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.
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 Analysis of Speech Disfluencies of Turkish Speakers Based on Age Variable - CONCEITO
J Psycholinguist Res. 2018 Jun;47(3):699-718
Altıparmak A, Kuruoğlu G.
National Defense University Turkish Air Academy, Yesilyurt, Istanbul, Turkey; Dokuz Eylul University, Izmir, Turkey.
The focus of this research is to verify the influence of the age variable on fluent Turkish native speakers' production of the various types of speech disfluencies. To accomplish this, four groups of native speakers of Turkish between ages 4-8, 18-23, 33-50 years respectively and those over 50-year-olds were constructed. A total of 84 participants took part in this study. Prepared and unprepared speech samples of at least 300 words were collected from each participant via face-to-face interviews that were tape recorded and transcribed; for practical reasons, only the unprepared speech samples were collected from children. As a result, for the prepared speech situation, there was no statistically significant difference in terms of age in the production rates of filled gaps, false starts, slips of the tongue and repetitions; however, participants in the over 50-year-old group produced more hesitations and prolongations than participants in the 18-23 and 33-50-year-old groups. For the unprepared speech situation, age variable was not effective on the production rates of filled gaps. However, 4-8 and over 50-year-old participants produced more hesitations and prolongations than the 18-23 and 33-50-year-old groups. 4-8-year-old children produced more slips of the tongue than the 18-23 and 33-50-year-old groups, and more false starts and repetitions than the participants in the other three age groups (18-23, 33-50, over 50). Further analyses revealed more extensive insights related to the types of disfluencies, the position of disfluencies, and the linguistic units involved in disfluency production in Turkish speech.
PMID: 29299779 DOI: 10.1007/s10936-017-9553-4
An evaluation of G-protein coupled membrane estrogen receptor-1 level in stuttering. - INFANTIL
Eur Arch Otorhinolaryngol. 2018 Feb;275(2):469-476. Epub 2018 Jan 3.
Bilal N, Kurutas EB, Orhan I.
Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey; Haydar Bey Mah. Sok, Kahramanmaras, Turkey.
OBJECTIVE: Stuttering is a widespread but little understood disease. There has been a recent increase in neuropathophysiological, genetic, and biochemical studies related to the etiopathogenesis. As developmental stuttering continues in adult males, hormonal factors are thought to have an effect. In this study, an evaluation was made for the first time of serum GPER-1 level in patients with a stutter.
STUDY DESIGN: Prospective case control.
MATERIALS AND METHODS: The study included 30 patients with a stutter, aged < 18 years, and 35 age-matched children as the control group. The Stuttering Severity Instrument-3 form was administered to the patients. Evaluations were made of serum GPER-1, TSH, estradiol, prolactin, and progesterone and testosterone levels.
RESULTS: GPER-1 level was determined as 0.51 (0.42-0.67) ng/mL in the patients and as 0.19 (0.13-0.25) ng/mL in the control group, and the difference was statistically significant (p < 0.001). A statistically significant difference was determined between genders with GPER-1 level of 0.56 (0.44-0.68) ng/mL in the male stuttering patient group and 0.44 (0.35-0.49) ng/mL in the female patient group (p = 0.026). Differential diagnosis with ROC analysis for the serum GPER-1 levels was statistically significant [Area under the ROC curve (AUC): 0.998, confidence interval, CI 0.992-1.000, p < 0.001].
CONCLUSION: The GPER-1 levels of the stuttering patients were found to be higher than those of the control group and GPER-1 levels of male patients were higher than those of females. As GPER-1 has high sensitivity and sensitivity, it could be considered important in the diagnosis and treatment of stuttering.
PMID: 29299745 DOI: 10.1007/s00405-017-4862-7
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
Best Practice for Developmental Stuttering: Balancing Evidence and Expertise. - TERAPIA
Lang Speech Hear Serv Sch. 2018 Jan 9;49(1):1-3.
Byrd CT, Donaher J.
The University of Texas at Austin; The Children's Hospital of Philadelphia, PA.
Best practice for developmental stuttering remains a topic of debate. In the clinical forum following this introduction, four fluency experts balance the evidence and expertise to describe their approach to assessment and treatment.
PMID: 29322181 DOI: 10.1044/2017_LSHSS-17-0089
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
Comparison of Percentage of Syllables Stuttered With Parent-Reported Severity Ratings as a Primary Outcome Measure in Clinical Trials of Early Stuttering Treatment. - AVALIAÇÃO
Onslow M, Jones M, O'Brian S, Packman A, Menzies R, Lowe R, Arnott S, Bridgman K, de Sonneville C, Franken MC.
