Eliana Maria Nigro Rocha



Abstract - Janeiro a Julho de 2018


A Hispanic mother's beliefs about stuttering aetiology: A systemic functional linguistic analysis - AMBIENTE

Clin Linguist Phon. 2018;32(11):1012-1026.. Epub 2018 Jun 1.


Medina AM.

Florida International University , Miami , Florida , USA.


The aim of this study was to identify the linguistic resources a Hispanic mother used to convey her beliefs about the aetiology of her adult son's stuttering. A qualitative research paradigm was adopted for data collection and analysis. An Ecuadorian mother and her adult son who stutters recorded a conversation in Spanish about the son's stuttering. Tools derived from systemic functional linguistic (SFL) theory were used to analyse conversation transcripts and to describe the word choices and sentence structures the mother used to talk about her son's stuttering. The mother deflected community-assigned blame for causing her son's stuttering by configuring her 'strong' temperament as a separate, uncontrollable entity. She structured the pervasiveness of stigma, lack of resources and misinformation within the community as causes for her inability to identify and seek help for her son's stuttering, which also served as a means for deflecting blame. SFL-based analyses were appropriate tools for the investigation of how a Hispanic mother construes her views, attitudes and experiences relative to her son's stuttering. Clinical implications of findings regarding parent education and the utility of SFL-based tools in the speech-language therapy setting are discussed.

PMID: 29856661 DOI: 10.1080/02699206.2018.1481145




A Persian-version of the stuttering severity instrument-version four (SSI-4): How the new additions to SSI-4 complement its stuttering severity score? - AVALIAÇÃO

J Commun Disord. 2018 Jul - Aug;74:1-9. Epub 2018 Apr 23.


Tahmasebi N, Shafie B, Karimi H, Mazaheri M.

Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Isfahan University of Medical Sciences, Iran; Vrije Universiteit Amsterdam, The Netherlands.


PURPOSE: The fourth version of the Stuttering Severity Instrument (SSI-4) has been available since 2009. It has some modifications and new features which make it more appropriate at least for clinical practice, although further documentation is needed. The objective of the current research was to translate SSI-4 into Persian language and to discuss its relative and absolute reliability as well as its criterion validity for Persian adults who stutter (PWS). We also aimed to study how the new subjective self-reports of the SSI-4 complement the stuttering severity score obtained from the SSI-3 or the SSI-4.

METHOD: The cross-cultural guideline recommended by the International Quality of Life Assessment project was used to translate the SSI-4 into Persian language. Thirty five PWS from ages 17 to 42 were recruited and 10 speech and language pathologists assessed their stuttering severity using either the SSI-4 or stuttering severity ratings (SR) to test validity and reliability of the Persian translated version.

RESULTS: A very high inter-judge relative reliability along with a poor absolute inter-judge reliability was found for the SSI-4 scores. The results were more promising for the intra-judge absolute reliability. Test-retest reliability of the complementary questions to the SSI-4 was also found acceptable. However, no strong relationship was found between the SSI-4 scores and its complementary questions.

CONCLUSION: The Persian version of the SSI-4 can be used reliably by trained SLPs for research and clinical purposes, but not to document small changes in stuttering severity. We argue that the response of participants to the complementary self-report questions should also be considered in calculating their stuttering severity score.

PMID: 29723653 DOI: 10.1016/j.jcomdis.2018.04.005




A pilot study to determine the feasibility of a cluster randomised controlled trial of an intervention to change peer attitudes towards children who stutter - OUTRAS ÁREAS

S Afr J Commun Disord. 2018 Jul 18;65(1):e1-e8.

Free PMC Article -  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111487/pdf/SAJCD-65-583.pdf


Mallick RB, Thabane L, Borhan ASM, Kathard H.

University of Cape Town.


 While randomised controlled trials (RCTs) are considered the gold standard of research, prior study is needed to determine the feasibility of a future large-scale RCT study. Objectives: This pilot study, therefore, aimed to determine feasibility of an RCT by exploring: (1) procedural issues and (2) treatment effect of the Classroom Communication Resource (CCR), an intervention for changing peer attitudes towards children who stutter. Method: A pilot cluster stratified RCT design was employed whereby the recruitment took place first at school-level and then at individual level. The dropout rate was reported at baseline, 1 and 6 months post-intervention. For treatment effect, schools were the unit of randomisation and were randomised to receive either the CCR intervention administered by teachers or usual practice, using a 1:1 allocation ratio. The stuttering resource outcomes measure (SROM) measured treatment effect at baseline, 1 and 6 months post-intervention overall and within the constructs (positive social distance, social pressure and verbal interaction). Results: For school recruitment, 11 schools were invited to participate and 82% (n = 9) were recruited. Based on the school recruitment, N = 610 participants were eligible for this study while only n = 449 were recruited, where there was n = 183 in the intervention group and n = 266 in the control group. The dropout rate from recruitment to baseline was as follows: intervention, 23% (n = 34), and control, 6% (n = 15). At 1 month a dropout rate of 7% (n = 10) was noted in the intervention and 6% (n = 15) in the control group, whereas at 6 months, dropout rates of 7% (n = 10) and 17% (n = 44) were found in the intervention and control groups, respectively. For treatment effect on the SROM, the estimated mean differences between intervention and control groups were (95% Confidence Interval (CI): -1.07, 5.11) at 1 month and 3.01 (95% CI: -0.69, 6.69) at 6 months. A statistically significant difference was observed at 6 months on the VI subscale of the SROM, with 1.35 (95% CI: 0.58, 2.13). Conclusion: A high recruitment rate of schools and participants was observed with a high dropout rate of participants. Significant differences were only noted at 6 months post-intervention within one of the constructs of the SROM. These findings suggest that a future RCT study is warranted and feasible.

PMID: 30035603 PMCID: PMC6111487 DOI: 10.4102/sajcd.v65i1.583




An fNIRS-Based Feature Learning and Classification Framework to Distinguish Hemodynamic Patterns in Children Who Stutter - AVALIAÇÃO

IEEE Trans Neural Syst Rehabil Eng. 2018 Jun;26(6):1254-1263.


Hosseini R, Walsh B, Tian F, Wang S.


Stuttering is a communication disorder that affects approximately 1% of the population. Although 5-8% of preschool children begin to stutter, the majority will recover with or without intervention. There is a significant gap, however, in our understanding of why many children recover from stuttering while others persist and stutter throughout their lives. Detecting neurophysiological biomarkers of stuttering persistence is a critical objective of this paper. In this paper, we developed a novel supervised sparse feature learning approach to discover discriminative biomarkers from functional near infrared spectroscopy (fNIRS) brain imaging data recorded during a speech production experiment from 46 children in three groups: children who stutter ( ); children who do not stutter ( ); and children who recovered from stuttering ( ). We made an extensive feature analysis of the cerebral hemodynamics from fNIRS signals and selected a small number of important discriminative features using the proposed sparse feature learning framework. The selected features are capable of differentiating neural activation patterns between children who do and do not stutter with an accuracy of 87.5% based on a five-fold cross-validation procedure. The discovered set cerebral hemodynamics features are presented as a set of promising biomarkers to elucidate the underlying neurophysiology in children who have recovered or persisted in stuttering and to facilitate future data-driven diagnostics in these children.

PMID: 29877850 PMCID: PMC6242270 [Available on 2019-06-01] DOI: 10.1109/TNSRE.2018.2829083




An investigation into the relationship between parent satisfaction and child fluency in the Lidcombe Program: Clinic versus telehealth delivery - AMBIENTE

Int J Speech Lang Pathol. 2018 Apr 5:1-8. [Epub ahead of print]


Ferdinands B, Bridgman K.

