisms that support speech timing. In this article, we used magnetoencephalography (MEG) to examine activity from auditory regions of the brain in stuttering and non-stuttering children aged 3-9years. For typically developing children, we found that MEG oscillations in the beta band responded to rhythmic sounds with a peak near the time of stimulus onset. In contrast, stuttering children showed an opposite phase of beta band envelope, with a trough of activity at stimulus onset. These results suggest that stuttering may result from abnormalities in predictive brain responses which are reflected in abnormal entrainment of the beta band envelope to rhythmic sounds.
Copyright © 2015. Published by Elsevier Inc.
PMID: 26545455 [PubMed - in process]
Altered functional connectivity in persistent developmental stuttering. - NEUROCIÊNCIAS
Sci Rep. 2016 Jan 8;6:19128. doi: 10.1038/srep19128.
Yang Y, Jia F, Siok WT, Tan LH.
Shenzhen University Health Science Center, Shenzhen, China; Shenzhen Institute of Neuroscience, Shenzhen, China; Guangdong Key Laboratory of Biomedical Information Detection and Ultrasound Imaging, Shenzhen, China; University of Hong Kong, Hong Kong.
Free Full Article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705486/pdf/srep19128.pdf
Persistent developmental stuttering (PDS) is a speech disorder that impairs communication skills. Despite extensive research, the core causes of PDS are elusive. Converging evidence from task-induced neuroimaging methods has demonstrated the contributions of the basal ganglia and the cerebellum to PDS, but such task-state neuroimaging findings are often confounded by behavioral performance differences between subjects who stutter and normal controls. Here, using resting-state functional magnetic resonance imaging, we investigated functional connectivity within cerebellar-cortical and basal ganglia-thalamocortical networks in 16 adults who stutter and 18 age-matched fluent speakers. Seed-to-voxel analysis demonstrated that, compared to controls, adults who stutter showed alternations in functional connectivity of cerebellum to motor cortex as well as connectivity among different locals within cerebellum. Additionally, we found that functional connectivity within cerebellar circuits was significantly correlated with severity of stuttering. The alternations of functional connectivity within basal ganglia-thalamocortical networks were identified as the reduced connectivity of the putamen to the superior temporal gyrus and inferior parietal lobules in adults who stutter. The abnormalities of resting state functional connectivity are assumed to affect language planning and motor execution critical for speaking fluently. Our findings may yield neurobiological cues to the biomarkers of PDS.
PMID: 26743821 [PubMed - in process] PMCID: PMC4705486
A Mutation Associated with Stuttering Alters Mouse Pup Ultrasonic Vocalizations. - GENÉTICA
Curr Biol. 2016 Apr 13. pii: S0960-9822(16)30179-8. doi: 10.1016/j.cub.2016.02.068. [Epub ahead of print]
Barnes TD, Wozniak DF, Gutierrez J, Han TU, Drayna D, Holy TE.
Washington University School of Medicine in St. Louis, St. Louis, USA; National Institutes of Health, Bethesda, USA.
A promising approach to understanding the mechanistic basis of speech is to study disorders that affect speech without compromising other cognitive or motor functions. Stuttering, also known as stammering, has been linked to mutations in the lysosomal enzyme-targeting pathway, but how this remarkably specific speech deficit arises from mutations in a family of general "cellular housekeeping" genes is unknown. To address this question, we asked whether a missense mutation associated with human stuttering causes vocal or other abnormalities in mice. We compared vocalizations from mice engineered to carry a mutation in the Gnptab (N-acetylglucosamine-1-phosphotransferase subunits alpha/beta) gene with wild-type littermates. We found significant differences in the vocalizations of pups with the human Gnptab stuttering mutation compared to littermate controls. Specifically, we found that mice with the mutation emitted fewer vocalizations per unit time and had longer pauses between vocalizations and that the entropy of the temporal sequence was significantly reduced. Furthermore, Gnptab missense mice were similar to wild-type mice on an extensive battery of non-vocal behaviors. We then used the same language-agnostic metrics for auditory signal analysis of human speech. We analyzed speech from people who stutter with mutations in this pathway and compared it to control speech and found abnormalities similar to those found in the mouse vocalizations. These data show that mutations in the lysosomal enzyme-targeting pathway produce highly specific effects in mouse pup vocalizations and establish the mouse as an attractive model for studying this disorder.
PMID: 27151663 [PubMed - as supplied by publisher]
[Analyzing stutter originated from the frustrated clinging instinct and its relation to anxiety and self-esteem]. - EMOCIONAL
Orv Hetil. 2016 May;157(21):825-9. doi: 10.1556/650.2016.30414.
[Article in Hungarian]
Nagy BE, Józsa T.
Magatartástudományi Intézet, Egészségpszichológiai Tanszék, Debreceni Egyetem, Népegészségügyi Kar Debrecen, Kassai út 113., 1/7., 4028.
INTRODUCTION: The analytic and family therapeutic theories connected to the topic of stutter have to be actualized.
AIM: The aim of this work was to point out connections which originate from the instinct of frustrated clinging, however, these can be interpretated in new ways these days.
METHOD: Two questionnaires in 48 subjects suffering from stutter were used; Rosenberg's Self-Esteem Scale measured the children's self representation, while the Multidimensional Anxiety Scale for Children measured the degree of their anxiety. At first the subjects had to anwser the questions as themselves, for the second time they had to anwser as an ordinary person without a speech disorder.
RESULTS: The hypothesis of the authors was verified: stutterers attributed a significant role to the speech disorder of the subjects in connection with their self-esteem. According to this a significant amount of their anxiety is based on their deficit. An unexpected result was that girls and boys estimated ordinary people's level of anxiety similarly. There was no significant difference between boys and girls regarding the level of other's self-esteem.
CONCLUSIONS: Based on the thesis of evolutionary psychology, the adequate use of speech is more important to women who have a connecting role in the family. This results that they see stutter as a major problem. Orv. Hetil., 2016, 157(21), 825-829.
PMID: 27177789 [PubMed - in process]
An autopsy case of frontotemporal lobar degeneration with the appearance of fused in sarcoma inclusions (basophilic inclusion body disease) clinically presenting corticobasal syndrome. - GAGUEIRA ADQUIRIDA
Neuropathology. 2016 Feb;36(1):77-87. doi: 10.1111/neup.12232. Epub 2015 Jul 31.
Matsumoto A, Suzuki H, Fukatsu R, Shimizu H, Suzuki Y, Hisanaga K.
Miyagi Hospital, Watari-gun, Miyagi; Sendai Medical Center; Department of Clinical Research, National Rehabilitation Center for Persons with Disabilities, Tokorozawa City, Saitama, Japan;
We describe an autopsy case of basophilic inclusion body disease (BIBD), a subtype of frontotemporal lobar degeneration (FTLD) with the appearance of fused in sarcoma (FUS) inclusions (FTLD-FUS), clinically presenting corticobasal syndrome (CBS). A 54-year-old man initially developed worsening of stuttering and right hand clumsiness. Neurological examinations revealed rigidity in the right upper and lower extremities, buccofacial apraxia, and right-side dominant limb-kinetic and ideomotor apraxia. Neuroimaging showed asymmetric left-dominant brain atrophy and a cerebral blood flow reduction in the ipsilateral frontal region. At 56 years, his apraxia had advanced, and ideational apraxia was observed. Furthermore, the asymmetry in the limb-kinetic and ideomotor apraxia had disappeared, and both conditions had become bilateral. He had a new onset of aphasia. His symptoms progressed and he died 9 years after the initial symptoms. The brain weighed 955 g. Diffuse brain atrophy was most obvious in the bilateral frontotemporal regions. The atrophy of the left superior frontal and precentral gyri and bilateral basal ganglia was remarkable. Histologically, there was a marked loss of neurons with gliosis in the affected areas, where basophilic neuronal cytoplasmic inclusions were observed. The inclusions were immunoreactive for FUS, p62, and TATA-binding protein-associated factor 15 (TAF15), but not for phosphorylated tau, transactive response DNA-binding protein of 43 kDa (TDP-43), neurofilament protein, or Ewing sarcoma (EWS). From these pathological findings, this case was diagnosed as having BIBD as an FTLD-FUS variant. Spinal cord lower motor neurons were spared in number, similar to primary lateral sclerosis. Mutations in FUS were undetectable. Common background pathologies for CBS include corticobasal degeneration, Alzheimer's disease, PSP, FTLD with phosphorylated TDP-43 inclusions (FTLD-TDP), Pick's disease, Lewy body disease and CJD. However, FTLD-FUS (BIBD) has been rarely reported. Our case suggested further pathological heterogeneity in CBS than had previously been reported. It is necessary to consider FTLD-FUS (BIBD) as a background pathology for CBS in the future.
© 2015 Japanese Society of Neuropathology.
PMID: 26227957 [PubMed - in process]
A preliminary investigation of daily variability of stuttering in adults. - AVALIAÇÃO
J Commun Disord. 2016 Feb 23;60:39-50. doi: 10.1016/j.jcomdis.2016.02.001. [Epub ahead of print]
Constantino CD, Leslie P, Quesal RW, Yaruss JS.
University of Pittsburgh, Pittsburgh, PA, United States; Western Illinois University, Macomb, IL, United States.
PURPOSE: Variability in frequency of stuttering has made the results of treatment outcome studies difficult to interpret. Many factors that affect variability have been investigated; yet the typical range of variability experienced by speakers remains unknown. This study examined the day-to-day variability in the percentage of syllables containing stuttered and nonstuttered disfluencies in the speech of six adult speakers in three spontaneous speaking situations and two reading tasks.
METHODS: The frequency of moments stuttering during the tasks were compared within and between speakers and days to document the degree of variability in stuttering frequency and explore whether there were any consistent patterns. The Stuttering Severity Instrument-Fourth Edition (SSI-4) and Overall Assessment of the Speaker's Experience of Stuttering for Adults (OASES-A) were also tested for day-to-day variability. Correlations between frequency, severity, and life impact were made.
RESULTS: The primary result of this study was the large range over which frequency of stuttering varied from day to day for the same individual. This variability did not correlate with any measures of stuttering severity but did correlate with life impact as measured by the OASES-A. No global pattern was detected in variability from day to day within or between participants. However, there were significantly more nonstuttered disfluencies present during the spontaneous speaking tasks than during the reading tasks. The day-to-day variability in the life impact of the disorder (OASES-A) was less than the day-to-day variability in observable stuttering behavior (percentage of syllables stuttered and SSI-4).
CONCLUSION: Frequency of stuttering varies significantly from situation to situation and day to day, with observed variability exceeding the degree of change often reported in treatment outcomes studies from before to after treatment. This variability must be accounted for in future clinical and scientific work.
PMID: 26945438 [PubMed - as supplied by publisher]
Assessing attentional biases with stuttering. - ATENÇÃO
Int J Lang Commun Disord. 2016 Jan;51(1):84-94. doi: 10.1111/1460-6984.12187. Epub 2015 Jul 14.
Lowe R, Menzies R, Packman A, O'Brian S, Jones M, Onslow M.
The University of Sydney, Lidcombe, NSW, Australia; University of Queensland, Herston, QLD, Australia.
BACKGROUND: Many adults who stutter presenting for speech treatment experience social anxiety disorder. The presence of mental health disorders in adults who stutter has been implicated in a failure to maintain speech treatment benefits. Contemporary theories of social anxiety disorder propose that the condition is maintained by negative cognitions and information processing biases. Consistent with cognitive theories, the probe detection task has shown that social anxiety is associated with an attentional bias to avoid social information. This information processing bias is suggested to be involved in maintaining anxiety. Evidence is emerging for information processing biases being involved with stuttering.
AIMS: This study investigated information processing in adults who stutter using the probe detection task. Information processing biases have been implicated in anxiety maintenance in social anxiety disorder and therefore may have implications for the assessment and treatment of stuttering. It was hypothesized that stuttering participants compared with control participants would display an attentional bias to avoid attending to social information.
METHODS & PROCEDURES: Twenty-three adults who stutter and 23 controls completed a probe detection task in which they were presented with pairs of photographs: a face displaying an emotional expression-positive, negative or neutral-and an everyday household object. All participants were subjected to a mild social threat induction being told they would speak to a small group of people on completion of the task.
OUTCOMES & RESULTS: The stuttering group scored significantly higher than controls for trait anxiety, but did not differ from controls on measures of social anxiety. Non-socially anxious adults who stutter did not display an attentional bias to avoid looking at photographs of faces relative to everyday objects. Higher scores on trait anxiety were positively correlated with attention towards photographs of negative faces.
CONCLUSION & IMPLICATIONS: Attentional biases as assessed by the probe detection task may not be a characteristic of non-socially anxious adults who stutter. A vigilance to attend to threat information with high trait anxiety is consistent with findings of studies using the emotional Stroop task in stuttering and social anxiety disorder. Future research should investigate attentional processing in people who stutter who are socially anxious. It will also be useful for future studies to employ research paradigms that involve speaking. Continued research is warranted to explore information processing and potential biases that could be involved in the maintenance of anxiety and failure to maintain the benefits of speech treatment outcomes.
