Eliana Maria Nigro Rocha



Abstract  - Agosto a Dezembro de 2023




A case study of bilingual neurogenic stuttering: Measures of fluency, emotion, and articulation rate - GAGUEIRA ADQUIRIDA

J Commun Disord. 2023 Dec 7:107:106385. Online ahead of print.

Full Text: https://www.sciencedirect.com/science/article/pii/S0021992423000850?via%3Dihub


Yael Neumann

City University of New York, Queens, NY, United States.


Introduction: This study explores the features of bilingual neurogenic stuttering and the potential connection between emotion and articulation rate on speech disfluencies.

Method: The participant is a 59-year old, Yiddish-English bilingual male with a moderate non-fluent aphasia. Thirty-two narratives (16 in each language), elicited using cue words, were analyzed for frequency of disfluency, type of disfluency (stuttering vs. non-stuttering-like), word-type (content vs. function), within-word location of disfluency, and occurrence of accessory behaviors. Additionally, the percentage and type of emotion (positive vs. negative) expressed, and articulation rate (fluent syllables spoken/duration of fluent utterances) was assessed.

Results: Disfluency occurred in each language with approximately equal frequency. The most common stuttering-like disfluencies were repetitions (monosyllabic, sound, and syllable) and prolongations. The most common non-stuttering-like disfluencies were self-correction/revisions, phrase and multisyllabic word repetitions, and pauses (silent and filled). In both languages, disfluencies occurred on both content and function words, but primarily content words, and in any position of the word, although primarily initial position. No accessory behaviors were noted. There was a similar amount of emotion words used in each language although the first acquired language, L1/Yiddish, had an overall more positive tone, and his second acquired language, L2/English, had a more negative tone. Additionally, there was a negative relationship between emotion and the number of disfluencies in L1/Yiddish, and a positive relationship in L2/English. A faster articulation rate was found in his native and more proficient language, Yiddish, than English. There was a negative relationship between articulation rate and the number of disfluencies in L1/Yiddish, and a positive relationship in L2/English.

Conclusions: Cross-linguistics differences for emotion and articulation rate demonstrates that these aspects impact on fluency and contributes to the disfluencies in each language. Clinical implications of the study demonstrates the importance of assessment of bilingual (i.e., proficiency and dominance) and fluency features of each language in the diagnostic process and the significance of considering emotional processes and articulation rate as part of a comprehensive intervention plan for acquired stuttering.

PMID: 38065050 DOI: 10.1016/j.jcomdis.2023.106385




A comparison of structural morphometry in children and adults with persistent developmental stuttering - INFANTIL / NEUROCIÊNCIAS

Brain Commun. 2023 Nov 6;5(6):fcad301

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653153/pdf/fcad301.pdf


Hilary E Miller, Emily O Garnett, Elizabeth S Heller Murray, Alfonso Nieto-Castañón, Jason A Tourville, Soo-Eun Chang, Frank H Guenther

Boston University, Boston, MA, USA; University of Michigan, Ann Arbor, MI, USA; Temple University, Philadelphia, PA, USA; Ewha Womans University, Seoul, Korea; Michigan State University, East Lansing, MI, USA; Massachusetts Institute of Technology, CambridgE, USA.


This cross-sectional study aimed to differentiate earlier occurring neuroanatomical differences that may reflect core deficits in stuttering versus changes associated with a longer duration of stuttering by analysing structural morphometry in a large sample of children and adults who stutter and age-matched controls. Whole-brain T1-weighted structural scans were obtained from 166 individuals who stutter (74 children, 92 adults; ages 3-58) and 191 controls (92 children, 99 adults; ages 3-53) from eight prior studies in our laboratories. Mean size and gyrification measures were extracted using FreeSurfer software for each cortical region of interest. FreeSurfer software was also used to generate subcortical volumes for regions in the automatic subcortical segmentation. For cortical analyses, separate ANOVA analyses of size (surface area, cortical thickness) and gyrification (local gyrification index) measures were conducted to test for a main effect of diagnosis (stuttering, control) and the interaction of diagnosis-group with age-group (children, adults) across cortical regions. Cortical analyses were first conducted across a set of regions that comprise the speech network and then in a second whole-brain analysis. Next, separate ANOVA analyses of volume were conducted across subcortical regions in each hemisphere. False discovery rate corrections were applied for all analyses. Additionally, we tested for correlations between structural morphometry and stuttering severity. Analyses revealed thinner cortex in children who stutter compared with controls in several key speech-planning regions, with significant correlations between cortical thickness and stuttering severity. These differences in cortical size were not present in adults who stutter, who instead showed reduced gyrification in the right inferior frontal gyrus. Findings suggest that early cortical anomalies in key speech planning regions may be associated with stuttering onset. Persistent stuttering into adulthood may result from network-level dysfunction instead of focal differences in cortical morphometry. Adults who stutter may also have a more heterogeneous neural presentation than children who stutter due to their unique lived experiences.

PMID: 38025273 PMCID: PMC10653153




A different perspective into clinical symptoms in CPT I deficiency - AVALIAÇÃO

Mol Genet Metab Rep. 2023 Nov 30:38:101032..

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10711229/pdf/main.pdf


Mehmet Cihan Balci, Meryem Karaca, Arzu Selamioglu, Huseyin Kutay Korbeyli, Asli Durmus, Belkis Ak, Tugba Kozanoglu, Gulden Fatma Gokcay

Istanbul Medical Faculty Children's Hospital, Istanbul University, Istanbul, Turkey.


Carnitine palmitoyltransferase I (CPT I) deficiency is an autosomal recessive disorder causing long-chain fatty acid oxidation defect, characterized by metabolic decompensation episodes accompanied by hypoketotic hypoglycemia, hepatomegaly, seizures, renal tubular acidosis, and hyperammonemia. The aim of this study was to investigate the neurological symptoms in CPT I deficiency and different outcomes with respect to predisposing factors for sequela and to draw attention to the neurological impairment that may develop during the course of the disease. The retrospective study reviewed clinical characteristics of 14 patients. Mean follow-up period was 10.3 ± 4.7 (range: 8 months-18.6 years; median: 10 years) years. Three patients were diagnosed with newborn screening. In the symptomatic group (n = 12) most common presenting symptoms were psychomotor retardation (n = 6), seizures (n = 5), encephalopathy (n = 5), dystonia (n = 1), Reye-like syndrome (n = 5), muscle weakness (n = 3), and autism (n = 1). Neurologic findings detected in the follow-up period included speech disorder (n = 9), abnormal cranial MRI findings (n = 5), neuropathy (n = 1), and attention deficit hyperactivity disorder (n = 1). Speech disorders collectively included delayed expressive language development, speech articulation disorder, speech delay, stuttering, and specific speech difficulties. After starting treatment for CPT I deficiency, speech disorders improved in 3 patients. Our findings confirmed that the clinical manifestations of CPT I deficiency is wider than previously thought, causing specific neurologic dysfunction, mainly speech disorders at a large scale, that were unexpected in a fatty acid oxidation disorder. We suggest that early diagnosis and treatment is the key factor to prevent neurologic sequelae while an extensive neurological evaluation is essential in patients with CPT I deficiency both at the time of diagnosis and during the follow-up period.

PMID: 38090675 PMCID: PMC10711229 DOI: 10.1016/j.ymgmr.2023.101032




A pilot study of an online self-compassion intervention for adults who stutter - TERAPIA

Int J Speech Lang Pathol. 2023 Aug 12;1-14. Online ahead of print.


Robyn L Croft, Courtney T Byrd

The University of Texas at Austin, Austin, TX, USA.


Purpose: The primary aim of this pilot study was to determine the preliminary effectiveness of an online self-compassion intervention for improving self-compassion and quality of life in adults who stutter. A secondary aim was to determine intervention acceptability and participant satisfaction.

Method: Participants included adults who stutter who completed an online self-compassion module once a week for six consecutive weeks. Pre- and post-intervention measures included the Self-Compassion Scale-Trait and the Overall Assessment of the Speaker's Experience of Stuttering. Participants also completed acceptability questionnaires weekly and post-intervention via quantitative and qualitative reports.

Result: Ten participants completed all six intervention modules, as well as pre- and post-intervention measures. Participants reported increased self-compassion and improved quality of life at post-intervention, as well as high intervention acceptability with regard to delivery format, content, duration, and relevance to stuttering and daily life. Individual variation was also observed across acceptability domains.

Conclusion: The present study provides pilot data supporting the use of online modules to increase self-compassion and decrease the negative impact of stuttering on the quality of life among adults who stutter. Future studies should employ larger sample sizes, compare outcomes to a control group, and determine if gains are maintained over time.

PMID: 37572047 DOI: 10.1080/17549507.2023.2236813




A preliminary comparison of fluent and non-fluent speech through Turkish predictive cluttering inventory-revised - TAQUIFEMIA

J Fluency Disord. 2023 Nov 10:79:106019. Online ahead of print.


Aslı Altınsoy, Ramazan Sertan Özdemir, Şükrü Torun

Akdeniz University, Turkey; Medipol University, Turkey; Anadolu University, Turkey.


Purpose: The aim of this study is to compare the speech fluency performance of non-fluent participants namely people with stuttering (PWS), people with cluttering (PWC) and people with cluttering and stuttering (PWCS) with a fluent control group using the Turkish version of Predictive Cluttering Inventory-revised (TR-PCI-r).

Methods: The study recruited non-fluent individuals (n = 60) and fluent controls (n = 60) between the ages of 6 and 55. The non-fluent group was perceptually evaluated by two speech and language pathologists (SLP). The speaking, reading and retelling samples were collected from 18 PWC, 17 PWCS, 25 PWS and 60 controls. The scores of each factor were compared. Age and gender differences were analyzed. Validity and reliability were calculated.

Results: The agreement between two SLPs was found to be at the barely acceptable level (κ = 0.378). PWC and PWCS produced parallel outcomes in the speech motor area. In every other domain and in total scores, PWC were different from PWCS, PWS, and the controls. There was a variation in the total scores obtained by the children and adolescents in the PWS and between males and females in the controls. Except for three items (namely items 8, 22, 27), TR-PCI-r met the content validity criterion. Furthermore, TR-PCI-r was found to be a reliable tool as shown by ɑ> 0.70 and ICC values of between 0.75 and 0.90.

Conclusion: The scores from TR-PCI-r indicated that, speech motor characteristics of PWC and PWCS were similar. Other features assessed by the tool seemed to distinguish PWC from PWCS, PWS and controls.

PMID: 37976907 DOI: 10.1016/j.jfludis.2023.106019




Amantadine-Induced Craniofacial Myoclonus: Distinctive Iatrogenic Dysarthria in Parkinson's Disease - FARMACOLOGIA

Review Mov Disord Clin Pract. 2023 Jul 14;10(9):1408-1413.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10525052/pdf/MDC3-10-1408.pdf


Iris Lin et al

University of Cincinnati Cincinnati Ohio USA; Toronto Western Hospital Toronto Ontario Canada.


Background: Amantadine is a widely prescribed medication in Parkinson's disease (PD). A distinctive craniofacial distribution of myoclonus with speech impairment is an underrecognized iatrogenic complication in amantadine-treated patients with PD.

Cases: We report 7 patients with idiopathic PD (disease duration, 6-21 years) who developed speech-induced craniofacial-predominant myoclonus with "stuttering-like" dysarthria and speech arrests days to months after amantadine initiation or dose increase. Renal insufficiency was identified as a risk factor in 4 cases. In all cases, reduction or discontinuation of amantadine markedly attenuated the myoclonus and restored speech intelligibility.

Literature review: Amantadine can induce subcortical segmental or generalized myoclonus. A report in 1996 of "vocal myoclonus" in an amantadine-treated patient with PD was the first observation of a focal distribution of myoclonus, particularly affecting speech. Since then, few cases of craniofacial myoclonus with speech impairment have been reported, none with accompanying video. With 1 exception, the craniofacial distribution was part of a generalized pattern of amantadine-induced myoclonus. Comorbid renal insufficiency is a recognized risk factor.

Conclusions: Speech-induced craniofacial myoclonus, with marked "stuttering-like" dysarthria and speech arrests, is a disabling iatrogenic complication in PD that resolves upon amantadine discontinuation.

PMID: 37772280 PMCID: PMC10525052 DOI: 10.1002/mdc3.13828




Análise de preditores de risco cumulativo para a gagueira persistente: percepção familiar e quantidade de rupturas da fala - INFANTIL / AVALIAÇÃO

[Article in Portuguese, English]

Codas. 2023 Nov 13; 35(6):e20220206.

Free article: https://www.scielo.br/j/codas/a/Pkq684v8WRyh4bKCjBNhX3n/?format=pdf&lang=pt


Julia Biancalana Costa, Fabiola Juste, Ana Paula Ritto, Fernanda Chiarion Sassi, Claudia Regina Furquim de Andrade

Universidade de São Paulo - USP - São Paulo (SP), Brasil.


Objetivo: Pesquisar duas variáveis independentes consideradas como possíveis preditores de risco cumulativo para a gagueira persistente (GP): percepção familiar da gagueira e quantidade de rupturas da fala.

Método: Participaram 452 crianças, com idade entre 3 a 11:11 anos, de ambos os gêneros, divididos em 4 grupos: grupo 1 (GGQ), 158 crianças com percentual de rupturas gagas ≥3% e queixa familiar de gagueira; grupo 2 (GGS), 42 crianças com percentual de rupturas gagas ≥3% e sem queixa familiar de gagueira; grupo 3 (FQ), 94 crianças com percentual de rupturas gagas ≤2.9% com queixa familiar de gagueira e grupo 4 (FS), 158 crianças com percentual de rupturas gagas ≤2.9 sem queixa familiar de gagueira.

Resultados: Para o grupo GGQ há relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala típicas da gagueira e houve predominância de crianças do sexo masculino. Para o grupo GGS não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FQ não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FS houve relação significante entre a ausência de queixa familiar de gagueira e a reduzida quantidade de rupturas de fala.

Conclusão: O percentual de rupturas ≥3% é um indicador de risco para a GP. A queixa familiar de rupturas do tipo repetições pode ser um indicador de risco para a GP. A queixa familiar de gagueira, isoladamente, não deve ser considerada como indicador de GP.




Analysis of cumulative risk predictors for persistent stuttering: family perception and amount of speech disruptions - INFANTIL / AVALIAÇÃO

[Article in Portuguese, English]

Codas. 2023 Nov 13; 35(6):e20220206.

Free article: https://www.scielo.br/j/codas/a/Pkq684v8WRyh4bKCjBNhX3n/?format=pdf&lang=en


Julia Biancalana Costa, Fabiola Juste, Ana Paula Ritto, Fernanda Chiarion Sassi, Claudia Regina Furquim de Andrade

Universidade de São Paulo - USP - São Paulo (SP), Brasil.


Purpose: To investigate two independent variables considered as two possible predictors of cumulative risk for persistent stuttering: family perception of stuttering and amount of speech disruptions.