The University of Sydney, Australian Stuttering Research Centre, Lidcombe, New South Wales; The University of Queensland, School of Public Health, Faculty of Medicine, Brisbane, Australia; Australian Catholic University, School of Allied and Public Health, Melbourne; La Trobe University, Department of Human Communication Science, Melbourne, Australia; Erasmus University Medical Centre, Rotterdam, the Netherlands.
PURPOSE: This report investigates whether parent-reported stuttering severity ratings (SRs) provide similar estimates of effect size as percentage of syllables stuttered (%SS) for randomized trials of early stuttering treatment with preschool children.
METHOD: Data sets from 3 randomized controlled trials of an early stuttering intervention were selected for analyses. Analyses included median changes and 95% confidence intervals per treatment group, Bland-Altman plots, analysis of covariance, and Spearman rho correlations.
RESULTS: Both SRs and %SS showed large effect sizes from pretreatment to follow-up, although correlations between the 2 measures were moderate at best. Absolute agreement between the 2 measures improved as percentage reduction of stuttering frequency and severity increased, probably due to innate measurement limitations for participants with low baseline severity. Analysis of covariance for the 3 trials showed consistent results.
CONCLUSION: There is no statistical reason to favor %SS over parent-reported stuttering SRs as primary outcomes for clinical trials of early stuttering treatment. However, there are logistical reasons to favor parent-reported stuttering SRs. We conclude that parent-reported rating of the child's typical stuttering severity for the week or month prior to each assessment is a justifiable alternative to %SS as a primary outcome measure in clinical trials of early stuttering treatment.
PMID: 29554191 DOI: 10.1044/2017_JSLHR-S-16-0448
Comprehensive Stuttering Treatment for Adolescents: A Case Study - TERAPIA
Lang Speech Hear Serv Sch. 2018 Jan 9;49(1):33-41.
Marshall University, Huntington, WV.
PURPOSE: This article will focus on a hypothetical case study to highlight comprehensive assessment and treatment for adolescent children who stutter.
METHOD: Assessment and treatment are laid out with a literature review utilizing the components of the International Classification of Functioning, Disability and Health model. Specific assessment and treatment strategies and approaches are discussed.
RESULTS: Using the International Classification of Functioning, Disability and Health model can help guide clinicians through the assessment and treatment process to ensure that all areas of stuttering are considered.
CONCLUSION: Comprehensive assessment and treatment helps clinicians address all relevant elements of a stuttering disorder, rather than focusing exclusively on reducing speech disruptions.
PMID: 29322184 DOI: 10.1044/2017_LSHSS-17-0019
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.
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.
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
Evidence, Goals, and Outcomes in Stuttering Treatment: Applications With an Adolescent Who Stutters - TERAPIA
Lang Speech Hear Serv Sch. 2018 Jan 9;49(1):23-32.
University of Georgia, Athens.
PURPOSE: The purpose of this clinical focus article is to summarize 1 possible process that a clinician might follow in designing and conducting a treatment program with John, a 14-year-old male individual who stutters.
METHOD: The available research evidence, practitioner experience, and consideration of individual preferences are combined to address goals, treatment procedures, and outcomes for John.
CONCLUSIONS: The stuttering treatment research literature includes multiple well-designed reviews and individual studies that have shown the effectiveness of prolonged speech (and smooth speech and related variations) for improving stuttered speech and for improving social, emotional, cognitive, and related variables in adolescents who stutter. Based on that evidence, and incorporating the additional elements of practitioner experience and client preferences, this clinical focus article suggests that John would be likely to benefit from a treatment program based on prolonged speech. The basic structure of 1 possible such program is also described, with an emphasis on the goals and outcomes that John could be expected to achieve.
PMID: 29322182 DOI: 10.1044/2017_LSHSS-17-0020
Executive function and childhood stuttering: Parent ratings and evidence from a behavioral task - PSICOMOTOR
J Fluency Disord. 2018 Jun;56:18-32. Epub 2017 Dec 30.
Ntourou K, Anderson JD, Wagovich SA.
Indiana University, Bloomington, IN, United States; University of Missouri, Columbia, MO, United States.
PURPOSE: The purpose of this study was to examine the executive function (EF) abilities of preschool children who do (CWS) and do not stutter (CWNS) using a parent-report questionnaire and a behavioral task.
METHOD: Participants were 75 CWS and 75 CWNS between the ages of 3;0 and 5;11 (years; months). Parents rated their children's EF abilities using the Behavioral Rating Inventory of Executive Function-Preschool Version (BRIEF-P; Gioia, Espy, & Isquith, 2003). Children's ability to integrate cognitive flexibility, inhibitory control, and working memory was measured using a behavioral task, the Head-Toes-Knees-Shoulders (HTKS; Cameron Ponitz, McClelland, Matthews, & Morrison, 2009).