© 2015 Royal College of Speech and Language Therapists.
PMID: 26176777 [PubMed - in process]
Attention demands of language production in adults who stutter. - ATENÇÃO
Clin Neurophysiol. 2016 Apr;127(4):1942-60. doi: 10.1016/j.clinph.2016.01.016. Epub 2016 Feb 1.
Maxfield ND, Olsen WL, Kleinman D, Frisch SA, Ferreira VS, Lister JJ.
University of South Florida, USA; University of Illinois, Urbana-Champaign, USA; University of California, San Diego, USA.
OBJECTIVE: We investigated whether language production is atypically resource-demanding in adults who stutter (AWS) versus typically-fluent adults (TFA).
METHODS: Fifteen TFA and 15 AWS named pictures overlaid with printed Semantic, Phonological or Unrelated Distractor words while monitoring frequent low tones versus rare high tones. Tones were presented at a short or long Stimulus Onset Asynchrony (SOA) relative to picture onset. Group, Tone Type, Tone SOA and Distractor Type effects on P3 amplitudes were the main focus. P3 amplitude was also investigated separately in a simple tone oddball task.
RESULTS: P3 morphology was similar between groups in the simple task. In the dual task, a P3 effect was detected in TFA in all three distractor conditions at each Tone SOA. In AWS, a P3 effect was attenuated or undetectable at the Short Tone SOA depending on Distractor Type.
CONCLUSIONS: In TFA, attentional resources were available for P3-indexed processes in tone perception and categorization in all distractor conditions at both Tone SOAs. For AWS, availability of attentional resources for secondary task processing was reduced as competition in word retrieval was resolved.
SIGNIFICANCE: Results suggest that language production can be atypically resource-demanding in AWS. Theoretical and clinical implications of the findings are discussed.
PMID: 26971476 [PubMed - in process] PMCID: PMC4792332 [Available on 2017-04-01]
Behavior Assessment Battery: A Pilot Study of the Affective, Behavioral, and Cognitive Correlates Surrounding Spasmodic Dysphonia. - OUTRAS ÁREAS
J Voice. 2016 Jan;30(1):53-60. doi: 10.1016/j.jvoice.2015.03.007. Epub 2015 Jul 22.
Vanryckeghem M, Hoffman Ruddy B, Lehman J.
University of Central Florida, Orlando, Florida; The Ear Nose Throat and Plastic Surgery Associates, Orlando, Florida.
OBJECTIVE/HYPOTHESIS: This study investigates if adults with adductor spasmodic dysphonia (ADSD) report to experience anxiety and voice problems in particular situations, indicate the presence of negative speech-associated attitude, and/or the use of coping behaviors, by means of the Behavior Assessment Battery (BAB) modified for voice.
METHODS: Thirty-two participants with ADSD and 32 adults without a voice disorder participated in this study. Each person completed four different BAB-Voice subtests. These standardized self-report tests are adaptations of the original BAB for people who stutter and explore an individual's speech-related belief, negative emotional reaction to and speech problems in particular speech situations, and the use of concomitant behaviors.
RESULTS: Individuals with spasmodic dysphonia (SD) scored statistically significantly higher compared to typical speakers on all BAB subtests, indicating that individuals with SD report being significantly more anxious and experiencing significantly more voice problems in particular speech circumstances. They also reported a significant amount of negative speech-associated attitude and the use of a significant number of coping behaviors. Internal reliability was good for three of the four BAB subtests.
CONCLUSIONS: The BAB is capable of reflecting the dimensions that surround the disorder of SD. The self-report measures have the potential to augment the observations made by the clinician and may lead to a more diverse and all-encompassing therapy for the person suffering from SD. Future research with a revised version of the BAB-Voice will continue to explore the validity, reliability, and replicability of the initial data.
Published by Elsevier Inc.
PMID: 26209041 [PubMed - in process]
Benign hereditary chorea, not only chorea: a family case presentation. - GENÉTICA
Cerebellum Ataxias. 2016 Feb 2;3:3. doi: 10.1186/s40673-016-0041-7. eCollection 2016.
Koht J, Løstegaard SO, Wedding I, Vidailhet M, Louha M, Tallaksen CM
Drammen Hospital, Vestre Viken Health Trust, Drammen, Norway; University of Oslo, Oslo, Norway; Oslo University Hospital, Ullevål, Oslo, Norway; Sorbonne Universités, UPMC Univ Paris Institut du Cerveau et de la Moelle épinière, Paris, France; Hôpital Armand Trousseau- AP-HP, Paris, France.
Free Article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4736661/pdf/40673_2016_Article_41.pdf
BACKGROUND: Benign hereditary chorea is a rare disorder which is characterized by early onset, non-progressive choreic movement disturbance, with other hyperkinetic movements and unsteadiness also commonly seen. Hypothyroidism and lung disease are frequent additional features. The disorder is caused by mutations of the NKX2-1 gene on chromosome 14.
CASE PRESENTATION: A Norwegian four-generation family with eight affected was identified. All family members had an early onset movement disorder, starting before one year of age with motor delay and chorea. Learning difficulties were commonly reported from early school years. The family presented with choreic movements at rest, but other movements were seen; myoclonus, dystonia, ataxia, stuttering and tics-like movements. All patients reported unsteadiness and ataxic gait was observed in two patients. Videos are provided in the supplementary material. Most affected family members had asthma and a subclinical or clinical hypothyroidism. Sequencing revealed a mutation in the NKX2-1 gene in all eight affected family members.
CONCLUSIONS: This is the first Norwegian family with benign hereditary chorea due to a mutation in the NKX2-1 gene, c.671 T > G (p.Leu224Arg). This family demonstrates well the wide phenotype, including dystonia, myoclonus and ataxia.
PMID: 26839702[PubMed] PMCID: PMC4736661
Beyond production: Brain responses during speech perception in adults who stutter -NEUROCIÊNCIAS
Neuroimage Clin. 2016 Mar 3;11:328-38. doi: 10.1016/j.nicl.2016.02.017. eCollection 2016.
Free PMC Article - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893016/pdf/main.pdf
Halag-Milo T, Stoppelman N, Kronfeld-Duenias V, Civier O, Amir O, Ezrati-Vinacour R, Ben-Shachar M
Bar-Ilan University, Ramat-Gan, Israel; Ben-Gurion University of the Negev, Beer-Sheva, Israel;
Tel-Aviv University, Tel-Aviv, Israel.
Developmental stuttering is a speech disorder that disrupts the ability to produce speech fluently. While stuttering is typically diagnosed based on one's behavior during speech production, some models suggest that it involves more central representations of language, and thus may affect language perception as well. Here we tested the hypothesis that developmental stuttering implicates neural systems involved in language perception, in a task that manipulates comprehensibility without an overt speech production component. We used functional magnetic resonance imaging to measure blood oxygenation level dependent (BOLD) signals in adults who do and do not stutter, while they were engaged in an incidental speech perception task. We found that speech perception evokes stronger activation in adults who stutter (AWS) compared to controls, specifically in the right inferior frontal gyrus (RIFG) and in left Heschl's gyrus (LHG). Significant differences were additionally found in the lateralization of response in the inferior frontal cortex: AWS showed bilateral inferior frontal activity, while controls showed a left lateralized pattern of activation. These findings suggest that developmental stuttering is associated with an imbalanced neural network for speech processing, which is not limited to speech production, but also affects cortical responses during speech perception.
PMID: 27298762 [PubMed - in process]
Bupropion-induced stuttering treated with haloperidol.
Clin Toxicol (Phila). 2016 May 9:1. [Epub ahead of print]
McAllister MW, Woodhall DM.
Columbus Regional Healthcare System, Columbus , GA , USA
No abstract available
PMID: 27159769 [PubMed - as supplied by publisher]
Case file audit of Lidcombe program outcomes in a student-led stuttering clinic. - TERAPIA
Int J Speech Lang Pathol. 2016 Apr 12:1-9. [Epub ahead of print]
McCulloch J, Swift MC, Wagnitz B.
Flinders University, Adelaide , South Australia , Australia.
PURPOSE: The current study aimed to benchmark clinical outcomes for preschool-aged clients (2;0-5;11 years old) that attended a student-led clinic and undertook the Lidcombe Program.
METHOD: A case file audit was undertaken for all preschool clients who attended the clinic between February 2008 and February 2013 and commenced the Lidcombe Program. Clients were grouped according to Stage 1 completion. A mixed ANOVA was used to test for differences between the groups in initial and final percentage syllables stuttered (%SS). Associations between case variable factors and treatment duration were investigated using Pearson correlations.
RESULT: Clients who completed Stage 1 had final %SS and severity rating (SR) scores comparable to the literature; however, the median Stage 1 duration was greater. Over half of the clients (57%) withdrew prior to completing Stage 1. These clients had a significantly higher %SS at final treatment session than their completing peers. Initial %SS and SR scores were the only case variables associated with treatment duration.
CONCLUSION: Students can achieve the same short-term treatment outcomes for children who stutter using the Lidcombe Program as the current published literature; however, treatment duration is greater and may impact completion. Implications of this for clinical education are discussed.
PMID: 27070028 [PubMed - as supplied by publisher]
Case report of aripiprazole in the treatment of adolescent stuttering.
Ann Clin Psychiatry. 2016 Feb 1;28(1):e1-e2.
Hoang JL1, Patel S, Maguire GA.
University of California, Riverside, Riverside, CA USA.
No abstract available
PMID: 26554374 [PubMed - as supplied by publisher]
Carry-over fluency induced by extreme prolongations: A new behavioral paradigm. - TERAPIA
Med Hypotheses. 2016 Apr;89:102-6. doi: 10.1016/j.mehy.2016.02.013. Epub 2016 Feb 23.
Briley PM, Barnes MP, Kalinowski JS
East Carolina University, Greenville, United States
Extreme prolongations, which can be generated via extreme delayed auditory feedback (DAF) (e.g., 250-500ms) or mediated cognitively with timing applications (e.g., analog stopwatch) at 2s per syllable, have long been behavioral techniques used to inhibit stuttering. Some therapies have used this rate solely to establish initial fluency, while others use extremely slowed speech to establish fluency and add other strategic techniques such as easy onsets and diaphragmatic breathing. Extreme prolongations generate effective, efficient, and immediate forward flowing fluent speech, removing the signature behaviors of discrete stuttering (i.e., syllable repetitions and audible and inaudible postural fixations). Prolonged use of extreme prolongations establishes carry-over fluency, which is spontaneous, effortless speech absent of most, if not all, overt and covert manifestations of stuttering. The creation of this immediate fluency and the immense potential of extreme prolongations to generate long periods of carry-over fluency have been overlooked by researchers and clinicians alike. Clinicians depart from these longer prolongation durations as they attempt to achieve the same fluent results at a near normal rate of speech. Clinicians assume they are re-teaching fluency and slow rates will give rise to more normal rates with less control, but without carry-over fluency, controls and cognitive mediation are always needed for the inherently unstable speech systems of persons who stutter to experience fluent speech. The assumption being that the speech system is untenable without some level of cognitive and motoric monitoring that is always necessary. The goal is omnipresent "near normal rate sounding fluency" with continuous mediation via cognitive and motoric processes. This pursuit of "normal sounding fluency" continues despite ever-present relapse. Relapse has become so common that acceptance of stuttering is the new therapy modality because relapse has come to be understood as somewhat inevitable. Researchers and clinicians fail to recognize that immediate amelioration of stuttering and its attendant carry-over fluency are signs of a different pathway to fluency. In this path, clinicians focus on extreme prolongations and the extent of their carry-over. While fluency is automatically generated under these extreme prolongations, the realization is that communication at this rate in routine speaking tasks is not feasible. The perceived solution is a systematic reduction in the duration of these prolongations, which attempts to approximate "normal speech." Typically, the reintroduction of speech at a normalized rate precipitates a laborious style that is undesirable to the person who stutters (PWS) and is discontinued, once departed from the comforts of the clinical setting. The inevitable typically occurs; the well-intentioned therapist instructs the PWS to focus on the techniques while speaking at a rate that is nearest normal speech, but the overlooked extreme prolongations are unlikely to ever be revisited. The foundation of this hypothesis is that the departure from fluency generators (e.g. extreme prolongations) is the cause of regression to the stuttering set point. In turn, we postulate that the continued use of extreme prolongations, as a solitary practice method, will establish and nurture different neural pathways that will create a modality of fluent speech, able to be experienced without cognitive or motoric mediation. This would therefore result in fewer occurrences of stuttering due to a phenomenon called carry-over fluency. Thus, we hypothesize that the use of extreme prolongations fosters neural pathways for fluent speech, which will result in carry-over fluency that does not require mediation by the speaker.
PMID: 26968921 [PubMed - in process]
Communication restriction in adults who stutter: Part II. - TERAPIA
Clin Linguist Phon. 2016 Apr 6:1-22. [Epub ahead of print]
Lee A, Robb M, van Dulm O, Ormond T.
