Eliana Maria Nigro Rocha




Abstract  - Janeiro a Julho de 2022





A Case Report of Stuttering Induced by Risperidone and Chlorpromazine - FARMACOLOGIA

Case Reports Psychopharmacol Bull. 2022 Feb 25;52(1):53-56.


Shabnam Sood

Creighton School of Medicine, Phoenix Regional Campus.


Stuttering, a disturbance in the normal fluency and time patterning of speech is usually developmental. In some cases, it is acquired, and causes include stroke, brain tumor, and trauma. Implicated in the causation of stuttering are overactive presynaptic dopamine systems in the region of the brain that modulate verbalization. It is a rare side effect of antipsychotic medications and has been reported with phenothiazines, clozapine, and risperidone. This is a report of a patient who developed stuttering when treated first with chlorpromazine and later with risperidone. Patient had a diagnosis of schizoaffective disorder and had been treated with antipsychotic medications including haloperidol, olanzapine, and paliperidone. He developed stuttering for the first time upon receiving intramuscular injections of chlorpromazine for treatment of agitation. The stutter improved and eventually resolved. He subsequently presented with a severe stutter when he was treated with risperidone. The stutter improved after risperidone was discontinued. It is speculated that drug-induced stuttering may be a manifestation of akathisia leading to noradrenergic and serotonergic mechanisms being implicated. It could be that either the cholinergic, dopaminergic or serotonergic systems are involved or that there is an imbalance of these systems that may be relevant.

PMID: 35342201 PMCID: PMC8896748 (available on 2023-02-25)




A cortical network processes auditory error signals during human speech production to maintain fluency - AUDITIVO

PLoS Biol. 2022 Feb 3;20(2):e3001493.


Muge Ozker, Werner Doyle, Orrin Devinsky, Adeen Flinker

New York University School of Medicine, New York, New York, United States of America; New York University School of Engineering, New York, New York, United States of America.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8812883/pdf/pbio.3001493.pdf


Hearing one's own voice is critical for fluent speech production as it allows for the detection and correction of vocalization errors in real time. This behavior known as the auditory feedback control of speech is impaired in various neurological disorders ranging from stuttering to aphasia; however, the underlying neural mechanisms are still poorly understood. Computational models of speech motor control suggest that, during speech production, the brain uses an efference copy of the motor command to generate an internal estimate of the speech output. When actual feedback differs from this internal estimate, an error signal is generated to correct the internal estimate and update necessary motor commands to produce intended speech. We were able to localize the auditory error signal using electrocorticographic recordings from neurosurgical participants during a delayed auditory feedback (DAF) paradigm. In this task, participants hear their voice with a time delay as they produced words and sentences (similar to an echo on a conference call), which is well known to disrupt fluency by causing slow and stutter-like speech in humans. We observed a significant response enhancement in auditory cortex that scaled with the duration of feedback delay, indicating an auditory speech error signal. Immediately following auditory cortex, dorsal precentral gyrus (dPreCG), a region that has not been implicated in auditory feedback processing before, exhibited a markedly similar response enhancement, suggesting a tight coupling between the 2 regions. Critically, response enhancement in dPreCG occurred only during articulation of long utterances due to a continuous mismatch between produced speech and reafferent feedback. These results suggest that dPreCG plays an essential role in processing auditory error signals during speech production to maintain fluency.

PMID: 35113857 PMCID: PMC8812883




A Point of View About Fluency - CONCEITO

J Speech Lang Hear Res. 2022 Jan 4;1-8. Online ahead of print.


Seth E Tichenor, Christopher Constantino, J Scott Yaruss

Duquesne University, Pittsburgh, PA; Florida State University, Tallahassee; Michigan State University, East Lansing.


Purpose: This article presents several potential concerns with the common usage of the term fluency in the study of stuttering and people who stutter (or, as many speakers now prefer, stutterers). Our goal is to bridge gaps between clinicians, researchers, and stutterers to foster a greater sense of collaboration and understanding regarding the words that are used and meanings that are intended.

Method: We begin by reviewing the history of the term fluency. We then explore its usage and current connotations to examine whether the term meaningfully describes constructs that are relevant to the study of the stuttering condition.

Results: By highlighting current research and perspectives of stutterers, we conclude that the term fluency (a) is not fully inclusive, (b) encourages the use of misleading measurement procedures, (c) constrains the subjective experience of stuttering within a false binary categorization, and (d) perpetuates a cycle of stigma that is detrimental to stutterers and to the stuttering community as a whole.

Conclusions: We recommend that researchers and clinicians cease referring to stuttering as a fluency disorder and simply refer to it as stuttering. Furthermore, we recommend that researchers and clinicians distinguish between moments of stuttering (i.e., what stutterers experience when they lose control of their speech or feel stuck) and the overall lived experience of the stuttering condition.

PMID: 34982943 DOI: 10.1044/2021_JSLHR-21-00342




Acquired stuttering as the sole manifestation of relapse in multiple sclerosis secondary to involvement of the left frontal aslant tract

Acta Neurol Belg. 2022 Feb 11. Online ahead of print.


Ismail Ibrahim Ismail, Khaled A Gad

Ibn Sina Hospital, Safat, Kuwait; Faculty of Medicine, Suez Canal University, Ismailia, Egypt.


No abstract available

PMID: 35149981 DOI: 10.1007/s13760-022-01895-3




Adults Who Stutter Show Diminished Word Fluency, Regardless of Mode - LINGUAGEM

J Speech Lang Hear Res. 2022 Feb 8;1-17. Online ahead of print.


Erica Lescht, Michael Walsh Dickey, Melissa D Stockbridge, Nan Bernstein Ratner

University of Pittsburgh, PA; VA Pittsburgh Healthcare System, PA; Johns Hopkins University School of Medicine, Baltimore, MD; University of Maryland, College Park.


Purpose: Language abilities have long been thought to be weaker in adults who stutter (AWS) compared to adults who do not stutter (AWNS). However, it is unknown whether modality affects language performance by AWS in time pressure situations. This study aimed to examine lexical access and retrieval abilities of AWS in oral and typed modes.

Method: Fifteen AWS and 15 well-matched AWNS completed computer-administered letter fluency tasks. Adults were asked to orally produce words that began with one of two letter targets and type words that began with one of two alternate letters. Conditions were counterbalanced across participants.

Results: Generalized linear mixed-effects models were evaluated to determine the effects of group (AWS/AWNS), mode (oral/typed), and expressive vocabulary on letter fluency performance. Group predicted letter fluency such that AWS generated fewer items on both the oral and typed letter fluency tasks. Mode did not impact letter fluency results. Expressive Vocabulary Test scores predicted letter fluency similarly in both AWS and AWNS.

Conclusions: AWS were not penalized by oral task demands. AWS generated fewer items on the letter fluency tasks regardless of response mode, suggesting that they have weaker lexical access abilities. Furthermore, better expressive vocabulary skills were associated with better letter fluency performance in both groups.

PMID: 35133869 DOI: 10.1044/2021_JSLHR-21-00344




Anxiety and Depression Symptoms in Children and Adolescents Who Stutter: A Systematic Review and Meta-Analysis - EMOCIONAL

J Speech Lang Hear Res. 2022 Jan 27;1-21. Online ahead of print.


Ria Bernard, Hilde Hofslundsengen, Courtenay Frazier Norbury

University College London, United Kingdom; Western Norway University of Applied Sciences, Bergen; University of Oslo, Norway.


Purpose: The purpose of this study was to investigate whether there are elevated symptoms of anxiety or depression in children and adolescents (aged 2-18 years) who stutter, and to identify potential moderators of increased symptom severity.

Method: We conducted a preregistered systematic review of databases and gray literature; 13 articles met criteria for inclusion. A meta-analysis using robust variance estimation was conducted with 11 cohort studies comparing symptoms of anxiety in children and adolescents who do and do not stutter. Twenty-six effect sizes from 11 studies contributed to the summary effect size for anxiety symptoms (851 participants). Meta-analysis of depression outcomes was not possible due to the small number of studies.

Results: The summary effect size indicates that children and adolescents who stutter present with increased anxiety symptoms (g = 0.42) compared with nonstuttering peers. There were insufficient studies to robustly analyze depression symptoms, and qualitative review is provided. No significant between-groups differences were reported in any of the depression studies.

Conclusions: Preliminary evidence indicates elevated symptoms of anxiety in some children and adolescents who stutter relative to peers. There was a tendency toward higher depression scores in this population, although reported between-groups differences did not reach statistical significance. These findings require replication in larger, preferably longitudinal studies that consider factors that may moderate risk. Nevertheless, our findings highlight a need for careful monitoring of mental health and well-being in young people who stutter.

PMID: 35084999 DOI: 10.1044/2021_JSLHR-21-00236




Artificial Neural Networks Combined with the Principal Component Analysis for Non-Fluent Speech Recognition - CONCEITO

Sensors (Basel). 2022 Jan 1;22(1):321

Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8749906/pdf/sensors-22-00321.pdf



Izabela Świetlicka, Wiesława Kuniszyk-Jóźkowiak, Michał Świetlicki

University of Life Sciences, Lublin, Poland; Faculty of Physical Education and Health in Biała Podlaska, Józef Piłsudski University of Physical Education in Warsaw,  Biała Podlaska, Poland; Faculty of Mechanical Engineering, Lublin University of Technology, Lublin, Poland.


The presented paper introduces principal component analysis application for dimensionality reduction of variables describing speech signal and applicability of obtained results for the disturbed and fluent speech recognition process. A set of fluent speech signals and three speech disturbances-blocks before words starting with plosives, syllable repetitions, and sound-initial prolongations-was transformed using principal component analysis. The result was a model containing four principal components describing analysed utterances. Distances between standardised original variables and elements of the observation matrix in a new system of coordinates were calculated and then applied in the recognition process. As a classifying algorithm, the multilayer perceptron network was used. Achieved results were compared with outcomes from previous experiments where speech samples were parameterised with the Kohonen network application. The classifying network achieved overall accuracy at 76% (from 50% to 91%, depending on the dysfluency type).

PMID: 35009863 DOI: 10.3390/s22010321




Challenges of Treating Bilingual and Multilingual Stuttering

J Patient Exp. 2022 Apr 7;9:23743735221092608.

Free PMC article:



Upasana Bagchi, K Jayasankara Reddy

Christ University, Bangalore, Karnataka, India.


No abstract available PMID: 35450092 PMCID: PMC9016556 DOI: 10.1177/23743735221092608




Characteristics of articulatory gestures in stuttered speech: A case study using real-time magnetic resonance imaging - FALA

J Commun Disord. 2022 Mar 18;97:106213. Online ahead of print.