The University of Melbourne , Melbourne , Australia and La Trobe University , Bundoora , Australia.


PURPOSE: Parents have a vital role in the delivery of the Lidcombe Program when treating stuttering in young children. Research into parent experiences and perceptions throughout the Lidcombe Program is currently limited. Qualitative literature indicates that parent experiences and child progress are closely linked with program duration. This preliminary quantitative study examined parent satisfaction with child fluency at three time points. Data from clinic and telehealth delivery of the Lidcombe Program were used to further explore between-group non-inferiority.

METHOD: The data were drawn from a parallel, non-inferiority, randomised controlled trial. Forty-nine children were randomised to the clinic or telehealth group. Parent satisfaction ratings with child fluency, the percentage of syllables stuttered and parent reported severity ratings were measured pre-treatment, 9 months and 18 months post-commencement of treatment.

RESULT: An increase in parent satisfaction paralleled a decrease in stuttering severity across the three time points universally, however, the relationship between parent satisfaction and stuttering severity was not found at every time point.

CONCLUSION: Though a general increase in parent satisfaction was seen as severity decreased, a global assumption on satisfaction cannot be made based on stuttering severity when measured using an ordinal scale.

PMID: 29621894 DOI: 10.1080/17549507.2018.1445779




Auditory-Perceptual Assessment of Fluency in Typical and Neurologically Disordered Speech - AVALIAÇÃO

J Speech Lang Hear Res. 2018 May 17;61(5):1086-1103


Penttilä N, Korpijaakko-Huuhka AM, Kent RD.

University of Tampere, Finland; University of Wisconsin-Madison.


PURPOSE: The aim of this study is to investigate how speech fluency in typical and atypical speech is perceptually assessed by speech-language pathologists (SLPs). Our research questions were as follows: (a) How do SLPs rate fluency in speakers with and without neurological communication disorders? (b) Do they differentiate the speaker groups? and (c) What features do they hear impairing speech fluency?

METHOD: Ten SLPs specialized in neurological communication disorders volunteered as expert judges to rate 90 narrative speech samples on a Visual Analogue Scale (see Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009; p. 127). The samples-randomly mixed-were from 70 neurologically healthy speakers (the control group) and 20 speakers with traumatic brain injury, 10 of whom had neurogenic stuttering (designated as Clinical Groups A and B).

RESULTS: The fluency rates were higher for typical speakers than for speakers with traumatic brain injury; however, the agreement among the judges was higher for atypical fluency. Auditory-perceptual assessment of fluency was significantly impaired by the features of stuttering and something else but not by speech rate. Stuttering was also perceived in speakers not diagnosed as stutterers. A borderline between typical and atypical fluency was found.

CONCLUSIONS: Speech fluency is a multifaceted phenomenon, and on the basis of this study, we suggest a more general approach to fluency and its deviations that will take into account, in addition to the motor and linguistic aspects of fluency, the metalinguistic component of expression as well. The results of this study indicate a need for further studies on the precise nature of borderline fluency and its different disfluencies.

PMID: 29710314 DOI: 10.1044/2018_JSLHR-S-17-0326




Beliefs and behavioural intentions towards pharmacotherapy for stuttering: A survey of adults who stutter - FARMACOLOGIA

J Commun Disord. 2018 May - Jun;73:15-24. Epub 2018 Mar 13.


McGroarty A, McCartan R.

University of Strathclyde, Glasgow, United Kingdom


PURPOSE: Although considerable efforts have been made to investigate the effectiveness of pharmacological treatments for stuttering, little is known about how the stuttering community perceives these treatments. This study aimed to assess and quantify beliefs regarding pharmacotherapy for adults who stutter and to establish whether behavioural intentions to undertake treatment were related to these beliefs.

METHOD: An adapted version of the Beliefs about Medicine Questionnaire was completed by adults who stutter. Participants also reported perceptions of their stuttering including its overall impact, ratings of previous speech therapy, and behavioural intentions to initiate pharmacotherapy and speech therapy in future.

RESULTS: Necessity and concern beliefs were distributed widely across the sample and in a pattern indicating a relatively balanced perception of the benefits and costs of medication prescribed specifically for stuttering. Of the study's measures, the necessity-concerns differential most strongly predicted the behavioural intention to initiate pharmacotherapy. The overall impact of stuttering predicted intentions to seek both pharmacotherapy and speech therapy. Participants reported the likelihood of pursuing pharmacotherapy and speech therapy in equal measure.

CONCLUSIONS: The theoretical model of medication representations appears to be a useful framework for understanding the beliefs of adults who stutter towards the medical treatment of their disorder. The findings of this study may be of interest to clinicians and researchers working in the field of stuttering treatment and to people who stutter considering pharmacotherapy.

PMID: 29558672 DOI: 10.1016/j.jcomdis.2018.03.002




Can offspring sex ratios help to explain the endocrine effects of toxoplasmosis infection on human behaviour? - OUTRAS ÁREAS

Early Hum Dev. 2018 Jul;122:42-44. Epub 2018 Jun 7.


James WH, Grech V.

University College London, London, UK; University of Malta Medical School, Msida, Malta.


Humans infected with the parasite Toxoplasma gondii display a wide variety of abnormal behaviours, from suicide and depression to stuttering. These behaviours have been seen as so serious as to constitute a public health problem. It is not clear to what extent the parasite is a cause of, or merely a marker for, these behaviours, but there is evidence for both. Some of these behaviours are associated with changes in steroid hormones, that is, estrogen in women and testosterone in men. It is suggested here that these endocrine-related states of infected people may be better understood by studying their offspring sex ratios.

PMID: 29886408 DOI: 10.1016/j.earlhumdev.2018.06.001




Characteristics of adults who stutter by treatments sought - AVALIAÇÃO

Logoped Phoniatr Vocol. 2018 Mar 23:1-9.. [Epub ahead of print]


Iverach L, Jones M, Lowe R, O'Brian S, Menzies RG, Packman A, Onslow M.

The University of Sydney , Lidcombe , Australia; University of Queensland , Herston , Australia.


Several treatment approaches are available for adults who stutter, including speech treatment, cognitive behaviour therapy (CBT) treatment for anxiety, and a combination of both. It is useful to determine whether any differences exist between adults who stutter enrolled in different types of treatment. Therefore, the purpose of this study was to compare demographic, speech, and psychological characteristics of adults who stutter enrolled in speech, psychological, and combined treatment programs. Participants were 288 adults who stuttered (18-80 years) enrolled in one of three different treatment programs: Speech Treatment for stuttering (n = 134), Anxiety Treatment for anxiety about stuttering (n = 70), or Speech Treatment for Stuttering With or Without Anxiety Treatment (n = 84). Participants completed a range of demographic, speech, and psychological measures prior to the start of treatment. A significantly higher proportion of participants in the Anxiety Treatment group were in a personal relationship than the other treatment groups. The Anxiety Treatment group had higher average age than the other treatment groups. The Speech Treatment group also demonstrated significantly higher self-rated stuttering severity than the Anxiety Treatment group, even though there were no significant difference between groups for clinician-rated percentage of syllables stuttered. Although most characteristics of adults who stuttered did not vary by treatment type, the present findings suggest that adults who stutter enrolled in speech treatment perceived their stuttering as more severe, which may have prompted treatment seeking. Further research is needed regarding the supportive influence of personal relationship for those with the disorder.