RESULTS: The CWS were judged by their parents as being less proficient in working memory, shift/flexibility, and overall EF than the parents of the CWNS. Children in the CWS group were also 2½ to 7 times more likely than children in the CWNS group to exhibit clinically significant difficulties with EF. Behavioral task findings revealed that 3-year old CWS performed more poorly than their peers on the HTKS. Parental ratings of executive function and working memory were significantly and moderately correlated with receptive and expressive vocabulary skills only for the CWNS group.
CONCLUSION: CWS have more difficulty with EF in everyday life and may experience early delays in their ability to integrate aspects of attention and EF compared to CWNS.
PMID: 29443692 PMCID: PMC5970042 [Available on 2019-06-01] DOI: 10.1016/j.jfludis.2017.12.001
Exogenously triggered response inhibition in developmental stuttering - INFANTIL
J Fluency Disord. 2018 Jun;56:33-44. Epub 2018 Feb 21.
Eggers K, De Nil LF, Van den Bergh BRH.
Thomas More University College, Belgium; University of Leuven, Belgium; University of Turku, Finland; University of Toronto, Canada.
PURPOSE: The purpose of the present study was to examine relations between children's exogenously triggered response inhibition and stuttering.
METHOD: Participants were 18 children who stutter (CWS; mean age = 9;01 years) and 18 children who not stutter (CWNS; mean age = 9;01 years). Participants were matched on age (±3 months) and gender. Response inhibition was assessed by a stop signal task (Verbruggen, Logan, & Stevens, 2008).
RESULTS: Results suggest that CWS, compared to CWNS, perform comparable to CWNS in a task where response control is externally triggered.
CONCLUSIONS: Our findings seem to indicate that previous questionnaire-based findings (Eggers, De Nil, & Van den Bergh, 2010) of a decreased efficiency of response inhibition cannot be generalized to all types of response inhibition.
PMID: 29494965 DOI: 10.1016/j.jfludis.2018.02.001
Expressed parental concern regarding childhood stuttering and the Test of Childhood Stuttering - INFANTIL
J Commun Disord. 2018 Mar - Apr;72:86-96. Epub 2018 Jan 12.
Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5860970/pdf/nihms937038.pdf
Tumanova V, Choi D, Conture EG, Walden TA.
Syracuse University, Syracuse, NY. United States; University of South Alabama, United States; Vanderbilt University, United States.
PURPOSE: The purpose of the present study was to determine whether the Test of Childhood Stuttering observational rating scales (TOCS; Gillam et al., 2009) (1) differed between parents who did versus did not express concern (independent from the TOCS) about their child's speech fluency; (2) correlated with children's frequency of stuttering measured during a child-examiner conversation; and (3) correlated with the length and complexity of children's utterances, as indexed by mean length of utterance (MLU).
METHOD: Participants were 183 young children ages 3:0-5:11. Ninety-one had parents who reported concern about their child's stuttering (65 boys, 26 girls) and 92 had parents who reported no such concern (50 boys, 42 girls). Participants' conversational speech during a child-examiner conversation was analyzed for (a) frequency of occurrence of stuttered and non-stuttered disfluencies, and (b) MLU. Besides expressing concern or lack thereof about their child's speech fluency, parents completed the TOCS observational rating scales documenting how often they observe different disfluency types in speech of their children, as well as disfluency-related consequences.
RESULTS: There were three main findings. First, parents who expressed concern (independently from the TOCS) about their child's stuttering reported significantly higher scores on the TOCS Speech Fluency and Disfluency-Related Consequences rating scales. Second, children whose parents rated them higher on the TOCS Speech Fluency rating scale produced more stuttered disfluencies during a child-examiner conversation. Third, children with higher scores on the TOCS Disfluency-Related Consequences rating scale had shorter MLU during child-examiner conversation, across age and level of language ability.
CONCLUSIONS: Findings support the use of the TOCS observational rating scales as one documentable, objective means to determine parental perception of and concern about their child's stuttering. Findings also support the notion that parents are reasonably accurate, if not reliable, judges of the quantity and quality (i.e., stuttered vs. non-stuttered) of their child's speech disfluencies. Lastly, findings that some children may decrease their verbal output in attempts to minimize instances of stuttering - as indexed by relatively low MLU and a high TOCS Disfluency-Related Consequences scores - provides strong support for sampling young children's speech and language across various situations to obtain the most representative index possible of the child's MLU and associated instances of stuttering.
PMID: 29397944 PMCID: PMC5860970 DOI: 10.1016/j.jcomdis.2018.01.002
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
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
Functional Speech and Voice Disorders: Case Series and Literature Review. - EMOCIONAL
Mov Disord Clin Pract. 2018 Apr 6;5(3):312-316. 2018 May-Jun.