Yijing Lu, Charlotte E E Wiltshire, Kate E Watkins, Mark Chiew, Louis Goldstein

University of Southern California, United States; University of Oxford,


Introduction: Most of the previous articulatory studies of stuttering have focussed on the fluent speech of people who stutter. However, to better understand what causes the actual moments of stuttering, it is necessary to probe articulatory behaviors during stuttered speech. We examined the supralaryngeal articulatory characteristics of stuttered speech using real-time structural magnetic resonance imaging (RT-MRI). We investigated how articulatory gestures differ across stuttered and fluent speech of the same speaker.

Methods: Vocal tract movements of an adult man who stutters during a pseudoword reading task were recorded using RT-MRI. Four regions of interest (ROIs) were defined on RT-MRI image sequences around the lips, tongue tip, tongue body, and velum. The variation of pixel intensity in each ROI over time provided an estimate of the movement of these four articulators.

Results: All disfluencies occurred on syllable-initial consonants. Three articulatory patterns were identified. Pattern 1 showed smooth gestural formation and release like fluent speech. Patterns 2 and 3 showed delayed release of gestures due to articulator fixation or oscillation respectively. Block and prolongation corresponded to either pattern 1 or 2. Repetition corresponded to pattern 3 or a mix of patterns. Gestures for disfluent consonants typically exhibited a greater constriction than fluent gestures, which was rarely corrected during disfluencies. Gestures for the upcoming vowel were initiated and executed during these consonant disfluencies, achieving a tongue body position similar to the fluent counterpart.

Conclusion: Different perceptual types of disfluencies did not necessarily result from distinct articulatory patterns, highlighting the importance of collecting articulatory data of stuttering. Disfluencies on syllable-initial consonants were related to the delayed release and the overshoot of consonant gestures, rather than the delayed initiation of vowel gestures. This suggests that stuttering does not arise from problems with planning the vowel gestures, but rather with releasing the overly constricted consonant gestures

PMID: 35397388 DOI: 10.1016/j.jcomdis.2022.106213




Comparison of Stuttering Severity and Anxiety During Standard and Challenge Phone Calls - AMBIENTE 

J Speech Lang Hear Res. 2022 Feb 14;1-9. Online ahead of print.


Sue O'Brian, Mark Onslow, Mark Jones, Robyn Lowe, Ann Packman, Ross Menzies

University of Technology Sydney, New South Wales, Australia; Bond University, Robina, Queensland, Australia.


Purpose: This study was designed to answer three questions. (a) Does percentage of syllables stuttered (%SS) differ between standard and challenge phone calls. (b) Does anxiety differ between standard and challenge phone calls. (c) Is there a relationship between %SS and anxiety during standard and challenge phone calls?

Method: Participants were 230 adults diagnosed with stuttering, who were participants from five clinical trials. Each participant received two 10-min phone calls at pretreatment and a further two phone calls 6 months or 20 weeks postrandomization. One phone call was standard, and the other presented challenge: occasionally disagreeing with, interrupting, and talking over participants, or asking for clarification of their views.

Results: Statistically significant, but clinically minor, increases of %SS and anxiety occurred during the challenge phone calls. There was a statistically significant association between %SS and anxiety.

Conclusions: Variable phone call procedures to assess stuttering severity in clinical trials are not likely to spuriously inflate or deflate treatment outcomes to a clinically important extent. Regardless, the present results suggest that there is statistical merit in controlling the nature of phone calls during clinical trials with the simple and replicable method developed in this report. Additionally, there is procedural merit in the challenge phone call procedure; it is a more valid representation of the challenges of everyday speech than the standard procedure. However, a disadvantage of the challenge phone call procedure is the practical issues associated with its use. The clinical and theoretical applications of the results are discussed.

PMID: 35157508 DOI: 10.1044/2021_JSLHR-21-00365




Drug-induced stuttering: A comprehensive literature review - FARMACOLOGIA

Review World J Psychiatry. 2022 Feb 19;12(2):236-263.


Naemeh Nikvarz, Salehe Sabouri

Kerman University of Medical Sciences, Kerman, Iran; Institute of Neuropharmacology, Kerman, Iran.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8900588/pdf/WJP-12-236.pdf


Drug-induced stuttering (DIS) is a type of neurogenic stuttering (NS). Although DIS has not been reported as frequently as other cases of NS in the literature, it is not a negligible adverse drug reaction (ADR) which can significantly affect the quality of life if not treated. This literature review aims to evaluate the epidemiological and clinical characteristics of DIS and suggests some pathophysiological mechanisms for this ADR. Relevant English-language reports in Google Scholar, PubMed, Web of Science, and Scopus were identified and assessed without time restriction. Finally, a total of 62 reports were included. Twenty-seven drugs caused 86 episodes of stuttering in 82 cases. The most episodes of DIS were related to antipsychotic drugs (57%), mostly including clozapine, followed by central nervous system agents (11.6%) and anticonvulsant drugs (9.3%). The majority of the cases were male and between the ages of 31 and 40 years. Repetitions were the most frequent core manifestations of DIS. In 55.8% of the episodes of DIS, the offending drug was withdrawn to manage stuttering, which resulted in significant improvement or complete relief of stuttering in all cases. Based on the suggested pathophysiological mechanisms for developmental stuttering and neurotransmitters dysfunctions involved in speech dysfluency, it seems that the abnormalities of several neurotransmitters, especially dopamine and glutamate, in different circuits and areas of the brain, including cortico-basal ganglia-thalamocortical loop and white matter fiber tracts, may be engaged in the pathogenesis of DIS.

PMID: 35317340 PMCID: PMC8900588 DOI: 10.5498/wjp.v12.i2.236




Early Childhood Professionals' Management of Young Children Who Stutter: A Cross-Sectional Study - INFANTIL / AMBIENTE

Am J Speech Lang Pathol. 2022 Feb 15;1-19. Online ahead of print.


Elaina Kefalianos, Linn Stokke Guttormsen, Elisabeth Holm Hansen, Hilde Christine Hofslundsengen, Kari-Anne Bottegård Næss , Konstantinos Antypas, Melanie Kirmess

The University of Melbourne, Victoria, Australia; University of Oslo, Norway; University of South-Eastern Norway, Notodden; Western Norway University of Applied Sciences, Bergen; SINTEF Digital, Oslo, Norway.


Purpose: Early childhood professionals must accurately identify, refer, and treat children who stutter (CWS) within the scope of their respective roles to ensure each child receives the best possible care. This study aimed to investigate similarities and differences between the practices of speech-language pathologists (SLPs), preschool teachers, and public health nurses when they initially meet a young child reported as stuttering.

Method: This cross-sectional study was conducted in Norway. A sample of 342 early childhood professionals (126 preschool teachers, 95 public health nurses, and 121 SLPs) completed an online survey about their management practices with young children reported as stuttering. Descriptive statistics, ordinal regression, and chi-square analyses were used to analyze data.

Results: Initial management practices reflected the different roles and competencies of each profession. Less than 15% of SLPs reported they have access to guidelines for working with CWS. This figure was even lower for public health nurses (6.5%) and preschool teachers (12%). The most common recommendations provided to parents by all professions was giving the child time to talk and maintaining eye contact. Each profession's referral for further speech-language pathology management was most commonly influenced by stuttering severity. All professions reported collaborating about management of CWS; the most common reported collaboration was with preschool teachers.

Conclusions: Initial management practices varied between professions; however, differences largely reflected the roles and competencies of each profession. The development of guidelines and interdisciplinary seminars is recommended to develop a more complementary approach across professions to improve management practices and ensure young CWS receive the best possible care.

PMID: 35167338 DOI: 10.1044/2021_AJSLP-21-00148




Editorial: The Neurophysiology of Developmental Stuttering: Unraveling the Mysteries of Fluency - INFANTIL / CONCEITO

Editorial Front Hum Neurosci. 2022 Jan 27;15:833870.


Pierpaolo Busan, Nicole E Neef, Maja Rogić Vidaković, Piero Paolo Battaglini, Martin Sommer

IRCCS Ospedale San Camillo, Venice, Italy; University Medical Center Göttingen, Göttingen, Germany; University of Split, Split, Croatia; University of Trieste, Trieste, Italy; University Medical Center Göttingen, Göttingen, Germany.


No abstract available
Free Full Text: https://www.frontiersin.org/articles/10.3389/fnhum.2021.833870/full

PMID: 35153704 PMCID: PMC8829424 DOI: 10.3389/fnhum.2021.833870




Effectiveness of the Enriched Stuttering Intervention Program Used in Stuttering Children - TERAPIA

Am J Health Behav. 2022 Jan 31;46(1):60-69.


Iclal Ertas, Gönül Akçamete, Mukaddes Sakallı Demirok

Near East University, Mersin, Turkey


Objectives: In this study, we examined the effectiveness of the Enriched Stuttering Intervention Program (ESIP), developed by the researchers, on children with stuttering difficulties. More specifically, we examined the frequency of stuttering, duration of stuttering, behaviors accompanying stuttering, and whether there was a significant difference in the naturalness of speech.

Methods: We used a quasi-experimental design. The study group study consisted of 5 boys admitted to a Special Education and Rehabilitation Centre during 2019-2020 and diagnosed by a pediatric psychiatrist with stuttering. The information forms prepared by the researchers were used to be completed by the family, the teacher, and the child to collect personal information about the children. We used the Stuttering Severity Instrument (SSI-4) to collect our research data.

Results: When we compared pre-test and post-test data, we found a statistically significant difference in the severity of stuttering in the 5 children.

Conclusion: The Enriched Stuttering Intervention Program improved stuttering in this group of children.

PMID: 35227370 DOI: 10.5993/AJHB.46.1.6




Electrophysiological correlates of stuttering severity: An ERP study - AUDITIVO

J Clin Neurosci. 2022 May 10;101:80-88. Online ahead of print.


Narges Moein, et al

Iran University of Medical Sciences, Tehran, Iran; Iran University of Medical Sciences, Tehran, Iran; University of Toronto, Toronto, ON, Canada; Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; University of Waterloo, Waterloo, ON, Canada; Shahid Beheshti University, Tehran, Iran.


Although a variety of theories have been proposed to explain the etiology of stuttering, the exact neurological origin of it is still uncertain. The aim of this study is to investigate the correlation between stuttering severity and ERP measures. The population of this study consisted of 12 adults with moderate, 12 adults with severe stuttering, and 12 fluent speakers as the control group. ERPs were recorded during an auditory task in which subjects should determine an oddball stimulus. The result of mismatch negativity (MMN) amplitude analysis revealed significant differences between severe stuttering and fluent speakers groups and between two stuttering groups. Moreover, the result showed significant differences between the three study groups for P300 amplitude. The findings of the present study suggest that the differences in ERP components are existed not only between people who stutter and fluent speakers but also between people with different levels of stuttering severity.

PMID: 35561434 DOI: 10.1016/j.jocn.2022.03.021




Emotion-related regulation strategy use in preschool-age children who stutter - INFANTIL / EMOCIONAL

J Commun Disord. 2022 May 4;97:106219. Online ahead of print.