Methods: Participants were 452 children, aged 3 to 11:11 years, male and female, divided into 4 groups: group 1 (SCG), composed of 158 children who presented a percentage of stuttered speech disruptions ≥ 3% and family complaint of stuttering; group 2 (SWCG), 42 children who presented percentage of stuttered speech disruptions ≥ 3% and without family complaint of stuttering; group 3 (FCG), 94 children who presented percentage of stuttered speech disruptions ≤ 2. 9% with family complaints of stuttering and group 4 (FWCG), 158 children who presented a percentage of stuttered speech disruptions ≤ 2.9 without family complaints of stuttering.

Results: For the SCG group, there was a significant relationship between family complaints of stuttering and the number of speech disruptions typical of stuttering. In this group, there was a predominance of male children. For the SWCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FWCG group, there was a significant relation between the absence of a family complaint of stuttering and the reduced number of speech disruptions.

Conclusion: The percentage of speech disruptions ≥ 3% is a risk indicator for persistent stuttering. The percentage of speech disruptions ≤ 2.9% associated with syllable and sound repetitions can be a risk indicator for persistent stuttering. Family complaints of syllable and sound repetitions may be a risk indicator for persistent stuttering. Family complaints of stuttering alone should not be considered an indicator of persistent stuttering.

PMID: 37971052 DOI: 10.1590/2317-1782/20232022206pt




Ann Packman: Reflections on a career - HISTÓRIA

J Fluency Disord. 2023 Nov 29:79:106034. Online ahead of print.

Full text: https://www.sciencedirect.com/science/article/pii/S0094730X23000773?via%3Dihub


Mark Onslow

University of Technology Sydney, NSW, Australia.


This is the fourth in a series of papers that provides an historical record in this journal of contributions made by the most influential figures in the field of stuttering. Ann Packman is an Australian researcher who will retire shortly. This paper reflects on her long and productive career, and her contributions to the field. With a background in literature, linguistics, philosophy, psychology, and the brain and language, she became well equipped to contribute to understanding stuttering causality. That work, and an accompanying collection of basic and applied clinical research, was constantly grounded with the thoughts and feelings of those who stutter in the community.

PMID: 38056155 DOI: 10.1016/j.jfludis.2023.106034




B - 13 A Written Stutter: a Case Study of Functional Neurologic Disorder - OUTRAS ÁREAS

Arch Clin Neuropsychol. 2023 Oct 8:acad067.220. Online ahead of print.


Laura Gramling, Erin I O'Connell, Shelley Peery


Objective: Functional neurologic disorder (FND) is a broad diagnostic construct that encompasses many heterogeneous conditions. The defining characteristic of FND is that the affected individual experiences symptoms for which there is no known biological mechanism. Often the symptoms are attributed to psychological factors. FND remains poorly understood, despite increased efforts to elucidate neural and neuropsychological correlates. To date, there have been only a few case studies published on acute onset of dysfluent writing that does not result in dysgraphia and is not associated with a major neurological event (i.e., stroke, or traumatic brain injury).

Methods: A 17-year-old, right-handed, White, cis-gender boy was referred to an outpatient neuropsychology private practice with a complaint of acute onset and progressive dysfluent and effortful writing without dysgraphia. A comprehensive neuropsychological evaluation was undertaken, and the patient's mother served as a collateral informant.

Results: Performance was grossly within normal limits with mild impairment in fine motor coordination. The patient evidenced a slowed, effortful writing style marked by initial hesitation followed by a smooth fluid motion. Clinical interview and measures of psychological functioning did not reveal any psychiatric conditions.

Conclusions: Parallels are drawn between this dysfluent writing style, which does not cause functional impairment, and a stutter. Neuroanatomical mechanisms are explored.

PMID: 37807390 DOI: 10.1093/arclin/acad067.220




"Behavioral and cognitive-affective features of stuttering in preschool-age children: Regression and exploratory cluster analyses" [Corrigendum to]

Published Erratum J Fluency Disord. 2023 Oct 16:106017.Online ahead of print.


Ryan A Millager, Mary S Dietrich, Robin M Jones

Vanderbilt University, Nashville, TN, United States.


No abstract available

The authors must correct the published description of the KiddyCAT. The previously published text states that the KiddyCAT is scored by “counting a child’s responses to the twelve yes (1)/no(0) items, with higher scores denoting more negative speech attitudes” (p. 6, Millager et al., 2023). Per the KiddyCAT test manual (Vanryckeghem & Brutten, 2007), however, six of the 12 test items must be reverse-scored, i.e., yes(0)/no(1). Specifically, items that indicate negative thinking are scored as 1, positive belief is scored as 0. Data for Millager et al. (2023) were scored in accordance with the scoring manual with no impact on findings or interpretation.

The authors would like to apologize for any inconvenience caused.

PMID: 37852862 DOI: 10.1016/j.jfludis.2023.106017




Brain response to errors in children who stutter - INFANTIL / EMOCIONAL

J Fluency Disord. 2023 Dec 27:79:106035. Online ahead of print


Yanni Liu, Amanda Hampton Wray, Melissa Hall, Erica R Lescht, William J Gehring, Kate D Fitzgerald, Soo-Eun Chang

University of Michigan, Ann Arbor, MI, USA; University of Pittsburgh, Pittsburgh, PA, USA; University of Notre Dame, Notre Dame, IN, USA; Columbia University, New York, NY, USA; Womans University, Seoul, South Korea.


Purpose: Heightened rates of social anxiety have been reported in adults who stutter (AWS), but it is unclear whether anxiety is heightened also in children who stutter (CWS). Objective neurophysiological responses such as the error-related negativity (ERN) have been associated with anxiety, and ERN was reported to be increased in AWS. In this study, we examined whether ERN and error positivity (Pe) are increased in CWS. We further characterized ERN associations with age and anxiety in CWS relative to children who do not stutter (CWNS).

Methods: EEG data were recorded from twenty-four CWS and twenty-four matched CWNS aged 3-9 years as they performed a Go/No-Go task. Parent-reported anxiety, and child-reported speech-associated attitude measures were collected. Linear regression models tested the effects of age, group, and their interaction, and the effects of anxiety, group, and their interaction on ERN and Pe.

Results: Contrary to expectations, no ERN or Pe difference were observed between CWS and CWNS. However, larger ERN amplitudes were associated with older age in CWS but not CWNS, suggesting altered development of the error monitoring system in CWS. Association of Pe with anxiety also differed between groups: smaller Pe amplitudes were associated with higher level of parent-reported child anxiety in CWNS but not in CWS. Neither anxiety nor self-reported communication attitude differed between groups.

Conclusions: Brain responses to errors were overall comparable between CWS and CWNS. However, CWS differed in how error monitoring responses varied with age and with anxiety levels. More research is warranted to examine how these factors contribute to persistent stuttering.

PMID: 38160505 DOI: 10.1016/j.jfludis.2023.106035




Clinical and Psychosocial Predictors of Post-Event Processing in Adults Who Stutter - TEMPERAMENTO

J Speech Lang Hear Res. 2023 Oct 10:1-21. Online ahead of print.


Robyn L Croft, Courtney T Byrd

The University of Texas at Austin.


Purpose: Post-event processing, defined by self-critical rumination following a stressful communication event, is significantly associated with reduced quality of life. However, despite its relevance to the stuttering experience, to date, only a few studies have investigated post-event processing among adults who stutter, and no study has identified clinical and psychosocial predictors of post-event processing. The purpose of this study was to determine the contributions of clinical markers of stuttering and psychosocial variables to post-event processing.

Method: Adults who stutter (N = 96) participated in two virtual sessions. After completing the Trier Social Stress Test, a standardized social stress task in Session 1, participants completed measures of post-event processing, clinical markers of stuttering (i.e., the experience of stuttering, self- and observer-rated stuttering severity), and psychosocial characteristics (i.e., self-perceived performance, self-esteem, social anxiety, trait, and state self-compassion) in Session 2.

Results: Hierarchical linear regression models indicated that a more negative experience of stuttering, higher self-rated stuttering severity, and greater social anxiety predicted more post-event processing. Greater self-perceived performance and state self-compassion predicted less rumination. Observer-rated severity, self-esteem, and trait self-compassion were not significantly associated with post-event processing behavior.

Conclusion: Findings reveal clinical and psychosocial variables to consider in the assessment and mitigation of post-event processing behavior in adults who stutter, and to bolster resiliency to social stress.

Supplemental material: https://doi.org/10.23641/asha.24223213.

PMID: 37816227 DOI: 10.1044/2023_JSLHR-23-00245




Clozapine-Induced Stuttering: Case Report and Literature Review - FARMACOLOGIA

Pharmacopsychiatry. 2023 Nov;56(6):240-243.

Full text: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2189-5597


Fares Jaballah, Amina Aissa, Uta Ouali, Yosra Zgueb, Rabaa Jomli

Avicenna Department (A), Razi Hospital, Tunis-El Manar University, Tunisia.


No abstract available

PMID: 37944562 DOI: 10.1055/a-2189-5597




Comparing the beliefs regarding biological or psychological causalities toward stereotyped perception of people who stutter - SOCIAL

Front Psychol. 2023 Nov 16:14:1279169.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10687552/pdf/fpsyg-14-1279169.pdf


Daichi Iimura, Osamu Ishida

University of Tsukuba, Ibaraki, Japan.


Purpose: Developmental stuttering is a fluency disorder that may be caused by neurological, genetic, or familial factors. However, a general perception that stuttering is caused by psychological problems could lead to negative attitudes toward stuttering, causing prejudice or discrimination against people who stutter (PWS). Thus, our study aimed to investigate whether certain beliefs in etiology of stuttering are related to the negative perception of stuttering.

Methods: A web-based survey of 413 native Japanese adults, aged 20-69, who did not suffer from stuttering, schizophrenia, or depression, was conducted in August 2021. The participants were recruited through the Web monitor panel. Participants were divided into three uniform groups based on their response to a 27-item questionnaire about their implicit belief regarding the etiology of stuttering: belief in the biological model (stuttering-biological group), belief in the psychological model (stuttering-psychological group), and the control group (those who responded to perception of healthy adult males). Participants were also asked to respond to 25 items of semantic differential scales about perception of stuttering or healthy adult males. Responses were summarized into several factors by factor analysis, and factor scores were compared among the three groups. The stuttering-biological group had the fewest participants, comprising 80 individuals. Overall, a total of 240 participants, 80 from each group, were included in the analysis.

Results: Some pairs of stereotypes included in semantic differential scales revealed differences between the groups; PWS, irrespective of the participants of the biological or psychological group, were considered as having negative stereotyping properties such as being "tense," "anxious," or "afraid." Additionally, three concepts from the factor analysis of these 25 items were analyzed using an analysis of variance, and significant differences were found; the mean factor score of the "danger" stereotype was lower in the stuttering-biological group compared to the stuttering-psychological group.

Conclusion: Although the simplification of the biological model is not recommended, anti-stigma campaigns to educate people that stuttering is caused by multidimensional factors, not just psychological ones, could change the general public's negative perceptions of stuttering.

PMID: 38034304 PMCID: PMC10687552 DOI: 10.3389/fpsyg.2023.1279169




Comparison of Participation in Online Games and Communication Experiences of School-Age Children Who Do and Do not Stutter: Exploratory Study - INFANTIL / SOCIAL

Folia Phoniatr Logop. 2023 Nov 23. Online ahead of print.


İlkem Kara, Ayşe İlayda Mutlu, Kübra Miraloğlu


Introduction: Online games provide a socializing environment for children aged 8-10 years, but there is a lack of information in the literature about whether children who stutter access online gaming environments as frequently as their non-affected peers and about their interaction habits. This study aimed to investigate the participation frequency of school-age children who do and do not stutter in online games, the speech characteristics during games, and whether they encountered bullying-like behaviors during games.

Methods: A total of 91 children who stutter (F/M = 18/73; age range = 8-13) and 116 children who do not stutter (F/M = 60/56; age range 8-13) participated in this study. Children's participation habits in online, chat-based, multiplayer, games were evaluated with web-based questionnaires. Differences between questionnaire responses were analyzed using the significance test for a difference in two proportions.

Results: There was no significant difference between the participation rates of children who do and do not stutter in online games (z = 1.46; p = 0.14), their frequency (p > 0.05) and the time they spent in the game (p > 0.05). It was found that those who stutter preferred to use one-word expressions more than their peers who do not stutter (z = 2.03; p = 0.04), and those who stutter had higher rates of not encountering bullying-like behaviors in online games than those who do not stutter (z = 2.2; p = 0.03).

Discussion/conclusion: Children who do and do not stutter show similar participation habits in online, chat-based, multiplayer games with similar frequency, and duration. Speech features that emerge in online games, and whether these games play a role in providing children who stutter a communication environment where the risk of bullying is reduced and fluency is increased may be the subject of future research.

PMID: 37995662 DOI: 10.1159/000535296




Computational Intelligence-Based Stuttering Detection: A Systematic Review - AVALIAÇÃO

Review Diagnostics (Basel). 2023 Nov 27;13(23):3537.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10706171/pdf/diagnostics-13-03537.pdf


Raghad Alnashwan, Noura Alhakbani, Abeer Al-Nafjan, Abdulaziz Almudhi, Waleed Al-Nuwaiser

King Saud University, Riyadh, Saudi Arabia; Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia; King Khalid University, Abha, Saudi Arabia.


Stuttering is a widespread speech disorder affecting people globally, and it impacts effective communication and quality of life. Recent advancements in artificial intelligence (AI) and computational intelligence have introduced new possibilities for augmenting stuttering detection and treatment procedures. In this systematic review, the latest AI advancements and computational intelligence techniques in the context of stuttering are explored. By examining the existing literature, we investigated the application of AI in accurately determining and classifying stuttering manifestations. Furthermore, we explored how computational intelligence can contribute to developing innovative assessment tools and intervention strategies for persons who stutter (PWS). We reviewed and analyzed 14 refereed journal articles that were indexed on the Web of Science from 2019 onward. The potential of AI and computational intelligence in revolutionizing stuttering assessment and treatment, which can enable personalized and effective approaches, is also highlighted in this review. By elucidating these advancements, we aim to encourage further research and development in this crucial area, enhancing in due course the lives of PWS.

PMID: 38066778 PMCID: PMC10706171




Contemporary clinical conversations about stuttering: Neurodiversity and ableism - INFANTIL / SOCIAL

J Fluency Disord. 2023 Sep 19;78:106014. Online ahead of print.


Rosalee Shenker, Naomi Rodgers, Barry Guitar, Mark Onslow

Private Practice, Montreal, Canada; University of Iowa, IA, USA; University of Vermont, Vermont, USA; University of Technology Sydney, NSW, Australia.


Purpose: To discuss issues about neurodiversity and ableism, and how they pertain to clinical management of stuttering, with particular reference to early childhood stuttering.

Methods: During a webinar this year, the issue emerged of how concepts of neurodiversity and ableism apply to early childhood stuttering during the pre-school years. It became apparent that this topic elicited disparate views and would be of particular interest to students of speech-language pathology. Consequently, the leaders of that webinar continued the conversation by written dialogue for the purpose of placing it on record.