Chung DS, Wettroth C, Hallett M, Maurer CW.
National Institutes of Health Bethesda MD; University School of Medicine Stony Brook NY.
BACKGROUND: Functional disorders of speech and voice, subtypes of functional movement disorders, represent abnormalities in speech and voice that are thought to have an underlying psychological cause. These disorders exhibit several positive and negative features that distinguish them from organic disorders.
METHODS AND RESULTS: We describe the clinical manifestations of functional disorders of speech and voice, and illustrate these features using six clinical cases.
CONCLUSIONS: Functional disorders of speech and voice may manifest in a variety of ways, including dysphonia, stuttering, or prosodic abnormalities. Given that these disorders have been understudied and may resemble organic disorders, diagnosis may be challenging. Appropriate treatment may be quite effective, highlighting the importance of prompt and accurate diagnosis.
PMID: 30800702 PMCID: PMC6336158 [Available on 2019-04-06] DOI: 10.1002/mdc3.12609
High prevalence of pineal cysts in adults who stutter.
Brain Lang. 2018 Feb - Mar;177-178:18-22.
Arenas RM, Shoemaker JM, Phillips J.
University of New Mexico, Albuquerque, NM, United States; Mind Research Network, Albuquerque, NM, United States.
No abstract available.
PMID: 29421268 DOI: 10.1016/j.bandl.2018.01.006
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
Language development in children who stutter: A review of recent research - LINGUAGEM
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
Neurogenic stuttering: a review of the literature - GAGUEIRA ADQUIRIDA
Rev Neurol. 2018 Jan 16;66(2):59-64.
nglês - https://www.neurologia.com/articulo/2017151/eng
Cruz C, Amorim H, Beca G, Nunes R.
Hospital de Braga, Braga, Portugal; Centro Hospitalar S. Joao, Porto, Portugal; Centro de Reabilitacao do Norte, Vila Nova de Gaia, Portugal.
INTRODUCTION: Neurogenic stuttering is a disorder of neurologic origin in the rhythm of speech during which the patient knows exactly what he wants to say but is unable to because of an involuntary prolongation, cessation or repetition of a sound.
AIM: To assemble new insights regarding the epidemiology, pathophysiology, diagnosis, evaluation and treatment of neurogenic stuttering.
DEVELOPMENT: A review of all PubMed and Scopus published articles between January 2000 and September 2016 was performed. Thirty-three publications were analyzed. Neurogenic stuttering is a rare entity whose epidemiological incidence is yet not fully established. It is correlated with several neurological diseases and with several possible localizations within the nervous system. Notwithstanding the recent advances in the understanding of the underlying mechanism, it is not yet possible to establish a single pathophysiological mechanism of neurogenic stuttering. The differential diagnosis is complex and requires the detailed knowledge of other language disorders. The treatment is currently based on specific speech language therapy strategies.
CONCLUSION: Neurogenic stuttering is a complex disorder which is not fully understood. Additional studies might help to better explain the underlying pathophysiological mechanism and to open doors to novel therapeutic methods.
Public awareness and knowledge of stuttering in Japan - SOCIAL
J Commun Disord. 2018 Mar - Apr;72:136-145. Epub 2018 Feb 8.
Iimura D, Yada Y, Imaizumi K, Takeuchi T, Miyawaki M, Van Borsel J.
Domo-work (Specified Nonprofit Corporation), Shinjuku-ku, Tokyo, Japan; Fuke Hospital, Hujimino-shi, Saitama, Japan; Tokyo Metropolitan University, Hachioji, Tokyo, Japan; Tokyo Healthcare University, Setagaya-ku, Tokyo, Japan; Ghent University Hospital, Gent, Belgium.
PURPOSE: To determine laypeople's knowledge and awareness of stuttering in Japan.
METHODS: A total of 303 respondents, recruited by street sampling, completed a questionnaire assessing the prevalence, onset, gender distribution, occurrence in different races, cause, treatment, association with intelligence, and hereditariness of stuttering. The questionnaire used was a Japanese version of that devised by Van Borsel, Verniers, and Bouvry (1999) for use in Belgium.
RESULTS: Although around half of the respondents had heard or met a stutterer, they tended to misunderstand the stuttering; e.g., respondents estimated the prevalence of stuttering as high. Knowledge also differed according to age, gender, and education level. Specifically, older individuals, females, and individuals with higher levels of education tended to have greater knowledge of stuttering. In comparing the results of the present study with similar studies conducted in Belgium, China, and Brazil, we observed several similarities and differences.