Marielle C Snyder, Hayley S Arnold

University of Pittsburgh, Pittsburgh, PA , United States; Kent State University, Kent, OH, United States.


Purpose: Past findings indicate the quality and quantity of emotion regulation often differs between preschool-age children who stutter (CWS) and children who do not stutter (CWNS). The purpose of this study was to identify whether specific emotion-related regulatory strategy types differ between preschool-age CWS and CWNS during a temptation task.

Methods: Participants were 13 CWS and 13 CWNS between 3;2 and 5;7 (years;months), matched for gender and age (+/- 6 months). Participants completed a Forbidden Toy paradigm, a resistance to temptation task, in which the children were asked to refrain from touching a toy. Types of emotion-related regulation, including (1) verbal regulation, (2) behavioral regulation, and (3) attentional regulation, were behaviorally coded during the temptation task.

Results: A higher proportion of the CWNS (92%) failed to resist the temptation to touch the toy than CWS (48%). Additionally, a higher proportion of the CWS (23%), compared to CWNS (0%), presented with signs of distress, resulting in their task ending prematurely. Limited differences were detected in the types of emotion-related regulatory strategies used by CWS, or the frequency of those strategies. CWNS, compared to the CWS, used more approach-related behavioral strategies.

Conclusions: Interpretations of these findings must be mitigated by the observation that a higher proportion of CWS than CWNS demonstrated distress during the paradigm, suggesting a need for further research into the interplay between emotional reactivity and emotion regulation for preschool-age CWS.

PMID: 35594756 DOI: 10.1016/j.jcomdis.2022.106219




Epilepsy and Diagnostic Dilemmas: The Role of Language and Speech-Related Seizures - OUTRAS ÁREAS

Review J Pers Med. 2022 Apr 18;12(4):647.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025095/pdf/jpm-12-00647.pdf


Soultana Papadopoulou et al

University Hospital of Ioannina, Ioannina, Greece; ENT Private Medical Office,Ioannina, Greece; Linguist Private Practice, Ioannina, Greece; University of Patras, Patras, Greece; Statistics and Research Design Company, DatAnalysis, Ioannina, Greece; Guy's and St Thomas' Hospital, Great Maze Pond, London, UK etc.


Although the impact of epilepsy on expressive language is heavily discussed, researched, and scientifically grounded, a limited volume of research points in the opposite direction. What about the causal relationship between disorder-related language activities and epileptic seizures? What are the possible diagnostic dilemmas that experts in the field of speech-language pathology, neurology, and related fields face? How far has research gone in investigating psychogenic nonepileptic seizures, the misdiagnosis of which can be a thorny issue for clinicians and a detrimental factor for the patients' health? In order to address these questions, the study at hand focuses on a common, ever-intensified (by the COVID-19 pandemic) speech disorder-stuttering, and explores the pathophysiological and psychogenic background of the phenomenon. It also looks at the role of stuttering as a contributing factor to the appearance of epileptic seizures, in the hope of drawing attention to the complexity and importance of precise detection of stuttering-induced epilepsy, as a specific subcategory of language-induced epilepsy.

PMID: 35455763 PMCID: PMC9025095 DOI: 10.3390/jpm12040647




Evaluation of elements in hair samples of children with developmental language disorder (DLD) - AVALIAÇÃO

Nutr Neurosci. 2022 Jan 15;1-10. Online ahead of print.


Ayat Bani Rashaid, Mazin Alqhazo, Dianne F Newbury, Heba Kanaan, Mohammad El-Khateeb, Ahmad Abukashabeh, Feda Al-Tamimi

Jordan University of Science and Technology, Irbid Jordan; Oxford Brookes University, Oxford, UK; Jordan Atomic Energy Commission, Amman, Jordan.


Background: Recent studies have highlighted a role for trace elements and toxic metals across neurodevelopmental disorders, including developmental stuttering, Autistic Spectrum Disorders (ASD), and Attention Deficit/Hyperactivity Disorder (ADHD). However, these environmental influences have yet to be explored in relation to Developmental Language Disorder (DLD).

Methods: Elemental hair composition of seven elements; zinc (64Zn), magnesium (26Mg), iron (57Fe), potassium (39K), aluminum (27Al), lead (208Pb), and barium (138Ba) were analyzed in hair samples from 35 children affected by DLD and 35 controls with typical language development (TLD) using both inductive coupled plasma optical emission spectroscopy (ICP-OES) and inductive coupled plasma mass spectroscopy (ICP-MS).

Results: The concentration of 64Zn was significantly lower in the hair of DLD group compared to the TLD control group. All other elements showed similar levels between cases and controls. This pilot study demonstrates the utility of trace elements and toxic metals screening in relation to language disorders and the use of hair samples in such investigations.

Conclusion: The finding that zinc levels differed between cases and controls could represent a clinically relevant result and should be replicated in larger sample size across time. A wider battery of related elements will help to better understand the role of trace elements and toxic metals in DLD.

PMID: 35034571 DOI: 10.1080/1028415X.2021.2022068




Green tea consumption and the management of adrenal stress hormones in adolescents who stutter- FARMACOLÓGICO

Biomed Rep. 2022 Apr;16(4):32. Epub 2022 Feb 24.


Abdulaziz Almudhi, Sami A Gabr

King Khalid University, Abha, Saudi Arabia.; Mansoura University, Mansoura, Egypt.


Green tea and its polyphenolic compounds have been shown to exert positive effects in individuals with psychological disorders. The protective role of green tea against stuttering or its related consequences, depression, anxiety and stress, were evaluated in adolescents with moderate stuttering (MS). A total of 60 adolescents aged (12-18) years old were enrolled in this study. Patients were classified according to standardized test material Stuttering Severity Instrument, 4th Edition was used to estimate the severity of stuttering; participants were classified into two groups: a normal healthy group (n=30) and a MS group (n=30). The Depression Anxiety Stress Scale and General Health Questionnaire were used to estimate the degree of depression, anxiety and stress as well as general mental health. The physiological profile of stress hormones, as a measure of the response to green tea response, was also measured amongst participants. Adrenal stress hormones cortisol, dehydroepiandrosterone (DHEA), acetylcholine (ACTH), corticosterone and the cortisol:DHEA ratio were assayed. In addition, the constituent green tea polyphenols and their quantities were determined using liquid chromatography analysis. Decaffeinated green tea was administered six cups/day for 6 weeks, and this significantly improved the depression, anxiety, stress and mental health consequences associated with stuttering in adolescents. In addition, increased consumption of green tea significantly reduced elevated levels of adrenal stress hormones; cortisol, DHEA, ACTH and corticosterone, and increased the cortisol:DHEA ratio in the control and adolescents who stuttered. The data showed that drinking six cups of decaffeinated green tea, which is enriched in catechins (1,580 mg) and other related polyphenols, was sufficient to improve the consequences of mental health associated with stuttering in younger aged individuals.

PMID: 35251619 PMCID: PMC8889529 DOI: 10.3892/br.2022.1515




Identifying Stuttering in Arabic Speakers Who Stutter: Development of a Non-word Repetition Task and Preliminary Results - FALA

Front Pediatr. 2022 Mar 11;10:750126.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8963185/pdf/fped-10-750126.pdf


Roaa Alsulaiman, John Harris, Sarah Bamaas, Peter Howell

University College London, London, United Kingdom; Jeddah Institute for Speech and Hearing, Jeddah, Saudi Arabia.


Stuttering and other conditions that affect speech fluency need to be identified at an early age in order that effective interventions can be given before the problems becomes chronic. This applies in countries where several languages are spoken including those in which English and Arabic are both widely used which calls for assessment procedures that work across these languages. The 'universal' non-word repetition task (UNWR) has been established as an effective screening tool for discriminating between children who stutter (CWS) and children with word-finding difficulty for a number of languages. However, the UNWR does not apply to languages such as Arabic and Spanish. The present study aimed to: (1) introduce an Arabic English NWR (AEN_NWR); which was developed based on the same phonologically informed approach used with UNWR; (2) present preliminary non-word repetition data from Arabic-speaking CWS and adults who stutter (AWS). The AEN_NWR items comprises twenty-seven non-words that meet lexical phonology constraints across Arabic and English. The set of items includes non-words of two, three and four syllables in length. Preliminary non-word repetition data were collected from ten CWS between the ages of 6;5 and 16;7 (M age = 12:1) and fourteen AWS between the ages of 19;2 and 31;0 (M age = 24). Participants performed the non-word repetition task and provided a sample of spontaneous speech. The spontaneous speech samples were used to estimate %stuttered syllables (%SS). To validate that AEN_NWR performance provides an alternative way of assessing stuttering, a significant correlation was predicted between %SS and AEN_NWR performance. Also, word length should affect repetition accuracy of AEN_NWR. As predicted, there was a significant negative correlation between the AEN_NWR and %SS scores (r (25) = -0.5), p < 0.000). Overall, CWS were less accurate in their repetition than AWS at all syllable lengths. The AEN_NWR provides a new assessment tool for detecting stuttering in speaker of Arabic and English. Future studies would benefit from a larger sample of participants, and by testing a population-based sample. These studies would allow further investigation of the AEN_NWR as a screening measure for stuttering in preschool children.

PMID: 35359884 PMCID: PMC8963185 DOI: 10.3389/fped.2022.750126




Improving young children's stuttering attitudes in Poland: Evidence for a cross-cultural stuttering inclusion program

J Commun Disord. 2022 Jan 16;96:106183. Online ahead of print.


Katarzyna Węsierska , Mary Weidner

University of Silesia, Katowice, Poland; Logopedic Centre, Katowice, Poland; Edinboro University, Human Services Building 247, 215 Scotland Rd, Edinboro, PA. United States.


Background: Young, nonstuttering children around the world have been shown to hold negative stuttering attitudes characterized by limited knowledge about stuttering and how to be a helpful listener. Educational programming using the Attitude Change & Tolerance program (Weidner, 2015, InterACT) has shown promise in improving American children's stuttering attitudes (Weidner, St. Louis, & Glover, 2018), but the utility of the program in other countries is unknown. The purpose of this study was to examine the efficacy of the InterACT program among nonstuttering Polish children.

Method: This study was a replication of Weidner et al. (2018). Participants included 43 nonstuttering preschool and first grade Polish children. Children's stuttering attitudes were measured using the Public Opinion Survey of Human Attributes-Stuttering/Child (Weidner & St. Louis, 2014) before and after participating in the Polish translation of the InterACT program.

Results: Pre-post results showed statistically significant improvements in children's overall stuttering attitudes. Most notably, children became more knowledgeable about how to be a supportive listener.

Conclusion: This study provides further evidence that young children worldwide have uninformed or negative stuttering attitudes, which are amenable to improvement. It also provides support for the translatability and cultural relevance of the InterACT program.