PMID: 29569967 DOI: 10.1080/14015439.2018.1452976




Children who stutter at 3 years of age: A community-based study - CONCEITO

J Fluency Disord. 2018 Jun;56:45-54. Epub 2018 Feb 22.


Shimada M, Toyomura A, Fujii T, Minami T.

College of Nishino Gakuen School Foundation, Chuoku, Sapporo, Japan; Gunma University, Showa-machi, Maebashi, Gunma,  Japan; Hokkaido University, Kita-ku, Sapporo, Japan; Minami-Tsukisamu Elementary School, Toyohira-ku, Sapporo, Japan; Japan Stuttering Genyukai Association, Toshima-ku, Tokyo, Japan.


PURPOSE: Lack of social resources to support children who stutter may be due, in part, to the absence of epidemiological data regarding stuttering. This study investigated the proportion of three-year-old children who stutter in a city located in Hokkaido, a northern island of Japan.

METHODS: The speech of individual children was assessed as part of a routine, government-conducted health care examination for 3-year-old children. The number of children screened was 2274, or 94.4% of all children in the city. The first author participated in the health care examination, and followed up all of the children who were found to stutter.

RESULTS: At 3 years of age, 1.41% of the children exhibited stuttering; 82.8% of these children subsequently did not exhibit stuttering six months later. Boys were 1.57 times more likely to stutter than girls, but they had only 86% of the probability of reported or observed fluency seen in girls six months later. Significantly higher probability of later fluency was observed in children who exhibited normal, rather than delayed, language development at the 1.5-year health checkup preceding the 3-year health checkup.

CONCLUSION: The proportion of three-year-old children who stutter and fluency status 6 months later are reported for a large cohort of Japanese children in Hokkaido. Language skills at 1;6 year may potentially be a factor in natural recovery or persistence; because of limitations in our study design, this assumption requires additional study. This is the first preliminary study to determine the proportion of three-year-old children who stutter in a Japanese community.

PMID: 29602051 DOI: 10.1016/j.jfludis.2018.02.002




Comparison of adults who stutter with and without social anxiety disorder - EMOCIONAL

J Fluency Disord. 2018 Jun;56:55-68. Epub 2018 Mar 19.


Iverach L, Jones M, Lowe R, O'Brian S, Menzies RG, Packman A, Onslow M.

Australian Stuttering Research Centre, Lidcombe, Sydney, Australia; University of Queensland, Herston, Australia; The University of Sydney


PURPOSE: Social anxiety disorder is a debilitating anxiety disorder associated with significant life impairment. The purpose of the present study is to evaluate overall functioning for adults who stutter with and without a diagnosis of social anxiety disorder.

METHOD: Participants were 275 adults who stuttered (18-80 years), including 219 males (79.6%) and 56 females (20.4%), who were enrolled to commence speech treatment for stuttering. Comparisons were made between participants diagnosed with social anxiety disorder (n = 82, 29.8%) and those without that diagnosis (n = 193, 70.2%).

RESULTS: Although the socially anxious group was significantly younger than the non-socially anxious group, no other demographic differences were found. When compared to the non-socially anxious group, the socially anxious group did not demonstrate significantly higher self-reported stuttering severity or percentage of syllables stuttered. Yet the socially anxious group reported more speech dissatisfaction and avoidance of speaking situations, significantly more psychological problems, and a greater negative impact of stuttering.

CONCLUSION: Significant differences in speech and psychological variables between groups suggest that, despite not demonstrating more severe stuttering, socially anxious adults who stutter demonstrate more psychological difficulties and have a more negative view of their speech. The present findings suggest that the demographic status of adults who stutter is not worse for those with social anxiety disorder. These findings pertain to a clinical sample, and cannot be generalized to the wider population of adults who stutter from the general community. Further research is needed to understand the longer-term impact of social anxiety disorder for those who stutter.

PMID: 29602052 DOI: 10.1016/j.jfludis.2018.03.001




Corpus callosum demyelination associated with acquired stuttering. - GAGUEIRA ADQUIRIDA

BMJ Case Rep. 2018 Apr 21;2018.


Decker BM, Guitar B, Solomon A.

University of Vermont Medical Center, Burlington, Vermont, USA.


Compared with developmental stuttering, adult onset acquired stuttering is rare. However, several case reports describe acquired stuttering and an association with callosal pathology. Interestingly, these cases share a neuroanatomical localisation also demonstrated in developmental stuttering. We present a case of adult onset acquired stuttering associated with inflammatory demyelination within the corpus callosum. This patient's disfluency improved after the initiation of immunomodulatory therapy.

PMID: 29680798 DOI: 10.1136/bcr-2017-223486




Corrigendum to "Communication attitudes in children who stutter: A meta-analytic review" [J. Fluency Disord. 46C (2015) 1-14]. - SOCIAL

J Fluency Disord. 2018 Jun;56:122. Epub 2018 May 4.


Guttormsen LS, Kefalianos E, Naess KB

University of Oslo, Norway; Murdoch Childrens Research Institute, Australia; University of Melbourne, Australia.


Erratum for

Communication attitudes in children who stutter: A meta-analytic review. [J Fluency Disord. 2015]

PMID: 29735345 DOI: 10.1016/j.jfludis.2018.04.002




Cortical associates of emotional reactivity and regulation in childhood stuttering - EMOCIONAL

J Fluency Disord. 2018 Jun;56:81-99. Epub 2018 Apr 19.


Zengin-Bolatkale H, Conture EG, Key AP, Walden TA, Jones RM.

Vanderbilt University, Nashville, TN, United States.


PURPOSE: This study sought to determine the cortical associates of emotional reactivity and emotion regulation (as indexed by the amplitude of evoked response potentials [ERP]) in young children who do and do not stutter during passive viewing of pleasant, unpleasant and neutral pictures.

METHOD: Participants were 17 young children who stutter and 22 young children who do not stutter (between 4 years 0 months to 6 years 11 months). The dependent measures were (1) mean amplitude of late positive potential (LPP, an ERP sensitive to emotional stimuli) during passive (i.e., no response required) picture viewing and directed reappraisal tasks and (2) emotional reactivity and regulation related scores on caregiver reports of young children's temperament (Children's Behavior Questionnaire, CBQ).

RESULTS: Young CWS, when compared to CWNS, exhibited significantly greater LPP amplitudes when viewing unpleasant pictures, but no significant between-group difference when viewing pleasant pictures and during the emotion regulation condition. There were, however, for CWS, but not CWNS, significant correlations between temperament-related measures of emotion and cortical measures of emotional reactivity and regulation.

CONCLUSIONS: Findings provide further empirical support for the notion that emotional processes are associated with childhood stuttering, and that CWS's inherent temperamental proclivities need to be taken into account when empirically studying or theorizing about this association.

PMID: 29723729 PMCID: PMC5970082 [Available on 2019-06-01] DOI: 10.1016/j.jfludis.2018.04.001




Delayed Phonological Encoding in Stuttering: Evidence from Eye Tracking - PSICOMOTOR

Lang Speech. 2018 Jul 1:23830918785203. [Epub ahead of print]


Pelczarski KM, Tendera A, Dye M, Loucks TM.

Kansas State University, USA; University of Illinois at Urbana-Champaign, USA; Rochester Institute of Technology, USA; University of Alberta, Canada.