University of Canterbury , Christchurch , New Zealand; Stellenbosch University, Stellenbosch , South Africa.
This article presents a follow-up study to Lee, van Dulm, Robb, and Ormond (2015). The aim was to explore communication restriction in adults with stuttering (AWS) using typical language measures and systemic functional linguistics (SFL) analyses. The article compared the pre- and post-treatment performance of AWS in language productivity and complexity, transitivity, modality, appraisal, and theme. Ten-minute conversational samples were obtained from 20 AWS before and after participation in intensive stuttering treatment. Transcripts were analysed for quantity and complexity of verbal output, and frequency of transitivity, modality, appraisal and theme resources. Between pre- and post-treatment, the following differences were observed: (1) a significant increase in frequency of modal operators, and trends approaching significance for (2) increased language complexity (3) increased language expressing appraisal. These changes suggest increased flexibility of language use in AWS following treatment, particularly towards interpersonal engagement. The value of SFL to this area of research is discussed.
PMID: 27050117 [PubMed - as supplied by publisher]
Comparison of different speech tasks among adults who stutter and adults who do not stutter. - AUDITIVO
Clinics (Sao Paulo). 2016 Mar;71(3):152-5. doi: 10.6061/clinics/2016(03)06.
Free Full Text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4785848/pdf/cln-71-03-152.pdf
Ritto AP, Costa JB, Juste FS, Andrade CR.
Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo/SP, Brazil.
OBJECTIVES: In this study, we compared the performance of both fluent speakers and people who stutter in three different speaking situations: monologue speech, oral reading and choral reading. This study follows the assumption that the neuromotor control of speech can be influenced by external auditory stimuli in both speakers who stutter and speakers who do not stutter.
METHOD: Seventeen adults who stutter and seventeen adults who do not stutter were assessed in three speaking tasks: monologue, oral reading (solo reading aloud) and choral reading (reading in unison with the evaluator). Speech fluency and rate were measured for each task.
RESULTS: The participants who stuttered had a lower frequency of stuttering during choral reading than during monologue and oral reading.
CONCLUSIONS: According to the dual premotor system model, choral speech enhanced fluency by providing external cues for the timing of each syllable compensating for deficient internal cues.
PMID: 27074176 [PubMed - in process] PMCID: PMC4785848
Decreased Cerebellar-Orbitofrontal Connectivity Correlates with Stuttering Severity: Whole-Brain Functional and Structural Connectivity Associations with Persistent Developmental Stuttering - NEUROCIÊNCIAS
Front Hum Neurosci. 2016 May 3;10:190. doi: 10.3389/fnhum.2016.00190. eCollection 2016.
Free PMC Article - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855981/pdf/fnhum-10-00190.pdf
Sitek KR, Cai S, Beal DS, Perkell JS, Guenther FH, Ghosh SS.
Harvard Medical School, Boston, MA, USA; Massachusetts Institute of Technology, Cambridge, MA, USA; Boston University, Boston, MA, USA; Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada.
Persistent developmental stuttering is characterized by speech production disfluency and affects 1% of adults. The degree of impairment varies widely across individuals and the neural mechanisms underlying the disorder and this variability remain poorly understood. Here we elucidate compensatory mechanisms related to this variability in impairment using whole-brain functional and white matter connectivity analyses in persistent developmental stuttering. We found that people who stutter had stronger functional connectivity between cerebellum and thalamus than people with fluent speech, while stutterers with the least severe symptoms had greater functional connectivity between left cerebellum and left orbitofrontal cortex (OFC). Additionally, people who stutter had decreased functional and white matter connectivity among the perisylvian auditory, motor, and speech planning regions compared to typical speakers, but greater functional connectivity between the right basal ganglia and bilateral temporal auditory regions. Structurally, disfluency ratings were negatively correlated with white matter connections to left perisylvian regions and to the brain stem. Overall, we found increased connectivity among subcortical and reward network structures in people who stutter compared to controls. These connections were negatively correlated with stuttering severity, suggesting the involvement of cerebellum and OFC may underlie successful compensatory mechanisms by more fluent stutterers.
PMID: 27199712 [PubMed] PMCID: PMC4855981
Deep brain stimulation for the treatment of obsessive-compulsive disorder with implications for improvements in stuttering.
Ann Clin Psychiatry. 2016 Feb;28(1):68-69.
Lochhead JD, Nelson MA, Lake K, Flick R, Maguire GA.
University of California, Irvine, Orange, CA USA.
No abstract available
PMID: 26855988 [PubMed - as supplied by publisher]
Delayed N2 response in Go condition in a visual Go/Nogo ERP study in children who stutter.
J Fluency Disord. 2016 Jun;48:16-26. doi: 10.1016/j.jfludis.2016.02.001. Epub 2016 Mar 5.
Piispala J, Kallio M, Bloigu R, Jansson-Verkasalo E.
Oulu University Hospital, Finland; University of Turku, Finland.
PURPOSE OF THE STUDY: The main aim of the study was to investigate the attentional and inhibitory abilities and their underlying processes of children who stutter by using behavioural measurement and event-related potentials (ERP) in a visual Go/Nogo paradigm.
METHODS: Participants were 11 children who stutter (CWS; mean age 8.1, age range 6.3-9.5 years) and 19 typically developed children (TDC; mean age 8.1, age range 5.8-9.6 years). They performed a visual Go/Nogo task with simultaneous EEG recording to obtain ERP responses.
RESULTS: Results showed that CWS had longer N2 and P3 latencies in the Go condition compared to the TDC. In contrast, the groups did not differ significantly in the Nogo condition or behavioural measures.
CONCLUSIONS: Our findings did not confirm less efficient inhibitory control in CWS but suggest atypical attentional processing such as stimulus evaluation and response selection.
EDUCATIONAL OBJECTIVES: The reader will be able to (a) describe recent findings on attention and inhibitory control in children who stutter, (b) describe the measurement of attentional processing, including inhibitory control, and (c) describe the findings on attentional processing in children who stutter as indexed by the event-related potentials in a visual Go/Nogo paradigm.
PMID: 27498891 DOI: 10.1016/j.jfludis.2016.02.001
[PubMed - in process]
Developing and Using Big Data Archives to Quantify Disfluency and Stuttering in Bilingual Children. - LINGUAGEM
Semin Speech Lang. 2016 May;37(2):117-27. doi: 10.1055/s-0036-1580739. Epub 2016 Apr 25.
Brundage SB, Corcoran T, Wu C, Sturgill C.
Department of Speech and Hearing Science, George Washington University, Washington, DC
Worldwide, bilingualism is the rule rather than the exception, and yet we have surprisingly little research data on the fluency development of bilingual children, and even less information on their potential risk for stuttering. Many variables influence a bilingual child's language, speech, and fluency development (e.g., amount of exposure to each language); controlling these variables in research studies necessitates large numbers of bilingual participants. The frequency and types of typical disfluencies in the speech of young children are also varied. In addition, stuttering is also variable in its presentation, and when we assess bilingual children for the presence of stuttering we are adding yet another layer of complexity. This article reviews research on typical disfluencies in monolingual and bilingual speakers, and how this information might be useful clinically. We provide examples from our laboratory to illustrate how computerized language analysis (CLAN) can be used over time to track the behaviors of research participants. We also present data on the identification of stuttering in bilingual children. We discuss challenges to studying bilingual speakers and how big data initiatives such as TalkBank address these challenges to increase our understanding of bilingual fluency development.
PMID: 27111271 [PubMed - in process]
Dissociations among linguistic, cognitive, and auditory-motor neuroanatomical domains in children who stutter. - INFANTIL
J Commun Disord. 2016 Mar 15;61:29-47. doi: 10.1016/j.jcomdis.2016.03.003. [Epub ahead of print]
Choo AL, Burnham E, Hicks K, Chang SE.
University of Michigan, Ann Arbor, MI, USA; Michigan State University, East Lansing, MI, USA.
The onset of developmental stuttering typically occurs between 2 to 4 years of age, coinciding with a period of rapid development in speech, language, motor and cognitive domains. Previous studies have reported generally poorer performance and uneven, or "dissociated" development across speech and language domains in children who stutter (CWS) relative to children who do not stutter (CWNS) (Anderson, Pellowski, & Conture, 2005). The aim of this study was to replicate and expand previous findings by examining whether CWS exhibit dissociated development across speech-language, cognitive, and motor domains that are also reflected in measures of neuroanatomical development. Participants were 66CWS (23 females) and 53CWNS (26 females) ranging from 3 to 10 years. Standardized speech, language, cognitive, and motor skills measures, and fractional anisotropy (FA) values derived from diffusion tensor imaging from speech relevant "dorsal auditory" left perisylvian areas (Hickok & Poeppel, 2007) were analyzed using a correlation-based statistical procedure (Coulter, Anderson, & Conture, 2009) that quantified dissociations across domains. Overall, CWS scored consistently lower on speech, language, cognitive and motor measures, and exhibited dissociated development involving these same measures and white matter neuroanatomical indices relative to CWNS. Boys who stutter exhibited a greater number of dissociations compared to girls who stutter. Results suggest a subgroup of CWS may have incongruent development across multiple domains, and the resolution of this imbalance may be a factor in recovery from stuttering.
PMID: 27010940 [PubMed - as supplied by publisher]
Does Working Memory Enhance or Interfere With Speech Fluency in Adults Who Do and Do Not Stutter? Evidence From a Dual-Task Paradigm. - TERAPIA
J Speech Lang Hear Res. 2016 May 10:1-15. doi: 10.1044/2015_JSLHR-S-15-0249. [Epub ahead of print]
Eichorn N, Marton K, Schwartz RG, Melara RD, Pirutinsky S.
PURPOSE: The present study examined whether engaging working memory in a secondary task benefits speech fluency. Effects of dual-task conditions on speech fluency, rate, and errors were examined with respect to predictions derived from three related theoretical accounts of disfluencies.
METHOD: Nineteen adults who stutter and twenty adults who do not stutter participated in the study. All participants completed 2 baseline tasks: a continuous-speaking task and a working-memory (WM) task involving manipulations of domain, load, and interstimulus interval. In the dual-task portion of the experiment, participants simultaneously performed the speaking task with each unique combination of WM conditions.
RESULTS: All speakers showed similar fluency benefits and decrements in WM accuracy as a result of dual-task conditions. Fluency effects were specific to atypical forms of disfluency and were comparable across WM-task manipulations. Changes in fluency were accompanied by reductions in speaking rate but not by corresponding changes in overt errors.
CONCLUSIONS: Findings suggest that WM contributes to disfluencies regardless of stuttering status and that engaging WM resources while speaking enhances fluency. Further research is needed to verify the cognitive mechanism involved in this effect and to determine how these findings can best inform clinical intervention.
PMID: 27168125 [PubMed - as supplied by publisher]
Dorsal and ventral language pathways in persistent developmental stuttering. - NEUROCIÊNCIAS
Cortex. 2016 Apr 12;81:79-92. doi: 10.1016/j.cortex.2016.04.001. [Epub ahead of print]
Kronfeld-Duenias V, Amir O, Ezrati-Vinacour R, Civier O, Ben-Shachar M.
Bar-Ilan University, Ramat-Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel.
Persistent developmental stuttering is a speech disorder that affects an individual's ability to fluently produce speech. While the disorder mainly manifests in situations that require language production, it is still unclear whether persistent developmental stuttering is indeed a language impairment, and if so, which language stream is implicated in people who stutter. In this study, we take a neuroanatomical approach to this question by examining the structural properties of the dorsal and ventral language pathways in adults who stutter (AWS) and fluent controls. We use diffusion magnetic resonance imaging and individualized tract identification to extract white matter volumes and diffusion properties of these tracts in samples of adults who do and do not stutter. We further quantify diffusion properties at multiple points along the tract and examine group differences within these diffusivity profiles. Our results show differences in the dorsal, but not in the ventral, language-related tracts. Specifically, AWS show reduced volume of the left dorsal stream, as well as lower anisotropy in the right dorsal stream. These data provide neuroanatomical support for the view that stuttering involves an impairment in the bidirectional mapping between auditory and articulatory cortices supported by the dorsal pathways, not in lexical access and semantic aspects of language processing which are thought to rely more heavily on the left ventral pathways.
PMID: 27179916 [PubMed - as supplied by publisher]
Effect(s) of Language Tasks on Severity of Disfluencies in Preschool Children with Stuttering. - INFANTIL
J Psycholinguist Res. 2016 May 28. [Epub ahead of print]
Zamani P, Ravanbakhsh M, Weisi F, Rashedi V, Naderi S, Hosseinzadeh A, Rezaei M.
Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Iran University of Medical Sciences, Tehran, Iran; University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Bu-Ali Sine University, Hamadan, Iran; Hamadan University of Medical Sciences and Health Services, Hamadan, Iran.