DISCUSSION: Although most respondents were to some extent familiar with stuttering, their overall knowledge of the condition was limited. Certain factors could be involved in having knowledge of stuttering, such as one's life experience, cultural background, and social attitudes toward stuttering. The findings suggest the need for growing knowledge and awareness of stuttering.
PMID: 29448988 DOI: 10.1016/j.jcomdis.2018.02.002
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
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
Selecting Treatments and Monitoring Outcomes: The Circle of Evidence-Based Practice and Client-Centered Care in Treating a Preschool Child Who Stutters. - INFANTIL /TERAPIA
Lang Speech Hear Serv Sch. 2018 Jan 9;49(1):13-22.
Free PMC Article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6105087/pdf/LSHSS-49-13.pdf
Bernstein Ratner N.
University of Maryland, College Park.
PURPOSE: The purpose of the present clinical forum is to compare how 2 clinicians might select among therapy options for a preschool-aged child who presents with stuttering close to onset.
METHOD: I discuss approaches to full evaluation of the child's profile, advisement of evidence-based practice options open to the family, the need for monitoring of the child's response, and selection of other approaches, if the child appears nonresponsive to the 1st-line approach.
RESULTS: Although some researchers and clinicians appear to favor endorsement of a single recommended treatment for early stuttering, I do not find this approach helpful or consistent with newer mandates for patient-centered care. I am also most comfortable recommending RESTART demands and capacities model as the 1st treatment approach, with parent consent, because its mechanism of action appears transparent and well-documented.
CONCLUSIONS: There are numerous well-supported intervention options for treating preschool children who stutter. No single therapy can possibly work for all clients. I discuss available options that I feel have sufficient evidence-based support for use with young children who stutter. I emphasize the need to consider more, not fewer, acceptable therapy options for children who do not respond positively to a selected treatment approach within a reasonable time frame.
PMID: 29322185 PMCID: PMC6105087 DOI: 10.1044/2017_LSHSS-17-0015
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
Spectral Coefficient Analyses of Word-Initial Stop Consonant Productions Suggest Similar Anticipatory Coarticulation for Stuttering and Nonstuttering Adults - FALA
Lang Speech. 2018 Mar;61(1):31-42. Epub 2017 Mar 9.
Free Full Text - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5747557/pdf/nihms852653.pdf
Maruthy S, Feng Y, Max L.
All India Institute of Speech and Hearing, India; Institute of Acoustics, Chinese Academy of Sciences, China; University of Washington, USA; Haskins Laboratories, USA.
A longstanding hypothesis about the sensorimotor mechanisms underlying stuttering suggests that stuttered speech dysfluencies result from a lack of coarticulation. Formant-based measures of either the stuttered or fluent speech of children and adults who stutter have generally failed to obtain compelling evidence in support of the hypothesis that these individuals differ in the timing or degree of coarticulation. Here, we used a sensitive acoustic technique-spectral coefficient analyses-that allowed us to compare stuttering and nonstuttering speakers with regard to vowel-dependent anticipatory influences as early as the onset burst of a preceding voiceless stop consonant. Eight adults who stutter and eight matched adults who do not stutter produced C1VC2 words, and the first four spectral coefficients were calculated for one analysis window centered on the burst of C1 and two subsequent windows covering the beginning of the aspiration phase. Findings confirmed that the combined use of four spectral coefficients is an effective method for detecting the anticipatory influence of a vowel on the initial burst of a preceding voiceless stop consonant. However, the observed patterns of anticipatory coarticulation showed no statistically significant differences, or trends toward such differences, between the stuttering and nonstuttering groups. Combining the present results for fluent speech in one given phonetic context with prior findings from both stuttered and fluent speech in a variety of other contexts, we conclude that there is currently no support for the hypothesis that the fluent speech of individuals who stutter is characterized by limited coarticulation.
PMID: 29280401 PMCID: PMC5747557 DOI: 10.1177/0023830917695853
Speech Disfluency-dependent Amygdala Activity in Adults Who Stutter: Neuroimaging of Interpersonal Communication in MRI Scanner Environment - NEUROCIÊNCIAS
Neuroscience. 2018 Mar 15;374:144-154. Epub 2018 Feb 3.
Toyomura A, Fujii T, Yokosawa K, Kuriki S.
Gunma University,Gunma, Japan; Tokyo Denki University, Chiba, Japan; Hokkaido University, Sapporo, Japan.