Results: The discussants reached agreement on many points, but there was some diversity of viewpoint about how neurodiversity and ableism should apply to clinical practice with children who have recently begun to stutter.

PMID: 37769595 DOI: 10.1016/j.jfludis.2023.106014




Cost of Illness and Health-Related Quality of Life for Stuttering: Two Systematic Reviews - CONCEITO

J Speech Lang Hear Res. 2023 Sep 26;1-18. Online ahead of print.


Alicia Norman et al

Macquarie University Business School, North Ryde, New South Wales, Australia; University of Technology Sydney, New South Wales, Australia; University of Oxford, United Kingdom.


Purpose: For those who stutter, verbal communication is typically compromised in social situations. This may attract negative responses from listeners and stigmatization by society. These have the potential to impair health-related quality of life across a range of domains, including qualitative and quantitative impacts on speech output, mental health issues, and failure to attain educational and occupational potential. These systematic reviews were designed to explore this matter using traditional health economics perspectives of utility measures and cost of illness.

Method: Studies were included if they involved children, adolescents, or adults with stuttering as a primary diagnosis. The quality of life search strategy identified 2,607 reports, of which three were included in the quality of life analysis. The cost of illness search strategy identified 3,778 reports, of which 39 were included in the cost of illness analysis.

Results: Two of the three studies included in the quality of life analysis had a high risk of bias. When measured using utility scores, quality of life for people who stutter was in the range of those reported for chronic health conditions such as diabetes mellitus, cardiovascular disease, and cancer. However, there is little such evidence of quality of life impairment during the preschool years. Studies included in the cost of illness analysis carried considerable risk of bias overall.

Conclusions: For people who stutter, there are substantive direct and indirect costs of illness. These include impairment, challenges, and distress across many domains throughout life, including income, education, employment, and social functioning. Evidence of quality of life impairment using utility measures is extremely limited. If this situation is not remedied, the lifetime impairment, challenges, and distress experienced by those who stutter cannot be documented in a form that can be used to influence health policy and health care spending.

PMID: 37751681 DOI: 10.1044/2023_JSLHR-23-00072





Delay frustration in children who do and do not stutter: A preliminary study - INFANTIL / EMOCIONAL

J Commun Disord. 2023 Dec 10:107:106403. Online ahead of print.


Kurt Eggers, Iris Heselmans

Ghent University, Belgium; Thomas More University College, Belgium; University of Turku, Finland..


Purpose: Frustration is an emotion often clinically reported by persons who stutter. So far, mainly questionnaire-based studies have reported findings related to increased frustration or decreased frustration tolerance. The aim of this preliminary study was to determine possible group differences between children who stutter (CWS) and children who do not stutter (CWNS) using a behavioral experimental task, as well as to evaluate possible associations with the frequency, duration, and physical concomitants of stuttering disfluencies.

Method: Participants were 13 CWS (mean age = 6;05 years) and 13 CWNS (mean age = 6;06 years), matched on age (±4 months) and gender. Frustration tolerance was assessed by the Delay Frustration task. This task includes normal delay, short delay, and long delay trials. Responses during long delay trials provide an indication of frustration tolerance and were recorded across time intervals during the response window.

Results: CWS, compared to CWNS, responded more frequently during the long delay trials, which is indicative of higher delay frustration. The variation in responding across time within intervals was similar for both groups. Decreased frustration tolerance was associated with increased duration of stuttered disfluencies and of physical concomitants.

Conclusions: In general, the current findings seem to provide support for earlier theoretical conceptualizations about the role of emotional reactivity in the development of stuttering.

PMID: 38101316 DOI: 10.1016/j.jcomdis.2023.106403




Delphi Survey of Items for the Test of Stuttering Screening in Children (TSSC) - AVALIAÇÃO

Clin Pract Epidemiol Ment Health. 2023 Jul 26:19

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10487328/pdf/CPEMH-19-E174501792305170.pdf


Aiswarya Liz Varghese, Radish Kumar Balasubramanium, Gagan Bajaj, Sudhin Karuppali, Unnikrishnan Bhaskaran

Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.


Purpose: Stuttering is a fluency disorder that mostly begins in childhood and affects many people in our societies. No standardized screening tools are available to check for stuttering in the Indian school-going population. Thus, the study aimed at developing a screening tool to identify children who stutter among the school-going population using a Delphi-based approach.

Methods: This study was carried out in four phases. During the first phase, five Speech Language Pathologists (SLPs) were asked about the need for screening and the nature & attributes of a stuttering screening test for school-going children. The second phase involved constructing appropriate stimuli for the screening tool based on expert opinion, relevant literature and students' academic textbooks. The third phase involved content validation of the speech elicitation stimuli by four teachers, five SLPs and an English Lecturer teaching in a university. The fourth phase encompassed the development of differential diagnosis criteria for stuttering identification in children using a rank analysis of the expert opinions.

Results: A stuttering screening stimuli comprising age, language and culture-specific reading, picture description and narration tasks for 1st to 10th-standard students was developed. The contents of the tool obtained satisfactory consensus of agreement among the panel of experts. Further, the tool outlined five critical diagnostic criteria which could differentially diagnose school-going children with stuttering from typically speaking counterparts using the developed material.

Conclusion: The developed screening tool could help practicing clinicians quickly identify stuttering in school-going populations. This would enable early identification and build up the statistical data to estimate the prevalence of stuttering among the school-going population. Further studies examining the psychometric properties of the developed test are in progress.

PMID: 37916211 PMCID: PMC10487328 DOI: 10.2174/17450179-v19-230615-2022-27




Dyslexia and Stuttering: An Overview of Processing Deficits and the Relationship Between Them - CONCEITO

Review Cureus. 2023 Oct 15;15(10):e47051.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644203/pdf/cureus-0015-00000047051.pdf


Sami A Algaidi, Amal M Sunyur, Khadija M Alshenqiti

Taibah University, Medina, SAU.


Stuttering and dyslexia are two processing deficits that have an impact on a person's social and academic lives, especially as they usually affect the pediatric population more than adults. Even though they affect different domains, they have similar characteristics in their pathogenesis, epidemiology, and impact on life. Both disorders represent a considerable percentage of the population worldwide and locally in Saudi Arabia, and they have similar epidemiological trends. Family history, genetic factors, early fetal and neonatal factors, and environmental factors are all identified as risk factors for both conditions. Moreover, it has been established that both diseases share a common genetic and anatomical basis, along with a mutual disruption of diadochokinetic skills. While rehabilitative techniques can be used in both conditions, stuttering could also benefit from pharmacological interventions. This review emphasizes that extensive research should be done to explore both of these conditions as they impact different areas of one's life and the relationship between them to better understand their pathophysiological origins.

PMID: 38021798 PMCID: PMC10644203 DOI: 10.7759/cureus.47051




Effectiveness of Stuttering Modification Treatment in School-Age Children Who Stutter: A Randomized Clinical Trial - INFANTIL / TERAPIA

J Speech Lang Hear Res. 2023 Oct 6:1-15. Online ahead of print.


Anke Kohmäscher, Annika Primaßin, Sabrina Heiler, Patricia Da Costa Avelar, Marie-Christine Franken, Stefan Heim

FH Münster University of Applied Sciences, Germany; RWTH Aachen University, Germany; Erasmus University Medical Centre, Rotterdam, the Netherlands; Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Germany.


Purpose: This study investigated the effectiveness of the stuttering modification intervention Kinder Dürfen Stottern (KIDS) in school-age children who stutter.

Method: Seventy-three children who stutter were included in this multicenter, two-group parallel, randomized, wait-list controlled trial with a follow-up of 12 months. Children aged 7-11 years were recruited from 34 centers for speech therapy and randomized to either the immediate-treatment group or the 3 months delayed-treatment group. KIDS was provided by 26 clinicians who followed a treatment manual. Although the primary outcome measure was the impact of stuttering (Overall Assessment of the Speaker's Experience of Stuttering-School-Age [OASES-S]), the secondary outcomes included objective and subjective data on stuttering severity.

Results: At 3 months postrandomization, the mean score changes of the OASES-S differed significantly between the experimental (n = 33) and control group (n = 29; p = .026). Furthermore, treatment outcomes up to 12 months were analyzed (n = 59), indicating large effects of time on the OASES-S score (p < .001, partial η2 = .324). This was paralleled by significant improvements in parental ratings and objective ratings (stuttering severity, frequency, and physical concomitants).

Conclusions: The significant short-term treatment effects in the OASES-S are in line with the (initial) focus of KIDS on cognitive and affective aspects of stuttering. Over 12 months, these changes were maintained and accompanied by behavioral improvements. The results suggest that individual treatment with KIDS is an adequate treatment option for this age group.

Supplemental material: https://doi.org/10.23641/asha.24207864.

PMID: 37801699 DOI: 10.1044/2023_JSLHR-23-00224




Expectations from stuttering therapy: Qualitative content analysis of client's perspective in Kannada-speaking adults who stutter - TERAPIA

J Commun Disord. 2023 Nov 5:107:106388. Online ahead of print.


Audrey J Dsouza, Vasupradaa Manivannan, Santosh Maruthy

All India Institute of Speech and Hearing, Manasagangothri, Mysore, India.


Purpose: The current study was carried out to explore clients' expectations from stuttering therapy using the qualitative content method in the Indian context.

Method: Twenty-one Kannada-speaking adults who stutter between the age range of 18-33 years participated in the study. The procedure involved three phases, including the formulation of semi-structured interview questions, data collection and analysis. Inductive content analysis was used to determine the categories and sub-categories arising from the participants verbatim. The frequency count of emerging sub-categories was completed, and the data was interpreted.

Results: The overall analysis of the data obtained from 21 participants generated three categories under the theme of expectations from speech therapy. The categories generated included beliefs and understanding of stuttering, stuttering and related behaviours, and goals and outcome of therapy.

Conclusion: Selecting personalised goals and techniques during therapy is necessary to improve client satisfaction. This study helps clinicians to understand the anticipatory beliefs of Kannada-speaking adults who stutter and educate them about achievable and realistic goals, leading to shared decision-making to ensure better quality of life and satisfaction in everyday speaking situations.

PMID: 37979437 DOI: 10.1016/j.jcomdis.2023.106388




Exploring participatory health research and its application to speech and language therapy research practices - OUTROS

Int J Lang Commun Disord. 2023 Dec 21. Online ahead of print.


Amy Connery, Jon Salsberg

Trinity College Dublin, Dublin, Ireland; University of Limerick, Limerick, Ireland.


Background: The role of participatory health research (PHR) is increasingly acknowledged by funding bodies, researchers and civil society globally; however, it continues to be under-represented in the speech and language therapy (SLT) research literature. This collaborative research approach is associated with the increased application of research evidence, and the generation of positive impacts in practice, policy, health systems and society.

Aims: To increase researchers' and other participatory partners' understanding of PHR, and to demonstrate its applicability to research in the SLT field.

Methods & procedures: This aim is achieved through a discussion on PHR, its principles, benefits and challenges, and the evaluation of its impact. A recently developed evaluation framework to support the implementation of best engagement practices is examined, and recommendations for how this framework can be used to plan and evaluate engagement in participatory stuttering research is presented.

Main contribution: This paper serves as an important conversation on the value of PHR to SLT research, and presents guidance to support its increased implementation in this research field.

Conclusions & implications: Conclusions & Implications: PHR remains an under-represented research approach in the SLT literature, despite increasing evidence demonstrating its effectiveness and value. It offers a potential solution to the research-practice gap, and challenges the ongoing research hierarchies by democrating the process of knowledge production.

PMID: 38130139 DOI: 10.1111/1460-6984.12994




Eye movement as a simple, cost-effective tool for people who stutter: A case study - TERAPIA

Randomized Controlled Trial S Afr J Commun Disord. 2023 Aug 31;70(1)


Hilary D-L McDonagh, Patrick Broderick, Kenneth Monaghan

Faculty of Science, Atlantic Technological University, Sligo.


Background: Access to services remains the biggest barrier to helping the most vulnerable in the South African Stuttering Community. This novel stuttering therapy, harnessing an unconscious link between eye and tongue movement, may provide a new therapeutic approach, easily communicated and deliverable online.

Objectives: This study provides both objective and subjective assessments of the feasibility of this intervention. Assessment tools holistically address all components of stuttering in line with comprehensive treatment approaches: core behaviours, secondary behaviours, anticipation and reactions.

Method: On receipt of ethical approval, this single-subject case design recruited one adult (21-year-old) male with a developmental stutter (DS). The participant gave informed consent and completed four scheduled assessments: baseline, after 5-week training, 3 months post-intervention and 24 months post-completion. The study used objective assessment tools: Stuttering Severity Instrument-4 (SSI-4); Subjective-assessment tools: SSI-4 clinical use self-report tool (CUSR); Overall Assessment of Speaker's Experience of Stuttering (OASES-A); Premonitory Awareness in Stuttering (PAiS) and Self-Report Stuttering Severity* (SRSS) (*final assessment).

Results: The participant's scores improved across all assessment measures, which may reflect a holistic improvement. The participant reported that the tool was very useful. There were no negative consequences.

Conclusion: This case report indicates that this innovative treatment may be feasible. No adverse effects were experienced, and the treatment only benefited the participant. The results justify the design of a pilot randomised feasibility clinical trial. Contribution: The results indicate that this is a needed breakthrough in stuttering therapy as the instructions can be easily translated into any language. It can also be delivered remotely reducing accessibility barriers.

PMID: 37782243 DOI: 10.4102/sajcd.v70i1.968




Functional Speech and Voice Disorders: Approaches to Diagnosis and Treatment - CONCEITO

Review Neurol Clin. 2023 Nov;41(4):635-646. Epub 2023 Apr 20.

Keywords: (…) Psychogenic stutter (…)


Jennifer L Freeburn, Janet Baker

Massachusetts General Hospital, Boston, MA, USA; Flinders University, Adelaide, Randwick, NSW, Australia.


Historically, formal training for speech-language therapists (SLTs) in the area of functional speech and voice disorders (FSVD) has been limited, as has the body of empirical research in this content area. Recent efforts in the field have codified expert opinions on best practices for diagnosing and treating FSVD and have begun to demonstrate positive treatment outcomes. To provide comprehensive interventions for these complex conditions at the intersection of neurology, psychiatry, and other medical specialties, the SLT must not only build knowledge of diagnostic strategies and components of symptomatic treatment in FSVD but also embrace behavior change techniques and counseling strategies.

PMID: 37775195 DOI: 10.1016/j.ncl.2023.02.005




Gabapentin-Associated Movement Disorders: A Literature Review - FARMACOLOGIA

Review Medicines (Basel). 2023 Sep 6;10(9):52.


Jamir Pitton Rissardo, Ursula Medeiros Araujo de Matos, Ana Letícia Fornari Caprara

Cooper University Hospital, Camden, NJ, USA; Medicine Department, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Medicine Department, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.


Background: Gabapentin (GBP)-induced movement disorders (MDs) are under-recognized adverse drug reactions. They are commonly not discussed with patients, and their sudden occurrence can lead to misdiagnosis. This literature review aims to evaluate the clinical-epidemiological profile, pathological mechanisms, and management of GBP-associated MD.