Speech disfluency in children can be increased or decreased depending on the type of linguistic task presented to them. In this study, the effect of sentence imitation and sentence modeling on severity of speech disfluencies in preschool children with stuttering is investigated. In this cross-sectional descriptive analytical study, 58 children with stuttering (29 with mild stuttering and 29 with moderate stuttering) and 58 typical children aged between 4 and 6 years old participated. The severity of speech disfluencies was assessed by SSI-3 and TOCS before and after offering each task. In boys with mild stuttering, The mean stuttering severity scores in two tasks of sentence imitation and sentence modeling were [Formula: see text] and [Formula: see text] respectively ([Formula: see text]). But, in boys with moderate stuttering the stuttering severity in the both tasks were [Formula: see text] and [Formula: see text] respectively ([Formula: see text]). In girls with mild stuttering, the stuttering severity in two tasks of sentence imitation and sentence modeling were [Formula: see text] and [Formula: see text] respectively ([Formula: see text]). But, in girls with moderate stuttering the mean stuttering severity in the both tasks were [Formula: see text] and [Formula: see text] respectively ([Formula: see text]). In both gender of typical children, the score of speech disfluencies had no significant difference between two tasks ([Formula: see text]). In preschool children with mild stuttering and peer non-stutters, performing the tasks of sentence imitation and sentence modeling could not increase the severity of stuttering. But, in preschool children with moderate stuttering, doing the task of sentence modeling increased the stuttering severity score.
PMID: 27236324 [PubMed - as supplied by publisher]
Formant transitions in the fluent speech of Farsi-speaking people who stutter - FALA
J Fluency Disord. 2016 Jun;48:1-15. doi: 10.1016/j.jfludis.2016.01.005. Epub 2016 Feb 11.
Dehqan A, Yadegari F, Blomgren M, Scherer RC.
University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Zahedan University of Medical Sciences, Zahedan, Iran; University of Utah, Salt Lake City, UT , USA; Bowling Green State University, Bowling Green, OH, USA.
PURPOSE: Second formant (F2) transitions can be used to infer attributes of articulatory transitions. This study compared formant transitions during fluent speech segments of Farsi (Persian) speaking people who stutter and normally fluent Farsi speakers.
METHODS: Ten Iranian males who stutter and 10 normally fluent Iranian males participated. Sixteen different "CVt" tokens were embedded within the phrase "Begu CVt an". Measures included overall F2 transition frequency extents, durations, and derived overall slopes, initial F2 transition slopes at 30ms and 60ms, and speaking rate.
RESULTS: (1) Mean overall formant frequency extent was significantly greater in 14 of the 16 CVt tokens for the group of stuttering speakers. (2) Stuttering speakers exhibited significantly longer overall F2 transitions for all 16 tokens compared to the nonstuttering speakers. (3) The overall F2 slopes were similar between the two groups. (4) The stuttering speakers exhibited significantly greater initial F2 transition slopes (positive or negative) for five of the 16 tokens at 30ms and six of the 16 tokens at 60ms. (5) The stuttering group produced a slower syllable rate than the non-stuttering group.
CONCLUSIONS: During perceptually fluent utterances, the stuttering speakers had greater F2 frequency extents during transitions, took longer to reach vowel steady state, exhibited some evidence of steeper slopes at the beginning of transitions, had overall similar F2 formant slopes, and had slower speaking rates compared to nonstuttering speakers. Findings support the notion of different speech motor timing strategies in stuttering speakers. Findings are likely to be independent of the language spoken.
Educational objectives This study compares aspects of F2 formant transitions between 10 stuttering and 10 nonstuttering speakers. Readers will be able to describe: (a) characteristics of formant frequency as a specific acoustic feature used to infer speech movements in stuttering and nonstuttering speakers, (b) two methods of measuring second formant (F2) transitions: the visual criteria method and fixed time criteria method, (c) characteristics of F2 transitions in the fluent speech of stuttering speakers and how those characteristics appear to differ from normally fluent speakers, and (d) possible cross-linguistic effects on acoustic analyses of stuttering.
PMID: 27498890 DOI: 10.1016/j.jfludis.2016.01.005
From Grapheme to Phonological Output: Performance of Adults Who Stutter on a Word Jumble Task. - LINGUAGEM
PLoS One. 2016 Mar 10;11(3):e0151107. doi: 10.1371/journal.pone.0151107. eCollection 2016.
Free full text - http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0151107
McGill M, Sussman H, Byrd CT.
The University of Texas at Austin, Austin, Texas, United States of America.
PURPOSE: The purpose of the present study was to extend previous research by analyzing the ability of adults who stutter to use phonological working memory in conjunction with lexical access to perform a word jumble task.
METHOD: Forty English words consisting of 3-, 4-, 5-, and 6-letters (n = 10 per letter length category) were randomly jumbled using a web-based application. During the experimental task, 26 participants were asked to silently manipulate the scrambled letters to form a real word. Each vocal response was coded for accuracy and speech reaction time (SRT).
RESULTS: Adults who stutter attempted to solve fewer word jumble stimuli than adults who do not stutter at the 4-letter, 5-letter, and 6-letter lengths. Additionally, adults who stutter were significantly less accurate solving word jumble tasks at the 4-letter, 5-letter, and 6-letter lengths compared to adults who do not stutter. At the longest word length (6-letter), SRT was significantly slower for the adults who stutter than the fluent controls.
CONCLUSION: Results of the current study lend further support to the notion that differences in various aspects of phonological processing, including vision-to-sound conversions, sub-vocal stimulus manipulation, and/or lexical access are compromised in adults who stutter.
PMID: 26963917 [PubMed - in process]
General vulnerability to stuttering: The experience of stuttering and conditions bringing about invulnerability.- CONCEITO
Med Hypotheses. 2016 Aug;93:55-61. doi: 10.1016/j.mehy.2016.05.016. Epub 2016 May 18.
Briley PM, Kalinowski JS.
East Carolina University, Greenville, United States.
General vulnerability to stuttering is the broad awareness of stuttering and the ever-present, experiential sense of a person who stutters (PWS). It is defined by stuttering in all its forms and the awareness of its presence, both in moments of stuttering and moments of perceivably fluent speech. Under the heading of general vulnerability to stuttering is specific vulnerability to stuttering, which includes the actual events of stuttering (i.e., overt symptoms, covert symptoms, subperceptual stuttering, and anticipation of stuttering). The differentiation between the two is that specific vulnerability requires a specific moment of stuttering where general vulnerability does not.
PMID: 27372857 DOI: 10.1016/j.mehy.2016.05.016
[PubMed - in process]
Heritability of non-speech auditory processing skills. - OUTRAS ÁREAS
Eur J Hum Genet. 2016 Feb 17. doi: 10.1038/ejhg.2015.277. [Epub ahead of print]
Brewer CC, Zalewski CK, King KA, Zobay O, Riley A, Ferguson MA, Bird JE, McCabe MM, Hood LJ, Drayna D, Griffith AJ, Morell RJ, Friedman TB, Moore DR.
National Institutes of Health, Bethesda, MD, USA; Institute of Hearing Research, Nottingham, UK; Nottingham Hearing Biomedical Research Unit, Nottingham, UK; University of Maryland, College Park, MD, USA; Vanderbilt University, Nashville, TN, USA; Cincinnati Children's Hospital, Cincinnati, OH, USA.
Recent insight into the genetic bases for autism spectrum disorder, dyslexia, stuttering, and language disorders suggest that neurogenetic approaches may also reveal at least one etiology of auditory processing disorder (APD). A person with an APD typically has difficulty understanding speech in background noise despite having normal pure-tone hearing sensitivity. The estimated prevalence of APD may be as high as 10% in the pediatric population, yet the causes are unknown and have not been explored by molecular or genetic approaches. The aim of our study was to determine the heritability of frequency and temporal resolution for auditory signals and speech recognition in noise in 96 identical or fraternal twin pairs, aged 6-11 years. Measures of auditory processing (AP) of non-speech sounds included backward masking (temporal resolution), notched noise masking (spectral resolution), pure-tone frequency discrimination (temporal fine structure sensitivity), and nonsense syllable recognition in noise. We provide evidence of significant heritability, ranging from 0.32 to 0.74, for individual measures of these non-speech-based AP skills that are crucial for understanding spoken language. Identification of specific heritable AP traits such as these serve as a basis to pursue the genetic underpinnings of APD by identifying genetic variants associated with common AP disorders in children and adults.
PMID: 26883091 [PubMed - as supplied by publisher]
International Phase II clinical trial of CBTPsych: A standalone Internet social anxiety treatment for adults who stutter - EMOCIONAL
J Fluency Disord. 2016 Jun;48:35-43. doi: 10.1016/j.jfludis.2016.06.002. Epub 2016 Jun 28.
Menzies R, O'Brian S, Lowe R, Packman A, Onslow M.
The University of Sydney, Australia.
PURPOSE: CBTPsych is an individualized, fully automated, standalone Internet treatment program that requires no clinical contact or support. It is designed specifically for those who stutter. Two preliminary trials demonstrated that it may be efficacious for treating the social anxiety commonly associated with stuttering. However, both trials involved pre- and post-treatment assessment at a speech clinic. This contact may have increased compliance, commitment and adherence with the program. The present study sought to establish the effectiveness of CBTPsych in a large international trial with no contact of any kind from researchers or clinicians.
METHOD: Participants were 267 adults with a reported history of stuttering who were given a maximum of 5 months access to CBTPsych. Pre- and post-treatment functioning was assessed within the online program with a range of psychometric measures.
RESULTS: Forty-nine participants (18.4%) completed all seven modules of CBTPsych and completed the post-treatment online assessments. That compliance rate was far superior to similar community trials of self-directed Internet mental health programs. Completion of the program was associated with large, statistically and clinically significant reductions for all measures. The reductions were similar to those obtained in earlier trials of CBTPsych, and those obtained in trials of in-clinic CBT with an expert clinician.
CONCLUSIONS: CBTPsych is a promising individualized treatment for social anxiety for a proportion of adults who stutter, which requires no health care costs in terms of clinician contact or support.
EDUCATIONAL OBJECTIVES: The reader will be able to: (a) discuss the reasons for investigating CBTPsych without any clinical contact; (b) describe the main components of the CBTPsych treatment; (c) summarize the results of this clinical trial; (d) describe how the results might affect clinical practice, if at all.
PMID: 27498893 DOI: 10.1016/j.jfludis.2016.06.002
[PubMed - in process]
Is it necessary to assess fluent symptoms, duration of dysfluent events, and physical concomitants when identifying children who have speech difficulties? - AVALIAÇÃO
Clin Linguist Phon. 2016;30(9):696-719. doi: 10.1080/02699206.2016.1179345. Epub 2016 Jun 17.
Mirawdeli A1, Howell P1.
Department of Experimental Psychology , University College London , London , UK
Riley's (1994) Stuttering Severity Instrument (SSI) has three components: a symptom frequency measure (%SS), average duration of the three longest stutters, and a physical concomitant (PC) score. An assessment of whether it was necessary to use all of these when using SSI-3 to identify which children are at risk of speech difficulties was performed. Participants were 879 reception class children aged 4-6 years from UK schools. The distributions of the separate components of SSI-3 were examined. Departures from normality were noted for each component. The features seen in the distribution of the individual components were also apparent in the distribution of the overall scores (this was not normal and had multiple modes). These findings undermine the usefulness of the overall measure for identifying children at risk of speech difficulties. Prior work used a fixed SSI-3 threshold to identify at risk children. Classification of children as fluent or at risk based on this threshold was compared with classifications based on thresholds applied to the individual components. Classifications were comparable for %SS, but less satisfactory for duration and PC. These findings suggest that %SS performs similarly to the overall SSI-3 scores when used to identify at risk children. Procedures for identifying at risk children in schools need to be short and easy to administer. Thus, since there is no justification for including all components of SSI-3 and duration and physical concomitants are not sensitive measures of fluency, a procedure based on the frequency measure alone is appropriate for use in schools.
PMID: 27315282 DOI: 10.1080/02699206.2016.1179345
[PubMed - in process]
Late Recovery from Stuttering: The Role of Hand Dominancy, Fine Motor and Inhibition Control - PSICOMOTOR
Iran J Psychiatry. 2016 Jan;11(1):51-8.
Free PMC Article - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888141/pdf/IJPS-11-51.pdf
Mohammadi H, Khazaie H, Rezaei M, Joghataei MT.
Iran University of Medical Sciences, Tehran, Iran; Kermanshah University of Medical Sciences, Kermanshah, Iran;
OBJECTIVE: There are controversial reports about factors that affect recovery from stuttering. In the present study, the effect of hand dominancy, fine motor and inhibition control on late recovery from stuttering was investigated among a group of Kurdish-Persian children who stuttered in Iran.
METHOD: Twenty-two Kurdish-Persian children aged 7-14 years who stuttered were followed for 6 years. Based on the evaluation of three experienced speech therapists and parental judgments, these children were classified into recovered or persistent groups. Data about fine motor control of hand and inhibition control were obtained, using Purdue Pegboard and Victoria Strop Color Word Tests, respectively. Risk factors including sex, age, and family history of stuttering, handedness, inhibitory control and fine motor control of hand were compared between the groups and modeled to predict recovery from stuttering using logistic regression.