Affective states, such as anticipatory anxiety, critically influence speech communication behavior in adults who stutter. However, there is currently little evidence regarding the involvement of the limbic system in speech disfluency during interpersonal communication. We designed this neuroimaging study and experimental procedure to sample neural activity during interpersonal communication between human participants, and to investigate the relationship between the amygdala activity and speech disfluency. Participants were required to engage in live communication with a stranger of the opposite sex in the MRI scanner environment. In the gaze condition, the stranger gazed at the participant without speaking, while in the live conversation condition, the stranger asked questions that the participant was required to answer. The stranger continued to gaze silently at the participant while the participant answered. Adults who stutter reported significantly higher discomfort than fluent controls during the experiment. Activity in the right amygdala, a key anatomical region in the limbic system involved in emotion, was significantly correlated with stuttering occurrences in adults who stutter. Right amygdala activity from pooled data of all participants also showed a significant correlation with discomfort level during the experiment. Activity in the prefrontal cortex, which forms emotion regulation neural circuitry with the amygdala, was decreased in adults who stutter than in fluent controls. This is the first study to demonstrate that amygdala activity during interpersonal communication is involved in disfluent speech in adults who stutter.
PMID: 29378280 DOI: 10.1016/j.neuroscience.2018.01.037
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 and levetiracetam: Case report and research proposal.
Ann Clin Psychiatry. 2018 Feb;30(1):68-69.
Mejías G, Oliviero A, Barcia JA, Nombela C.
Instituto de Investigación Biosanitaria del Hospital Clínico San Carlos, Madrid, Spain.
No abstract available.
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
Stuttering in Parkinson's disease after deep brain stimulation: A note on dystonia and low-frequency stimulation - NEUROCIÊNCIAS
J Clin Neurosci. 2018 Apr;50:150-151. Epub 2018 Feb 1.
Mendonça MD, Barbosa R, Seromenho-Santos A, Reizinho C, Bugalho P
Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal; Universidade Nova de Lisboa, Lisbon, Portugal; Champalimaud Center for the Unknown, Lisbon, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Stuttering, a speech fluency disorder, is a rare complication of Deep Brain Stimulation (DBS) in Parkinson's Disease (PD). We report a 61 years-old patient with PD, afflicted by severe On and Off dystonia, treated with Subthalamic Nucleus DBS that developed post-DBS stuttering while on 130 Hz stimulation. Stuttering reduction was noted when frequency was changed to 80 Hz, but the previously observed dystonia improvement was lost. There are no reports in literature on patients developing stuttering with low-frequency stimulation. We question if low-frequency stimulation could have a role for managing PD's post-DBS stuttering, and notice that stuttering improvement was associated with dystonia worsening suggesting that they are distinct phenomena.
PMID: 29396058 DOI: 10.1016/j.jocn.2018.01.042
Stuttering in Preschool Children: Direct Versus Indirect Treatment. - INFANTIL/TERAPIA
Lang Speech Hear Serv Sch. 2018 Jan 9;49(1):4-12.
University of Oregon, Eugene.
PURPOSE: The purpose of this article is to discuss the controversial topic of stuttering in preschool children and how to evaluate the options for treatment, emphasizing the role of external research evidence.
METHOD: A hypothetical but realistic case study of a 3-year-old boy who stutters is described. Two contrasting approaches to treatment are presented, the Lidcombe Program (LP) and the demands and capacities model (DCM). Studies published in peer-reviewed research journals that have examined the effectiveness of each approach are summarized and critiqued.
RESULTS: The review indicates that the LP is the preferred treatment approach for stuttering in preschool children and that it offers the best opportunity for rapid success.
CONCLUSION: The LP should be carried out by knowledgeable, experienced, and flexible speech-language pathologists who are able to accommodate the individual needs and differences of every child and family.
PMID: 29322186 DOI: 10.1044/2017_LSHSS-17-0066
Sympathetic arousal as a marker of chronicity in childhood stuttering - INFANTIL
Dev Neuropsychol. 2018;43(2):135-151.. Epub 2018 Feb 7.
Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826607/pdf/nihms941778.pdf
Zengin-Bolatkale H, Conture EG, Walden TA, Jones RM.
Vanderbilt University , Nashville , TN , USA.
PURPOSE: This study investigated whether sympathetic activity during a stressful speaking task was an early marker for stuttering chronicity.
METHOD: Participants were 9 children with persisting stuttering, 23 children who recovered, and 17 children who do not stutter. Participants performed a stress-inducing picture-naming task and skin conductance was measured across three time points.
RESULTS: Findings indicated that at the initial time point, children with persisting stuttering exhibited higher sympathetic arousal during the stressful speaking task than children whose stuttering recovered.
CONCLUSIONS: Findings are taken to suggest that sympathetic activity may be an early marker of heightened risk for chronic stuttering.
PMID: 29412003 PMCID: PMC5826607 DOI: 10.1080/87565641.2018.1432621
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 Classroom Communication Resource (CCR) intervention to change peer's attitudes towards children who stutter (CWS): study protocol for a randomised controlled trial - SOCIAL
Trials. 2018 Jan 17;19(1):43.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773158/pdf/13063_2017_Article_2365.pdf
Mallick R, Kathard H, Thabane L, Pillay M.