Methods: Two reviewers identified and assessed relevant reports in six databases without language restriction between 1990 and 2023.

Results: A total of 99 reports of 204 individuals who developed a MD associated with GBP were identified. The MDs encountered were 135 myoclonus, 22 dyskinesias, 7 dystonia, 3 akathisia, 3 stutterings, 1 myokymia, and 1 parkinsonism. The mean and median ages were 54.54 (SD: 17.79) and 57 years (age range: 10-89), respectively. Subjects were predominantly male (53.57%). The mean and median doses of GBP when the MD occurred were 1324.66 (SD: 1117.66) and 1033 mg/daily (GBP dose range: 100-9600), respectively. The mean time from GBP-onset to GBP-associated MD was 4.58 weeks (SD: 8.08). The mean recovery time after MD treatment was 4.17 days (SD: 4.87). The MD management involved GBP discontinuation. A total of 82.5% of the individuals had a full recovery in the follow-up period.

Conclusions: Myoclonus (GRADE A) and dyskinesia (GRADE C) were the most common movement disorders associated with GBP.

PMID: 37755242 DOI: 10.3390/medicines10090052




Hand Preference in Stuttering: Meta-Analyses - PSICOMOTOR

Review Neuropsychol Rev. 2023 Oct 5. Online ahead of print.


Marietta Papadatou-Pastou, Anastasia-Konstantina Papadopoulou, Christos Samsouris, Annakarina Mundorf, Maria-Myrto Valtou, Sebastian Ocklenburg

National and Kapodistrian University of Athens, Athens, Greece; Academy of Athens, Athens, Greece; MSH Medical School Hamburg, Hamburg, Germany; University Bochum, Bochum, Germany.


Reduced hemispheric asymmetries, as well as their behavioral manifestation in the form of atypical handedness (i.e., non-right, left-, or mixed-handedness), are linked to neurodevelopmental disorders, such as autism spectrum disorder, and several psychiatric disorders, such as schizophrenia. One neurodevelopmental disorder that is associated with reduced hemispheric asymmetries, but for which findings on behavioral laterality are conflicting, is stuttering. Here, we report a series of meta-analyses of studies that report handedness (assessed as hand preference) levels in individuals who stutter (otherwise healthy) compared to controls. For this purpose, articles were identified via a search in PubMed, Scopus, and PsycInfo (13 June 2023). On the basis of k = 52 identified studies totaling n = 2590 individuals who stutter and n = 17,148 controls, five random effects meta-analyses were conducted: four using the odds ratio [left-handers (forced choice); left-handers (extreme); mixed-handers; non-right-handers vs. total)] and one using the standardized difference in means as the effect size. We did not find evidence of a left (extreme)- or mixed-handedness difference or a difference in mean handedness scores, but evidence did emerge, when it came to left-handedness (forced-choice) and (inconclusively for) non-right-handedness. Risk-of-bias analysis was not deemed necessary in the context of these meta-analyses. Differences in hand skill or strength of handedness could not be assessed as no pertinent studies were located. Severity of stuttering could not be used s a moderator, as too few studies broke down their data according to severity. Our findings do not allow for firm conclusions to be drawn on whether stuttering is associated with reduced hemispheric asymmetries, at least when it comes to their behavioral manifestation.

PMID: 37796428 DOI: 10.1007/s11065-023-09617-z




"I Just Want People to Think I'm Normal": An Interview Study of Young Swedish Women With Covert Stuttering - SOCIAL

Am J Speech Lang Pathol. 2023 Aug 18;1-19. Online ahead of print.


Ineke Samson, Jill Nyberg, Elisabeth Lindström, Ellika Schalling

Karolinska Institutet, Stockholm, Sweden; Danderyd Hospital, Stockholm, Sweden; Åbo Akademi University, Turkku, Finland; Uppsala University, Sweden.


Purpose: Research indicates that there is a tendency for females who stutter, more often than males, to use coping strategies that involve covering their stutter, for example, by avoiding situations that require verbal participation. The aim of the study is to increase knowledge about how covert stuttering develops and its impact on self-image and quality of life for women who stutter.

Method: Eleven young women who stutter covertly were interviewed, and data were subjected to qualitative content analysis. Background information was obtained from the self-report instruments measuring the impact of stuttering on different aspects of life (Overall Assessment of the Speaker's Experiences of Stuttering) and degree of perceived social anxiety (Liebowitz Social Anxiety Scale, Self-Report).

Results: Three main themes were identified: (a) managing stuttering, (b) personal aspects, and (c) stuttering as a phenomenon. Shame and a desire to fit in emerged as distinct motives for covering stuttering. The women described that stuttering controlled both life choices and everyday life. Development of self-image had been strongly negatively affected, resulting in social anxiety. The women expressed a particular vulnerability of being a woman who stutters, due to societal norms of female behavior and a lack of female role models who stutter.

Conclusions: The choice of coping strategy was motivated by a desire to "be normal." As a result, stuttering had come to dominate life and affect self-image and life choices. The study highlights the importance for clinicians to be alert to and aware of the fact that the experiences of women who stutter can lead them to develop coping strategies that have far-reaching negative consequences.

PMID: 37595785 DOI: 10.1044/2023_AJSLP-22-00354




Improving specificity of stimulation-based language mapping in stuttering glioma patients: A mixed methods serial case study – OUTRAS ÁREAS

Heliyon. 2023 Nov 7;9(11):e21984.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692765/pdf/main.pdf


Leonie Kram, Beate Neu, Axel Schröder, Bernhard Meyer, Sandro M Krieg, Sebastian Ille

Technical University of Munich, Germany; Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Germany.


Objective: Stimulation-based language mapping relies on identifying stimulation-induced language disruptions, which preexisting speech disorders affecting the laryngeal and orofacial speech system can confound. This study ascertained the effects of preexisting stuttering on pre- and intraoperative language mapping to improve the reliability and specificity of established language mapping protocols in the context of speech fluency disorders.

Method: Differentiation-ability of a speech therapist and two experienced nrTMS examiners between stuttering symptoms and stimulation-induced language errors during preoperative mappings were retrospectively compared (05/2018-01/2021). Subsequently, the impact of stuttering on intraoperative mappings was evaluated in all prospective patients (01/2021-12/2022).

Results: In the first part, 4.85 % of 103 glioma patients stuttered. While both examiners had a significant agreement for misclassifying pauses in speech flow and prolongations (Κ ≥ 0.50, p ≤ 0.02, respectively), less experience resulted in more misclassified stuttering symptoms. In one awake surgery case within the second part, stuttering decreased the reliability of intraoperative language mapping. Comparison with Existing Method(s): By thoroughly differentiating speech fluency symptoms from stimulation-induced disruptions, the reliability and proportion of stuttering symptoms falsely attributed to stimulation-induced language network disruptions can be improved. This may increase the consistency and specificity of language mapping results in stuttering glioma patients.

Conclusions: Preexisting stuttering negatively impacted language mapping specificity. Thus, surgical planning and the functional outcome may benefit substantially from thoroughly differentiating speech fluency symptoms from stimulation-induced disruptions by trained specialists.

PMID: 38045205 PMCID: PMC10692765




Language sample analysis of conversation samples from school-age children who stutter: The role of syntactic factors in stuttering - INFANTIL / LINGUAGEM

J Commun Disord. 2023 Sep 6;106:106369. Online ahead of print.


Jayanthi Sasisekaran, Shriya Basu

University of Minnesota Twin Cities, Minneapolis, MN, United States; California State University Long Beach, CA, United States.


Introduction: The purpose of the study was to compare school-age children who stutter (CWS) and age-matched children who do not stutter (CWNS) in syntactic abilities and syntactic performance.

Methods: Computerized Language Sample Analysis (LSA) was conducted on the conversation samples obtained from 46 school-age CWS and CWNS between 7 and 16 years (CWS, n = 23). Syntactic abilities were assessed using the Index of Productive Syntax (the IPsyn) and Developmental Sentence Scores (DSS) and mixed effects logistic regression analyses with participants as random effects were conducted to determine if the scores were predictive of group membership. Additionally, the groups were compared in the IPsyn subcategories to assess the use of syntactic structures. Syntactic performance was assessed by: (a) Categorizing the sentences from each conversation sample into high vs. low syntactic complexity categories based on DSS scores and comparing the sentence categories in % stuttered sentences (% SS); and (b) Comparing the groups in the proportion of phrase-level disfluencies (phrase repetitions vs. revisions) that are associated with syntactic planning.

Results: In terms of syntactic abilities, the IPsyn scores interacted with the number of utterances (sample size) used to compute the scores in predicting group membership. In comparison to the CWNS, the CWS obtained higher scores in the IPsyn and the sentence structure subcategory of the IPsyn that were independent of sample size. In terms of syntactic performance: (a) Significantly more sentences were stuttered in the high compared to the low syntactic sentence category; (b) Compared to the CWNS who demonstrated significantly more phrase revisions, the CWS showed comparable and fewer phrase revisions and repetitions. Additionally, post-hoc analysis showed that the CWS used significantly elaborated noun phrases and a similar trend was evident for verb phrase elaborations. A significant association between verb phrase elaborations and%SS was also obtained.

Conclusions: Findings from the IPsyn and the use of elaborate noun phrases, and to some extent verb phrases, suggested that the CWS used more complex syntax even in shorter conversational samples. More stuttered sentences in the high DSS sentence category, the use of fewer phrase revisions, and the association between stuttering and elaborated verb phrases in the CWS are interpreted to suggest the effects of syntactic planning and reformulation demands on fluency during ongoing articulation.

PMID: 37699262 DOI: 10.1016/j.jcomdis.2023.106369




Linguistic features of stuttering during spontaneous speech - FALA

J Fluency Disord. 2023 Sep 30:78:106016. Online ahead of print.


Haley J Warner, Ravi Shroff, Arianna Zuanazzi, Richard M Arenas, Eric S Jackson

New York University, New York, NY. USA; University of New Mexico, Albuquerque, NM, USA.


Purpose: Previous work shows that linguistic features (e.g., word length, word frequency) impact the predictability of stuttering events. Most of this work has been conducted using reading tasks. Our study examined how linguistic features impact the predictability of stuttering events during spontaneous speech.

Methods: The data were sourced from the FluencyBank database and consisted of interviews with 35 adult stutterers (27,009 words). Three logistic regression mixed models were fit as the primary analyses: one model with four features (i.e., initial phoneme, grammatical function, word length, and word position within a sentence), a second model with six features (i.e., the features from the previous model plus word frequency and neighborhood density), and a third model with nine features (i.e., the features from the previous model plus bigram frequency, word concreteness, and typical age of word acquisition). We compared our models using the Area Under the Curve statistic.

Results: The four-feature model revealed that initial phoneme, grammatical function, and word length were predictive of stuttering events. The six-feature model revealed that initial phoneme, word length, word frequency, and neighborhood density were predictive of stuttering events. The nine-feature model was not more predictive than the six-feature model.

Conclusion: Linguistic features that were previously found to be predictive of stuttering during reading were predictive of stuttering during spontaneous speech. The results indicate the influence of linguistic processes on the predictability of stuttering events such that words associated with increased planning demands (e.g., longer words, low frequency words) were more likely to be stuttered.

PMID: 37852018 DOI: 10.1016/j.jfludis.2023.106016




Meta-analysis of structural integrity of white matter and functional connectivity in developmental stuttering - NEUROCIÊNCIAS

Review Brain Res Bull. 2023 Dec:205:110827. Epub 2023 Nov 25.

Free article: https://www.sciencedirect.com/science/article/pii/S0361923023002526?via%3Dihub


Kengo Matsuhashi, Takashi Itahashi, Ryuta Aoki, Ryu-Ichiro Hashimoto

Tokyo Metropolitan University, Tokyo, Japan; Showa University, Tokyo, Japan.


Developmental stuttering is a speech disfluency disorder characterized by repetitions, prolongations, and blocks of speech. While a number of neuroimaging studies have identified alterations in localized brain activation during speaking in persons with stuttering (PWS), it is unclear whether neuroimaging evidence converges on alterations in structural integrity of white matter and functional connectivity (FC) among multiple regions involved in supporting fluent speech. In the present study, we conducted coordinate-based meta-analyses according to the PRISMA guidelines for available publications that studied fractional anisotropy (FA) using tract-based spatial statistics (TBSS) for structural integrity and the seed-based voxel-wise FC analyses. The search retrieved 11 publications for the TBSS FA studies, 29 seed-based FC datasets from 6 publications for the resting-state, and 29 datasets from 6 publications for the task-based studies. The meta-analysis of TBSS FA revealed that PWS exhibited FA reductions in the middle and posterior segments of the left superior longitudinal fasciculus. Furthermore, the analysis of resting-state FC demonstrated that PWS had reduced FC in the right supplementary motor area and inferior parietal cortex, whereas an increase in FC was observed in the left cerebellum crus I. Conversely, we observed increased FC for task-based FC in regions implicated in speech production or sequential movements, including the anterior cingulate cortex, posterior insula, and bilateral cerebellum crus I in PWS. Functional network characterization of the altered FCs revealed that the sets of reduced resting-state and increased task-based FCs were largely distinct, but the somatomotor and striatum/thalamus networks were foci of alterations in both conditions. These observations indicate that developmental stuttering is characterized by structural and functional alterations in multiple brain networks that support speech fluency or sequential motor processes, including cortico-cortical and subcortical connections.

PMID: 38013029 DOI: 10.1016/j.brainresbull.2023.110827




Mothers' and fathers' attitudes toward stuttering in the Middle East compared to Europe and North America - INFANTIL / AMBIENTE

Int J Lang Commun Disord. 2023 Sep 16. Online ahead of print.


Stephanie Hughes, Lejla Junuzovic-Zunic, Eman Mostafa, Mary Weidner, R Sertan Özdemir, Derek E Daniels, Haley Glover, Ayşenur Göksu, Ahmet Konrot, Kenneth O St Louis

ABC Stuttering Services, Auburn, Michigan, USA; Faculty of Education and Rehabilitation, University of Tuzla, Tuzla, Bosnia and Herzegovina; Phoniatric Unit, Ear, Nose and Throat Department, Sohag University Hospital, Sohag, Egypt; Pennsylvania Western University Edinboro, Edinboro, Pennsylvania, USA; Istanbul Medipol University, İstanbul, Türkiye; Wayne State University, Detroit, Michigan, USA; West Virginia Birth to Three, Morgantown, West Virginia, USA; Üsküdar University, İstanbul, Türkiye; West Virginia University, Morgantown, West Virginia, USA.


Background: Parents play a central role in the treatment of childhood stuttering. Addressing parental attitudes toward stuttering is helpful therapeutically. The extent to which differences in attitudes toward stuttering exist on the basis of sex, geographical region and parental status (e.g., parent of a stuttering child, parent of a nonstuttering child, nonparent) is unclear. Many studies investigating such factors have used the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) questionnaire. A large POSHA-S database has collected responses from over 20 000 people from 49 countries.