PMID: 35091360 DOI: 10.1016/j.jcomdis.2022.106183




Internet searches conducted by people who stutter: association with speech-language therapy and severity of stuttering - SOCIAL

Logoped Phoniatr Vocol. 2022 Apr 12;1-8. Online ahead of print.


Ana Leko Krhen, Lucia Šušak

University of Zagreb, Zagreb, Croatia; Elementary School Eugen Kumičić, Slatina, Croatia.


Stuttering is a fluency disorder that is multidimensional because it involves more than speech difficulties. People who stutter can use the Internet to find out more about their condition and connect with other people in the same position, yet in Croatia, there are not nearly as many online sources on stuttering or as many possibilities to connect with other people who stutter as in the USA or Great Britain. If one does not speak English well, a lot of information about stuttering will simply be denied to them, especially to those who have never received speech therapy. The present study, the first of its kind in Croatia, was conducted in order to understand how often and for what reasons people who stutter search for Internet resources related to their condition. The study also assessed whether Internet use depended on age, experience with speech-language therapy, self-reported satisfaction with such therapy, and self-assessed severity of stuttering. An online questionnaire integrating the 9-Point Stuttering Severity Scale was developed for this study and administered to 51 individuals aged 18 years and older in Croatia. All collected data and findings on the internet searches come from the questionnaire. Age did not significantly affect the frequency or purpose of Internet searches. Individuals who were not attending speech therapy were more likely to search online sources about stuttering than those who received it before. People who rated their stuttering as severe were more likely to search online sources for stuttering than those who rated their condition as mild. These results suggest that there is a need for more useful, high-quality online content and materials in Croatian for people who stutter. Such resources would offer people who stutter a new world of support, mutual understanding, shared experiences and knowledge, and ways for them to help themselves.

PMID: 35412931 DOI: 10.1080/14015439.2022.2044513




"Knowledge Without Action Means Nothing": Stakeholder Insights on the Behaviors That Constitute Positive Change for Adults Who Stutter - TERAPIA

Am J Speech Lang Pathol. 2022 Apr 22;1-16. Online ahead of print.


Naomi H Rodgers, Hope Gerlach-Houck

University of Nebraska-Lincoln; Western Michigan University, Kalamazoo.


Purpose: The aim of this study was to document the behaviors that adults who stutter (AWS) may engage in to make positive changes to living with stuttering.

Method: We interviewed 23 key stakeholders, including 11 AWS and 12 speech-language pathologists who specialize in stuttering therapy. The semi-structured interviews began with the primary question, "If an adult who stutters was making positive changes to living with stuttering, what would they be doing?" Follow-up probing questions focused the interviews on identifying actionable behaviors that would suggest positive changes. The interviews were transcribed and qualitatively analyzed using applied and reflexive thematic analyses to develop multilevel themes.

Results: Meaningful units extracted from the interviews contributed to three high-order global themes: (a) noticing and adjusting physical behaviors involved in speaking, to the extent that it is personally important to do so; (b) developing neutral or positive thoughts and feelings about stuttering; and (c) participating more fully in social and professional activities, even if the person stutters or thinks they might stutter. We developed 35 low-order basic themes, which we grouped into 11 mid-order organizing themes, to richly illustrate the three global themes.

Conclusions: These findings extend the ongoing discussion regarding best practices for therapy targets in stuttering intervention. We identified measurable, multidimensional actions that clinicians can integrate in their therapy plans with AWS. While these actions represent a holistic approach to making positive changes, it grants clients and clinicians space to develop individualized intentions and outcomes.

PMID: 35452272 DOI: 10.1044/2022_AJSLP-21-00251




Linguistic aspects of stuttering: research updates on the language-fluency interface - LINGUAGEM

Top Lang Disord. Jan-Mar 2022;42(1):5-23.


Shelley B Brundage, Nan Bernstein Ratner

George Washington University, Washington, DC; University of Maryland, College Park, MD.


Purpose: Although commonly defined as a speech disorder, stuttering interacts with the language production system in important ways. Our purpose is to summarize research findings on linguistic variables that influence stuttering assessment and treatment.

Method and results: Numerous topics are summarized. First, we review research that has examined linguistic features that increase stuttering frequency and influence where it occurs. Second, we tackle the question of whether or not persons who stutter exhibit subtle language differences or deficits. Next, we explore language factors that appear to influence recovery from early stuttering in children. The final topic discusses the unique challenges inherent in differentially diagnosing stuttering in bilingual children. Clinical implications for each topic are discussed.

Discussion: The article concludes with a discussion of the unique differences in the integration of language and speech demands by people who stutter, when compared to people who are typically fluent, and their clinical ramifications.

PMID: 35321534 PMCID: PMC8936424 (available on 2023-01-01)




Neurogenic Stuttering: Etiology, Symptomatology, and Treatment - GAGUEIRA ADQUIIRIDA

Review Med Arch. 2021 Dec;75(6):456-461.


Lejla Junuzovic-Zunic, Osman Sinanovic, Blazenka Majic

University of Tuzla, Tuzla, Bosnia and Herzegovina; University Sarajevo, School of Science and technology, Sarajevo; International Academy of Art and Science, Sarajevo, Bosnia and Herzegovina; Nurseries Public Institution "Ciciban", Mostar, Bosnia and Herzegovina.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8802677/pdf/medarch-75-456.pdf


Background: Neurogenic stuttering is a subtype of acquired stuttering, and it is characterized by disfluencies associated with acquired brain damage.

Objective: To provide an insight into pathophysiology, symptomatology, differential diagnosis, assessment, and treatment of neurogenic stuttering through a critical review of the literature.

Methods: Studies published during the past and recent years were searched and analyzed on neurogenic stuttering.

Results: Neurogenic stuttering is a complex disorder. The pathophysiological mechanism of neurogenic stuttering is not yet fully understood. It appears with several neurological diseases and conditions, and the use of some drugs. Differential diagnosis of neurogenic and psychogenic stuttering is a challenge for clinicians. Treatment usually requires a joint effort from speech therapists and doctors, most often neurologists.

Conclusion: Although research on neurogenic stuttering can be found in the literature, the complexity of this disorder still requires detailed monitoring and studying to provide the best treatment for patients.

PMID: 35169374 PMCID: PMC8802677 DOI




Nonword Repetition Performance Differentiates Children Who Stutter With and Without Concomitant Speech Sound and Developmental Language Disorders - INFANTIL / FALA

J Speech Lang Hear Res. 2022 Jan 4;1-13. Online ahead of print.


Katelyn L Gerwin, Bridget Walsh, Seth E Tichenor

Michigan State University, East Lansing; Duquesne University, Pittsburgh, PA.


Purpose: The aim of this study was to examine how nonword repetition (NWR) performance may be impacted by the presence of concomitant speech and language disorders in young children who stutter (CWS).

Method: One hundred forty-one children (88 CWS and 53 children who do not stutter [CWNS]) participated. CWS were divided into groups based on the presence of speech sound and/or language disorder or typical speech sound production and language abilities. NWR abilities were measured using stimuli composed of one- to four-syllable nonwords.

Results: CWS with typical speech and language and CWNS had higher accuracy scores than CWS with concomitant speech and language disorders. We found no difference in accuracy scores between CWNS and CWS with typical speech and language abilities, nor did we find differences between CWS with speech sound disorder and CWS with both speech sound and language disorders. Accuracy decreased as nonword length increased for all groups.

Conclusions: We found that the presence of a concomitant speech and language disorder was a driving factor behind poorer NWR performance in CWS. Accuracy scores differentiated CWS with concomitant disorders from CWS with typical speech and language but not CWS with typical speech and language from CWNS. Considering the speech and language abilities of CWS helped clarify poorer NWR performance and enhances generalizability to the population that exists clinically.

PMID: 34982942 DOI: 10.1044/2021_JSLHR-21-00334




Novel word recognition in childhood stuttering – INFANTIL / LINGUAGEM

Top Lang Disord. Jan-Mar 2022;42(1):41-56.
Free Ful Text



Erica Lescht, Courtney Venker, Jacie R McHaney, Jason W Bohland, Amanda Hampton Wray

University of Pittsburgh, Pittsburgh, Pennsylvania; Michigan State University, East Lansing, Michigan.


Language skills have long been posited to be a factor contributing to developmental stuttering. The current study aimed to evaluate whether novel word recognition, a critical skill for language development, differentiated children who stutter from children who do not stutter. Twenty children who stutter and 18 children who do not stutter, aged 3–8 years, completed a novel word recognition task. Real-time eye gaze was used to evaluate online learning. Retention was measured immediately and after a 1-hr delay. Children who stutter and children who do not stutter exhibited similar patterns of online novel word recognition. Both groups also had comparable retention accuracy. Together, these results revealed that novel word recognition and retention were similar in children who stutter and children who do not stutter. These patterns suggest that differences observed in previous studies of language in stuttering may not be driven by novel word recognition abilities in children who stutter.

PMID: 35295185 PMCID: PMC8920118




Palin parent-child interaction therapy with children with autism spectrum disorder and stuttering - INFANTIL / OUTRAS ÁREAS

J Commun Disord. 2022 May 17;97:106217. Online ahead of print.

Free article: https://www.sciencedirect.com/science/article/pii/S0021992422000363?via%3Dihub


Rachel Preston, Marie Halpin, Gemma Clarke, Sharon Millard

University of London, London, United Kingdom; Michael Palin Centre, London, United Kingdom.


Introduction: It is estimated that 8% of children who stutter (CWS) have autism spectrum disorder (ASD) Briley & Ellis (2018). There is evidence that interventions for CWS and interventions for children with ASD can be effective, but there is little evidence to guide clinical decision making when working with CWS with a co-existing diagnosis of ASD. Palin Parent-Child Interaction (PCI) therapy Kelman & Nicholas (2020) is an evidence-based intervention for CWS, with the authors suggesting that the approach may be beneficial for CWS with ASD. The aim of this study was to examine outcomes for three CWS with ASD who received Palin PCI at a specialist centre for stuttering in London.

Method: The participants were three CWS with ASD aged 4;5, 6;7 and 7;7. Assessments were administered before therapy, and then at three, six and twelve months after therapy began. Outcome measures included stuttering frequency, child's communication attitude, parents' perception of the impact of stuttering on the child, the severity of stuttering and its impact on the parents, and parents' knowledge and confidence in managing stuttering.

Results: All three children showed improvement in three or more variables. Four out of five parents reported reduced impact of stuttering on the child and themselves following therapy, and change was maintained one year post-therapy. All five parents reported increased knowledge of stuttering and confidence in managing it after therapy, and four parents maintained these changes for a year.

Conclusions: Over a one year period, these CWS with ASD who received Palin PCI showed change across multiple variables. The observed increases in parent knowledge and confidence were comparable to previously published data. These preliminary findings suggest that CWS with ASD and their parents can benefit from Palin PCI therapy and that further experimental evaluation of this approach with this client group is indicated.