University of Cape Town, Cape Town, WC, South Africa; University of KwaZulu Natal, Durban, South Africa; McMaster University, Toronto, Canada.
BACKGROUND: Children who stutter (CWS) are at a high-risk of being teased and bullied in primary school because of negative peer attitudes and perceptions towards stuttering. There is little evidence to determine if classroom-based interventions are effective in changing peer attitudes towards stuttering. The primary objective is to determine the effect of the Classroom Communication Resource (CCR) intervention versus usual practice, measured using the Stuttering Resource Outcomes Measure (SROM) 6-months post-intervention among grade 7 students. The secondary objective is to investigate attitude changes towards stuttering among grade participants on the SROM subscales.
METHODS: A cluster randomised controlled trial (RCT) will be conducted with schools as the unit of randomization. Schools will be stratified into quintile groups, and then randomized to receive the CCR intervention or usual practice. Quintile stratification will be conducted in accordance to the Western Cape Department of Education classification of schools according to geographical location, fee per school and allocation of resources and funding. Participants will include primary schools in the lower (second and third) and higher (fourth and fifth) quintiles and children aged 11 years or older in grade 7 will be included. The study will consist of the CCR intervention program or usual practice as a no-CCR control. The CCR is a classroom-based, teacher led intervention tool including a story, role-play and discussion. The grade 7 teachers allocated to the CCR intervention, will be trained and will administer the intervention. The analysis will follow intention-to-treat (ITT) principle and generalized estimating equations (GEE) to compare groups on the global SROM and its subscales to account for possible clustering within schools. The subgroup hypothesis will be tested by adding an interaction term of quintile group x intervention.
DISCUSSION: This study is designed to assess whether the CCR intervention versus usual practice in schools will lead to positive shift in attitudes about stuttering at 6-months post-intervention among grade 7 participants.
PMID: 29343283 PMCID: PMC5773158 DOI: 10.1186/s13063-017-23
The effect of emotion on articulation rate in persistence and recovery of childhood stuttering - INFANTIL: EMOCIONAL E FALA
J Fluency Disord. 2018 Jun;56:1-17. Epub 2017 Nov 22.
Erdemir A, Walden TA, Jefferson CM, Choi D, Jones RM.
Vanderbilt University, United States; University of South Alabama, United States.
PURPOSE: This study investigated the possible association of emotional processes and articulation rate in pre-school age children who stutter and persist (persisting), children who stutter and recover (recovered) and children who do not stutter (nonstuttering).
METHODS: The participants were ten persisting, ten recovered, and ten nonstuttering children between the ages of 3-5 years; who were classified as persisting, recovered, or nonstuttering approximately 2-2.5 years after the experimental testing took place. The children were exposed to three emotionally-arousing video clips (baseline, positive and negative) and produced a narrative based on a text-free storybook following each video clip. From the audio-recordings of these narratives, individual utterances were transcribed and articulation rates were calculated.
RESULTS: Results indicated that persisting children exhibited significantly slower articulation rates following the negative emotion condition, unlike recovered and nonstuttering children whose articulation rates were not affected by either of the two emotion-inducing conditions. Moreover, all stuttering children displayed faster rates during fluent compared to stuttered speech; however, the recovered children were significantly faster than the persisting children during fluent speech.
CONCLUSION: Negative emotion plays a detrimental role on the speech-motor control processes of children who persist, whereas children who eventually recover seem to exhibit a relatively more stable and mature speech-motor system. This suggests that complex interactions between speech-motor and emotional processes are at play in stuttering recovery and persistency; and articulation rates following negative emotion or during stuttered versus fluent speech might be considered as potential factors to prospectively predict persistence and recovery from stuttering.
PMID: 29443691 PMCID: PMC5963974 [Available on 2019-06-01] DOI: 10.1016/j.jfludis.2017.11.003
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.
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
Transcranial direct current stimulation over left inferior frontal cortex improves speech fluency in adults who stutter - NEUROCIÊNCIAS
Brain. 2018 Apr 1;141(4):1161-1171.
Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019054/pdf/awy011.pdf
Chesters J, Möttönen R, Watkins KE.
University of Oxford, Oxford, UK; University of Nottingham, Nottingham, UK.