Aims: The aim of this study was to use the POSHA-S database to examine the extent to which the following variables influence attitudes toward stuttering: (a) parents' sex (mothers vs. fathers), (b) geographic region (Middle East vs. Europe and North America), (c) parents' children (stuttering vs. nonstuttering) and (d) parental status (parents versus nonparents).

Methods & procedures: Data used in this study were extracted from selected, relevant studies that administered the POSHA-S to respondents. The Overall Stuttering Scores were compared on the basis of sex and parent status (i.e., mothers and fathers; nonparent women and men) and were then compared within and across the two geographical areas. Group comparisons were performed using analysis of variance followed by independent t tests, and Cohen's d was calculated to determine effect sizes.

Outcomes & results: Statistically significant differences were observed upon the basis of geographical region. In general, male parents and nonparents tend to have more positive stuttering attitudes among the Middle Eastern samples while female parents and nonparents tend to show more positive attitudes in European and North American samples in the POSHA-S database. Effect sizes were small for all comparisons.

Conclusions & implications: The effect of geographic region and culture may predict sex-based differences among mothers' and fathers' attitudes toward stuttering; however, the clinical significance is unclear. Additional research is needed to better understand how children who stutter are affected by their parents' attitudes toward stuttering.

PMID: 37715532 DOI: 10.1111/1460-6984.12952




Multilingualism and neurodevelopmental disorders [Editorial] - LINGUAGEM

eCollection 2023.

Free full text: https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1267023/full


Ai Leen Choo, Sara Smith, Amy Pratt, Sibylla Leon Guerrero

Georgia State University, Atlanta, GA, United States; University of South Florida, Tampa, FL, United States; University of Cincinnati, Cincinnati, OH, United States; University of California, Irvine, Irvine, CA, United States.


No abstract available

PMID: 37655193 PMCID: PMC10466220




Neural oscillatory activity and connectivity in children who stutter during a non-speech motor task - INFANTIL / PSICOMOTOR

J Neurodev Disord. 2023 Nov 15;15(1):40.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10647051/pdf/11689_2023_Article_9507.pdf


Valeria C Caruso, Amanda Hampton Wray, Erica Lescht, Soo-Eun Chang

University of Michigan, Ann Arbor, MI, US; University of Pittsburgh, Pittsburgh, PA, USA; Ewha Womans University, Seoul, South Korea.


Background: Neural motor control rests on the dynamic interaction of cortical and subcortical regions, which is reflected in the modulation of oscillatory activity and connectivity in multiple frequency bands. Motor control is thought to be compromised in developmental stuttering, particularly involving circuits in the left hemisphere that support speech, movement initiation, and timing control. However, to date, evidence comes from adult studies, with a limited understanding of motor processes in childhood, closer to the onset of stuttering.

Methods: We investigated the neural control of movement initiation in children who stutter and children who do not stutter by evaluating transient changes in EEG oscillatory activity (power, phase locking to button press) and connectivity (phase synchronization) during a simple button press motor task. We compared temporal changes in these oscillatory dynamics between the left and right hemispheres and between children who stutter and children who do not stutter, using mixed-model analysis of variance.

Results: We found reduced modulation of left hemisphere oscillatory power, phase locking to button press and phase connectivity in children who stutter compared to children who do not stutter, consistent with previous findings of dysfunction within the left sensorimotor circuits. Interhemispheric connectivity was weaker at lower frequencies (delta, theta) and stronger in the beta band in children who stutter than in children who do not stutter.

Conclusions: Taken together, these findings indicate weaker engagement of the contralateral left motor network in children who stutter even during low-demand non-speech tasks, and suggest that the right hemisphere might be recruited to support sensorimotor processing in childhood stuttering. Differences in oscillatory dynamics occurred despite comparable task performance between groups, indicating that an altered balance of cortical activity might be a core aspect of stuttering, observable during normal motor behavior.

PMID: 37964200 PMCID: PMC10647051 DOI: 10.1186/s11689-023-09507-8




New insights into the genetics of stuttering - Editorial - GENÉTICA

Brain. 2023 Dec 1;146(12):4788-4790. doi: 10.1093/brain/awad369.


Pierre Szepetowski

Aix-Marseille University, Marseille, France.


No abstract available

Comment on

Stuttering associated with a pathogenic variant in the chaperone protein cyclophilin 40.

Morgan AT, et al



Norwegian speech-language pathologists treatment practices for preschool children who stutter: An explorative study - INFANTIL / TERAPIA

J Fluency Disord. 2023 Aug 5;77:105999. Online ahead of print.


Melanie Kirmess, Linn Stokke Guttormsen, Hilde Hofslundsengen, Kari-Anne Bottegaard Næss, Elaina Kefalianos

University of Oslo, Oslo, Norway; Oslo Metropolitan University Oslo, Norway; Western Norway University of Applied Sciences, Sogndal, Norway; University of Melbourne, Parkville, Australia.


Purpose: This study investigated the treatment practices of speech-language pathologists (SLPs) with preschool children who stutter to explore variations in service delivery and, consequently to better inform and support evidence-based practice.

Method: 121 Norwegian SLPs completed an online survey about stuttering treatment for preschool children aged up to six years. They reported on treatment training, choices, setting, dosage, and outcomes. Data was analysed descriptively. Correlation analyses between years of clinical experience and clinician perceived outcomes were conducted.

Result: Sixty-eight percent of SLPs were trained in one or more stuttering treatment programs. The majority of SLPs (83 %) provided treatment in person in preschool centers; 59 % reported providing treatment once a week. Thirty-four percent of SLPs reported that they often or always delivered the whole treatment program. Treatment practice addressed various elements, including advising parents about language and communication strategies, supporting the child's self-image, and perceived outcomes. The SLPs reported their clinician perceived outcomes as 'always' or 'often' reduction of audible stuttering (70 %), reduced cognitive and emotional reactions (55 %), and improved communication skills (58 %). Factors influencing treatment choices were identified at the systemic level (e.g., work place regulations) and individual level (e.g., SLPs competency, child's best).

Conclusion: Stuttering treatment services in Norway differ from those reported in existing literature as treatment is given in preschool settings, only 34 % of SLPs deliver programs as intended whilst the majority use treatment elements only, and still experience positive changes. Provision is variable, and seems influenced by SLP training and competence.

PMID: 37562079 DOI: 10.1016/j.jfludis.2023.105999




Perceptions and experiences of Australian speech-language pathologists who use the Lidcombe Program with children who stutter - INFANTIL / LIDCOMBE

Int J Speech Lang Pathol. 2023 Sep 9;1-12. Online ahead of print.


Kate Bridgman, Shane Erickson

La Trobe University, Bundoora, Australia.


Purpose: Speech-language pathologists (SLPs) have varying levels of training and experience working with children who stutter (CWS). They often work in contexts and populations that require clinical management to take them beyond the borders of translating clinical trial protocols and evidence-based practice (EBP). This study sought to investigate the clinical experiences of Australian SLPs working with CWS, including their Lidcombe Program confidence and practices. Method: A cross-sectional online survey was completed by 215 Australian SLPs during 2017-2020. They were recruited prior to attending one of 14 workshops hosted by Speech Pathology Australia (SPA). Result: Participants worked in a range of contexts and were from all states and territories. The majority assessed and/or treated up to five CWS annually. Six predictor variables were considered for self-reported clinical confidence. The quantitative analysis identified that an SLP's previous training, reading the SPA stuttering management clinical guideline, and the annual number of CWS treated were found to significantly impact self-reported clinical confidence. Themes included: (1) client, family, service, and context factors that influence clinical decision-making; (2) SLP areas of clinical strength and aspects of paediatric stuttering management requiring further development; and (3) factors that impact Lidcombe Program success and modifications. Conclusion: This study has found that Australian SLPs working with CWS identify a range of important factors that impact their practice.

PMID: 37688534 DOI: 10.1080/17549507.2023.2241677





Perfil da fluência na fala espontânea, leitura e no reconto de textos de adultos que gaguejam - AVALIAÇÃO

Codas. 2023 Sep 25;35(5)

Free article :

Portuguese: https://www.scielo.br/j/codas/a/vYfZkQ8mQXQRgmP74LDs7tr/?format=pdf&lang=pt

English: https://www.scielo.br/j/codas/a/vYfZkQ8mQXQRgmP74LDs7tr/?format=pdf&lang=en


Samuel Lopes da Silva, Luciana Mendonça Alves, Denise Brandão de Oliveira E Britto

Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil.


Objetivo: descrever o perfil da fluência em relação à tipologia das disfluências, velocidade e frequência de rupturas na fala espontânea, na leitura e no reconto; comparar o perfil da fluência em adultos que gaguejam na fala espontânea, na leitura e no reconto de texto.

Método: O trabalho é um estudo transversal comparativo com amostra composta por 15 adultos que gaguejam de ambos os sexos, com formação superior ou equivalente ao ensino fundamental II completo. Foram coletadas amostras nas tarefas de fala espontânea, leitura e reconto de texto por meio de video chamadas realizadas individualmente. As 200 primeiras sílabas expressas de cada tarefa foram transcritas e analisadas segundo o Protocolo de Avaliação do Perfil da Fluência (PAPF). O estudo comparou a frequência das disfluências comuns e gagas e a velocidade nas tarefas pesquisadas. Adotou-se o teste de Kruskal & Wallis em conjunto com o de comparações múltiplas de Duncan para comparar as medianas e verificar possíveis diferenças entre as tarefas pesquisadas com nível de significância de 5%.

Resultados: A tarefa de leitura apresentou menor número de disfluências comuns e percentual de descontinuidade de fala em relação às tarefas de fala espontânea e reconto. Não foram encontradas diferenças estatisticamente significantes entre as disfluências gagas nas três tarefas pesquisadas.


Este trabalho mostrou que existem diferenças na ocorrência das disfluências comuns - hesitações, interjeições e revisões - e no percentual de descontinuidade de fala durante a leitura oral de adultos que gaguejam em relação à fala espontânea e ao reconto de texto.




Predictors of Functional Communication Outcomes in Children With Idiopathic Motor Speech Disorders - OUTRAS ÁREAS

J Speech Lang Hear Res. 2023 Sep 6;1-16. Online ahead of print.


Aravind K Namasivayam, Hyunji Shin, Rosane Nisenbaum, Margit Pukonen, Pascal van Lieshout

University of Toronto, Ontario, Canada; Speech Research Centre, Toronto, Ontario, Canada; Unity Health Toronto, Ontario, Canada; The Speech and Stuttering Institute, Toronto, Ontario, Canada.


Purpose: The purpose of the study was to investigate child- and intervention-level factors that predict improvements in functional communication outcomes in children with motor-based speech sound disorders.

Method: Eighty-five preschool-age children with childhood apraxia of speech (n = 37) and speech motor delay (n = 48) participated. Multivariable logistic regression models estimated odds ratios and 95% confidence intervals for the association between minimal clinically important difference in the Focus on the Outcomes of Communication Under Six scores and multiple child-level (e.g., age, sex, speech intelligibility, Kaufman Speech Praxis Test diagnostic rating scale) and intervention-level predictors (dose frequency and home practice duration).

Results: Overall, 65% of participants demonstrated minimal clinically important difference changes in the functional communication outcomes. Kaufman Speech Praxis Test rating scale was significantly associated with higher odds of noticeable change in functional communication outcomes in children. There is some evidence that delivering the intervention for 2 times per week for 10 weeks provides benefit.

Conclusion: A rating scale based on task complexity has the potential for serving as a screening tool to triage children for intervention from waitlist and/or determining service delivery for this population.

PMID: 37672787 DOI: 10.1044/2023_JSLHR-23-00070




Predictors of public attitudes in Saudi Arabia toward people who stutter - SOCIAL

PLoS One. 2023 Dec 21;18(12):e0295029.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10734922/pdf/pone.0295029.pdf


Nisreen Naser Al Awaji, Reem Fouzan Alfouzan, Afnan Razen Almutairi, Eman M Mortada

Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.


Purpose: The Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) was used to measure the attitudes of the general population in Saudi Arabia toward people who stutter (PWS) and to identify the predictors of the overall stuttering score (OSS).

Method: A total of 404 adults from Saudi Arabia (16.8% male and 83.2% female) completed an online POSHA-S questionnaire.

Results: The attitudes of adults in Saudi Arabia were similar to those of other samples worldwide. Working status, income, and multilingualism were substantial predictors of the OSS.

Conclusion: Saudi adults have positive impressions, beliefs, and self-reactions to PWS. However, their knowledge of stuttering tends to be limited. Therefore, campaigns conducted to raise awareness of stuttering should adopt the most widely used sources of knowledge in the Saudi Arabian community (i.e., the Internet and social media). Sociodemographic variables predictive of positive versus negative OSS include working status and multilingualism. Unpredictive variables, that do not predict positive versus negative OSS, include age, gender, education, parental status, health, abilities, and income.

PMID: 38127923 PMCID: PMC10734922




Preferred Communication Strategies for People with Communication Disabilities in Health Care Encounters: a Qualitative Study - SOCIAL

J Gen Intern Med. 2023 Nov 27. Online ahead of print.


Erin Hickey et al

University of Illinois at Chicago, Chicago, IL, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA; University of Colorado, Aurora, CO, USA.


Background: People with communication disabilities (CDs), which includes disabilities in speech, language, voice and/or hearing, experience health and healthcare disparities. A barrier to accessing high-quality, equitable care is the lack of effective communication between patients and their providers.

Objective: In designing a patient-prompted tool to facilitate communication, we analyzed qualitative feedback on communication strategies and the experience of people with CDs, caregivers, and providers in healthcare encounters. We aimed to describe communication strategies that patients with CDs find most useful and optimize a tool for patients to share their communication strategy preferences during clinical encounters. While patient-provider communication is paramount in every interaction, we aimed to highlight the intricacies of optimizing communication for this population.

Design: We performed a qualitative study utilizing focus groups and interviews with patients with CDs, their caregivers, and healthcare providers.

Participants: A total of 46 individuals participated in focus groups or interviews; 26 participants self-reported a CD, nine were caregivers, and 11 were providers. Participants represented diverse types of CDs, including stuttering, aphasia, hearing loss, and people with autism or cerebral palsy who use assistive technology to communicate.

Approach: Analysis of qualitative interview and focus group data was guided by a qualitative content analysis approach.

Key results: We identified three themes: (1) While communication strategies should be individualized, participants agreed upon a consolidated list of best strategies and accommodations. We used this consolidated list to finalize tool development. (2) Patients and providers preferred disclosure of the CD and desired communication strategies before the appointment. (3) Providers often do not use communication strategies and accommodations during clinical encounters.

Conclusions: For patients with CDs, it is critical to acknowledge and document the CD and individualize communication strategies during healthcare visits to facilitate communication. Studies are needed to evaluate whether improved communication strategy usage leads to improved health outcomes for this population.