RESULTS: From the 22 participants, 5 (22.7%) recovered from stuttering. The recovered and persistent groups did not show significant differences in the interference effect. By dividing the scores of the Purdue Pegboard tests to the right and left hand, we created a new Handedness Index (HI). HI was significantly higher in the recovered group. The score of right hand was higher than the left in the recovered group, but no difference was found between the two hands in the persistent group. Among the investigated risk factors, only HI could predict the recovery from or persistency of stuttering with 94% sensitivity and 84% specificity.
CONCLUSION: Handedness Index can predict the recovery from stuttering significantly among children who stutter..
PMID: 27252769 [PubMed] PMCID: PMC4888141
Measuring Stuttering in Preschool-Aged Children across Different Languages: An International Study. - AVALIAÇÃO
Folia Phoniatr Logop. 2016 Feb 5;67(5):221-230. [Epub ahead of print]
Bosshardt HG1, Packman A, Blomgren M, Kretschmann J.
Ruhr-University Bochum, Bochum, Germany.
BACKGROUND/AIMS: Many speech-language pathologists (SLPs) are working in linguistically diverse communities and have to identify and measure stuttering in a language other than their own. The aim of the present study was to extend our understanding of how well SLPs can measurestuttering in other languages and to encourage collaboration between SLPs across cultures.
METHODS: Speech samples consisted of seven preschool-aged children each speaking one of the following languages: Danish, English, French, German, Greek, Italian, and Persian (Farsi). The judges were classified in seven groups of SLPs (n = 170) each speaking one of the seven languages of the children and two more English-speaking groups. Each judge rated the severity of stuttering in each child using a 10-point scale. The study was conducted over the Internet.
RESULTS: Overall, the judges' proficiency in a child's language was not systematically related to the variability and agreement of the severity ratings, accounting for maximally 4.6% of the variance.
CONCLUSION: SLPs should not be overly concerned about the appropriateness of their severity ratings if they feel less proficient in the native language of the stuttering children. It may also be encouraging for beginning clinicians that the severity ratings were not systematically related to professional experience.
© 2016 S. Karger AG, Basel.
PMID: 26845773 [PubMed - as supplied by publisher]
Mirror neurons as a model for the science and treatment of stuttering - TERAPIA
Neuroreport. 2016 Jan 6;27(1):56-60. doi: 10.1097/WNR.0000000000000500.
Snyder GJ, Waddell DE, Blanchet P.
University of Mississippi, Oxford, Mississippi; Baylor University, Waco, Texas, USA.
Persistent developmental stuttering is generally considered a speech disorder and affects ∼1% of the global population. While mainstream treatments continue to rely on unreliable behavioral speech motor targets, an emerging research perspective utilizes the mirror neuron system hypothesis as a neural substrate in the science and treatment of stuttering. The purpose of this exploratory study is to test the viability of the mirror neuron system hypothesis in the fluency enhancement of those who stutter. Participants were asked to speak while they were producing self-generated manual gestures, producing and visually perceiving self-generated manual gestures, and visually perceiving manual gestures, relative to a nonmanual gesture control speaking condition. Data reveal that all experimental speaking conditions enhanced fluent speech in all research participants, and the simultaneous perception and production of manual gesturing trended toward greater efficacious fluency enhancement. Coupled with existing research, we interpret these data as suggestive of fluency enhancement through subcortical involvement within multiple levels of an action understanding mirror neuron network. In addition, incidental findings report that stuttering moments were observed to simultaneously occur both orally and manually. Consequently, these data suggest that stuttering behaviors are compensatory, distal manifestations over multiple expressive modalities to an underlying centralized genetic neural substrate of the disorder.
PMID: 26565808 [PubMed - in process]
Neurophysiologic markers of primary motor cortex for laryngeal muscles and premotor cortex in caudal opercular part of inferior frontal gyrus investigated in motor speech disorder: a navigated transcranial magnetic stimulation (TMS) study. - NEUROCIÊNCIAS
Cogn Process. 2016 Apr 29. [Epub ahead of print]
Rogić Vidaković M, Jerković A, Jurić T, Vujović I, Šoda J, Erceg N, Bubić A, Zmajević Schönwald M, Lioumis P, Gabelica D, Đogaš
University of Split, Split, Croatia; University of Zagreb, Zagreb, Croatia; Clinical Unit for Intraoperative Neurophysiologic Monitoring, Zagreb, Croatia; Helsinki University Hospital, HUS, Helsinki, Finland; SGM Medical Monitoring, Split, Croatia.
Transcranial magnetic stimulation studies have so far reported the results of mapping the primary motor cortex (M1) for hand and tongue muscles in stuttering disorder. This study was designed to evaluate the feasibility of repetitive navigated transcranial magnetic stimulation (rTMS) for locating the M1 for laryngeal muscle and premotor cortical area in the caudal opercular part of inferior frontal gyrus, corresponding to Broca's area in stuttering subjects by applying new methodology for mapping these motor speech areas. Sixteen stuttering and eleven control subjects underwent rTMS motor speech mapping using modified patterned rTMS. The subjects performed visual object naming task during rTMS applied to the (a) left M1 for laryngeal muscles for recording corticobulbar motor-evoked potentials (CoMEP) from cricothyroid muscle and (b) left premotor cortical area in the caudal opercular part of inferior frontal gyrus while recording long latency responses (LLR) from cricothyroid muscle. The latency of CoMEP in control subjects was 11.75 ± 2.07 ms and CoMEP amplitude was 294.47 ± 208.87 µV, and in stuttering subjects CoMEP latency was 12.13 ± 0.75 ms and 504.64 ± 487.93 µV CoMEP amplitude. The latency of LLR in control subjects was 52.8 ± 8.6 ms and 54.95 ± 4.86 in stuttering subjects. No significant differences were found in CoMEP latency, CoMEP amplitude, and LLR latency between stuttering and control-fluent speakers. These results indicate there are probably no differences in stuttering compared to controls in functional anatomy of the pathway used for transmission of information from premotor cortex to the M1 cortices for laryngeal muscle representation and from there via corticobulbar tract to laryngeal muscles.
PMID: 27130564 [PubMed - as supplied by publisher]
Non-pharmacological treatments for stuttering in children and adults: a systematic review and evaluation of clinical effectiveness, and exploration of barriers to successful outcomes. - TERAPIA
Health Technol Assess. 2016 Jan;20(2):1-302. doi: 10.3310/hta20020.
Baxter S, Johnson M, Blank L, Cantrell A, Brumfitt S, Enderby P, Goyder E.
University of Sheffield, Sheffield, UK.
Free full text: http://www.ncbi.nlm.nih.gov/books/NBK338617/pdf/Bookshelf_NBK338617.pdf
BACKGROUND: Despite many years of research, there is no certainty regarding the cause of stuttering. Although numerous interventions have been developed, a broad-based systematic review across all forms of intervention for adults and children was needed including views and perceptions of people who stutter.
OBJECTIVE: The aims of the study were to report the clinical effectiveness of interventions for people who stutter(or clutter), to examine evidence regarding the views of people who stutter and the views of professionals regarding interventions.
DATA SOURCES: A systematic review of quantitative and qualitative literature was carried out between August 2013 and April 2014. The following electronic databases were searched: (1) MEDLINE, (2) EMBASE, (3) The Cochrane Library (including The Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, Health Technology Assessment Database and NHS Economic Evaluations Database), (4) PsycINFO, (5) Science Citation Index, (6) Social Science Citation Index, (7) Cumulative Index to Nursing and Allied Health Literature, (8) ASSIA, (9) Linguistics and Language Behavior Abstracts, (10) Sociological Abstracts and (11) the EPPI Centre. Reference lists of included papers and other reviews were screened and also key journals in the subject area were hand-searched.
REVIEW METHODS: The searches aimed to identify (1) evidence of clinical effectiveness in populations of pre-school children, school-aged children, adolescents and adults, and (2) data relating to perceptions of barriers and facilitators to intervention clinical effectiveness among staff and people who stutter. A metasynthesis of the two linked elements via development of a conceptual model was also carried out to provide further interpretation of the review findings.
RESULTS: A systematic search of the literature identified a large number of potentially relevant studies. Of these, 111 studies examining the clinical effectiveness of interventions, 25 qualitative papers and one mixed-methods paper met the criteria for inclusion in this review. Review of the effectiveness literature indicated evidence of positive outcomes across all types of interventions. Virtually all evidence we identified reported at least some positive effect for some participants. However, there was evidence of considerable individual variation in outcome for study participants. The qualitative literature highlighted the need for programmes to be tailored to individual need with variation at the levels of the intervention, the individual and interpersonal/social elements. Metasynthesis of the data highlighted the complexity of elements that need to be considered in evaluation of long-term impacts following stuttering interventions.
LIMITATIONS: Around two-thirds of the studies were considered to be at higher risk of bias. The heterogeneous nature and variability in outcomes meant that we were unable to complete a meta-analysis.
CONCLUSIONS: Although much of the evidence we identified was from studies at risk of bias, it is suggested that most available interventions for stuttering may be of benefit to at least some people who stutter. There is a requirement for greater clarity regarding what the core outcomes following stuttering intervention should be and also enhanced understanding of the process whereby interventions effect change. Further analysis of those for whom interventions have not produced a significant benefit may provide additional insights into the complex intervention-outcomes pathway.
STUDY REGISTRATION: This study is registered as PROSPERO CRD42013004861.
FUNDING: The National Institute for Health Research Health Technology Assessment programme.
[PubMed - in process]
Perceptual Accent Rating and Attribution in Psychogenic FAS: Some Further Evidence Challenging Whitaker's Operational Definition. - EMOCIONAL
Front Hum Neurosci. 2016 Mar 2;10:62. doi: 10.3389/fnhum.2016.00062. eCollection 2016.
Free PMC Article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773440/
Keulen S, Verhoeven J, Bastiaanse R, Mariën P, Jonkers R, Mavroudakis N5, Paquier P
Vrije Universiteit Brussel, Brussels, Belgium; Rijksuniversiteit Groningen, Groningen, Netherlands; Universiteit Antwerpen, Antwerp, Belgium; City University London, London, UK; Vrije Universiteit Brussel, Brussels, Belgium; ZNA Middelheim General Hospital, Antwerp, Belgium; Université Libre de Bruxelles , Brussels , Belgium
A 40-year-old, non-aphasic, right-handed, and polyglot (L1: French, L2: Dutch, and L3: English) woman with a 12-year history of addiction to opiates and psychoactive substances, and clear psychiatric problems, presented with a foreign accent of sudden onset in L1. Speech evolved toward a mostly fluent output, despite a stutter-like behavior and a marked grammatical output disorder. The psychogenic etiology of the accent foreignness was construed based on the patient's complex medical history and psychodiagnostic, neuropsychological, and neurolinguistic assessments. The presence of a foreign accent was affirmed by a perceptual accent rating and attribution experiment. It is argued that this patient provides additional evidence demonstrating the outdatedness of Whitaker's (1982) definition of foreign accent syndrome, as only one of the four operational criteria was unequivocally applicable to our patient: her accent foreignness was not only recognized by her relatives and the medical staff but also by a group of native French-speaking laymen. However, our patient defied the three remaining criteria, as central nervous system damage could not conclusively be demonstrated, psychodiagnostic assessment raised the hypothesis of a conversion disorder, and the patient was a polyglot whose newly gained accent was associated with a range of foreign languages, which exceeded the ones she spoke.
PMID: 26973488 [PubMed] PMCID: PMC4773440
Phase II trial of a syllable-timed speech treatment for school-age children who stutter - TERAPIA
J Fluency Disord. 2016 Jun;48:44-55. doi: 10.1016/j.jfludis.2016.06.001. Epub 2016 Jun 21.
Andrews C, O'Brian S, Onslow M, Packman A, Menzies R, Lowe R.
The University of Sydney, Australia.
PURPOSE: A recent clinical trial (Andrews et al., 2012) showed Syllable Timed Speech (STS) to be a potentially useful treatment agent for the reduction of stuttering for school-age children. The present trial investigated a modified version of this program that incorporated parent verbal contingencies.
METHODS: Participants were 22 stuttering children aged 6-11 years. Treatment involved training the children and their parents to use STS in conversation. Parents were also taught to use verbal contingencies in response to their child's stuttered and stutter-free speech and to praise their child's use of STS. Outcome assessments were conducted pre-treatment, at the completion of Stage 1 of the program and 6 months and 12 months after Stage 1 completion.
RESULTS: Outcomes are reported for the 19 children who completed Stage 1 of the program. The group mean percent stuttering reduction was 77% from pre-treatment to 12 months post-treatment, and 82% with the two least responsive participants removed. There was considerable variation in response to the treatment. Eleven of the children showed reduced avoidance of speaking situations and 18 were more satisfied with their fluency post-treatment. However, there was some suggestion that stuttering control was not sufficient to fully eliminate situation avoidance for the children.