Stuttering is a multifactorial disorder that is characterized by disruptions in the forward flow of speech believed to be caused by differences in the motor and linguistic systems. Several psycholinguistic theories of stuttering suggest that delayed or disrupted phonological encoding contributes to stuttered speech. However, phonological encoding remains difficult to measure without controlling for the involvement of the speech-motor system. Eye-tracking is proposed to be a reliable approach for measuring phonological encoding duration while controlling for the influence of speech production. Eighteen adults who stutter and 18 adults who do not stutter read nonwords under silent and overt conditions. Eye-tracking was used to measure dwell time, number of fixations, and response time. Adults who stutter demonstrated significantly more fixations and longer dwell times during overt reading than adults who do not stutter. In the silent condition, the adults who stutter produced more fixations on the nonwords than adults who do not stutter, but dwell-time differences were not found. Overt production may have resulted in additional requirements at the phonological and phonetic levels of encoding for adults who stutter. Direct measurement of eye-gaze fixation and dwell time suggests that adults who stutter require additional processing that could potentially delay or interfere with phonological-to-motor encoding.

PMID: 29976115 DOI: 10.1177/0023830918785203




Dualistic effect of pallidal deep brain stimulation on motor speech disorders in dystonia - GAGUEIRA ADQUIRIDA

Brain Stimul. 2018 Jul - Aug;11(4):896-903. Epub 2018 Mar 15.


Rusz J, Tykalová T, Fečíková A, Šťastná D, Urgošík D, Jech R.

Czech Technical University in Prague, Prague, Czech Republic; Charles University, Prague, Czech Republic. Na Homolce Hospital, Prague, Czech Republic.


BACKGROUND: Although pallidal deep brain stimulation (GPi-DBS) is an effective treatment for dystonia, it may cause important stimulation-induced side-effects such as hypokinetic dysarthria or stuttering. However, the reasons behind the occurrence of these side-effects remain unknown.

OBJECTIVE: To objectively investigate the impact of GPi-DBS on patients with dystonia on speech fluency, intelligibility, and key aspects of hyperkinetic and hypokinetic dysarthria.

METHODS: Speech was systematically evaluated in 19 dystonic patients with GPi-DBS. Each patient was tested twice within one day in both the GPi-DBS ON and GPi-DBS OFF stimulation conditions. A control sample of 19 matched healthy speakers underwent the same speech assessment.

RESULTS: We observed an improvement of hyperkinetic dysarthria symptoms in 47% and an aggravation of hypokinetic dysarthria symptoms in 26% of patients with the GPi-DBS switched ON. A higher stimulus intensity was found in a group of patients in whom the hypokinetic dysarthria worsened with the GPi-DBS ON when compared to other dystonic patients (p = 0.02). Furthermore, we revealed a significant increase of dysfluent words in the GPi-DBS ON when compared to OFF condition (p = 0.001) associated with the shorter distance of the active contact localization along the medio-lateral direction (r = -0.70, p = 0.005).

CONCLUSION: This study provides evidence of dualistic effects of GPi-DBS on speech in dystonia manifested as an improvement of hyperkinetic or a deterioration of hypokinetic dysarthria. Our findings suggest that lower stimulation parameters and placement of active contacts more laterally in the internal globus pallidus should be preferred to avoid the possible side effects of hypokinetic dysarthria and dysfluency.

PMID: 29576500 DOI: 10.1016/j.brs.2018.03.007




Effects of measurement method and transcript availability on inexperienced raters' stuttering frequency scores - AVALIAÇÃO

J Commun Disord. 2018 Jul - Aug;74:23-34. Epub 2018 Apr 24.


Chakraborty N, Logan KJ.

University of Florida, United States.


PURPOSE: To examine the effects of measurement method and transcript availability on the accuracy, reliability, and efficiency of inexperienced raters' stuttering frequency measurements.

METHOD: 44 adults, all inexperienced at evaluating stuttered speech, underwent 20 min of preliminary training in stuttering measurement and then analyzed a series of sentences, with and without access to transcripts of sentence stimuli, using either a syllable-based analysis (SBA) or an utterance-based analysis (UBA). Participants' analyses were compared between groups and to a composite analysis from two experienced evaluators.

RESULTS: Stuttering frequency scores from the SBA and UBA groups differed significantly from the experienced evaluators' scores; however, UBA scores were significantly closer to the experienced evaluators' scores and were completed significantly faster than the SBA scores. Transcript availability facilitated scoring accuracy and efficiency in both groups. The internal reliability of stuttering frequency scores was acceptable for the SBA and UBA groups; however, the SBA group demonstrated only modest point-by-point agreement with ratings from the experienced evaluators.

CONCLUSIONS: Given its accuracy and efficiency advantages over syllable-based analysis, utterance-based fluency analysis appears to be an appropriate context for introducing stuttering frequency measurement to raters who have limited experience in stuttering measurement. To address accuracy gaps between experienced and inexperienced raters, however, use of either analysis must be supplemented with training activities that expose inexperienced raters to the decision-making processes used by experienced raters when identifying stuttered syllables.

PMID: 29738875 DOI: 10.1016/j.jcomdis.2018.04.006




Enacted stigma and felt stigma experienced by adults who stutter - SOCIAL

J Commun Disord. 2018 May - Jun;73:50-61. Epub 2018 Mar 13.


Boyle MP

Montclair State University, Bloomfield, NJ, United States


PURPOSE: The aim of this study was to (1) document the experiences of enacted stigma (external stigma, experienced discrimination) and felt stigma (anticipation and expectation of discrimination or negative treatment by others) in adults who stutter, (2) investigate their relationships to each other, and (3) investigate their relationships to global mental health.

METHOD: Participants were 324 adults who stutter recruited from clinicians and self-help group leaders in the United States. Participants completed an anonymous web survey consisting of measures of enacted stigma, felt stigma, and global mental health. Data analysis focused on obtaining descriptive statistics for enacted stigma and felt stigma, and performing correlational analysis between these variables, and also between these variables and global mental health.

RESULTS: Most participants reported experiencing several different forms of social devaluation and negative treatment from other people at some point in their lives (i.e., enacted stigma), although they rarely experienced these events during the past year. Most participants agreed that they anticipate future stigmatizing experiences (i.e., felt stigma). Enacted stigma in the past year demonstrated a significant positive relationship to felt stigma. Both enacted stigma in the past year and felt stigma demonstrated significant negative relationships with global mental health. Enacted stigma in the past year and felt stigma were unique predictors of participants' global mental health.

CONCLUSIONS: People who stutter experience discrimination and social devaluation, and they anticipate future stigmatizing experiences. Both of these types of stigma, enacted and felt, are associated with reduced mental health in adults who stutter. Assessment and therapy with adults who stutter should address these aspects of stuttering.

PMID: 29574262 DOI: 10.1016/j.jcomdis.2018.03.004  




Evaluating satisfaction of patients with stutter regarding the tele-speech therapy method and infrastructure - TERAPIA

Int J Med Inform. 2018 Jul;115:128-133. Epub 2018 Mar 16.


Eslami Jahromi M, Ahmadian L.

Kerman University of Medical Sciences, Kerman, Iran.


OBJECTIVE: Investigating the required infrastructure for the implementation of telemedicine and the satisfaction of target groups improves the acceptance of this technology and facilitates the delivery of healthcare services. The aim of this study was to assess the satisfaction of patients with stutter concerning the therapeutic method and the infrastructure used to receive tele-speech therapy services.

METHODS: This descriptive-analytical study was conducted on all patients with stutter aged between 14 and 39 years at Jahrom Social Welfare Bureau (n = 30). The patients underwent speech therapy sessions through video conferencing with Skype. Data were collected by a researcher-made questionnaire. Its content validity was confirmed by three medical informatics specialists. Data were analyzed using SPSS version 19.