PMID: 38010462 DOI: 10.1007/s11606-023-08526-4




Prevalence, comorbidities, and profiles of neurodevelopmental disorders according to the DSM-5-TR in children aged 6 years old in a European region – INFANTIL / CONCEITO

Front Psychiatry. 2023 Nov 10:14:1260747.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10667691/pdf/fpsyt-14-1260747.pdf


Lorena Francés, Antoni Ruiz, C Virgínia Soler, Joan Francés, Jessica Caules, Amaia Hervás , Carolina Carretero, Bárbara Cardona, Elizabeth Quezada, Alberto Fernández, Javier Quintero

Universidad Complutense de Madrid, Madrid, Spain; University of Barcelona, Barcelona, Spain; Dalt Sant Joan Center, Mahón, Spain; Miguel Hernández University, Elche, Spain; Arrels Institute, Ciutadella de Menorca, Spain; Mutua Terrasa University Hospital, Terrassa, Catalonia, Spain; Autonomous University of Barcelona, Bellaterra, Catalonia, Spain; Saint George Hospital, London, United Kingdom; Maudsley Hospital, London, United Kingdom; UCSMIA, UBS Es Mercadal, Menorca, Spain; UBS Es Castell, Menorca, Spain; Canal Salat, Ciutadella de Menorca, Spain.

13Psychiatry Department of Complutense University of Madrid, Madrid, Spain; Psychiatry Service of Infanta Leonor Hospital, Madrid, Spain.


Background: There are no studies that measure the prevalence and real comorbidities of neurodevelopmental disorders (NDDs) according to the DSM-5-TR in 6-year-old children in population and clinical samples or studies that measure them as a whole. The data on the prevalence of these disorders are usually disparate because of the estimation methods (direct/indirect), the type of sample (population/clinical/school), and the ages studied.

Methods: The initial sample (289 subjects) was representative of 6-year-old children in the entire population of Menorca, obtained from pediatric primary care services (100% of the sample). The patients were divided into two groups based on the criterion of verification of clinical warning signs. One of the groups represented the clinical or experimental sample (EG) (81 subjects) at risk of NDDs; the other group was considered the control sample (CG) (210 subjects), and they were subjects without risk of suffering NDDs. A direct clinical assessment of the clinical sample was carried out, and they were administered the Wechsler Intelligence Scale for Children (WISC-V), the Clinical Evaluation of Language Fundamentals (CELF-5), the Battery for the evaluation of the processes of revised reading (Batería para la evaluación de los procesos de lectura revisada - PROLEC-R), the Test for the Diagnosis of Basic Mathematical Competences, (TEDI-MATH), and the Developmental Coordination Disorder Questionnaire (DCDQ).

Results: A total of 21.5% of the initial sample suffered from an NDD. A total of 2.4% presented autism spectrum disorder (ASD); 14% presented attention-deficit hyperactivity disorder (ADHD); 0.34% presented mild intellectual disability; 9.54% presented communication disorder (CD) (5.8% language disorder, 3.4% phonological disorder, and 0.34% stuttering); 10% presented learning disorder with reading difficulties; 5.8% presented learning disorder with difficulties in writing; 3.11% presented learning disorder with difficulties in mathematics; 1% presented transitory tic disorder; 0.34% presented chronic tic disorder; 1% presented Tourette syndrome; 2% presented motor coordination disorder (MCD); and 0.34% presented stereotypic movement disorders. Male children were more affected than female children in general, with male/female ORs of 0.14/0.92 for the presence of comorbidities, 0.11/0.88 for combined ADHD, 0.06/0.87 for language disorder, 1.02/1.27 for MCD, and 1.39/1.02 for inattentive ADHD.

Conclusion: In disadvantaged contexts, there was a higher prevalence of NDDs and comorbidities, unless the disorder was extreme, in which case only the NDD manifestations were presented. A significant proportion of the sample had not been previously diagnosed (88.6%); therefore, early detection programs are recommended to identify warning signs and develop policies that help and support the most disadvantaged sectors of the population.

PMID: 38025459 PMCID: PMC10667691 DOI: 10.3389/fpsyt.2023.1260747




Profile of fluency in spontaneous speech, reading, and retelling of texts by adults who stutter - AVALIAÇÃO

Codas. 2023 Sep 25;35(5)

Free article :

Portuguese: https://www.scielo.br/j/codas/a/vYfZkQ8mQXQRgmP74LDs7tr/?format=pdf&lang=pt

English: https://www.scielo.br/j/codas/a/vYfZkQ8mQXQRgmP74LDs7tr/?format=pdf&lang=en


Samuel Lopes da Silva, Luciana Mendonça Alves, Denise Brandão de Oliveira E Britto

Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil.


Purpose: to describe the profile of fluency concerning the typology of disfluencies, speed, and frequency of disruptions in spontaneous speech, reading, and retelling; to compare the fluency profile in adults who stutter in spontaneous speech, reading, and retelling of text.

Methods: The present work is a cross-sectional comparative study with a sample composed of 15 adults who stutter of both sexes, with higher education or equivalent to complete elementary school II. Samples were collected in the tasks of spontaneous speech, reading, and text retelling through video calls made individually with the participants. The first 200 syllables expressed in each task were transcribed and analyzed according to the Fluency Profile Assessment Protocol (FPAP). The study compared the frequency of common and stuttering disfluencies and the speed in the different tasks surveyed. The Kruskal & Wallis test was used together with Duncan's multiple comparisons test to compare the medians and verify possible differences between the tasks researched with a significance level of 5%.

Results: The reading task presented a lower number of common disfluencies and a percentage of speech discontinuity about spontaneous speech and retelling tasks. No statistically significant differences were found between stuttering disfluencies in the three tasks surveyed.

Conclusion: This study showed that there are differences in the occurrence of common disfluencies - hesitations, interjections, and revisions - and in the percentage of speech discontinuity during an oral reading of adults who stutter concerning spontaneous speech and text retelling.

PMID: 37792751 DOI: 10.1590/2317-1782/20232022009pt




Reduced stuttering for school-age children: A systematic review - INFANTIL / TERAPIA

Review J Fluency Disord. 2023 Sep 22;78:106015. Online ahead of print.


Georgina Johnson, Mark Onslow, Sarah Horton, Elaina Kefalianos

University of Melbourne, VIC, Australia; University of Technology Sydney, NSW, Australia; Murdoch Children's Research Institute, VIC, Australia.


Background: Treatment of school-age children (6-12 years of age) who stutter is a public health priority. Their clinical needs include a psychosocial focus and stuttering reduction. For the latter clinical need, there is a critical window of opportunity for these children warranting research attention.

Purpose: The purpose of the review is to guide future clinical research by establishing (a) what interventions are associated with stuttering reduction for school-age children (b) the reported immediate and longer-term effects of those interventions, and (c) the level of evidence for these interventions in terms of study design.

Methods: Fourteen databases and three conference proceedings were searched for interventions used to reduce stuttering in school-age children. Primary outcomes were mean stuttering reductions pre-treatment, immediately post-treatment, and any follow-up assessments.

Results: Of the 4305 studies identified from the databases, 67 studies met inclusion criteria. Five different treatment approaches were reported in the literature that might reduce stuttering for a school-age child, but with varying effect sizes. These include (a) operant methods, (b) speech restructuring, (c) combined operant methods and speech restructuring, (d) machine-driven treatments, and (e) treatments with a cognitive behaviour therapy component.

Conclusions: Operant methods warrant investigation in future clinical trial research, as do variants of speech restructuring. Hybrid approaches showed encouraging results, including speech restructuring variants combined with operant methods or with cognitive behaviour therapy. However, evidence is preliminary only at Phase I and II trials. Several treatments with reported clinical promise have been overlooked for decades and require further investigation.

PMID: 37776613 DOI: 10.1016/j.jfludis.2023.106015




Relationships Between Psychological Distress and Affective, Behavioral, and Cognitive Experiences of Stuttering - EMOCIONAL

Am J Speech Lang Pathol. 2023 Nov 13:1-17. Online ahead of print.


Randy Panzarino, Martine Vanryckeghem, Jeffrey S Bedwell, Oliver Wendt

Capistrano Unified School District, San Juan Capistrano, CA; University of Central Florida, Orlando; University of Potsdam, Germany; Purdue University, West Lafayette, IN; University of Pretoria, South Africa.


Purpose: People who stutter (PWS) are vulnerable to the development of various psychopathological symptoms, although prevalence data are mixed and less clarity exists about factors that potentially influence their occurrence. The current study sought to shed light on the prevalence of self-reported psychopathology in PWS and aimed to identify relationships between affective, behavioral, and cognitive (ABC) experiences of stuttering and psychological distress (PD).

Method: Forty-four PWS were administered the Behavior Assessment Battery (BAB) for Adults who Stutter and the Brief Symptom Inventory-18. The prevalence of clinically significant PD was calculated via BSI-18 global severity index t-score cutoffs. Regression analyses examined relationships between ABC variables of stuttering and PD.

Results: Participants' BAB scores approximated normative values, while the PD score distribution was similar to that of a nonclinical sample. Nine percent of participants met thresholds for clinically significant PD. All ABC correlates of stuttering significantly and positively correlated with PD scores, capturing considerable amounts of shared variance.

Conclusions: Levels of PD in PWS approximate those of the general community, highlighting the existence of psychologically distressed subgroups of PWS. Speech situation-specific anxiety had the strongest relationship to PD, followed closely by one's report of situation-specific speech disruption. To a lesser but still significant extent, PWS' frequency to which they engage in various avoidance/escape behaviors, as well as their communication attitude, predicted levels of psychopathology. These data inform diagnostic and clinical decision making, drawing attention to factors that should be attended to in treatment.

PMID: 37956694 DOI: 10.1044/2023_AJSLP-22-00347




Resolution of stuttering during ketamine treatment: a case report - FARMACOLOGIA

J Med Case Rep. 2023 Oct 10;17(1):447.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563367/pdf/13256_2023_Article_4158.pdf


Dan Bolton, Tegest Hailu, Christina A Porucznik

Washington State Office of Financial Management, Olympia, WA, USA; Providence SoundHomeCare and Hospice, Lacey, WA, USA; University of Utah, Salt Lake City, UT, USA.


Background: Stuttering may include repetition of words in whole or part, difficulty saying words, and elongated pauses in speech. Approximately 5% of children stutter for a period lasting 6 months or more. Most of those children stop stuttering as they approach adulthood, but the condition persists in approximately 1% of adults. The cause of stuttering is unknown. Adults who stutter face substantial burdens in many aspects of their lives. Stutterers may choose not to pursue meaningful employment opportunities, may not be hired for positions they seek, or may be denied promotions or positive performance evaluations. Stuttering can cause physical tension from fear of speaking. Social challenges arise when a person who stutters is seen as less capable or of lower intelligence than fluent speakers. Stuttering causes emotional difficulties through the frustration and embarrassment that disfluent speakers feel. Stutterers may experience a general loss of self-esteem and personal satisfaction in life. Speech therapy is the primary intervention for stuttering. Medications have been investigated as treatments for stuttering, but no medication has been identified that has widespread effectiveness.

Case presentation: A 60-year-old white non-Hispanic woman who had been a near lifelong stutterer was prescribed ketamine for an unrelated condition and experienced an almost immediate resolution of her stuttering.

Conclusions: Many possible pharmacological treatments for stuttering have been studied. Some medications appear to be effective in some patients; some appear to be more generally effective but have negative side effects. No reporting in relevant literature has addressed a possible role for ketamine in stuttering treatment. On the basis of this case report, research on the effect of ketamine on stuttering would be useful. Any effective treatment for stuttering would have a significant positive effect on quality of life for persons who stutter.

PMID: 37817273 PMCID: PMC10563367 DOI: 10.1186/s13256-023-04158-8




Self-perceived outcomes of informative and apologetic self-disclosure: A mixed methods study - SOCIAL

J Commun Disord. 2023 Oct 26:106:106387. Online ahead of print.


Megan M Young, Courtney T Byrd, Rodney Gabel

The University of Texas at Austin, Austin, TX, United States of America; Binghamton University, Binghamton, NY, United States of America.


Purpose: Self-disclosure statements that are informative, rather than apologetic, have been demonstrated to improve listener perceptions of adults who stutter (Byrd et al., 2017). The purpose of the present study is to investigate the benefits of self-disclosure from the perspective of the speaker and to determine whether self-disclosure statement type is associated with self-perceived outcomes of use.

Method: A total of 156 adults who stutter completed a survey adapted from a previous study investigating affective, behavioral, and cognitive outcomes of voluntary stuttering. Survey responses were analyzed using descriptive and inferential statistics to determine if there was a significant relationship between self-disclosure statement type and self-reported outcomes. Additionally, responses to two open-ended questions relating to timing of self-disclosure and self-disclosure experiences in general were analyzed using reflexive thematic analysis.

Results: Self-disclosure was perceived as beneficial in at least one context by 96.8 % of respondents. Respondents who used an informative self-disclosure statement were more likely to agree that self-disclosure increased confidence and were less likely to report attempting to conceal or avoid stuttering than respondents who used an apologetic self-disclosure statement. Themes relating to additional aspects of self-disclosure experiences included personalized use, social connection, acceptance of stuttering, challenging cognitive distortions, communication is easier, self-empowerment, humor, voluntary stuttering, and vulnerability to prejudice.

Conclusion: Similar to studies investigating the influence of self-disclosure on listener perceptions, informative self-disclosure is associated with greater self-perceived benefits than apologetic self-disclosure for adults who stutter.

PMID: 37918083 DOI: 10.1016/j.jcomdis.2023.106387




Self-Reported Stuttering Severity Is Accurate: Informing Methods for Large-Scale Data Collection in Stuttering - AVALIAÇÃO

J Speech Lang Hear Res. 2023 Dec 5:1-10. Online ahead of print.


Sarah Horton et al

Murdoch Children's Research Institute, Melbourne, Victoria, Australia; University of Melbourne, Victoria, Australia; Erasmus University Medical Centre, Rotterdam, the Netherlands; Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands; Radboud University, Nijmegen, the Netherlands; Griffith University, Southport, Australia.


Purpose: To our knowledge, there are no data examining the agreement between self-reported and clinician-rated stuttering severity. In the era of big data, self-reported ratings have great potential utility for large-scale data collection, where cost and time preclude in-depth assessment by a clinician. Equally, there is increasing emphasis on the need to recognize an individual's experience of their own condition. Here, we examined the agreement between self-reported stuttering severity compared to clinician ratings during a speech assessment. As a secondary objective, we determined whether self-reported stuttering severity correlated with an individual's subjective impact of stuttering.

Method: Speech-language pathologists conducted face-to-face speech assessments with 195 participants (137 males) aged 5-84 years, recruited from a cohort of people with self-reported stuttering. Stuttering severity was rated on a 10-point scale by the participant and by two speech-language pathologists. Participants also completed the Overall Assessment of the Subjective Experience of Stuttering (OASES). Clinician and participant ratings were compared. The association between stuttering severity and the OASES scores was examined.

Results: There was a strong positive correlation between speech-language pathologist and participant-reported ratings of stuttering severity. Participant-reported stuttering severity correlated weakly with the four OASES domains and with the OASES overall impact score.

Conclusions: Participants were able to accurately rate their stuttering severity during a speech assessment using a simple one-item question. This finding indicates that self-report stuttering severity is a suitable method for large-scale data collection. Findings also support the collection of self-report subjective experience data using questionnaires, such as the OASES, which add vital information about the participants' experience of stuttering that is not captured by overt speech severity ratings alone.