CONCLUSIONS: The results of this trial are sufficiently encouraging to warrant further clinical trials of the method.
PMID: 27498894 DOI: 10.1016/j.jfludis.2016.06.001
[PubMed - in process]
Phonetic complexity of words immediately following utterance-initial productions in children who stutter. - FALA
J Fluency Disord. 2015 Nov 2. pii: S0094-730X(15)00078-9. doi: 10.1016/j.jfludis.2015.10.002. [Epub ahead of print]
Coalson GA, Byrd CT.
Louisiana State University, Baton Rouge, LA, USA; The University of Texas at Austin, Austin, TX, USA.
PURPOSE: The purpose of the present study was to analyze phonetic complexity in the speech of children who stutter in a manner distinct from previous research with specific emphasis on three methodological considerations: (1) analysis of the word immediately following the initial word in the utterance; (2) accounting for other additional linguistic and lexical factors; and (3) discrimination of disfluency types produced.
METHODS: Parent-child conversations were transcribed for 14 children who stutter (mean age=3 years, 7 months; SD=11.20 months) and coded for phonetic complexity using the Word Complexity Measure (WCM). Phonetic complexity of words immediately following the initial fluent or stuttered words of an utterance were included within binomial regression analyses, along with additional linguistic and lexical factors.
RESULTS: Analyses indicate that the phonetic complexity of the second word of an utterance was not a significant contributor to the likelihood of whole- or part-word repetitions on the preceding initial word of the utterance.
CONCLUSION: Findings support previous data that suggest the phonetic complexity of speech, at least as measured by the WCM, does not distinctly influence stuttered speech in preschool-age children.
EDUCATIONAL OBJECTIVES: Readers will be able to (a) describe the impact of phonetic complexity on the fluency of the preceding word in preschool-aged children, (b) summarize the findings within the context of the EXPLAN model, and (c) discuss the potential role of phonetic complexity, if any, during moments of stuttered speech.
Published by Elsevier Inc.
PMID: 26586416 [PubMed - as supplied by publisher]
Phonological memory in young children who stutter - FALA
J Commun Disord. 2016 May 17;62:54-66. doi: 10.1016/j.jcomdis.2016.05.006. [Epub ahead of print]
Pelczarski KM, Yaruss JS.
Kansas State University, Manhattan, USA; University of Pittsburgh, Pittsburgh, PA, USA.
This study investigated phonological memory in 5- and 6-year old children who stutter. Participants were 11 children who stutter matched on general language abilities, maternal education level, and sex to 11 typically fluent children. Participants completed norm-referenced nonword repetition and digit span tasks, as well as measures of expressive and receptive vocabulary and articulation. The nonword repetition task included stimuli that ranged from 1 to 7 syllables, while the digit naming task contained number strings containing 2-10 digits. Standardized tests of vocabulary and articulation abilities were tested as well. Groups were comparable on measures expressive vocabulary, receptive vocabulary, and articulation. Despite the fact that the majority of participants scored within typical limits, young children who stutter still performed significantly less well than children who do not stutter on the nonword repetition task. No between-group differences were revealed in the digit naming task. Typically fluent children demonstrated strong correlations between phonological memory tasks and language measures, while children who stutter did not. These findings indicate that young children who stutter may have sub-clinical differences in nonword repetition.
PMID: 27280891 [PubMed - as supplied by publisher]
Primary school teachers' opinions and attitudes towards stuttering in two South African urban education districts - SOCIAL
S Afr J Commun Disord. 2016 Jul 27;63:e1-e10. doi: 10.4102/sajcd.v63i1.157.
Abrahams K, Harty M, St Louis KO, Thabane L, Kathard H.
University of Cape Town
BACKGROUND: As teachers form an important part of the intervention process with children who stutter in primary school, the primary aim was to describe primary school teachers' attitudes in South Africa. The secondary aim was to compare teachers' attitudes towards stuttering in South Africa with those from a pooled group of respondents in the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) database from different countries collected in 2009-2014.
METHOD: A quantitative, cross-sectional survey research design was used. Primary schools in two education districts in Western Cape, South Africa, were sampled. The POSHA-S, a self-administered questionnaire, was completed by a cluster sample of 469 participants.
RESULTS: Overall positive attitudes towards stuttering were found, specifically related to the potential of people who stutter, although the result should be interpreted with caution as the sample was not homogenously positive. Teachers still had misconceptions about personality stereotypes and the cause of stuttering. The attitudes of the South African sample were slightly more positive compared with the samples in the current POSHA-S database.
CONCLUSION: When developing stuttering intervention strategies, there are a number of key considerations to take into account. The study provides a basis for speech-language therapists to think about intervention with teachers and which areas of stuttering to consider.
Public attitudes toward stuttering in Europe: Within-country and between-country comparisons. - SOCIAL
J Commun Disord. 2016 Jul-Aug;62:115-30. doi: 10.1016/j.jcomdis.2016.05.010. Epub 2016 Jun 1.
St Louis KO, Sønsterud H, Junuzović-Žunić L, Tomaiuoli D, Del Gado F, Caparelli E, Theiling M, Flobakk C, Helmen LN, Heitmann RR, Kvenseth H, Nilsson S, Wetterling T, Lundström C, Daly C, Leahy M, Tyrrell L, Ward D, Węsierska M.
West Virginia University, Morgantown, WV; Statped, Department of Speech and Language Disorders, Oslo, Norway; University of Tuzla, Tuzla, Bosnia and Herzegovina; CRC Balbuzie and University of Rome, Italy; Rheinisch Westfälische Technische Hochschule Aachen University, Germany; Aakershagan Training and Activity Centre, Stange, Hedmark, Norway; The Special Pedagogical Team, Gran, Oppland, Norway; Statped, Department of Speech and Language Disorders, Bergen, Norway; Trondheim, Norway; Lund University, Lund, Sweden; Helsingborg Hospital, Helsingborg, Sweden; Wicklow Primary Healthcare Centre, Knockrobin, Wicklow Town, Ireland; Trinity College, Dublin, Ireland;Berkshire Healthcare NHS Foundation Trust, Thatcham, UK; University of Reading, Reading, UK; University of York, York, UK.
INTRODUCTION: Epidemiological research methods have been shown to be useful in determining factors that might predict commonly reported negative public attitudes toward stuttering. Previous research has suggested that stuttering attitudes of respondents from North America and Europe (i.e., "The West"), though characterized by stereotypes and potential stigma, are more positive than those from several other regions of the world. This inference assumes that public attitudes within various regions characterized by "The West" are similar.
PURPOSE: This study aimed to determine the extent to which public stuttering attitudes are similar or different both within regions of three different European countries and between or among five different European countries or similar geographic areas. It also aimed to compare these European attitudes to attitudes from 135 samples around the world using a standard measure.
MATERIAL AND METHODS: Using convenience sampling, 1111 adult respondents from eight different investigations completed the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) in the dominant language of each country or area. In Study I, the authors compared attitudes within three different regions of Bosnia & Herzegovina, Italy, and Norway. In Study II, the authors compared attitudes between combined samples from Bosnia & Herzegovina, Italy, and Norway (with additional respondents from Sweden), and two other samples, one from Germany and the other from Ireland and England.
RESULTS: Attitudes of adults from the three samples within Bosnia & Herzegovina, Italy, and Norway were remarkably similar. By contrast, attitudes between the five different countries or area were quite dramatically different. Demographic variables on the POSHA-S did not predict the rank order of these between-country/area differences. Compared to the POSHA-S worldwide database, European attitudes ranged from less positive than average (i.e., Italians) to more positive than average (i.e., Norwegians and Swedes).
CONCLUSION: Factors related to national identity appear to play a significant role in differences in public attitudes in Europe and should be explored in future research.
PMID: 27367742 DOI: 10.1016/j.jcomdis.2016.05.010
[PubMed - in process]
Putting the cart before the horse: A cost effectiveness analysis of treatments for stuttering in young children requires evidence that the treatments analyzed were effective - TERAPIA
J Commun Disord. 2016 Apr 13. pii: S0021-9924(16)30022-3. doi: 10.1016/j.jcomdis.2016.04.006. [Epub ahead of print]
Bergþórsdóttir ÍÖ, Ingham RJ.
University of Iceland, Iceland; University of California, Santa Barbara, Santa Barbara, USA.
PURPOSE: To investigate the validity of findings from a recent study reported in this journal by de Sonneville-Koedoot, Bouwmans, Franken, and Stolk (2015) on the cost effectiveness of two programs for treating young children who stutter.
METHODS: The de Sonneville-Koedoot, Bouwmans et al. study was based directly on the results obtained in an earlier study, known as the RESTART-study, which compared the outcomes from the Lidcombe Program and a Demands and Capacities Model program. The methodology of the RESTART-study was critically reviewed.
RESULTS: The absence of an untreated control group in the RESTART-study makes the results of that study uninterpretable. An inappropriate comparison made with the Yairi and Ambrose (2005) Illinois Study findings failed to resolve the control group problem. Furthermore, the criteria used to classify treated children as "non-stuttering" was also shown to be confounded. The foregoing problems meant that neither treatment program could be shown to be more effective than no treatment.
CONCLUSION: de Sonneville-Koedoot, Bouwmans et al's findings, which compared the cost effectiveness of two treatments for young children who stutter, have no value for clinical management because the treatments investigated were not shown to be more effective than no treatment.
PMID: 27181034 [PubMed - as supplied by publisher]
Randomized clinical trial: the use of SpeechEasy® in stuttering treatment - AUDITIVO
Int J Lang Commun Disord. 2016 Jun 8. doi: 10.1111/1460-6984.12237. [Epub ahead of print]
Ritto AP, Juste FS, Stuart A, Kalinowski J, de Andrade CR.
University of São Paulo, Sao Paulo, Brazil; East Carolina University, Greenville, NC, USA.
BACKGROUND: Numerous studies have demonstrated the benefit of devices delivering altered auditory feedback (AAF) as a therapeutic alternative for those who stutter.
AIMS: The effectiveness of a device delivering AAF (SpeechEasy®) was compared with behavioural techniques in the treatment of stuttering in a randomized clinical trial.
METHODS & PROCEDURES: Two groups of adults who stutter participated: group 1 consisted of 10 men and one woman aged 21-42 years (mean = 30.0). Group 2 consisted of six men and one woman aged 20-50 years (mean = 35.6). Participants in group 1 were fit with a SpeechEasy® device and were not given any additional training (i.e., supplementary fluency enhancing techniques). Participants used the device daily for 6 months. Participants in group 2 received treatment in the form of a 12-week fluency promotion protocol with techniques based on both fluency shaping and stuttering modification.
OUTCOMES & RESULTS: There were no statistically significant differences (p > .05) between groups in participants' stuttered syllables following treatment. That is, both therapeutic protocols achieved approximately 40% reduction in number of stuttered syllables from baseline measures, with no significant relapse after 3 or 6 months post-treatment.
CONCLUSIONS & IMPLICATIONS: The results suggest that the SpeechEasy® device can be a viable option for the treatment of stuttering.
PMID: 27271500 [PubMed - as supplied by publisher]
Relationship between Speech Production and Perception in People Who Stutter. - NEUROCIÊNCOAS
Front Hum Neurosci. 2016 May 18;10:224. doi: 10.3389/fnhum.2016.00224. eCollection 2016.
Free PMC Article - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870257/pdf/fnhum-10-00224.pdf
Lu C, Long Y, Zheng L, Shi G, Liu L, Ding G, Howell P.
University Beijing, China; University College London, London, UK.
Speech production difficulties are apparent in people who stutter (PWS). PWS also have difficulties in speech perception compared to controls. It is unclear whether the speech perception difficulties in PWS are independent of, or related to, their speech production difficulties. To investigate this issue, functional MRI data were collected on 13 PWS and 13 controls whilst the participants performed a speech production task and a speech perception task. PWS performed poorer than controls in the perception task and the poorer performance was associated with a functional activity difference in the left anterior insula (part of the speech motor area) compared to controls. PWS also showed a functional activity difference in this and the surrounding area [left inferior frontal cortex (IFC)/anterior insula] in the production task compared to controls. Conjunction analysis showed that the functional activity differences between PWS and controls in the left IFC/anterior insula coincided across the perception and production tasks. Furthermore, Granger Causality Analysis on the resting-state fMRI data of the participants showed that the causal connection from the left IFC/anterior insula to an area in the left primary auditory cortex (Heschl's gyrus) differed significantly between PWS and controls. The strength of this connection correlated significantly with performance in the perception task. These results suggest that speech perception difficulties in PWS are associated with anomalous functional activity in the speech motor area, and the altered functional connectivity from this area to the auditory area plays a role in the speech perception difficulties of PWS.