PMID: 35594755 DOI: 10.1016/j.jcomdis.2022.106217




Population-based genetic effects for developmental stuttering - GENÉTICA

HGG Adv. 2021 Dec 2;3(1):100073. eCollection 2022 Jan 13.


Hannah G Polikowsky et al

Vanderbilt University Medical Center, Nashville, TN, USA; Irish Stammering Association, Dublin, Ireland; Curtin University, Perth, WA, Australia; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Wayne State University, Detroit, MI, USA.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8756529/pdf/main.pdf


Despite a lifetime prevalence of at least 5%, developmental stuttering, characterized by prolongations, blocks, and repetitions of speech sounds, remains a largely idiopathic speech disorder. Family, twin, and segregation studies overwhelmingly support a strong genetic influence on stuttering risk; however, its complex mode of inheritance combined with thus-far underpowered genetic studies contribute to the challenge of identifying and reproducing genes implicated in developmental stuttering susceptibility. We conducted a trans-ancestry genome-wide association study (GWAS) and meta-analysis of developmental stuttering in two primary datasets: The International Stuttering Project comprising 1,345 clinically ascertained cases from multiple global sites and 6,759 matched population controls from the biobank at Vanderbilt University Medical Center (VUMC), and 785 self-reported stuttering cases and 7,572 controls ascertained from The National Longitudinal Study of Adolescent to Adult Health (Add Health). Meta-analysis of these genome-wide association studies identified a genome-wide significant (GWS) signal for clinically reported developmental stuttering in the general population: a protective variant in the intronic or genic upstream region of SSUH2 (rs113284510, protective allele frequency = 7.49%, Z = -5.576, p = 2.46 × 10-8) that acts as an expression quantitative trait locus (eQTL) in esophagus-muscularis tissue by reducing its gene expression. In addition, we identified 15 loci reaching suggestive significance (p < 5 × 10-6). This foundational population-based genetic study of a common speech disorder reports the findings of a clinically ascertained study of developmental stuttering and highlights the need for further research.

PMID: 35047858 PMCID: PMC8756529 DOI: 10.1016/j.xhgg.2021.100073




Prevalence and Determinants of Hoarseness in School-Aged Children – INFANTIL / AVALIAÇÃO

Int J Environ Res Public Health. 2022 Apr 30;19(9):5468.

Free PMC article: https://www.mdpi.com/1660-4601/19/9/5468


Ahmed Alrahim et al

Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.


Hoarseness in school-aged children may affect their educational achievement and interfere with their communication and social skills development. The global prevalence of hoarseness in school-aged children ranges between 6% and 23%. To the best of our knowledge, there is a scarcity of studies describing the prevalence or determinates of hoarseness in Saudi school-aged children. Our aim was to measure the prevalence of hoarseness among school-aged children and to identify its determinants. A cross-sectional questionnaire-based survey was used that included randomly selected primary and early childhood schools from private and governmental sectors in Saudi Arabia. The data were collected using a questionnaire which was self-completed by the children's parents and covered the following aspects: sociodemographic features, health and its related comorbidities about children and their families, attendance and performance in school, child's voice tone, past history of frequent crying during infancy, history of letter pronunciation problems and stuttering, the Reflux Symptom Index (RSI) and the Children's Voice Handicap Index-10 for parents (CVHI-10-P). Determinants of hoarseness were investigated using the SPSS software (version 20). The mean age of the study children (n = 428) was 9.05 years (SD = 2.15), and 69.40% of them were male. The rate of hoarseness in the participants was 7.5%. Hoarseness was significantly common in children with a history of excessive infancy crying (p = 0.006), letter pronunciation issues (especially 'R' and 'S'; p = 0.003), and stuttering (p = 0.004) and in those with a previous history of hoarseness (p = 0.023). In addition, having the symptoms of gastrointestinal reflux increased the risk of hoarseness by four times (OR = 4.77, 95% CI = 2.171, 10.51). In summary, hoarseness in children may be dangerously underestimated, as it may reflect the presence of speech problems, in addition to the presence of laryngopharyngeal reflux (LPR). Hoarseness was assumed on the basis of parental complaints. Therefore, further research with diagnoses based on a clinical assessment is needed to understand the magnitude of the hoarseness problem and its consequences in children.

PMID: 35564863 PMCID: PMC9103237




Professors' Perceptions and Evaluations of Students Who Do and Do Not Stutter Following Oral Presentations - SOCIAL

Lang Speech Hear Serv Sch. 2022 Jan 5;53(1):133-149. Epub 2021 Dec 3.


Danielle Werle, Courtney T Byrd

The University of Texas at Austin.


Purpose: The purpose of this study was to examine the perceptual ratings and performance evaluations of students who do and do not stutter by professors who require oral presentations. Additionally, this study sought to investigate the influence of behaviors related to communication competence on perceptual and evaluative ratings.

Method: One hundred fifty-eight college instructors who require oral presentations in their classes participated in this study. Participants viewed one video of four possible randomized conditions: (a) presence of stuttering + low communication competence, (b) absence of stuttering + low communication competence, (c) presence of stuttering + high communication competence, and (d) absence of stuttering + high communication competence. Participants evaluated student performance against a standardized rubric and rated the student along 16 personality traits.

Results: Results of separate 2 × 2 analyses of variance revealed professors' view and evaluate students presenting with high communication competence more positively overall, regardless as to whether stuttering is present or not. Significant interactions between fluency (i.e., presence vs. absence of stuttering) and communication competence (i.e., high vs. low) were found for negative personality traits, as well as delivery evaluation scores. The video for which the student stuttered and presented with low communication competence was rated more positively than the video for which the student did not stutter and presented with low communication competence.

Conclusions: Professors perceive and evaluate students who stutter differently from their nonstuttering peers, and those ratings are moderated by levels of communication competence. High-communication-competence behaviors improved perceptual and evaluation scores; however, in the presence of low-communication-competence behaviors, professors overcorrect in the form of positive feedback bias, which may have negative long-term academic consequences.

PMID: 34861764 DOI: 10.1044/2021_LSHSS-21-00069




Rate of Stuttering and Factors Associated With Speech Fluency Characteristics in Adult Struggling Readers - FALA

J Learn Disabil. 2022 May 12;222194221095265. Online ahead of print.


Ai Leen Choo, Daphne Greenberg, Hongli Li, Amani Talwar

Georgia State University, Atlanta, USA.


Stuttering is a disorder that affects about 1% of the population and manifests as speech disfluencies. Reading difficulties and disabilities are commonly found in this population. Nonetheless, speech disfluencies have not been explored in adult struggling readers (ASRs). In the current study, we examined the rate of stuttering in ASRs as well as the relationships between their speech fluency and reading skills. A total of 120 participants were interviewed about their experiences with reading and administered standardized reading and reading-related assessments. Speech fluency and the criterion for stuttering were based on the interview. About 18.3% of the sample met the criterion for stuttering. ASRs who stutter (ASRs-S) and ASRs who do not stutter (ASRs-NS) did not differ in their reading and reading-related skills. ASRs-S had higher rates of negative correlations between reading and reading-related skills compared with ASRs-NS. Correlation patterns between performance on standardized assessments point to higher rates of uneven skills or dissociations in ASRs-S. These findings may have implications for the assessment and instruction for ASRs.

PMID: 35549596 DOI: 10.1177/00222194221095265




Relapse in Stuttering with the Onset of Primary Progressive Aphasia - NEUROCIÊNCIAS

Ann Indian Acad Neurol. Nov-Dec 2021;24(6):981-983. Epub 2021 Aug 20.

Free PMC article



Nikita Dadlani, Prathiksha Vaidhyanathan, Divya Swaminathan, Nagarajarao Shivashankar, Rose Dawn Bharath, Shoba S Meera

National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India; Jupiter Hospital, Pune, India; National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.


No abstract available

PMID: 35359514 PMCID: PMC8965931 DOI: 10.4103/aian.AIAN_865_20




Risk Factors for the Development of Persistent Stuttering: What Every Pediatrician Should Know – INFANTIL / CONCEITO

Int J Environ Res Public Health. 2022 Apr 25;19(9):5225.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9101135/pdf/ijerph-19-05225.pdf


Julia Biancalana Costa et al

School of Medicine, University of São Paulo, Sao Paulo, Brazil.


Early identification and adequate treatment of children who stutter is important, since it has an impact on speech development. Considering the importance of aiding pediatricians to recognize children at risk for developing persistent stuttering, the aim of the present study was to correlate speech fluency characteristics of children, whose parents reported stuttering behaviors, to the risk factors of persistent stuttering. The participants were 419 children aged 2:0 to 11:11 years, who were divided into two groups: children with stuttering complaints (CSC), composed of children whose parents reported the presence of stuttering behaviors; and children with no stuttering complaint (CNSCs), composed of children with no stuttering behaviors. Risk variables were gathered based on a questionnaire answered by parents involving the following variables: sex, presence of family history of stuttering, whether stuttering behaviors were observed for more than 12 months, whether stuttering behaviors began before 5 years of age, increased effort to speak (i.e., syllable and sound repetitions and fixed articulatory positions), negative family attitude towards the child's speech, and negative attitude towards the child's own speech. The diagnosis of stuttering was determined by a formal speech assessment by a pathologist (SLP). The risk analysis indicated that increased effort to speak, negative family attitude towards the child's speech, and complaints of stuttering for more than 12 months were associated with a higher risk of stuttering in children. Therefore, when pediatricians are faced with complaints about the presence of stuttering behaviors and these factors are present, they should immediately refer the patient to an SLP for specific assessment.

PMID: 35564619 PMCID: PMC9101135 DOI: 10.3390/ijerph19095225




Self-reported impact of developmental stuttering across the lifespan - CONCEITO

Dev Med Child Neurol. 2022 Mar 21.. Online ahead of print.


Jessica O Boyce et al

Australia; the Netherlands; USA.


Aim: To examine the phenomenology of stuttering across the lifespan in the largest prospective cohort to date.

Method: Participants aged 7 years and older with a history of developmental stuttering were recruited. Self-reported phenotypic data were collected online including stuttering symptomatology, co-occurring phenotypes, genetic predisposition, factors associated with stuttering severity, and impact on anxiety, education, and employment.

Results: A total of 987 participants (852 adults: 590 males, 262 females, mean age 49 years [SD = 17 years 10 months; range = 18-93 years] and 135 children: 97 males, 38 females, mean age 11 years 4 months [SD = 3 years; range = 7-17 years]) were recruited. Stuttering onset occurred at age 3 to 6 years in 64.0%. Blocking (73.2%) was the most frequent phenotype; 75.9% had sought stuttering therapy and 15.5% identified as having recovered. Half (49.9%) reported a family history. There was a significant negative correlation with age for both stuttering frequency and severity in adults. Most were anxious due to stuttering (90.4%) and perceived stuttering as a barrier to education and employment outcomes (80.7%).