PMID: 38052068 DOI: 10.1044/2023_JSLHR-23-00081




Social anxiety disorder in adolescents who stutter: A risk for school refusal - EMOCIONAL

Pediatr Int. 2023 Jan-Dec;65(1):e15622.


Yoshikazu Kikuchi et al

Kyushu University, Fukuoka, Japan; University of Teacher Education Fukuoka, Fukuoka, Japan; University of Nagasaki, Nagasaki, Japan; Fussa Dai-nana Elementary School, Tokyo, Japan; Fukuoka Sanno Hospital, Fukuoka, Japan; Adachi Otorhinolaryngology Clinic, Fukuoka, Japan; Fukuoka University Hospital, Fukuoka, Japan; International University of Health and Welfare, Fukuoka, Japan.


Background: Stuttering is a childhood-onset fluency disorder. Part of the counseling for middle and high school students with persistent stuttering is related to school refusal. Anxiety disorders are known to contribute to school refusal. However, it is not known whether social anxiety disorder (SAD) is a factor in school refusal among adolescents who stutter.

Methods: In our first study, we examined the relationship between school refusal and SAD in 84 middle and high school students who stutter; 26% of the 84 students were in the school refusal group and the remaining 74% were in the school attendance group. The second study examined whether SAD was associated with 10 factors related to speech and stuttering frequency using the Japanese version of the Liebowitz Social Anxiety Scale for Children and Adolescents to determine the presence of SAD. Of the 84 students in the first study, 40 participated in the second study.

Results: The school refusal group of adolescents who stutter had significantly higher rates of SAD than the school attendance group. Fifty percent of adolescents who stutter met the criteria for SAD. Moreover, adolescents who stutter with SAD had significantly higher scores on the items "When speaking in public, do you experience tremors in your limbs?" and "After you stutter, do you have negative thoughts about yourself?" than the adolescents who stutter without SAD.

Conclusions: When examining adolescents who stutter, checking for comorbid SAD may lead to better support. Moreover, noticing their repetitive negative thinking, nervousness, and trembling during speech may help to resolve SAD.

PMID: 37690080 DOI: 10.1111/ped.15622




Solution-Focused Brief Therapy for Stuttering in the Public Schools: Children Solve Their Own Stuttering Problems in This Case Study - TERAPIA

Lang Speech Hear Serv Sch. 2023 Aug 2;1-14. Online ahead of print.


Lourdes Ramos-Heinrichs

Boston Public Schools, MA.


Purpose: This clinical focus article follows the case studies of three school-age children who stutter in solution-focused brief therapy (SFBT), highlighting treatment features and demonstrating positive outcomes. Empowerment and self-agency are emphasized as desired characteristics. Children searched within themselves and acted to influence therapy results. Techniques such as self-disclosure and fluency shaping were incorporated into this approach.

Method: In a public school district, participants with moderate-to-severe stuttering used the Clinical Use of Self-Reports to measure their perceived stuttering severity across various contexts and audiences. The speech-language pathologist (SLP) provided verbal feedback/contingencies including personalized questions, supportive statements, and positive gestures/comments. The students identified a stuttering problem, implemented the suggested techniques in clinic and in their natural environments, and shared pertinent feedback during the following therapy sessions.

Results: Participants solved stuttering problems and took charge of their own treatment. After 5 weeks of SFBT, the 18-year-old demonstrated sufficient problem-solving skills to agree to be discharged from the program. The remaining two students exhibited growth toward their individualized goals. They showed curiosity about their own stuttering situations and applied innovative strategies, in the outside world, that had been practiced and formulated in their therapy sessions.

Conclusions: The participants engaged in conversations with the SLP, teachers, peers, and family members. They documented conversations, reflections, performance scales, and personal goals in their journals. During therapy sessions, the children clarified real-life goals and tried out techniques for managing their stuttering difficulties. In addition, they completed the Clinical Use of Self-Reports to assess their communication values, successes, and challenges.

PMID: 37532244 DOI: 10.1044/2023_LSHSS-22-00172




Speech disfluencies in bilingual Greek-English young adults - LINGUAGEM

J Fluency Disord. 2023 Aug 23;78:106001. Online ahead of print.


Zoi Gkalitsiou, Danielle Werle

The University of Texas at Austin, USA.


Purpose: The purpose of this study was to investigate the frequency and types of disfluencies in Greek-English bilingual adults across naturalistic speech samples and compare frequency and types of disfluencies between the participants' L1 and L2.

Methods: Participants in the study included 26 Greek-English bilingual young adults. All participants were sequential bilinguals, whose first language was Greek and second language was English. Two speech samples were collected in each language, a conversational and a narrative sample, which were subsequently analyzed for the frequency and types of disfluencies.

Results: Results indicated that participants produced more typical disfluencies in English compared to Greek across speaking samples. The most frequent types of disfluencies were filled pauses and vowel prolongations (without tension or struggle) across speaking samples and languages.

Conclusion: Our results revealed differences in the types and frequencies of disfluencies produced in participants' native compared to their second language. Results add to the growing body of literature addressing the manifestation of speech disfluencies in bilingual speakers.

PMID: 37660637 DOI: 10.1016/j.jfludis.2023.106001




Statistical Information Affects Spoken Word Recognition of Tone Languages in Stutterers: Evidence From an Auditory-Perceptual Gating Study - AUDITIVO

J Speech Lang Hear Res. 2023 Aug 30;1-17. Online ahead of print.


Jiaqiang Zhu, Jing Shao, Caicai Zhang, Fei Chen, Seth Wiener

The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China; Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China; Hunan University, Changsha, China; Carnegie Mellon University, Pittsburgh, PA.


Purpose: Previous studies have shown that individuals who stutter exhibit abnormal speech perception in addition to disfluent production as compared with their nonstuttering peers. This study investigated whether adult Chinese-speaking stutterers are still able to use knowledge of statistical regularities embedded in their native language to recognize spoken words and, if so, how much acoustic information is needed to trigger this information.

Method: Seventeen stutterers and 20 typical, nonstuttering controls participated in a gating experiment. All participants listened to monosyllabic words that consisted of syllables and lexical tones and were segmented into eight successive gates. These words differed in syllable token frequency and syllable-tone co-occurrence probability in line with a Chinese spoken word corpus. The correct syllable-only, correct tone-only, correct syllable-tone word, and correct syllable-incorrect tone responses were analyzed between the two groups using mixed-effects models.

Results: Stutterers were less accurate overall than controls, with fewer correct syllables, tones, and their combination as words. However, stutterers showed consistent and reliable perceptual patterns triggered by statistical information of speech, as reflected by more accurate responses to high-frequency syllables, high-probability tones, and tone errors all in manners similar to those of nonstuttering controls.

Conclusions: Stutterers' atypical speech perception is not due to a lack of statistical learning. Stutterers were able to perceive spoken words with phonological tones based on statistical regularities embedded in their native speech. This finding echoes previous production studies of stuttering and lends some support for a link between perception and production. Implications of pathological, diagnostic, and therapeutic conditions of stuttering are discussed.

PMID: 37647655 DOI: 10.1044/2023_JSLHR-23-00123




Stuttering as a spectrum disorder: A hypothesis - CONCEITO

Review Curr Res Neurobiol. 2023 Nov 1:5:100116.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10663130/pdf/main.pdf


Shahriar SheikhBahaei, Marissa Millwater, Gerald A Maguire

National Institutes of Health (NIH), Bethesda, MD, USA; American University of Health Sciences, Signal Hill, CA, USA.


Childhood-onset fluency disorder, commonly referred to as stuttering, affects over 70 million adults worldwide. While stuttering predominantly initiates during childhood and is more prevalent in males, it presents consistent symptoms during conversational speech. Despite these common clinical manifestations, evidence suggests that stuttering, may arise from different etiologies, emphasizing the need for personalized therapy approaches. Current research models often regard the stuttering population as a singular, homogenous group, potentially overlooking the inherent heterogeneity. This perspective consolidates both historical and recent observations to emphasize that stuttering is a heterogeneous condition with diverse causes. As such, it is crucial that both therapeutic research and clinical practices consider the potential for varied etiologies leading to stuttering. Recognizing stuttering as a spectrum disorder embraces its inherent variability, allowing for a more nuanced categorization of individuals based on the underlying causes. This perspective aligns with the principles of precision medicine, advocating for tailored treatments for distinct subgroups of people who stutter, ultimately leading to personalized therapeutic approaches.

PMID: 38020803 PMCID: PMC10663130




Stuttering associated with a pathogenic variant in the chaperone protein cyclophilin 40 - GENÉTICA

Brain. 2023 Dec 1;146(12):5086-5097. doi: 10.1093/brain/awad314.


Angela T Morgan et al

Murdoch Children's Research Institute, Parkville, Australia e 20 outras instituições


Stuttering is a common speech disorder that interrupts speech fluency and tends to cluster in families. Typically, stuttering is characterized by speech sounds, words or syllables which may be repeated or prolonged and speech that may be further interrupted by hesitations or 'blocks'. Rare variants in a small number of genes encoding lysosomal pathway proteins have been linked to stuttering. We studied a large four-generation family in which persistent stuttering was inherited in an autosomal dominant manner with disruption of the cortico-basal-ganglia-thalamo-cortical network found on imaging. Exome sequencing of three affected family members revealed the PPID c.808C>T (p.Pro270Ser) variant that segregated with stuttering in the family. We generated a Ppid p.Pro270Ser knock-in mouse model and performed ex vivo imaging to assess for brain changes. Diffusion-weighted MRI in the mouse revealed significant microstructural changes in the left corticospinal tract, as previously implicated in stuttering. Quantitative susceptibility mapping also detected changes in cortico-striatal-thalamo-cortical loop tissue composition, consistent with findings in affected family members. This is the first report to implicate a chaperone protein in the pathogenesis of stuttering. The humanized Ppid murine model recapitulates network findings observed in affected family members.

PMID: 37977818 PMCID: PMC10689913




[Stuttering in Children: A Primary Health Care Perspective] - SOCIAL

[Article in Portuguese]

Comment Acta Med Port. 2023 Nov 2;36(11):767-768.

Free article: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20352/15247


Sara Nabais, Carolina Reis Penedo, Susana Corte-Real

Agrupamento de Centros de Saúde de Lisboa Ocidental e Oeiras. Oeiras. Portugal.


No abstract available

PMID: 37924317 DOI: 10.20344/amp.20352





Stuttering in individuals with Down syndrome: a systematic review of earlier research - AVALIAÇÃO

Review Front Psychol. 2023 Nov 29:14:1176743.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716236/pdf/fpsyg-14-1176743.pdf


Silje Hokstad, Kari-Anne B Næss

Inland Norway University of Applied Sciences, Lillehammer, Norway.; University of Oslo, Oslo, Norway.


The main objective of this systematic review was to synthesize the evidence on the occurrence and characteristics of stuttering in individuals with Down syndrome and thus contribute knowledge about stuttering in this population. Group studies reporting outcome measures of stuttering were included. Studies with participants who were preselected based on their fluency status were excluded. We searched the Eric, PsychInfo, Medline, Scopus, and Web of Science Core Collection databases on 3rd January 2022 and conducted supplementary searches of the reference lists of previous reviews and the studies included in the current review, as well as relevant speech and language journals. The included studies were coded in terms of information concerning sample characteristics, measurement approaches, and stuttering-related outcomes. The appraisal tool for cross-sectional studies (AXIS) was used to evaluate study quality. We identified 14 eligible studies, with a total of 1,833 participants (mean = 131.29, standard deviation = 227.85, median = 45.5) between 3 and 58 years of age. The estimated occurrence of stuttering ranged from 2.38 to 56%, which is substantially higher than the estimated prevalence (1%) of stuttering in the general population. The results also showed that stuttering severity most often was judged to be mild-to-moderate and that individuals with Down syndrome displayed secondary behaviors when these were measured. However, little attention has been paid to investigating the potential adverse effects of stuttering for individuals with Down syndrome. We judged the quality of the evidence to be moderate-to-low. The negative evaluation was mostly due to sampling limitations that decreased the representability and generalizability of the results. Based on the high occurrence of stuttering and the potential negative effects of this condition, individuals with Down syndrome who show signs of stuttering should be referred to a speech and language pathologist for an evaluation of their need for stuttering treatment.

PMID: 38094702 PMCID: PMC10716236




Stuttering on Instagram: What is the focus of stuttering-related Instagram posts and how do users engage with them? - SOCIAL

J Fluency Disord. 2023 Dec:78:106021. doi: 10.1016/j.jfludis.2023.106021. Epub 2023 Nov 7.


Amir Hossein Rasoli Jokar, Steven Roche, Hamid Karimi

Michigan State University, USA; Charles Darwin University, Australia.


Purpose: Instagram has become a popular platform for sharing and seeking health-related information, including stuttering. However, concerns have been raised about the accuracy, confidentiality, and potential negative impact of such information. This study aims to examine how stuttering is defined and understood on Instagram, and how users engage with related content.

Methods: We analyzed highly engaged Instagram posts with the hashtag "#Stuttering" published within a year and their corresponding comments using thematic analysis.

Results: The results revealed four main themes and nine sub-themes that highlighted different understandings of stuttering on Instagram, including the need for intervention, emotional impact on people who stutter, positive meanings, and mental health implications. User engagement varied based on the nature of the post, with users showing appreciation, objections, seeking advice, celebrating success stories, mocking, or advocating for people who stutter.

Conclusion: Although Instagram can serve as a means of normalizing stuttering and highlighting success stories, it raises concerns about the promotion of non-evidence-based treatments and the use of stuttering for political or entertainment purposes. This study emphasizes the need to critically evaluate health-related information presented on social media platforms. To provide reliable information to PWS and their families who seek information on social media, it is recommended to promote evidence-based information on stuttering through trustworthy organizations such as the National Stuttering Association or the Stuttering Foundation, particularly on special occasions like International Stuttering Awareness Day.

PMID: 37972424 DOI: 10.1016/j.jfludis.2023.106021




The Fifth Croatia Stuttering Symposium: Part I. Treatments for early stuttering - INFANTIL / TERAPIA

J Fluency Disord. 2023 Nov 19:79:106022. Online ahead of print.


Mark Onslow , Robyn Lowe, Suzana Jelčić Jakšić, Nan Bernstein Ratner, Kristin Chmela, Valerie Lim, Stacey Sheedy

University of Technology Sydney, Australia; University of Rijeka, Rijeka, Croatia; University of Maryland, Maryland, United States; Chmela Communication Center, Illinois, United States; Singapore Institute of Technology, Singapore; South Western Sydney Local Health District, NSW, Australia; Ingham Institute for Applied Medical Research, NSW, Australia.


Purpose: The Fifth Croatia Stuttering Symposium in 2022 continued the Fourth Croatia Stuttering Symposium 2019 theme of the connection between research and clinical practice. At the 2022 Symposium, there were 145 delegates from 21 countries. This paper documents the contents of the first of three Symposium modules.