See Crinion (doi:10.1093/brain/awy075) for a scientific commentary on this article. Stuttering is a neurodevelopmental condition affecting 5% of children, and persisting in 1% of adults. Promoting lasting fluency improvement in adults who stutter is a particular challenge. Novel interventions to improve outcomes are of value, therefore. Previous work in patients with acquired motor and language disorders reported enhanced benefits of behavioural therapies when paired with transcranial direct current stimulation. Here, we report the results of the first trial investigating whether transcranial direct current stimulation can improve speech fluency in adults who stutter. We predicted that applying anodal stimulation to the left inferior frontal cortex during speech production with temporary fluency inducers would result in longer-lasting fluency improvements. Thirty male adults who stutter completed a randomized, double-blind, controlled trial of anodal transcranial direct current stimulation over left inferior frontal cortex. Fifteen participants received 20 min of 1-mA stimulation on five consecutive days while speech fluency was temporarily induced using choral and metronome-timed speech. The other 15 participants received the same speech fluency intervention with sham stimulation. Speech fluency during reading and conversation was assessed at baseline, before and after the stimulation on each day of the 5-day intervention, and at 1 and 6 weeks after the end of the intervention. Anodal stimulation combined with speech fluency training significantly reduced the percentage of disfluent speech measured 1 week after the intervention compared with fluency intervention alone. At 6 weeks after the intervention, this improvement was maintained during reading but not during conversation. Outcome scores at both post-intervention time points on a clinical assessment tool (the Stuttering Severity Instrument, version 4) also showed significant improvement in the group receiving transcranial direct current stimulation compared with the sham group, in whom fluency was unchanged from baseline. We conclude that transcranial direct current stimulation combined with behavioural fluency intervention can improve fluency in adults who stutter. Transcranial direct current stimulation thereby offers a potentially useful adjunct to future speech therapy interventions for this population, for whom fluency therapy outcomes are currently limited.
PMID: 29394325 PMCID: PMC6019054 DOI: 10.1093/brain/awy011
Variants in GNPTAB, GNPTG and NAGPA genes are associated with stutterers - GENÉTICA
Gene. 2018 Mar 20;647:93-100. Epub 2017 Dec 28.
Kazemi N, Estiar MA, Fazilaty H, Sakhinia E.
Tabriz University of Medical Sciences, Tabriz, Iran; Tehran University of Medical Sciences, Tehran, Iran; Instituto de Neurociencias UMH-SIC, Alicante, Spain.
Non-syndromic stuttering is a neurodevelopmental disorder characterized by disruptions in normal flow of speech in the form of repetition, prolongation and involuntary halts. Previously, mutations with more severe effects on GNPTAB and GNPTG have been reported to cause Mucolipidosisll (ML-ll) and Mucolipidosislll (ML-lll), two lysosomal storage disorders with multiple pathologies. We used homozygosity mapping and Sanger sequencing to investigate variants of the three genes in 25 Iranian families with at least two first degree related non-syndromic stutterers. Bioinformatic evaluation and Segregation analysis of the found variants helped us define probable consequences. We also compared our findings with those related to Mucolipidosis. 14 variations were found in the three genes 3 of which, including a novel variant within intronic region of GNPTG and a heterozygous 2-bp deletion in coding region of GNPTAB, co-segregated with stuttering in the families they were found. Bioinformatics analysis predicted all three variants causing deleterious effects on gene functioning. Our findings support the role of these three variants in non-syndromic stuttering. This finding may challenge the current belief that variations causing stuttering are at different sites and have less severe consequences than genetic changes that cause ML-ll and ML-lll.
PMID: 29289611 DOI: 10.1016/j.gene.2017.12.054
White matter tractography of the neural network for speech-motor control in children who stutter - INFANTIL
Neurosci Lett. 2018 Mar 6;668:37-42. Epub 2018 Jan 5.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5839127/pdf/nihms933632.pdf
Misaghi E, Zhang Z, Gracco VL, De Nil LF, Beal DS.
University of Alberta, Edmonton, AB, Canada; Sichuan University, Chengdu, Sichuan, China; McGill University, Montreal, QC, Canada; Haskins Laboratories, New Haven, CN, USA; University of Toronto, Toronto, ON, Canada; , Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
Stuttering is a neurodevelopmental speech disorder with a phenotype characterized by speech sound repetitions, prolongations and silent blocks during speech production. Developmental stuttering affects 1% of the population and 5% of children. Neuroanatomical abnormalities in the major white matter tracts, including the arcuate fasciculus, corpus callosum, corticospinal, and frontal aslant tracts (FAT), are associated with the disorder in adults who stutter but are less well studied in children who stutter (CWS). We used deterministic tractography to assess the structural connectivity of the neural network for speech production in CWS and controls. CWS had higher fractional anisotropy and axial diffusivity in the right FAT than controls. Our findings support the involvement of the corticostriatal network early in persistent developmental stuttering.
PMID: 29309858 PMCID: PMC5839127 DOI: 10.1016/j.neulet.2018.01.009