Interpretation: The frequent persistence of stuttering and the high proportion with a family history suggest that stuttering is a complex trait that does not often resolve, even with therapy. These data provide new insights into the phenotype and prognosis of stuttering, information that is critically needed to encourage the development of more effective speech therapies.

PMID: 35307825 DOI: 10.1111/dmcn.15211




Speech kinematic variability in adults who stutter is influenced by treatment and speaking style - TERAPIA

J Commun Disord. 2022 Feb 2;96:106194. Online ahead of print.


Torrey M Loucks, Kristin M Pelczarski, Holly Lomheim, Daniel Aalto

University of Alberta, Edmonton, Alberta, Canada; Kansas State University, Manhattan, KS, United States.


Aim: We tested whether completion of the Comprehensive Stuttering Program (CSP) is associated with a reduction in speech kinematic variability relative to pre-treatment when adults who stutter (AWS) use a casual speaking manner or fluency skills.

Rational: Kinematic variability is higher in AWS suggesting a sensorimotor vulnerability; however, it is not clear whether high variability is a trait related to the underlying disorder or reflects the mutable state of stuttering. Speech restructuring intervention such as the CSP could support more consistent articulatory control and stable movement patterns.

Methodology: Thirteen AWS were tested before and after completing the CSP while 11 adults who do not stutter (AWNS) completed a single session. Participants were instructed to use a casual manner of speaking in the first post-treatment session. In the second post-treatment condition, the AWS employed their fluency skills at a control speaking rate. An optical tracking system captured lower lip movements while participants spoke two English phrases and a complex nonword. Across-utterance kinematic variability was measured using the spatiotemporal index (STI) and within-utterance variability was measured with recurrence quantification analysis (RQA).

Results: There was a positive treatment outcome based on significant reductions in percentage syllables stuttered (%SS) during speaking and reading, decreases in stuttering severity and improved perceptions of stuttering and communication confidence. The STI of the AWS decreased significantly after treatment for both speaking styles. The RQA variables indicated that AWS used a less stereotyped and more flexible manner of speaking in the casual condition after treatment, but speech movement regularity increased when using fluency skills.

Conclusions: The AWS showed a significant decrease in labial kinematic variability alongside a successful treatment outcome involving speech restructuring and cognitive behavioral techniques. These changes in across-utterance and within-utterance kinematic indices demonstrate that effective stuttering treatment can promote speech motor stability along with fluent speech.

PMID: 35134668 DOI: 10.1016/j.jcomdis.2022.106194




Structural brain network topological alterations in stuttering adults - NEUROCIÊNCIAS

Brain Commun. 2022 Mar 10;4(2)
Free Full Text: https://academic.oup.com/braincomms/article/4/2/fcac058/6546188


Vincent L Gracco, Anastasia G Sares, Nabin Koirala

Haskins Laboratories, New Haven, CT, USA; McGill University, Montreal, Canada; Concordia University, Montreal, Canada.


Persistent developmental stuttering is a speech disorder that primarily affects normal speech fluency but encompasses a complex set of symptoms ranging from reduced sensorimotor integration to socioemotional challenges. Here, we investigated the whole-brain structural connectome and its topological alterations in adults who stutter. Diffusion-weighted imaging data of 33 subjects (13 adults who stutter and 20 fluent speakers) were obtained along with a stuttering severity evaluation. The structural brain network properties were analysed using network-based statistics and graph theoretical measures particularly focussing on community structure, network hubs and controllability. Bayesian power estimation was used to assess the reliability of the structural connectivity differences by examining the effect size. The analysis revealed reliable and wide-spread decreases in connectivity for adults who stutter in regions associated with sensorimotor, cognitive, emotional and memory-related functions. The community detection algorithms revealed different subnetworks for fluent speakers and adults who stutter, indicating considerable network adaptation in adults who stutter. Average and modal controllability differed between groups in a subnetwork encompassing frontal brain regions and parts of the basal ganglia. The results revealed extensive structural network alterations and substantial adaptation in neural architecture in adults who stutter well beyond the sensorimotor network. These findings highlight the impact of the neurodevelopmental effects of persistent stuttering on neural organization and the importance of examining the full structural connectome and the network alterations that underscore the behavioural phenotype.

PMID: 35368614 PMCID: PMC8971894 DOI: 10.1093/braincomms/fcac058




Stuttering after Intravenous Anesthesia: A Case Report - GAGUEIRA ADQUIRIDA

Case Reports JNMA J Nepal Med Assoc. 2021 Sep 11;59(241):929-931.


Suraj Lamichhane, Murari Raj Upreti, Yogesh Dhakal

HAMS Hospital, Kathmandu, Nepal; Koirala Institute of Health Sciences, Dharan, Nepal.


Stuttering is a form of speech disorder characterized by involuntary prolongation and repetition of sound, words, syllables or phrases as well as involuntary silent pauses or blocks. We report a case of a healthy twenty-six-year-old male patient without significant past history, who underwent short intravenous anesthesia for incision and drainage for perianal abscess. Postoperatively, the patient presented with prominent stuttering after six hours of surgery. To our knowledge, this is the first reported case of stuttering following short intravenous anesthesia without any airway manipulation. He was diagnosed with a functional speech disorder after excluding organic causes. His speech eventually normalized with six weeks of intensive speech therapy. This event posed a significant challenge for the surgical and anesthesia team to find the potential cause, to plan further management, and lead to two days prolongation of hospital stay.

PMID: 35199741 DOI: 10.31729/jnma.5343




Stuttering and the social model - CONCEITO

Review J Commun Disord. 2022 Feb 23;96:106200. Online ahead of print.


Christopher Constantino, Patrick Campbell, Sam Simpson

Florida State University, St, Tallahassee, FL, USA; Stammerer, Cambridge, UK; Redefining Stammering, London, UK.


Stuttering has traditionally been thought of as a defect located within an individual. As such, stuttering is caused by pathology, leading to impaired communication and reduced quality of life. Research from this medical tradition has looked to understand the etiology of stuttering to develop curative therapeutic approaches. From this frame, professionals and academics are experts and holders of knowledge; people who stutter the recipients of this expertise. The social model emerged from within the disability rights movement and offers a counter narrative. It sees the way society is structured as disabling rather than physical impairment itself. Disability is experienced when a person is unable to participate fully in society through a mismatch between their body and the environment around them; thus, disability becomes a dynamic process, not an inherent characteristic. The social model highlights society's norms and values, and, in the case of stuttering, demonstrates how society is designed for, and expects, fluent speakers. From this frame, people who stutter are the experts of their experience and holders of knowledge; professionals and academics are their allies, collaborators, and advocates for social change. This theoretical framework poses challenging questions of the foundational theories upon which stuttering therapy is historically rooted. They call into question the hierarchical structures, power dynamics and even purpose of stuttering therapy and research. In this discussion paper, we will explore the social model of disability and its implications for stuttering therapy and research. We discuss the benefits of a social model approach as well as its limitations.

PMID: 35248920 DOI: 10.1016/j.jcomdis.2022.106200




Stuttering severity relates to frontotemporal low-beta synchronization during pre-speech preparation - NEUROCIÊNCIAS

Clin Neurophysiol. 2022 Mar 21;138:84-96. Online ahead of print.

Free article: https://www.sciencedirect.com/science/article/pii/S1388245722002139


Alexandra Korzeczek, Nicole E Neef, Iris Steinmann, Walter Paulus, Martin Sommer

University Medical Center Göttingen, Göttingen, Germany.


Objective: The neurophysiological dynamics of the occurrence of a stuttering event are largely unknown. This sensor-level EEG study investigated whether already the intention to speak alters the formation of the speech production network in stuttering.

Methods: We studied alpha (8-13 Hz), low beta (15-25 Hz) and high beta (25-30 Hz) power modulation in 19 adults with developmental stuttering (AWS) and 19 fluently speaking control participants during speech intention.

Results: Both groups show that the anticipation of overt reading coincides with broadband low-frequency suppression in posterior sensors, a common sign of network formation for speech production. Prior to fluent speech, frontotemporal alpha and low-beta power were weaker in AWS with mild stuttering but stronger in AWS with severe stuttering. These correlations were not significant prior stuttered speech. Further, post hoc comparisons confirmed the difference between AWS with mild and severe stuttering in low beta power.

Conclusions: AWS with more severe stuttering seem to show stronger maintenance of the current cognitive or sensorimotor state, as stuttering severity was associated with increased beta power. Increased beta power levels may influence subsequent speech preparation and execution processes.

Significance: Upcoming breakdowns of the speech production network as evident in actual stuttering are related to beta power during the intention to speak.

PMID: 35366481 DOI: 10.1016/j.clinph.2022.03.010




Temperament, anxiety, and depression in school-age children who stutter - INFANTIL/EMOCIONAL

J Commun Disord. 2022 May 4;97:106218. Online ahead of print.


Kurt Eggers, Sharon K Millard, Elaine Kelman

Ghent University, Belgium; Thomas More University College, Belgium; University of Turku, Finland; Michael Palin Centre, London, United Kingdom.


Purpose: The main aim of this study was to gain insight into whether temperament and/or stuttering severity were associated with anxiety and depression in children who stutter. Additionally, the study also provided an indication into the prevalence of anxiety and depression in children who stutter in a clinical cohort.

Method: The participants were 132 English-speaking children (105 boys and 27 girls) between 9;0 and 14;11 years old (M = 11;8, SD = 1;10) and their mothers. At their first visit to a specialist center for children who stutter, mothers and children completed the relevant versions of the Early Adolescent Temperament Questionnaire-Revised (EATQ-R; Ellis & Rothbart, 2001) and a screening of children's anxiety and depression, using the Revised Children's Anxiety and Depression Scale (RCADS; Chorpita et al., 2000). Stuttering was evaluated using the Stuttering Severity Instrument Fourth Edition (SSI-4). Correlations were conducted between child and parent versions of the EATQ-R and RCADS; EATQ-R and RCADS; as well as the SSI-4 and RCADS. A comparison was made between those children who scored below the clinical threshold for anxiety and depression, and those who scored above.

Results: Significant correlations were found for all mother and child EATQ-R factors and RCADS scales (except for Obsessive Compulsive Disorder). Correlations were also found between the child- and mother-reported temperament factors of positive reactivity, negative reactivity, and self-regulation and anxiety and depression. Children who scored above the clinical threshold for any category of anxiety or depression had significantly lower positive reactivity and higher negative reactivity scores, compared to those who scored below the threshold. There were no differences between the two groups with regard to SSI-4 scores.

Conclusions: This is the first study to evaluate associations between temperament and anxiety and depression in children who stutter. Higher negative reactivity scores and lower positive reactivity and self-regulation scores are associated with elevated levels of anxiety and depression in children who stutter. Further, those who score above the clinical threshold have significantly higher levels of negative reactivity and lower levels of positive reactivity compared to those scoring below the threshold. Findings suggest that levels of anxiety that reach clinical threshold are more prevalent in children who stutter than would be expected based on population data. Current findings have implications for both the assessment and therapy of children who stutter presenting at clinics for support.