Methods: The module topic was that three treatments for early childhood stuttering are supported by randomized controlled trial evidence. A clinical situation was considered where a parent of a 3-year-old child asked what results to expect of stuttering treatment.

Results: A distinguished scholar presented a 5-minute video interpretation of the research concerning the randomized controlled trial evidence for the three treatments. Three master clinicians then each presented a 2-minute video demonstration of how those research findings might be applied in a clinical situation. Following that, the convenors moderated a discussion between the distinguished scholar, master clinicians, and delegates regarding the research and how it applies to clinical practice.

PMID: 37995385 DOI: 10.1016/j.jfludis.2023.106022




The Fifth Croatia Stuttering Symposium: Part II. Natural recovery from early stuttering - INFANTIL / AVALIAÇAIO

J Fluency Disord. 2023 Oct 21:78:106018. Online ahead of print.


Mark Onslow, Robyn Lowe, Suzana Jelčić Jakšić, Ann Packman, Ellen Kelly, Verity MacMillan, Gabrielle Hodes

University of Technology Sydney, NSW, Australia; University of Rijeka, Croatia; The Stuttering Foundation, United States; South Western Sydney Local Health District, Australia; Ingham Institute for Applied Medical Research, Australia.


Purpose: The Fifth Croatia Stuttering Symposium of 2022 continued the Fourth Croatia Stuttering Symposium 2019 theme of the connection between research and clinical practice. At the 2022 Symposium, there were 145 delegates from 21 countries. This paper documents the contents of the second of three Symposium modules.

Methods: The module topic was that some children with early stuttering will recover naturally. A clinical situation was considered where a parent of a 3-year-old child asked if a clinician can predict whether their child will recover from stuttering without treatment.

Results: A distinguished scholar presented a 5-minute video interpretation of research about this topic. Three master clinicians then each presented a 2-minute video demonstration of how that research might be applied in a clinical situation. Following that, the convenors moderated a discussion between the distinguished scholar, master clinicians, and delegates regarding the research and how it applies to clinical practice.

PMID: 37898032 DOI: 10.1016/j.jfludis.2023.106018




The Fifth Croatia Stuttering Symposium: Part III. Mental health and early stuttering - INFANTIL / EMOCIONAL

J Fluency Disord. 2023 Aug 2;77:106000. Online ahead of print.


Mark Onslow, Robyn Lowe, Suzana Jelčić Jakšić, Marie-Christine Franken, Anna Hearne, Irma Uijterlinde, Kurt Eggers

University of Technology Sydney, NSW, Australia; University of Rijeka, Croatia; Erasmus University Medical Center, the Netherlands; Stottercentrum Utrecht, the Netherlands; Ghent University, Department of Rehabilitation Sciences, Belgium; Thomas More University College, Belgium; Turku University, Finland.


Purpose: The Fifth Croatia Stuttering Symposium of 2022 continued the Fourth Croatia Stuttering Symposium 2019 theme of the connection between research and clinical practice. At the 2022 Symposium, there were 145 delegates from 21 countries. This paper documents the contents of the third of three Symposium modules.

Methods: The module topic was mental health and early stuttering, and that pre-schoolers who stutter are at risk of developing mental health issues. A clinical situation was considered where a parent of a 3-year-old child asked a clinician what the early signs of mental health issues might be for a child who stutters.

Results: A distinguished scholar presented a 5-minute video interpretation of research about this topic. Three master clinicians then each presented a 2-minute video demonstration of how that research might be applied in a clinical situation. Following that, the convenors moderated a discussion between the distinguished scholar, master clinicians, and delegates regarding the research and how it applies to clinical practice.

PMID: 37586168 DOI: 10.1016/j.jfludis.2023.106000




The relation between long latency cortical auditory evoked potentials and stuttering severity in stuttering school-age children - AUDITIVO

Int J Pediatr Otorhinolaryngol. 2023 Dec:175:111766.


Engy Samy Elhakeem, Rania Mohamed Abdou Mohamed Mustafa, Mohamed Aziz Mohamed Talaat, Alaa Mamdouh Abdelhamed Radwan, Mirhan Eldeeb

Alexandria University, Egypt


Background: Disturbances in auditory processing and feedback have been suggested to play a role in the pathogenesis of developmental stuttering. Long latency cortical auditory evoked potentials in response to non-linguistic and linguistic stimuli can be used to investigate these disturbances. There were differences between developmental stuttering patients. However, there is no solid evidence of these differences to date.

Objective: This study aims to determine whether there is a statistically significant difference in component P1-N1-P2 of long latency cortical auditory evoked potentials between stuttering school-aged children and non-stuttering children. In addition, the study aims to investigate the relationship between these potentials and objective quantitative measures of stuttering.

Method: The study included two groups, patients and controls, consisting of 40 subjects aged 6-12 years. For the cases group, the severity of stuttering symptoms and P1-N1-P2 responses to a non-linguistic stimulus were evaluated. In addition, the P1-N1-P2 responses of the matched control group were evaluated.

Results: The P1-N1 responses were similar in both study groups, while P2 response was shorter in the patient group, but the difference was not statistically significant compared to the control group. N1 latency has the only statistically significant correlation with the percentage of repetitions, prolongation, and blocks. The female cases had a decreased, not statistically significant, latency than the male cases group.

Conclusion: In contrast to the previous finding, the study revealed a non-statistically significant different P1-N1, a non-statistically significant reduced P2 response to a non-linguistic stimulus, in CWS, in as evidence for basic auditory processing. The study also revealed a significant correlation between N1 latency and proportion of the repetition symptoms.

PMID: 37875046 DOI: 10.1016/j.ijporl.2023.111766




TranStutter: A Convolution-Free Transformer-Based Deep Learning Method to Classify Stuttered Speech Using 2D Mel-Spectrogram Visualization and Attention-Based Feature Representation - AVALIAÇÃO

Sensors (Basel). 2023 Sep 22;23(19):8033

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10575465/pdf/sensors-23-08033.pdf


Krishna Basak, Nilamadhab Mishra, Hsien-Tsung Chang

VIT Bhopal University, Sehore, India; Chang Gung University, Taoyuan, Taiwan; Chang Gung Memorial Hospital, Taoyuan, Taiwan.


Stuttering, a prevalent neurodevelopmental disorder, profoundly affects fluent speech, causing involuntary interruptions and recurrent sound patterns. This study addresses the critical need for the accurate classification of stuttering types. The researchers introduce "TranStutter", a pioneering Convolution-free Transformer-based DL model, designed to excel in speech disfluency classification. Unlike conventional methods, TranStutter leverages Multi-Head Self-Attention and Positional Encoding to capture intricate temporal patterns, yielding superior accuracy. In this study, the researchers employed two benchmark datasets: the Stuttering Events in Podcasts Dataset (SEP-28k) and the FluencyBank Interview Subset. SEP-28k comprises 28,177 audio clips from podcasts, meticulously annotated into distinct dysfluent and non-dysfluent labels, including Block (BL), Prolongation (PR), Sound Repetition (SR), Word Repetition (WR), and Interjection (IJ). The FluencyBank subset encompasses 4144 audio clips from 32 People Who Stutter (PWS), providing a diverse set of speech samples. TranStutter's performance was assessed rigorously. On SEP-28k, the model achieved an impressive accuracy of 88.1%. Furthermore, on the FluencyBank dataset, TranStutter demonstrated its efficacy with an accuracy of 80.6%. These results highlight TranStutter's significant potential in revolutionizing the diagnosis and treatment of stuttering, thereby contributing to the evolving landscape of speech pathology and neurodevelopmental research. The innovative integration of Multi-Head Self-Attention and Positional Encoding distinguishes TranStutter, enabling it to discern nuanced disfluencies with unparalleled precision. This novel approach represents a substantial leap forward in the field of speech pathology, promising more accurate diagnostics and targeted interventions for individuals with stuttering disorders.

PMID: 37836863 PMCID: PMC10575465 DOI: 10.3390/s23198033




Turkish adaptation of the self-stigma of stuttering scale (4S): Study of validity and reliability (4S-TR) - AVALIAÇÃO

J Fluency Disord. 2023 Dec:78:106020.


Nurten Tiryaki, R Sertan Özdemir, Çağdaş Karsan, Michael P Boyle

İstanbul Medipol University, İstanbul, Turkey; Biruni University, İstanbul, Turkey; Montclair State University, Bloomfield, NJ, USA.


Purpose: This study aimed to adapt the Self-Stigma of Stuttering Scale (4S) into Turkish and evaluate its factor structure, reliability, and validity in Turkish culture.

Methods: The original 4S scale was translated into Turkish (4S-TR) using a forward-backward translation technique and was administered to 350 adults who stutter (AWS). To discover latent variables evaluated on the scale, two-factor analyses were performed. Internal consistency and temporal stability were calculated to ensure reliability. Test-retest reliability correlation scores were calculated with multiple applications of the scale within about two weeks. To verify construct validity, participants also completed the Turkish versions of the Self-Esteem Rating Scale-Short Form (BSDÖ-KF) and the Satisfaction with Life Scale(YDÖ).

Results: The explanatory factor analysis showed three factors explaining 74.76 % of the total variance. The findings were also validated by confirmatory factor analysis. High levels of internal consistency (r = .89) and test-retest reliability (r = .96) were obtained. In terms of construct validity, our findings revealed that self-stigma has a significant negative correlation with self-esteem (r = -.41) and life satisfaction (r = -.38) as was predicted.

Conclusions: The findings demonstrate preliminary evidence that the 4S-TR is a viable and valid instrument for self-stigma evaluation in three domains (stigma awareness, stereotype agreement, and self-concurrence). The 4S-TR can be applied for research and clinical purposes in Turkish.

PMID: 37948902 DOI: 10.1016/j.jfludis.2023.106020




Unique Patterns of Bilingual Speech: Factors Affecting Disfluency Rates in Russian-Hebrew Bilingual Children - INFANTIL / BILINIGUISMO

J Speech Lang Hear Res. 2023 Nov 6:1-17. Online ahead of print.


Sveta Fichman, Cahtia Adelman, Carmit Altman

Hadassah Academic College, Jerusalem, Israel; Talpiot College of Education, Holon, Israel; Hadassah University Medical Center, Jerusalem, Israel; Faculty of Education, Bar-Ilan University, Ramat Gan, Israel.


Purpose: Bilingual children often demonstrate a high rate of disfluencies, which might impact the diagnostic evaluation of fluency disorders; however, research on the rates and types of disfluencies in bilinguals' two languages is limited. The purpose of this research is to profile disfluencies of two types, stuttering-like disfluencies (SLDs) and other disfluencies (ODs), in the speech of Russian-Hebrew bilingual typically developing children, focusing on cross-linguistic differences and the effect of language proficiency in both languages.

Method: Spontaneous narratives based on the Frog, Where Are You? (Mayer, 1969) picture book were collected in both languages from 40 bilingual Russian-Hebrew children aged 5;6-6;6 (years;months). The transcribed narratives were coded for SLD (sound, syllable, and monosyllabic word repetitions) and OD (multisyllabic word/phrase repetitions, interjections, and revisions), and their frequencies per 100 syllables were calculated.

Results: Overall, most children had a percentage of SLD and OD below the cutoff point and within the existing criteria for stuttering diagnosis established based on monolingual data, but several children exceeded this stuttering criterion. Monosyllabic word repetitions (part of SLD) and interjections (part of OD) were more frequent in Hebrew than in Russian. Lower proficiency was associated with a higher percentage of monosyllabic word repetitions and of interjections in both languages.

Conclusions: Bilingual disfluency criteria are needed, since based on the existing monolingual criteria, some children might be erroneously assessed as children who stutter, thus leading to overdiagnosis. The results support the claim that proficiency is an important factor in the production of disfluencies.

PMID: 37931116 DOI: 10.1044/2023_JSLHR-23-00048




Voice analysis in healthy subjects and patients with neurologic disorders: Editorial - OUTRAS ÁREAS

Editorial Front Neurol. 2023 Sep 28:14:1288370.

Free PMC article: https://www.frontiersin.org/articles/10.3389/fneur.2023.1288370/full


Antonio Suppa, Giovanni Costantini, Pedro Gomez-Vilda, Giovanni Saggio

Sapienza University of Rome, Rome, Italy; 2IRCCS Neuromed Institute, Pozzilli, Italy; University of Rome Tor Vergata, Rome, Italy; Universidad Politécnica de Madrid, Madrid, Spain.


PMID: 37840929 PMCID: PMC10569294




Why do people who stutter attend stuttering support groups? -  TERAPIA EM GRUPO

S Afr J Commun Disord. 2023 Aug 3;70(1):e1-e8.


Nicola E Bloye, Shabnam S Abdoola, Casey J Eslick

Faculty of Humanities, University of Pretoria, Pretoria.


Background: Stuttering support groups (SSGs) have been a long-standing invaluable resource for people who stutter (PWS) but research into SSGs is only emerging. Speech-language therapists (SLTs) need further insight to successfully facilitate SSGs.

Objectives: To determine PWS' perspectives regarding why they attend SSGs in South Africa.

Method: Thirteen PWS who attend SSGs, between 20 and 58 years old, were a part of this qualitative study. Purposive sampling was utilised. Semi-structured telephonic interviews were used and data was analysed thematically.

Results: Four themes, namely, 'altered perceptions', 'increased sense of community', 'support group reciprocity', and 'support group environment, participants and topics', were identified. The results yielded clinical implications which included SLTs encouraging: (1) improved perceptions of being a PWS through education and self-empowerment, (2) PWS' connections between meetings to increase the sense of community, (3) reciprocity in meetings, (4) sharing personal stories to promote learning and general self-management and (5) support, praise and education to empower and encourage PWS. This study's findings show that SSGs helped PWS accept their stutter and gain confidence. This study showcased how SSGs can help PWS manage their fluency and gain confidence. Additionally, this study supports current research which suggests that dysfluency and social-emotional well-being should be equally addressed.

Conclusion: Recommendations were generated from PWS' perspectives and included focusing discussions on fluency, emotions and sharing personal stories. Insights from PWS helped better inform SLTs of their role within SSGs including guiding and facilitating conversations.Contribution: People who stutters' perspectives can be used in clinical practice to help SLTs meet the needs of PWS and guide best practice when facilitating SSGs.

PMID: 37782242 DOI: 10.4102/sajcd.v70i1.958




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                                     janeiro a julho de 2022

                                    agosto a dezembro de 2022


                                    janeiro a julho de 2021

                                    agosto a dezembro de 2021


                                    janeiro a julho de 2020

                                   agosto a dezembro de 2020


                                    janeiro a julho de 2019

                                   agosto a dezembro de 2019


                                    janeiro a julho de 2018

                                    agosto a dezembro de 2018


                                    janeiro a julho de 2017

                                    agosto a dezembro de 2017


                                    janeiro a julho de 2016

                                    agosto a dezembro de 2016


                                    janeiro a julho de 2015

                                    agosto a dezembro de 2015


                                    janeiro a julho de 2014
                                    agosto a dezembro de 2014


                                     janeiro a julho de 2013

                                     agosto a dezembro de 2013


                                      janeiro a julho de 2012

                                      agosto a dezembro de 2012