PMID: 27242487 [PubMed] PMCID: PMC4870257
Response to "Putting the cart before the horse: A cost effectiveness analysis of treatments for stuttering in young children requires evidence that the treatments analyzed were effective" - TERAPIA
J Commun Disord. 2016 May 18. pii: S0021-9924(16)30040-5. doi: 10.1016/j.jcomdis.2016.05.009. [Epub ahead of print]
de Sonneville-Koedoot C, Stolk E, Rietveld T, Franken MC.
Erasmus University Rotterdam, Rotterdam, The Netherlands; Radboud University Nijmegen, The Netherlands; Sophia Children's Hospital, Rotterdam, The Netherlands.
PMID: 27264968 [PubMed - as supplied by publisher]
Role of the left frontal aslant tract in stuttering: a brain stimulation and tractographic study. - NEUROCIÊNCIAS
J Neurol. 2016 Jan;263(1):157-67. doi: 10.1007/s00415-015-7949-3. Epub 2015 Nov 11.
Kemerdere R, de Champfleur NM, Deverdun J, Cochereau J, Moritz-Gasser S, Herbet G, Duffau H.
Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey; Montpellier University Medical Center, Montpellier, France; Institute of Neurosciences of Montpellier, Montpellier, France.
The neural correlates of stuttering are to date incompletely understood. Although the possible involvement of the basal ganglia, the cerebellum and certain parts of the cerebral cortex in this speech disorder has previously been reported, there are still not many studies investigating the role of white matter fibers in stuttering. Axonal stimulation during awake surgery provides a unique opportunity to study the functional role of structural connectivity. Here, our goal was to investigate the white matter tracts implicated in stuttering, by combining direct electrostimulation mapping and postoperative tractography imaging, with a special focus on the left frontal aslant tract. Eight patients with no preoperative stuttering underwent awake surgery for a left frontal low-grade glioma. Intraoperative cortical and axonal electrical mapping was used to interfere in speech processing and subsequently provoke stuttering. We further assessed the relationship between the subcortical sites leading to stuttering and the spatial course of the frontal aslant tract. All patients experienced intraoperative stuttering during axonal electrostimulation. On postsurgical tractographies, the subcortical distribution of stimulated sites matched the topographical position of the left frontal aslant tract. This white matter pathway was preserved during surgery, and no patients had postoperative stuttering. For the first time to our knowledge, by using direct axonal stimulation combined with postoperative tractography, we provide original data supporting a pivotal role of the left frontal aslant tract in stuttering. We propose that this speech disorder could be the result of a disconnection within a large-scale cortico-subcortical circuit subserving speech motor control.
PMID: 26559819 [PubMed - in process]
Secondary School Teachers' Beliefs, Attitudes, and Reactions to Stuttering. - SOCIAL
Lang Speech Hear Serv Sch. 2016 Apr 1;47(2):135-47. doi: 10.1044/2016_LSHSS-15-0019.
Adriaensens S, Struyf E.
PURPOSE: The study identifies teachers' beliefs about and attitudes toward stuttering and explores to what extent these beliefs and attitudes prompt specific teachers' reactions to the stuttering of a student.
METHOD: Participants were teachers in secondary education in Flanders (Belgium), currently teaching an adolescent who stutters. They were the student's class teacher or instructed a course in which communication is important. Ten semistructured interviews were conducted and analyzed thematically.
RESULTS: Teachers believed that (a) when peers do not react to the stuttering, the lesson is not disrupted by it, and the student who stutters participates in the lesson, stuttering is not necessarily a problem; (b) when attention is paid to it, stuttering can become a problem; (c) they try to react as little as possible to the stuttering; and (d) they seldom talk about the stuttering.
CONCLUSION: Although teachers reported that they feel confident in how to deal with stuttering, and although it is possible that students who stutter do not feel the need to talk about their stuttering, teachers could consult their students on this matter. This way, they would acknowledge the stuttering and likely encourage the students to approach them when they feel the need.
PMID: 27071027 [PubMed - in process]
Segmental transition of the first syllables of words in Japanese children who stutter: Comparison between word and sentence production. - FALA
Clin Linguist Phon. 2016 Mar 30:1-12. [Epub ahead of print]
Matsumoto S, Ito T.
The Japan Society for the Promotion of Science , Tokyo , Japan; Tokyo Gakugei University , Tokyo , Japan.
Matsumoto-Shimamori, Ito, Fukuda, & Fukuda (2011) proposed the hypothesis that in Japanese, the transition from the core vowels (i.e. syllable nucleus) of the first syllables of words to the following segments affected the occurrence of stuttering. Moreover, in this transition position, an inter-syllabic transition precipitated more stuttering than an intra-syllabic one (Shimamori & Ito, 2007, 2008). However, these studies have only used word production tasks. The purpose of this study was to investigate whether the same results could be obtained in sentence production tasks. Participants were 28 Japanese school-age children who stutter, ranging in age from 7;3 to 12;7. The frequency of stuttering on words with an inter-syllabic transition was significantly higher than on those having an intra-syllabic transition, not only in isolated words but in the first words of sentences. These results suggested that Matsumoto et al.'s hypothesis could be applicable to the results of sentence production tasks.
PMID: 27030682 [PubMed - as supplied by publisher]
Speech-activated Myoclonus Mimicking Stuttering in a Patient with Myoclonus-Dystonia Syndrome. - GAGUEIRA ADQUIRIDA
Tremor Other Hyperkinet Mov (N Y). 2016 Jul 1;6:405. doi: 10.7916/D8J966FP. eCollection 2016.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4930628/pdf/tre-06-405-7522-1.pdf
Isaacs DA, Hedera P.
Vanderbilt University Medical Center, Nashville, TN, USA.
BACKGROUND: Acquired neurogenic stuttering has been considered a fairly uncommon clinical occurrence; speech-activated myoclonus is a rare entity that can mimic stuttering and is caused by a wide array of etiologies.
CASE REPORT: Here we report a patient with myoclonus-dystonia syndrome (MDS), due to an identified disease-causing mutation, who displayed speech-activated myoclonus mimicking stuttering.
DISCUSSION: In MDS, myoclonus has only infrequently been reported to affect speech. This case further expands the spectrum of conditions causing the rare clinical phenomenon of speech-activated myoclonus.
PMID: 27441098 PMCID: PMC4930628 DOI: 10.7916/D8J966FP
Stuttering, alcohol consumption and smoking - OUTROS
J Fluency Disord. 2016 Jun;48:27-34. doi: 10.1016/j.jfludis.2016.05.001. Epub 2016 Jun 6.
Heelan M, McAllister J, Skinner J.
Virgin Care, United Kingdom; University of East Anglia, United Kingdom.
PURPOSE: Limited research has been published regarding the association between stuttering and substance use. An earlier study provided no evidence for such an association, but the authors called for further research to be conducted using a community sample. The present study used data from a community sample to investigate whether an association between stuttering and alcohol consumption or regular smoking exists in late adolescence and adulthood.
METHODS: Regression analyses were carried out on data from a birth cohort study, the National Child Development Study (NCDS), whose initial cohort included 18,558 participants who have since been followed up until age 55. In the analyses, the main predictor variable was parent-reported stuttering at age 16. Parental socio-economic group, cohort member's sex and childhood behavioural problems were also included. The outcome variables related to alcohol consumption and smoking habits at ages 16, 23, 33, 41, 46, 50 and 55.
RESULTS: No significant association was found between stuttering and alcohol consumption or stuttering and smoking at any of the ages. It was speculated that the absence of significant associations might be due to avoidance of social situations on the part of many of the participants who stutter, or adoption of alternative coping strategies.
CONCLUSION: Because of the association between anxiety and substance use, individuals who stutter and are anxious might be found to drink or smoke excessively, but as a group, people who stutter are not more likely than those who do not to have high levels of consumption of alcohol or nicotine.
PMID: 27498892 DOI: 10.1016/j.jfludis.2016.05.001
[PubMed - in process]
Stuttering at school: the effect of a teacher training program on stuttering. - SOCIAL
Codas. 2016 Jul 4;0:0. doi: 10.1590/2317-1782/20162015158.
[Article in English, Portuguese]
Free full text:
Silva LK, Martins-Reis Vde O, Maciel TM, Ribeiro JK, Souza MA, Chaves FG.
Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil.
PURPOSE: Verify the knowledge of teachers from public and private schools about stuttering and attest the effectiveness of the Teacher Training Program on Stuttering in the expansion of this knowledge.
METHODS: The study sample comprised 137 early-childhood teachers. Initially, the teachers responded to a questionnaire on stuttering. After that, 75 teachers attended a 4-hour Teacher Training Program on Stuttering. One month later, the teachers responded to the same questionnaire again.
RESULTS: The following points were observed after the training program: increased percentage of teachers who consider as low the prevalence of stuttering in the population; beginning of reports stating that stuttering is more frequent in males; increased number of teachers who consider stuttering hereditary; decreased incidence of teachers who believe stuttering is psychological; prevalence of those who believe stuttering is a consequence of multiple causes; decreased rate of teachers who believe stuttering is emotional; a better understanding of how educators should behave to help stutterers.
CONCLUSION: Before the course, the teachers had some knowledge regarding stuttering, but it was insufficient to differentiate from other language disorders. The Program expanded their knowledge on stuttering. However, it proved to be more effective with respect to the characteristics of stuttering than to the attitudes of the teachers.
PMID: 27383227 DOI: 10.1590/2317-1782/20162015158
[PubMed - in process]
Stuttering: Clinical and research update- CONCEITO
Can Fam Physician. 2016 Jun;62(6):479-84.
Free full text - http://www.cfp.ca/content/62/6/479.full.pdf
Perez HR, Stoeckle JH.
Albert Einstein College of Medicine in New York, NY; Tulane University School of Medicine in New Orleans, LA.
OBJECTIVE: To provide an update on the epidemiology, genetics, pathophysiology, diagnosis, and treatment of developmental stuttering.
QUALITY OF EVIDENCE: The MEDLINE and Cochrane databases were searched for past and recent studies on the epidemiology, genetics, pathophysiology, diagnosis, and treatment of developmental stuttering. Most recommendations are based on small studies, limited-quality evidence, or consensus.
MAIN MESSAGE: Stuttering is a speech disorder, common in persons of all ages, that affects normal fluency and time patterning of speech. Stuttering has been associated with differences in brain anatomy, functioning, and dopamine regulation thought to be due to genetic causes. Attention to making a correct diagnosis or referral in children is important because there is growing consensus that early intervention with speech therapy for children who stutter is critical. For adults, stuttering can be associated with substantial psychosocial morbidity including social anxiety and low quality of life. Pharmacologic treatment has received attention in recent years, but clinical evidence is limited. The mainstay of treatment for children and adults remains speech therapy.
CONCLUSION: A growing body of research has attempted to uncover the pathophysiology of stuttering. Referral for speech therapy remains the best option for children and adults.
PMID: 27303004 [PubMed - in process]
Teachers' screening estimations of speech-language impairments in primary school children in Nepal. - CONCEITO
Int J Lang Commun Disord. 2016 Jan 12. doi: 10.1111/1460-6984.12209. [Epub ahead of print]
Thapa KB, Okalidou A, Anastasiadou S.
University of Macedonia, Greece; University of Western Macedonia, Greece.
BACKGROUND: The prevalence of speech-language impairments in children have been estimated for several languages, primarily in developed countries. However, prevalence data is lacking for developing countries, such as Nepal.
AIMS: (1) To obtain teacher estimates of incidence and overall prevalence of speech-language impairments and its subtypes as a function of gender, age and grade level; and (2) to validate the screening instrument on Nepalese children.
METHODOLOGY: The adapted teachers' screening instrument, namely adapted Teachers' Speech and Language Referral Checklist (a-TSLRC), was administered in 2776 (690 and 2086) primary school children aged 5;00-11;11 years (mean = 8;11 years). The screening was conducted at four different points in time, i.e. Incidences I and II, and each incidence consisted of a testing and a retesting phase. Prior to this, teachers were trained in forum meetings, and an information sheet containing an overview of speech-language impairments, and guidelines/criteria for marking the occurrence of speech-language impairments in the TSLRC were disseminated.
OUTCOMES & RESULTS: Overall prevalence of speech-language impairments in children was estimated as 8.11%. Specifically, overall speech problems were estimated as 4.68%, and language problems as 8.0%. Additionally, the prevalence by subtypes of speech-language impairments as categorized in the TSLRC were reported to be 2.95% for an articulation/phonological problems, 2.09% for stuttering, 3.42% for a voice problems, 4.97% for a receptive language problems and 7.74% for an expressive language problems. The internal consistency among items was sufficient and a good intra-rater reliability was obtained.
CONCLUSIONS & IMPLICATIONS: The study indicates that the overall results of speech-language impairments in children via the adapted in-Nepalese criterion-referenced instrument are supported by international studies. In addition, justifiable reliability and validity was obtained. Therefore, based on these overall evidence, this instrument can be useful for the screening of speech-language impairments in primary school children in Nepal.
© 2016 Royal College of Speech and Language Therapists.