RESULTS: The mean and standard deviation of patient satisfaction scores concerning the infrastructure and the tele-speech therapy method were 3.15 ± 0.52 and 3.49 ± 0.52, respectively. No significant relationship was found between the patients satisfaction and their gender, education level and age (p > 0.05). The results of this study showed that the number of speech therapy sessions did not affect the overall satisfaction of the patients (p > 0.05), but the number of therapeutic sessions had a direct relationship with their satisfaction with the infrastructure used for tele-speech therapy (p < 0.05).

CONCLUSIONS: The present study showed that patients were satisfied with tele-speech therapy. According to most patients the low speed of the Internet connection in the country was a major challenge for receiving tele-speech therapy. The results suggest that healthcare planner and policy makers invest on increasing bandwidth to improve the success rate of telemedicine programs.

PMID: 29779715 DOI: 10.1016/j.ijmedinf.2018.03.004




Evidence for a Resting State Network Abnormality in Adults Who Stutter - NEUROCIÊNCIAS

Front Integr Neurosci. 2018 Apr 27;12:16.

Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5934488/pdf/fnint-12-00016.pdf


Ghaderi AH, Andevari MN, Sowman PF

University of Tabriz, Tabriz, Iran; Iranian Neuro-wave Laboratory, Center of Isfahan, Isfahan, Iran; Babol Noshirvani University of Technology, Babol, Iran; Macquarie University, Sydney, NSW, Australia.


Neural network-based investigations of stuttering have begun to provide a possible integrative account for the large number of brain-based anomalies associated with stuttering. Here we used resting-state EEG to investigate functional brain networks in adults who stutter (AWS). Participants were 19 AWS and 52 age-, and gender-matched normally fluent speakers. EEGs were recorded and connectivity matrices were generated by LORETA in the theta (4-8 Hz), alpha (8-12 Hz), beta1 (12-20 Hz), and beta2 (20-30 Hz) bands. Small-world propensity (SWP), shortest path, and clustering coefficients were computed for weighted graphs. Minimum spanning tree analysis was also performed and measures were compared by non-parametric permutation test. The results show that small-world topology was evident in the functional networks of all participants. Three graph indices (diameter, clustering coefficient, and shortest path) exhibited significant differences between groups in the theta band and one [maximum betweenness centrality (BC)] measure was significantly different between groups in the beta2 band. AWS show higher BC than control in right temporal and inferior frontal areas and lower BC in the right primary motor cortex. Abnormal functional networks during rest state suggest an anomaly of DMN activity in AWS. Furthermore, functional segregation/integration deficits in the theta network are evident in AWS. These deficits reinforce the hypothesis that there is a neural basis for abnormal executive function in AWS. Increased beta2 BC in the right speech-motor related areas confirms previous evidence that right audio-speech areas are over-activated in AWS. Decreased beta2 BC in the right primary motor cortex is discussed in relation to abnormal neural mechanisms associated with time perception in AWS.

PMID: 29755328 PMCID: PMC5934488 DOI: 10.3389/fnint.2018.00016




Facilitating fluency in adults who stutter - NEUROCIÊNCIAS

Brain. 2018 Apr 1;141(4):944-946.

Free PMC Article - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889009/pdf/awy075.pdf


Crinion JT.

University College London, UK.


No abstract available.

PMID: 29596670 PMCID: PMC5889009 DOI: 10.1093/brain/awy075




Frequency of speech disruptions in Parkinson's Disease and developmental stuttering: A comparison among speech tasks  - GAGUEIRA ADQUIRIDA

PLoS One. 2018 Jun 18;13(6):e0199054. doi: 10.1371/journal.pone.0199054. eCollection 2018.

Free PMC Article - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005540/pdf/pone.0199054.pdf


Juste FS, Sassi FC, Costa JB, de Andrade CRF.

Department of Speech-Language and Hearing Science, School of Medicine, University of São Paulo, São Paulo, Brazi


OBJECTIVE: To analyze the frequency of speech disruptions across different speech tasks, comparing the performance of individuals with Parkinson's Disease (PD) and DS.

METHOD: Participants were 20 people with PD, 20 people with DS and 40 fluent individuals. Speech samples were recorded during monologue speech, choral and solo oral reading. Transcriptions of 200 fluent syllables were performed to identify stuttering-like disfluencies (SLDs) and other disfluencies (ODs).

RESULTS: People with PD presented significantly less speech disruptions when compared to people with DS, but significantly more speech disruptions than the control group. Stuttering-like disfluencies ocurred more frequently during monologue speech and solo oral reading for both PD and DS, whereas the control group did not present difference between these tasks.

CONCLUSION: The stuttering pattern presented by people with PD is different from what is usually described as being neurogenic stuttering.

PMID: 29912919 PMCID: PMC6005540 DOI: 10.1371/journal.pone.0199054




Identification of neural structures involved in stuttering using vibrotactile feedback - AUDITIVO

Brain Lang. 2018 May - Jul;180-182:50-61. Epub 2018 May 7.


Cheadle O, Sorger C, Howell P.

University College London, UK.


Feedback delivered over auditory and vibratory afferent pathways has different effects on the fluency of people who stutter (PWS). These features were exploited to investigate the neural structures involved in stuttering. The speech signal vibrated locations on the body (vibrotactile feedback, VTF). Eleven PWS read passages under VTF and control (no-VTF) conditions. All combinations of vibration amplitude, synchronous or delayed VTF and vibrator position (hand, sternum or forehead) were presented. Control conditions were performed at the beginning, middle and end of test sessions. Stuttering rate, but not speaking rate, differed between the control and VTF conditions. Notably, speaking rate did not change between when VTF was delayed versus when it was synchronous in contrast with what happens with auditory feedback. This showed that cerebellar mechanisms, which are affected when auditory feedback is delayed, were not implicated in the fluency-enhancing effects of VTF, suggesting that there is a second fluency-enhancing mechanism.

PMID: 29747034 DOI: 10.1016/j.bandl.2018.03.002




Recovery of brain abscess-induced stuttering after neurosurgical intervention. - NEUROCIÊNCIAS

BMJ Case Rep. 2018 May 12;2018.


Sudo D, Doutake Y, Yokota H, Watanabe E.

Ooshima Prefecture Hospital, Amami, Japan; Jichi Medical University, Shimotsuke, Japan.


Stuttering occurs in approximately 5% of all children and 1% of adults. One type, neurogenic stuttering, is usually attributable to strokes or other structural damages to the brain areas that are responsible for language fluency. Here, we present the first case of neurogenic stuttering caused by a brain abscess. The patient was a 60-year-old man admitted for a seizure and administered an anticonvulsant, after which he began stuttering. MRI revealed a brain abscess in the left frontal lobe that extended to the dorsolateral prefrontal cortex (BA (Brodmann's area) 9 and 46), frontal eye field (BA 8) and premotor cortex and supplementary motor area (BA 6). After neurosurgical drainage and antibiotic treatment, the symptoms had resolved. This case is unique in that the therapeutic effects and localisation of the cause of stuttering were rapidly identified, allowing for a more accurate description of the neural circuitry related to stuttering.

PMID: 29754132 DOI: 10.1136/bcr-2017-223259




Language development in children who stutter: A review of recent research - LINGUAGEM

Nippold MA


Int J Speech Lang Pathol. 2018 Apr 11:1-9. [Epub ahead of print]

University of Oregon , Eugene , OR , USA.