PMID: 35597191 DOI: 10.1016/j.jcomdis.2022.106218




The disabling nature of hope in discovering a biological explanation of stuttering - CONCEITO

J Fluency Disord. 2022 Apr 4;72:105906. Online ahead of print.


Prabhat, Ellen Rombouts, Pascal Borry

Centre for Biomedical Ethics and Law, KU Leuven, Belgium


Discovering developmental stuttering's biological explanation has been an enduring concern. Novel advances in genomics and neuroscience are making it possible to isolate and pinpoint genetic and brain differences implicated in stuttering. This is giving rise to a hope that, in the future, dysfluency could be better managed if stuttering's biological basis could be better understood. Concurrent to this, there is another hope rising: a hope of a future where differing fluencies would not be viewed through a reductive lens of biology and associated pathologies. The central aim of this paper is to edge out ethical implications of novel research into stuttering's biological explanation. In doing so, the paper proposes to look beyond the bifurcation sketched by the medical and social model of disability. The paper demonstrates how the scientific hope of discovering stuttering's biological explanation acts as an accessory of disablement due to the language of 'lack' and 'deficit' employed in reporting scientific findings and proposes participatory research with people who stutter as an antidote to manage this disablement.

PMID: 35421761 DOI: 10.1016/j.jfludis.2022.105906




The effect of gap duration on the perception of fluent versus disfluent speech - AVALIAÇÃO

J Fluency Disord. 2022 Jan 7;71:105896. Online ahead of print.


Haley J Warner, D H Whalen, Daphna Harel, Eric S Jackson

New York University, New York, NY, United States; City University of New York, New York, NY, United States; Haskins Laboratories, New Haven, CT, United States; Yale University, New Haven, CT, United States.


Purpose: Gap duration contributes to the perception of utterances as fluent or disfluent, but few studies have systematically investigated the impact of gap duration on fluency judgments. The purposes of this study were to determine how gaps impact disfluency perception, and how listener background and experience impact these judgments.

Methods: Sixty participants (20 adults who stutter [AWS], 20 speech-language pathologists [SLPs], and 20 naïve listeners) listened to four tokens of the utterance, "Buy Bobby a puppy," produced at typical speech rates. The gap duration between "Buy" and "Bobby" was systematically manipulated with gaps ranging from 23.59 ms to 325.44 ms. Participants identified stimuli as fluent or disfluent.

Results: The disfluency threshold - the point at which 50 % of trials were categorized as disfluent - occurred at a gap duration of 126.46 ms, across all participants and tokens. The SLPs exhibited higher disfluency thresholds than the AWS and the naïve listeners.

Conclusion: This study determined, based on the specific set of stimuli used, when the perception of utterances tends to shift from fluent to disfluent. Group differences indicated that SLPs are less inclined to identify disfluencies in speech potentially because they aim to be less critical of speech that deviates from "typical".

PMID: 35032922 DOI: 10.1016/j.jfludis.2022.105896




The Fluency Trust Residential Course for young people who stutter: A pragmatic feasibility study - TERAPIA EM GRUPO

J Commun Disord. 2022 Jan 17;95:106181. Online ahead of print.


Anna Prince, Jonathan Marsden, Yvonne Wren, Rosemarie Hayhow, Sam Harding

Community Children's Health Partnership, Bristol, United Kingdom; University of Plymouth, United Kingdom; University of Bristol, United Kingdom.


Introduction: A feasibility study of The Fluency Trust Residential Course (FTRC) for adolescents who stutter was conducted. The study aimed to measure key areas of a feasibility trial, for example, recruitment and retention, outcome measure completion, outcome measure reliability, and acceptability of the intervention to inform future research into the FTRC.

Methods: Quantitative and qualitative methods were used. Participants were 23 adolescents (12-17 years), 23 parents and 2 Speech-Language Pathologists (SLPs) from the FTRC. Data collection included: outcome measure collection via a pre-test post-test quasi-experimental design (including two baseline measures), intervention fidelity checklists, semi-structured interviews with adolescents to explore acceptability of the intervention and semi-structured interviews with SLPs to explore their experiences of research participation and views on a future trial.

Results: Recruitment, retention and outcome measure completion levels were all 100%. Intervention fidelity was 95% and there were no adverse events. Outcome measures showed good test- re-test reliability: Progress Questionnaire Child Intraclass Correlation Coefficient (ICC) = 0.87 (95% CI = 0.69-0.94 sig< 0.001) and Progress Questionnaire Parent ICC = 0.88 (95% CI = 0.70-0.95 sig< 0.001). Descriptive statistics showed that group medians and means of all outcome measures shifted in a positive direction between pre and post-tests (9 weeks follow-up). Twenty-five percent of young people showed changes on the Progress Questionnaire Child that were above the minimal important difference. Seventy-five percent of parents showed changes on the Progress Questionnaire Parent that were above the minimal important difference. Acceptability of the intervention by adolescents was high. SLPs reported participation was manageable and they were pleased to be part of the research.

Conclusion: Quantitative and qualitative data suggest that a future definitive trial of the FTRC is indicated after additional development work and feasibility testing. Recommendations for further research are included.

PMID: 35051833 DOI: 10.1016/j.jcomdis.2021.106181




The relation between gestures and stuttering in individuals with Down syndrome - PSICOMOTOR

J Appl Res Intellect Disabil. 2022 Jan 24. Online ahead of print.


Babette Maessen, Ellen Rombouts, Bea Maes, Inge Zink

Experimental Otorhinolaryngology, Leuven, Belgium; Faculty of Psychology and Educational Sciences, Leuven, Belgium.


Background: Evidence shows that neurotypical individuals who stutter use fewer gestures than those who do not stutter. Presently, no research exists about the interaction of stuttering and gestures in individuals with Down syndrome.

Method: Twenty-nine individuals with Down syndrome (7-19 years) of whom 16 stuttered and 13 spoke fluently and 20 neurotypical children (3-10 years) of whom 8 stuttered and 12 spoke fluently participated in this study. In spontaneous speech transcriptions, stuttering events and gestures were coded.

Results: Comparisons of gesture frequency during stuttered and fluent speech inside the Down syndrome and neurotypical group show that the Down syndrome group uses significantly more gestures during stuttered than during fluent speech while no significant difference is seen in the neurotypical group.

Conclusions: There is some preliminary evidence that individuals with Down syndrome try to compensate for their stuttering events, however, analyses on word level are necessary to confirm a successful compensation.

PMID: 35068025 DOI: 10.1111/jar.12980




The Relationship Between Auditory-Motor Integration, Interoceptive Awareness, and Self-Reported Stuttering Severity - CONCEITO

Front Integr Neurosci. 2022 May 6;16:869571. eCollection 2022.

Free PMC Article: https://www.frontiersin.org/articles/10.3389/fnint.2022.869571/full


M Florencia Assaneo, Pablo Ripollés, Seth E Tichenor, J Scott Yaruss, Eric S Jackson

National Autonomous University of Mexico, Querétaro, Mexico; New York University, New York, NY, United States, Duquesne University, Pittsburgh, PA, United States; Michigan State University, East Lansing, MI, United States.


Stuttering is a neurodevelopmental speech disorder associated with motor timing that differs from non-stutterers. While neurodevelopmental disorders impacted by timing are associated with compromised auditory-motor integration and interoception, the interplay between those abilities and stuttering remains unexplored. Here, we studied the relationships between speech auditory-motor synchronization (a proxy for auditory-motor integration), interoceptive awareness, and self-reported stuttering severity using remotely delivered assessments. Results indicate that in general, stutterers and non-stutterers exhibit similar auditory-motor integration and interoceptive abilities. However, while speech auditory-motor synchrony (i.e., integration) and interoceptive awareness were not related, speech synchrony was inversely related to the speaker's perception of stuttering severity as perceived by others, and interoceptive awareness was inversely related to self-reported stuttering impact. These findings support claims that stuttering is a heterogeneous, multi-faceted disorder such that uncorrelated auditory-motor integration and interoception measurements predicted different aspects of stuttering, suggesting two unrelated sources of timing differences associated with the disorder.

PMID: 35600224 PMCID: PMC9120354 DOI: 10.3389/fnint.2022.869571




The role of temperament in stuttering frequency and impact in children under 7 - EMOCIONAL

J Commun Disord. 2022 Feb 24;97:106201. Online ahead of print.


Sarah Delpeche, Sharon Millard, Elaine Kelman

University of London, Northampton Square, Clerkenwell, London, United Kingdom; Michael Palin Centre, Farringdon, London, United Kingdom;


Introduction: Increased emotional reactivity and decreased regulation have been associated with increased stuttering severity and frequency in preschool children who stutter (CWS) and may be predictors for the development of negative reactions to stuttering in young children. Understanding which children are likely to be impacted to a greater or lesser degree has implications for clinical decision making. Associations between temperament and stuttering impact have been explored with older CWS, but not with preschool CWS.

Aim: To investigate the relationship between temperament (specifically emotional reactivity and regulation) and both stuttering frequency and stuttering impact in preschool CWS.

Methods: Data collected at initial assessment for 119 young CWS (age range= 3;00-6;11 years) at a specialist centre for stuttering in London, UK were analysed. The following measures were completed: The Children's Behaviour Questionnaire-Short Form (Putnam & Rothbart, 2006); Palin Parent Rating Scales (Millard & Davis, 2016); The Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (Vanryckeghem & Brutten, 2007); and a stuttering frequency measure.

Results: Emotional reactivity and regulation were not significantly associated with stuttering frequency. Higher scores on negative reactivity were significantly associated with an increased impact of stuttering on the child (from parents' perspective), but not significantly associated with child-reported communication attitude. Positive reactivity was not significantly associated with parent-reported impact of stuttering or child-reported communication attitude. Additional investigation revealed negative affect as a significant predictor of parent-reported impact of stuttering before and after adjusting for age.

Discussion: The results provide evidence to support the role of temperament on the impact that stuttering has in the early years. While the directionality of the relationship between negative reactivity and impact of stuttering is unknown, the importance of targeting emotional reactions in therapy for young CWS is implicated.

PMID: 35278843 DOI: 10.1016/j.jcomdis.2022.106201




The unique role of the frontal aslant tract in speech and language processing - NEUROCIÊNCIAS

Neuroimage Clin. 2022 Apr 26;34:103020. Online ahead of print.