PMID: 26757345 [PubMed - as supplied by publisher]
Temporal processing and long-latency auditory evoked potential in stutterers. - AUDITIVO
Braz J Otorhinolaryngol. 2016 Apr 28. pii: S1808-8694(16)30062-3. doi: 10.1016/j.bjorl.2016.02.015. [Epub ahead of print]
Free full text - http://ac.els-cdn.com/S1808869416300623/1-s2.0-S1808869416300623-main.pdf?_tid=efba0ce0-340b-11e6-8f54-00000aacb35e&acdnat=1466113835_46e4cd37ae42f346b5af57ba5ef84696
Prestes R, de Andrade AN, Santos RB, Marangoni AT, Schiefer AM, Gil D.
Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
INTRODUCTION: Stuttering is a speech fluency disorder, and may be associated with neuroaudiological factors linked to central auditory processing, including changes in auditory processing skills and temporal resolution.
OBJECTIVE: To characterize the temporal processing and long-latency auditory evoked potential in stutterers and to compare them with non-stutterers.
METHODS: The study included 41 right-handed subjects, aged 18-46 years, divided into two groups: stutterers (n=20) and non-stutters (n=21), compared according to age, education, and sex. All subjects were submitted to the duration pattern tests, random gap detection test, and long-latency auditory evoked potential.
RESULTS: Individuals who stutter showed poorer performance on Duration Pattern and Random Gap Detection tests when compared with fluent individuals. In the long-latency auditory evoked potential, there was a difference in the latency of N2 and P3 components; stutterers had higher latency values.
CONCLUSIONS: Stutterers have poor performance in temporal processing and higher latency values for N2 and P3 components.
PMID: 27233690 [PubMed - as supplied by publisher]
Temporal variability in sung productions of adolescents who stutter. - FALA
J Commun Disord. 2016 Jul-Aug;62:101-14. doi: 10.1016/j.jcomdis.2016.05.012. Epub 2016 Jun 2.
Falk S, Maslow E, Thum G, Hoole P.
Ludwig-Maximilians-University, Munich, Germany; Aix-Marseille University, CNRS, Aix-en-Provence, France.
Singing has long been used as a technique to enhance and reeducate temporal aspects of articulation in speech disorders. In the present study, differences in temporal structure of sung versus spoken speech were investigated in stuttering. In particular, the question was examined if singing helps to reduce VOT variability of voiceless plosives, which would indicate enhanced temporal coordination of oral and laryngeal processes. Eight German adolescents who stutter and eight typically fluent peers repeatedly spoke and sang a simple German congratulation formula in which a disyllabic target word (e.g., /'ki:ta/) was repeated five times. Every trial, the first syllable of the word was varied starting equally often with one of the three voiceless German stops /p/, /t/, /k/. Acoustic analyses showed that mean VOT and stop gap duration reduced during singing compared to speaking while mean vowel and utterance duration was prolonged in singing in both groups. Importantly, adolescents who stutter significantly reduced VOT variability (measured as the Coefficient of Variation) during sung productions compared to speaking in word-initial stressed positions while the control group showed a slight increase in VOT variability. However, in unstressed syllables, VOT variability increased in both adolescents who do and do not stutter from speech to song. In addition, vowel and utterance durational variability decreased in both groups, yet, adolescents who stutter were still more variable in utterance duration independent of the form of vocalization. These findings shed new light on how singing alters temporal structure and in particular, the coordination of laryngeal-oral timing in stuttering. Future perspectives for investigating how rhythmic aspects could aid the management of fluent speech in stuttering are discussed.
LEARNING OUTCOMES: Readers will be able to describe (1) current perspectives on singing and its effects on articulation and fluency in stuttering and (2) acoustic parameters such as VOT variability which indicate the efficiency of control and coordination of laryngeal-oral movements. They will understand and be able to discuss (3) how singing reduces temporal variability in the productions of adolescents who do and do not stutter and 4) how this is linked to altered articulatory patterns in singing as well as to its rhythmic structure.
PMID: 27323225 DOI: 10.1016/j.jcomdis.2016.05.012
The frontal aslant tract underlies speech fluency in persistent developmental stuttering. - NEUROCIÊNCIAS
Brain Struct Funct. 2016 Jan;221(1):365-81. doi: 10.1007/s00429-014-0912-8. Epub 2014 Oct 26.
Kronfeld-Duenias V, Amir O, Ezrati-Vinacour R, Civier O, Ben-Shachar M.
Bar-Ilan University, Ramat-Gan, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
The frontal aslant tract (FAT) is a pathway that connects the inferior frontal gyrus with the supplementary motor area (SMA) and pre-SMA. The FAT was recently identified and introduced as part of a "motor stream" that plays an important role in speech production. In this study, we use diffusion imaging to examine the hypothesis that the FAT underlies speech fluency, by studying its properties in individuals with persistent developmental stuttering, a speech disorder that disrupts the production of fluent speech. We use tractography to quantify the volume and diffusion properties of the FAT in a group of adults who stutter (AWS) and fluent controls. Additionally, we use tractography to extract these measures from the corticospinal tract (CST), a well-known component of the motor system. We compute diffusion measures in multiple points along the tracts, and examine the correlation between these diffusion measures and behavioral measures of speech fluency. Our data show increased mean diffusivity in bilateral FAT of AWS compared with controls. In addition, the results show regions within the left FAT and the left CST where diffusivity values are increased in AWS compared with controls. Last, we report that in AWS, diffusivity values measured within sub-regions of the left FAT negatively correlate with speech fluency. Our findings are the first to relate the FAT with fluent speech production in stuttering, thus adding to the current knowledge of the functional role that this tract plays in speech production and to the literature of the etiology of persistent developmental stuttering.
PMID: 25344925 [PubMed - in process]
The perceived impact of stuttering on personality as measured by the NEO-FFI-3. - SOCIAL
Logoped Phoniatr Vocol. 2016 Mar 16:1-7. [Epub ahead of print]
Banerjee S, Casenhiser D, Hedinger T, Kittilstved T, Saltuklaroglu T
University of Tennessee Health Science Center , Knoxville , Tennessee , USA.
The NEO-FFI has been widely used to demonstrate personality differences between people who stutter (PWS) and those who do not. These differences can be interpreted as indicators of internal sources of disability that contribute to handicaps associated with stuttering. The aim of the current study was to use this same tool to determine the perceived impact of stuttering on personality in order to provide a similar indicator of how external factors may contribute to the stuttering disability. A total of 49 non-stuttering young adults were given the NEO-FFI-3 after watching a video of someone stuttering (moderately to severely) and after watching a video of someone speaking fluently. Participants were asked to answer test items while imagining that they had spoken like the persons in the videos for their entire lives. When asked to assume the stuttering perspective, participants reported themselves to be significantly more neurotic (P < 0.01) and less extraverted (P < 0.01) than when they assumed the perspective of the fluent speaker. The large differences (∼10 points; greater than one standard deviation) in these domains between the fluent and stuttered perspectives are consistent with existing stereotypes about PWS. These differences are greater than and only partially consistent with differences in personality found between PWS and non-stuttering individuals. The findings support the notion that external factors (e.g. listener reactions and stereotypes about PWS) contribute strongly to the manner in which stuttering restricts function and results in handicaps.
PMID: 26981706 [PubMed - as supplied by publisher]
The state of the art in non-pharmacological interventions for developmental stuttering. Part 2: qualitative evidence synthesis of views and experiences. - TERAPIA
Int J Lang Commun Disord. 2016 Jan;51(1):3-17. doi: 10.1111/1460-6984.12182. Epub 2015 Jun 30.
Johnson M, Baxter S, Blank L, Cantrell A, Brumfitt S, Enderby P, Goyder E.
University of Sheffield, Sheffield, UK
BACKGROUND: A range of interventions have been developed to treat stuttering in recent years. The effectiveness of these interventions has largely been assessed in studies focusing on the impact of specific types of therapy on patient outcomes. Relatively little is known about the factors that influence how the delivery and impact of different types of intervention may be experienced from the perspective of both people who deliver as well as those who receive interventions.
AIMS: To synthesize the available evidence in relation to factors that might enhance or mitigate against successful outcomes following interventions for stuttering by identifying and synthesizing relevant qualitative research that explored the experiences of people delivering and receiving interventions that aim to improve fluency.
METHODS & PROCEDURES: We carried out a systematic review including research that had used in-depth interviews and focus groups and conducted a substantive qualitative analysis of the data collected. Included study populations were either adults or children affected by a diagnosed stutter and/or providers of therapy for stuttering. An iterative approach was used to search for published qualitative evidence in relevant databases from 1990 to 2014. Retrieved citations were sifted for relevance and the data from articles that met the inclusion criteria were extracted. Each included paper was assessed for quality and a thematic analysis and synthesis of findings was carried out.
MAIN CONTRIBUTION: Synthesized qualitative evidence highlights the changing experiences for people who stutter both historically and, for individuals, over the life course. Barriers and facilitators to the implementation of interventions for stuttering are encountered at the individual, intervention, interpersonal and social levels. Interventions may be particularly pertinent at certain transition points in the life course. Attention to emotional as well as practical aspects of stuttering is valued by people receiving therapy. The client-therapist relationship and support from others are also key factors in achieving successful outcomes.
CONCLUSIONS & IMPLICATIONS: A synthesis of qualitative findings from published papers has added to the effectiveness data reported in an accompanying paper in understanding how stuttering impacts on people across the life course. Evidence suggests that a client-centred and individually tailored approach enhances the likelihood of successful intervention outcomes through attention to emotional, situational and practical needs.
© 2015 Royal College of Speech and Language Therapists.
PMID: 26123598 [PubMed - in process]
When will a stuttering moment occur? The determining role of speech motor preparation. - NEUROCIÊNCIAS
Neuropsychologia. 2016 Apr 19;86:93-102. doi: 10.1016/j.neuropsychologia.2016.04.018. [Epub ahead of print]
Vanhoutte S, Cosyns M, van Mierlo P, Batens K, Corthals P, De Letter M, Van Borsel J, Santens P
Ghent University Hospital, Ghent, Belgium; University College Ghent, Ghent, Belgium.
The present study aimed to evaluate whether increased activity related to speech motor preparation preceding fluently produced words reflects a successful compensation strategy in stuttering. For this purpose, a contingent negative variation (CNV) was evoked during a picture naming task and measured by use of electro-encephalography. A CNV is a slow, negative event-related potential known to reflect motor preparation generated by the basal ganglia-thalamo-cortical (BGTC) - loop. In a previous analysis, the CNV of 25 adults with developmental stuttering (AWS) was significantly increased, especially over the right hemisphere, compared to the CNV of 35 fluent speakers (FS) when both groups were speaking fluently (Vanhoutte et al., (2015) doi: 10.1016/j.neuropsychologia.2015.05.013). To elucidate whether this increase is a compensation strategy enabling fluent speech in AWS, the present analysis evaluated the CNV of 7 AWS who stuttered during this picture naming task. The CNV preceding AWS stuttered words was statistically compared to the CNV preceding AWS fluent words and FS fluent words. Though no difference emerged between the CNV of the AWS stuttered words and the FS fluent words, a significant reduction was observed when comparing the CNV preceding AWS stuttered words to the CNV preceding AWS fluent words. The latter seems to confirm the compensation hypothesis: the increased CNV prior to AWS fluent words is a successful compensation strategy, especially when it occurs over the right hemisphere. The words are produced fluently because of an enlarged activity during speech motor preparation. The left CNV preceding AWS stuttered words correlated negatively with stuttering frequency and severity suggestive for a link between the left BGTC - network and the stuttering pathology. Overall, speech motor preparatory activity generated by the BGTC - loop seems to have a determining role in stuttering. An important divergence between left and right hemisphere is hypothesized.
PMID: 27106391 [PubMed - as supplied by publisher]
Yoga: Potential Benefits for Persons Who Stutter. - TERAPIA
Percept Mot Skills. 2016 Feb;122(1):193-9. doi: 10.1177/0031512516628987. Epub 2016 Feb 1.
Temple University, Philadelphia, PA, USA
Yoga has been demonstrated to modulate autonomic nervous system activity, decreasing anxiety and stress, and improving quality of life. This preliminary study sought to examine the use of yogic techniques on persons who stutter given the interaction between physiological arousal/anxiety and stuttering that current multifactorial models of stuttering propose. Four participants (M = 52 yr, SD = 10; 2 female, 2 male), recruited from local stuttering support groups in the greater Philadelphia community volunteered to participate. Stuttering severity, anxiety, and experiences regarding stuttering and communication were measured at baseline, post intervention, and at 4 months follow-up. The participants attended group yoga sessions and engaged in home practice. Descriptive results revealed that participants showed improvements across outcome measures, with the most improvement related to anxiety. Participants also reported improvements in their perceptions about communication as per qualitative analysis of responses to the open-ended questionnaires. The results suggest the potential benefits of yoga for persons who stutter and warrants further study using an experimental design.
PMID: 27420315 DOI: 10.1177/0031512516628987
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