PURPOSE: This article reviews recent studies that examined the controversial claim that children who stutter (CWS), as a group, have weaker language skills than children who do not stutter (CWNS). The article was an effort to address the conflicting conclusions of two previous reviews of the research in this area.

METHOD: Studies published in research journals during the past 7 years (2011-2018) were located through a systematic review of the literature. Each study was analysed to determine how well it supported the claim that CWS, as a group, have weaker language skills than CWNS.

RESULT: The evidence was not convincing to support this controversial claim. Rather, the review indicated that CWS performed as well as or better than CWNS on formal language tasks.

CONCLUSION: The claim that language weaknesses are linked to children's stuttering is not well supported by recently published studies. Alternative interpretations of the literature are offered.

PMID: 29642734 DOI: 10.1080/17549507.2018.1457721




Maintenance of Improved Attitudes Toward Stuttering - SOCIAL

Am J Speech Lang Pathol. 2018 May 3;27(2):721-736.


St Louis KO,  Flynn TW.

West Virginia University, Morgantown; EBS Healthcare, Alexandria, VA.


PURPOSE: This study sought to determine the extent to which experimentally induced positive attitudes in high school students in a previous investigation were maintained 7 years later.

METHOD: Authors and assistants recruited 36 adults in their early 20s (Follow-up group) who, in high school, had witnessed either a live oral talk by a person who stutters or a professionally made video on stuttering designed for teens followed by a short talk by the same speaker. The Public Opinion Survey of Human Attributes-Stuttering was administered before and after the interventions in high school and 7 years later such that pre-post group comparisons were made. Previously, the Follow-up group had demonstrated highly positive changes in their attitudes after the interventions. In addition, a control group of 56 former high school students from the same state, who did not participate in the interventions, were recruited and compared to the Follow-up group.

RESULTS: The Follow-up group, which was found to be representative of the original high school cohort, held more positive Public Opinion Survey of Human Attributes-Stuttering mean ratings than the Control group, although somewhat less positive than their previous postintervention ratings.

CONCLUSIONS: The Follow-up group maintained many of the positive changes in their beliefs and self reactions regarding stuttering that were induced 7 years earlier after witnessing personal stories and facts about stuttering.

PMID: 29623339 DOI: 10.1044/2017_AJSLP-17-0146




Reliability and validity evidence of the Assessment of Language Use in Social Contexts for Adults (ALUSCA). - AVALIAÇÃO

Logoped Phoniatr Vocol. 2018 Apr 12:1-12 [Epub ahead of print]


Valente ARS, Hall A, Alvelos H, Leahy M, Jesus LMT.

University of Aveiro , Aveiro , Portugal; The University of Dublin , Dublin , Ireland.


BACKGROUND: The appropriate use of language in context depends on the speaker's pragmatic language competencies. A coding system was used to develop a specific and adult-focused self-administered questionnaire to adults who stutter and adults who do not stutter, The Assessment of Language Use in Social Contexts for Adults, with three categories: precursors, basic exchanges, and extended literal/non-literal discourse. This paper presents the content validity, item analysis, reliability coefficients and evidences of construct validity of the instrument.

METHODS: Content validity analysis was based on a two-stage process: first, 11 pragmatic questionnaires were assessed to identify items that probe each pragmatic competency and to create the first version of the instrument; second, items were assessed qualitatively by an expert panel composed by adults who stutter and controls, and quantitatively and qualitatively by an expert panel composed by clinicians. A pilot study was conducted with five adults who stutter and five controls to analyse items and calculate reliability. Construct validity evidences were obtained using the hypothesized relationships method and factor analysis with 28 adults who stutter and 28 controls.

RESULTS: Concerning content validity, the questionnaires assessed up to 13 pragmatic competencies. Qualitative and quantitative analysis revealed ambiguities in items construction. Disagreement between experts was solved through item modification. The pilot study showed that the instrument presented internal consistency and temporal stability. Significant differences between adults who stutter and controls and different response profiles revealed the instrument's underlying construct.

CONCLUSION: The instrument is reliable and presented evidences of construct validity.

PMID: 29648952 DOI: 10.1080/14015439.2018.1458898




Rhythmic speech and stuttering reduction in a syllable-timed language - FALA

Clin Linguist Phon. 2018;32(10):932-949. Epub 2018 Jun 6.


Law T, Packman A, Onslow M, To CK, Tong MC, Lee KY.

The University of Sydney , Sydney , Australia; The Chinese University of Hong Kong , NT , Hong Kong SAR; The University of Hong Kong , Pok Fu Lam , Hong Kong SAR.


Speaking rhythmically, also known as syllable-timed speech (STS), has been known for centuries to be a fluency-inducing condition for people who stutter. Cantonese is a tonal syllable-timed language and it has been shown that, of all languages, Cantonese is the most rhythmic (Mok, 2009). However, it is not known if STS reduces stuttering in Cantonese as it does in English. This is the first study to investigate the effects of STS on stuttering in a syllable-timed language. Nineteen native Cantonese-speaking adults who stutter were engaged in conversational tasks in Cantonese under two conditions: one in their usual speaking style and one using STS. The speakers' percentage syllables stuttered (%SS) and speech rhythmicity were rated. The rhythmicity ratings were used to estimate the extent to which speakers were using STS in the syllable-timed condition. Results revealed a statistically significant reduction in %SS in the STS condition; however, this reduction was not as large as in previous studies in other languages and the amount of stuttering reduction varied across speakers. The rhythmicity ratings showed that some speakers were perceived to be speaking more rhythmically than others and that the perceived rhythmicity correlated positively with reductions in stuttering. The findings were unexpected, as it was anticipated that speakers of a highly rhythmic language such as Cantonese would find STS easy to use and that the consequent reductions in stuttering would be great, even greater perhaps than in a stress-timed language such as English. The theoretical and clinical implications of the findings are discussed.

PMID: 29873568 DOI: 10.1080/02699206.2018.1480655




Separation of trait and state in stuttering - NEUROCIÊNCIAS

Hum Brain Mapp. 2018 Aug;39(8):3109-3126. Epub 2018 Apr 6.

Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6055715/pdf/HBM-39-3109.pdf


Connally EL, Ward D, Pliatsikas C, Finnegan S, Jenkinson M, Boyles R, Watkins KE.

University of Oxford, Oxford, United Kingdom; University of Reading, Reading, United Kingdom.


Stuttering is a disorder in which the smooth flow of speech is interrupted. People who stutter show structural and functional abnormalities in the speech and motor system. It is unclear whether functional differences reflect general traits of the disorder or are specifically related to the dysfluent speech state. We used a hierarchical approach to separate state and trait effects within stuttering. We collected sparse-sampled functional MRI during two overt speech tasks (sentence reading and picture description) in 17 people who stutter and 16 fluent controls. Separate analyses identified indicators of: (1) general traits of people who stutter; (2) frequency of dysfluent speech states in subgroups of people who stutter; and (3) the differences between fluent and dysfluent states in people who stutter. We found that reduced activation of left auditory cortex, inferior frontal cortex bilaterally, and medial cerebellum were general traits that distinguished fluent speech in people who stutter from that of controls. The stuttering subgroup with higher frequency of dysfluent states during scanning (n = 9) had reduced activation in the right subcortical grey matter, left temporo-occipital cortex, the cingulate cortex, and medial parieto-occipital cortex relative to the subgroup who were more fluent (n = 8). Finally, during dysfluent states relative to fluent ones, there was greater activation of inferior frontal and premotor cortex extending into the frontal operculum, bilaterally. The above differences were seen across both tasks. Subcortical state effects differed according to the task. Overall, our data emphasise the independence of trait and state effects in stuttering.