Allison J Zhong, Juliana V Baldo, Nina F Dronkers, Maria V Ivanova

New York Medical College, Valhalla, NY, USA;  VA Northern California Healthcare System, Martinez, CA, USA.; Northern California Healthcare System, Martinez, CA, USA; University of California, Berkeley, CA, USA


The frontal aslant tract (FAT) is a recently described intralobar tract that connects the superior and inferior frontal gyri. The FAT has been implicated in various speech and language processes and disorders, including motor speech impairments, stuttering disorders, opercular syndrome, and verbal fluency, but the specific function(s) of the FAT have yet to be elucidated. In the current study, we aimed to address this knowledge gap by investigating the underlying role that the FAT plays in motor aspects of speech and language abilities in post-stroke aphasia. Our goals were three-fold: 1) To identify which specific motor speech or language abilities are impacted by FAT damage by utilizing a powerful imaging analysis method, High Angular Resolution Diffusion Imaging (HARDI) tractography; 2) To determine whether damage to the FAT is associated with functional deficits on a range of motor speech and language tasks even when accounting for cortical damage to adjacent cortical regions; and 3) To explore whether subsections of the FAT (lateral and medial segments) play distinct roles in motor speech performance. We hypothesized that damage to the FAT would be most strongly associated with motor speech performance in comparison to language tasks. We analyzed HARDI data from thirty-three people with aphasia (PWA) with a history of chronic left hemisphere stroke. FAT metrics were related to scores on several speech and language tests: the Motor Speech Evaluation (MSE), the Western Aphasia Battery (WAB) aphasia quotient and subtests, and the Boston Naming Test (BNT). Our results indicated that the integrity of the FAT was strongly associated with the MSE as predicted, and weakly negatively associated with WAB subtest scores including Naming, Comprehension, and Repetition, likely reflecting the fact that performance on these WAB subtests is associated with damage to posterior areas of the brain that are unlikely to be damaged with a frontal lesion. We also performed hierarchical stepwise regressions to predict language function based on FAT properties and lesion load to surrounding cortical areas. After accounting for the contributions of the inferior frontal gyrus, the ventral precentral gyrus, and the superior precentral gyrus of the insula, the FAT still remained a significant predictor of MSE apraxia scores. Our results further showed that the medial and lateral subsections of the FAT did not appear to play distinct roles but rather may indicate normal anatomical variations of the FAT. Overall, current results indicate that the FAT plays a specific and unique role in motor speech. These results further our understanding of the role that white matter tracts play in speech and language.

PMID: 35526498 DOI: 10.1016/j.nicl.2022.103020




Tract profiles of the cerebellar peduncles in children who stutter - INFANTIL / NEUROCIÊNCIAS

Brain Struct Funct. 2022 Feb 27. Online ahead of print.


Chelsea A Johnson, Yanni Liu, Noah Waller, Soo-Eun Chang

Michigan State University, East Lansing, MI, USA; University of Michigan, Ann Arbor, MI, USA.


Cerebellar-cortical loops comprise critical neural circuitry that supports self-initiated movements and motor adjustments in response to perceived errors, functions that are affected in stuttering. It is unknown whether structural aspects of cerebellar circuitry are affected in stuttering, particularly in children close to symptom onset. Here we examined white matter diffusivity characteristics of the three cerebellar peduncles (CPs) based on diffusion MRI (dMRI) data collected from 41 children who stutter (CWS) and 42 controls in the 3-11 years range. We hypothesized that CWS would exhibit decreased fractional anisotropy (FA) in the right CPs given the contralateral connectivity of the cerebellar-cortical loops and past reports of structural differences in left cortical areas in stuttering speakers. Automatic Fiber Quantification (AFQ) was used to track and segment cerebellar white matter pathways and to extract diffusivity measures. We found significant group differences for FA in the right inferior CP (ICP) only: controls showed significantly higher FA in the right ventral ICP compared to CWS, controlling for age, sex, and verbal IQ. Furthermore, FA of right ICP was negatively correlated with stuttering frequency in CWS. These results suggest an early developmental difference in the right ICP for CWS compared to age-matched peers, which may indicate an alteration in error processing, a function previously linked to the ICP. Lower FA here may impact error monitoring and sensory input processing to guide motor corrections. Further longitudinal investigations in children may provide additional insights into how CP development links to stuttering persistence and recovery.

PMID: 35220486 DOI: 10.1007/s00429-022-02471-4




Treatment for School-Age Children Who Stutter: A Systematic Review of Japanese Literature - INFANTIL / TERAPIA

Lang Speech Hear Serv Sch. 2022 Feb 14;1-23. Online ahead of print.


Daichi Iimura, Kohei Kakuta, Takuya Oe, Hiroaki Kobayashi, Naomi Sakai, Shoko Miyamoto

Kawasaki University of Medical Welfare, Okayama, Japan; University of Tsukuba, Japan; Hospital, National Rehabilitation Center for Persons with Disabilities, Saitama, Japan; Kanazawa University, Japan; Osaka University; Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan; National Rehabilitation Center for Persons with Disabilities, Saitama, Japan.


Purpose: This systematic review identified and synthesized published research articles, written in Japanese, on the clinical effectiveness of a broad range of nonpharmacological interventions for school-age children who stutter.

Method: A systematic review of Japanese literature published between January 1, 1980, and July 7, 2020, reporting interventions for school-age children who stutter, was carried out through a search of two databases (CiNii Article database and Japan Medical Abstract Society database) using the key words "stuttering" and "school-age" or "child" or "primary school students" or "children" or "school child" in Japanese. To be included in the review, the articles must report studies where data were subjectively reported by clinicians, where school-age participants were treated for developmental stuttering, where participants received interventions conducted by clinicians, and where quantitative outcomes (pre- and/or posttreatment) were measured; and they must be published in Japanese.

Results: Forty articles met all the inclusion criteria. Most articles adopted a case series or single-case study design. A total of 179 intervention programs were identified from all the articles and broadly classified into speech therapy, psychological therapy, interventions for modifying the child's environment, and others.

Conclusions: Our systematic review provided a broad overview of the treatments used for school-age children who stutter in Japan. Future research should focus on gathering more reliable, systematic, and rigorous evidence to establish the effectiveness of stuttering treatments for school-age children and thereby develop evidence-based practices.

PMID: 35157506 DOI: 10.1044/2021_LSHSS-21-00044




Virtual Reality Exposure Therapy for Treating Social Anxiety: A Scoping Review of Treatment Designs and Adaptation to Stuttering - TERAPIA

Review Front Digit Health. 2022 Feb 25;4:842460

Free Full Text: https://www.frontiersin.org/articles/10.3389/fdgth.2022.842460/full


Ian Chard, Nejra van Zalk

Imperial College London, London, United Kingdom.


Virtual Reality Exposure Therapy (VRET) has been shown to be an effective technique for reducing social anxiety. People who stutter are at greater risk of developing heightened social anxiety. Cognitive behavior therapy protocols have shown promise in reducing social anxiety in people who stutter, but no studies have investigated VRET targeting social anxiety associated with stuttering. The aim of the current review is to provide an overview of VRET techniques used to treat social anxiety and insights into how these techniques might be adopted in the case of comorbid stuttering and social anxiety. Twelve studies were reviewed to understand key distinctions in VRET protocols used to treat social anxiety. Distinctions include exercises targeting public speaking vs. general social anxiety, computer-generated virtual environments vs. 360° video, and therapist guided vs. automated VRET. Based on the review findings, we propose how certain features could be applied in the case of stuttering. Virtual therapists, inhibitory learning techniques and integration into speech therapy may be suitable ways to tailor VRET. Regardless of these different techniques, VRET should consider the situations and cognitive-behavioral processes that underlie the experience of social anxiety amongst people who stutter.

PMID: 35281220 PMCID: PMC8913509 DOI: 10.3389/fdgth.2022.842460




White matter connectivity in neonates at risk of stuttering: Preliminary data - INFANTIL / NEUROCIÊNCIAS

Neurosci Lett. 2022 Apr 22;136655.  Online ahead of print.


Ann Packman et al

University of Technology Sydney, NSW, Australia; University of the Sunshine Coast, QLD, Australia; University Medical Centre Göttingen, Germany.


Background: Developmental stuttering is thought to be underpinned by structural impairments in the brain. The only way to support the claim that these are causal is to determine if they are present before onset.

Materials and methods: Magnetic resonance imaging (MRI) was conducted on 18 neonates, aged 8-18 weeks, 6 of whom were determined to be genetically at risk of stuttering.

Results: With tract-based spatial statistics (TBSS) analysis, no statistically significant differences were found between the at-risk group and the control group. However, fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) in the corpus callosum of the at-risk group were lower (uncorrected) than in the control group. Automated Fiber Quantification (AFQ) yielded lower FA in the at-risk group than in the control group in the medial section of the callosum forceps minor.

Discussion: The findings, albeit with a small number of participants, support the proposition that reduced integrity of white matter in the corpus callosum has a causal role in developmental stuttering. Longitudinal research to determine if children with this impairment at birth later start to stutter is needed to confirm this. The left arcuate fasciculus is thought to develop as speech develops, which likely explains why there were no abnormal findings in this area in our at-risk neonates so soon after birth. This is the first study to investigate the brains of children before the onset of stuttering and the findings warrant further research.

PMID: 35469821 DOI: 10.1016/j.neulet.2022.136655




White matter tract strength correlates with therapy outcome in persistent developmental stuttering - NEUROCIÊNCIAS

Hum Brain Mapp. 2022 Apr 12. Online ahead of print.


Nicole E Neef, et al

University Medical Center Göttingen, Göttingen, Germany; FH Münster University of Applied Sciences, Münster, Germany; Institut der Kasseler Stottertherapie, Bad Emstal, Germany.


Persistent stuttering is a prevalent neurodevelopmental speech disorder, which presents with involuntary speech blocks, sound and syllable repetitions, and sound prolongations. Affected individuals often struggle with negative feelings, elevated anxiety, and low self-esteem. Neuroimaging studies frequently link persistent stuttering with cortical alterations and dysfunctional cortico-basal ganglia-thalamocortical loops; dMRI data also point toward connectivity changes of the superior longitudinal fasciculus (SLF) and the frontal aslant tract (FAT). Both tracts are involved in speech and language functions, and the FAT also supports inhibitory control and conflict monitoring. Whether the two tracts are involved in therapy-associated improvements and how they relate to therapeutic outcomes is currently unknown. Here, we analyzed dMRI data of 22 patients who participated in a fluency-shaping program, 18 patients not participating in therapy, and 27 fluent control participants, measured 1 year apart. We used diffusion tractography to segment the SLF and FAT bilaterally and to quantify their microstructural properties before and after a fluency-shaping program. Participants learned to speak with soft articulation, pitch, and voicing during a 2-week on-site boot camp and computer-assisted biofeedback-based daily training for 1 year. Therapy had no impact on the microstructural properties of the two tracts. Yet, after therapy, stuttering severity correlated positively with left SLF fractional anisotropy, whereas relief from the social-emotional burden to stutter correlated negatively with right FAT fractional anisotropy. Thus, posttreatment, speech motor performance relates to the left dorsal stream, while the experience of the adverse impact of stuttering relates to the structure recently associated with conflict monitoring and action inhibition.

PMID: 35415866 DOI: 10.1002/hbm.25853