PMID: 29624772 PMCID: PMC6055715 DOI: 10.1002/hbm.24063




Short-Term Memory, Inhibition, and Attention in Developmental Stuttering: A Meta-Analysis - INFANTIL

J Speech Lang Hear Res. 2018 Jul 13;61(7):1626-1648.

Free PMC Article - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195058/pdf/JSLHR-61-1626.pdf


Ofoe LC, Anderson JD, Ntourou K

Indiana University, Bloomington.


PURPOSE: This study presents a meta-analytic review of differences in verbal short-term memory, inhibition, and attention between children who stutter (CWS) and children who do not stutter (CWNS).

METHOD: Electronic databases and reference sections of articles were searched for candidate studies that examined verbal short-term memory, inhibition, and attention using behavioral and/or parent report measures. Twenty-nine studies met the eligibility criteria, which included, among other things, children between the ages of 3 and 18 years and the availability of quantitative data for effect size calculations. Data were extracted, coded, and analyzed, with the magnitude of the difference between the 2 groups of children being estimated using Hedge's g (Hedges & Olkin, 1985).

RESULTS: Based on the random-effects model (Hunter & Schmidt, 2004), findings revealed that CWS scored lower than CWNS on measures of nonword repetition (Hedges' g = -0.62), particularly at lengths of 2 and 3 syllables (Hedges' g = -0.62 and - 0.50, respectively), and forward span (Hedges' g = -0.40). Analyses further revealed that the parents of CWS rated their children as having weaker inhibition (Hedges' g = -0.44) and attentional focus/persistence (Hedges' g = -0.36) skills than the parents of CWNS, but there were no significant differences between CWS and CWNS in behavioral measures of inhibition and attention.

CONCLUSION: The present findings were taken to suggest that cognitive processes are important variables associated with developmental stuttering.

PMID: 29984373 PMCID: PMC6195058 DOI: 10.1044/2018_JSLHR-S-17-0372




Stuttering and Labor Market Outcomes in the United States - SOCIAL

J Speech Lang Hear Res. 2018 Jul 13;61(7):1649-1663.

Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195060/pdf/JSLHR-61-1649.pdf


Gerlach H, Totty E, Subramanian A, Zebrowski P

University of Iowa, Iowa City; Purdue University, West Lafayette, IN.


PURPOSE: The purpose of this study was to quantify relationships between stuttering and labor market outcomes, determine if outcomes differ by gender, and explain the earnings difference between people who stutter and people who do not stutter.

METHOD: Survey and interview data were obtained from the National Longitudinal Study of Adolescent to Adult Health. Of the 13,564 respondents who completed 4 waves of surveys over 14 years and answered questions about stuttering, 261 people indicated that they stutter. Regression analysis, propensity score matching, and Blinder-Oaxaca decomposition were used.

RESULTS: After controlling for numerous variables related to demographics and comorbidity, the deficit in earnings associated with stuttering exceeded $7,000. Differences in observable characteristics between people who stutter and people who do not stutter (e.g., education, occupation, self-perception, hours worked) accounted for most of the earnings gap for males but relatively little for females. Females who stutter were also 23% more likely to be underemployed than females who do not stutter.

CONCLUSIONS: Stuttering was associated with reduced earnings and other gender-specific disadvantages in the labor market. Preliminary evidence indicates that discrimination may have contributed to the earnings gap associated with stuttering, particularly for females.

PMID: 29933430 PMCID: PMC6195060 DOI: 10.1044/2018_JSLHR-S-17-0353




Stuttering Frequency, Speech Rate, Speech Naturalness, and Speech Effort During the Production of Voluntary Stuttering - TERAPIA

Lang Speech. 2018 May 1:23830918766962. [Epub ahead of print]


Davidow JH, Grossman HL, Edge RL.

Hofstra University, USA; The American Institute for Stuttering, USA; Jacksonville University, USA.


PURPOSE: Voluntary stuttering techniques involve persons who stutter purposefully interjecting disfluencies into their speech. Little research has been conducted on the impact of these techniques on the speech pattern of persons who stutter. The present study examined whether changes in the frequency of voluntary stuttering accompanied changes in stuttering frequency, articulation rate, speech naturalness, and speech effort.

METHOD: In total, 12 persons who stutter aged 16-34 years participated. Participants read four 300-syllable passages during a control condition, and three voluntary stuttering conditions that involved attempting to produce purposeful, tension-free repetitions of initial sounds or syllables of a word for two or more repetitions (i.e., bouncing). The three voluntary stuttering conditions included bouncing on 5%, 10%, and 15% of syllables read. Friedman tests and follow-up Wilcoxon signed ranks tests were conducted for the statistical analyses.

RESULTS: Stuttering frequency, articulation rate, and speech naturalness were significantly different between the voluntary stuttering conditions. Speech effort did not differ between the voluntary stuttering conditions. Stuttering frequency was significantly lower during the three voluntary stuttering conditions compared to the control condition, and speech effort was significantly lower during two of the three voluntary stuttering conditions compared to the control condition.

CONCLUSIONS: Due to changes in articulation rate across the voluntary stuttering conditions, it is difficult to conclude, as has been suggested previously, that voluntary stuttering is the reason for stuttering reductions found when using voluntary stuttering techniques. Additionally, future investigations should examine different types of voluntary stuttering over an extended period of time to determine their impact on stuttering frequency, speech rate, speech naturalness, and speech effort.

PMID: 29756528 DOI: 10.1177/0023830918766962




Telepractice Treatment of Stuttering: A Systematic Review - TERAPIA

Telemed J E Health. 2018 Jul 31. doi: 10.1089/tmj.2017.0319. [Epub ahead of print]


McGill M, Noureal N, Siegel J.

Portland State University , Portland, Oregon.


PURPOSE: The purpose of the current systematic review is to (1) guide and inform speech language pathologists involved in the treatment of persons who stutter in the development and implementation of live-stream, video telepractice services and (2) identify areas for future research related to telepractice and stuttering.

MATERIALS AND METHODS: Systematic searches of electronic databases, reference lists and journals identified seven studies that met predetermined inclusion criteria. These seven studies were analyzed and summarized in terms of the: (1) sample size, (2) characteristics of the participants, (3) technology and equipment utilized, (4) clinical setting, (5) treatment type, (6) research methodology, (7) results of the study, and (8) Oxford evidence-based practice levels.

RESULTS: Telepractice was used by university-based researchers and educators in the delivery of services to 80 participants who stutter. The services delivered included implementation of the Camperdown Program, the Lidcombe Program, and an integrated treatment approach.

CONCLUSION: Live-stream, video telepractice appears to be a promising service- delivery method for treatment of stuttering using the Camperdown Program, Lidcombe Program, and integrated approaches. Further research is needed to determine if the initial evaluation and diagnosis of stuttering can be made using telepractice methodologies.

PMID: 30063187 DOI: 10.1089/tmj.2017.0319




The Effects of Emotion on Second Formant Frequency Fluctuations in Adults Who Stutter - EMOCIONAL

Folia Phoniatr Logop. 2018;70(1):13-23. Epub 2018 Jun 5.


Bauerly KR.


OBJECTIVE: Changes in second formant frequency fluctuations (FFF2) were examined in adults who stutter (AWS) and adults who do not stutter (ANS) when producing nonwords under varying emotional conditions.

METHODS: Ten AWS and 10 ANS viewed images selected from the International Affective Picture System representing dimensions of arousal (e.g., excited versus bored) and hedonic valence (e.g., happy versus sad). Immediately following picture presentation, participants produced a consonant-vowel + final /t/ (CVt) nonword consisting of the initial sounds /p/, /b/, /s/, or /z/, followed by a vowel (/i/, /u/, /ε/) and a final /t/. CVt tokens were assessed for word duration and FFF2.

RESULTS: Significantly slower word durations were shown in the AWS compared to the ANS across conditions. Although these differences appeared to increase under arousing conditions, no interaction was found. Results for FFF2 revealed a significant group-condition interaction. Post hoc analysis indicated that this was due to the AWS showing significantly greater FFF2 when speaking under conditions eliciting increases in arousal and unpleasantness. ANS showed little change in FFF2 across conditions.

CONCLUSIONS: The results suggest that AWS' articulatory stability is more susceptible to breakdown under negative emotional influences.

PMID: 29870993 DOI: 10.1159/000488758




The Effects of Fluency Enhancing Conditions on Sensorimotor Control of Speech in Typically Fluent Speakers: An EEG Mu Rhythm Study.

Front Hum Neurosci. 2018 Apr 4;12:126.

Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5893846/pdf/fnhum-12-00126.pdf


Kittilstved T, Reilly KJ, Harkrider AW, Casenhiser D, Thornton D, Jenson DE, Hedinger T, Bowers AL, Saltuklaroglu T.

The University of Tennessee Health Science Center, Knoxville, TN, United States; The University of Arkansas, Fayetteville, AR, United States.


Objective: To determine whether changes in sensorimotor control resulting from speaking conditions that induce fluency in people who stutter (PWS) can be measured using electroencephalographic (EEG) mu rhythms in neurotypical speakers. Methods: Non-stuttering (NS) adults spoke in one control condition (solo speaking) and four experimental conditions (choral speech, delayed auditory feedback (DAF), prolonged speech and pseudostuttering). Independent component analysis (ICA) was used to identify sensorimotor μ components from EEG recordings. Time-frequency analyses measured μ-alpha (8-13 Hz) and μ-beta (15-25 Hz) event-related synchronization (ERS) and desynchronization (ERD) during each speech condition. Results: 19/24 participants contributed μ components. Relative to the control condition, the choral and DAF conditions elicited increases in μ-alpha ERD in the right hemisphere. In the pseudostuttering condition, increases in μ-beta ERD were observed in the left hemisphere. No differences were present between the prolonged speech and control conditions. Conclusions: Differences observed in the experimental conditions are thought to reflect sensorimotor control changes. Increases in right hemisphere μ-alpha ERD likely reflect increased reliance on auditory information, including auditory feedback, during the choral and DAF conditions. In the left hemisphere, increases in μ-beta ERD during pseudostuttering may have resulted from the different movement characteristics of this task compared with the solo speaking task. Relationships to findings in stuttering are discussed. Significance: Changes in sensorimotor control related feedforward and feedback control in fluency-enhancing speech manipulations can be measured using time-frequency decompositions of EEG μ rhythms in neurotypical speakers. This quiet, non-invasive, and temporally sensitive technique may be applied to learn more about normal sensorimotor control and fluency enhancement in PWS.

PMID: 29670516 PMCID: PMC5893846 DOI: 10.3389/fnhum.2018.00126




The Lidcombe Program and child language development: Long-term assessment - LINGUAGEM

Clin Linguist Phon. 2018;32(9):860-875. Epub 2018 Mar 15.


Imeson J, Lowe R, Onslow M, Munro N, Heard R, O'Brian S, Arnott S.

The University of Sydney , Sydney , Australia; Australian Catholic University , Sydney , Australia .


This study was driven by the need to understand the mechanisms underlying Lidcombe Program treatment efficacy. The aim of the present study was to extend existing data exploring whether stuttering reductions observed when children successfully treated with the Lidcombe Program are associated with restricted language development. Audio recordings of 10-min parent-child conversations at home were transcribed verbatim for 11 pre-school-age children with various stuttering severities. Language samples from three assessments-pre-treatment, 9 and 18 months after beginning treatment-were analysed using SALT software for lexical diversity, utterance length and sentence complexity. At 18 months posttreatment commencement, the children had attained and maintained statistically significant stuttering reductions. During that period, there was no evidence that Lidcombe Program treatment was associated with restricted language development. The continued search for the mechanisms underlying this successful treatment needs to focus on other domains.

PMID: 29543506 DOI: 10.1080/02699206.2018.1448897




The linguistic aspects of the speech of Jordanian children who stutter - AVALIAÇÃO

Int J Pediatr Otorhinolaryngol. 2018 Jun;109:174-179. Epub 2018 Apr 9.


Alqhazo M, Al-Dennawi S.

Jordan University of Science and Technology, Jordan.


BACKGROUND: The influence of linguistic variables on moments of stuttering has been a popular area of research for several years. The purpose of this study is to assess the linguistic factors of the speech of children who stutter.

METHODS: Forty-one children who stutter (31 males, 10 females) were selected from 14 schools with age range of 6-13 years. Phonological and morphological variables were measured using spontaneous speech task, whereas syntactic variables were measured using sentence completion task.

RESULTS: Results indicated significantly that (a) inflected words (M = 50, SD = 30) are more likely to be stuttered than non-inflected words (M = 32, SD = 18) [P = 0.000], (b) stuttering occurs more on initial position of the word than medial or final position [P = 0.000], (c) higher rate of stuttering is associated with increasing length of the word [P = 0.000], (d) long sentences are more likely to be stuttered than short sentences [P = 0.000], (e) the loci of stuttering is higher in stressed syllables (M = 34, SD = 30) than unstressed syllables (M = 24, SD = 20) [p = 0.002], (f) the occurrence of stuttering is more on consonant sounds (M = 36, SD = 18) than vowel sounds (M = 25, SD = 28) [P = 0.009].

CONCLUSIONS: These results support the relationship between the linguistic factors and the frequency of stuttering which could be taken into consideration in the development of treatment protocols for children who stutter.

PMID: 29728176 DOI: 10.1016/j.ijporl.2018.04.003




Trait related sensorimotor deficits in people who stutter: An EEG investigation of μ rhythm dynamics during spontaneous fluency - NEUROCIÊNCIAS

Neuroimage Clin. 2018 May 21;19:690-702.

Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5986168/pdf/main.pdf


Jenson D, Reilly KJ, Harkrider AW, Thornton D, Saltuklaroglu T.

University of Tennessee Health Science Center, United States;


Stuttering is associated with compromised sensorimotor control (i.e., internal modeling) across the dorsal stream and oscillations of EEG mu (μ) rhythms have been proposed as reliable indices of anterior dorsal stream processing. The purpose of this study was to compare μ rhythm oscillatory activity between (PWS) and matched typically fluent speakers (TFS) during spontaneously fluent overt and covert speech production tasks. Independent component analysis identified bilateral μ components from 24/27 PWS and matched TFS that localized over premotor cortex. Time-frequency analysis of the left hemisphere μ clusters demonstrated significantly reduced μ-α and μ-β ERD (pCLUSTER < 0.05) in PWS across the time course of overt and covert speech production, while no group differences were found in the right hemisphere in any condition. Results were interpreted through the framework of State Feedback Control. They suggest that weak forward modeling and evaluation of sensory feedback across the time course of speech production characterizes the trait related sensorimotor impairment in PWS. This weakness is proposed to represent an underlying sensorimotor instability that may predispose the speech of PWS to breakdown.

PMID: 29872634 PMCID: PMC5986168 DOI: 10.1016/j.nicl.2018.05.026