Abstract  - Agosto a Dezembro de 2024

 

 

A theory building critical realist evaluation of an integrated cognitive-behavioural fluency enhancing stuttering treatment for school-age children. Part 1: Development of a preliminary program theory from expert speech-language pathologist data - INFANTIL / TERAPIA

J Fluency Disord. 2024 Aug 24:82:106076. Online ahead of print.

 

Michelle C Swift, Marilyn Langevin

University of South Australia, Adelaide, SA, Australia; Flinders University, Adelaide, SA, Australia; University of Alberta, Edmonton, Canada.

 

Purpose: This study initiated a program of research that aims to develop a program theory underlying integrated cognitive-behavioural fluency enhancing stuttering treatments for school-age children. This research asks, what in the treatment program works (or does not work), for whom, in what contexts, and why.

Methods: Using a critical realist evaluation approach, seven speech-language pathologists (SLPs) with extensive experience in treating children who stutter were asked about barriers and facilitators of optimal treatment outcomes within the context of the Comprehensive Stuttering Program - School-aged Children (CSP-SC). From these data discrete resource mechanisms, contexts, within child reasoning mechanisms, and outcomes were derived and a preliminary program theory was proposed.

Results: Facilitating and impeding child physiology, treatment and SLP resource mechanisms, family and school contexts, and within-child mechanisms were identified. Facilitating mechanisms included motivation, personality/psychological characteristics, understanding and trust of the treatment process, experience of speaking with less effort, and self-efficacy. Impeding mechanisms included reduced motivation, impeding personality/psychological characteristics, lack of buy-in, and, for some children, a prohibitive cost of effort in using learned strategies.

Conclusion: A preliminary program theory was hypothesized which will be further developed in future analysis of data obtained from children and parents who participated in the CSP-SC at the same centre from which the SLPs came. Subsequent research with new cohorts of SLPs, children, and parents from other treatment programs and centres will be needed to establish the generalizability of the program theory generated in this program of research.

PMID: 39216178 DOI: 10.1016/j.jfludis.2024.106076

 

 

 

Contemporary clinical conversations about stuttering: Can intervention stop early stuttering development? - INFANTIL / TERAPIA

Int J Speech Lang Pathol. 2024 Sep 1:1-8. Online ahead of print.

 

Brooke L Edwards, Eric S Jackson, Elaina Kefalianos, Stacey Sheedy, Mark Onslow

SAY: The Stuttering Association for the Young, New York, NY, USA; New York University, New York, NY, USA; University of Melbourne, Parkville, VIC, Australia; South Western Sydney Local Health District, Bankstown, NSW, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia; University of Technology Sydney, Ultimo, NSW, Australia.

 

Purpose: To discuss whether early intervention can stop stuttering development. To inform junior clinicians and students of speech-language pathology about contemporary views on this issue.

Method: The issue was discussed by two university researchers and two speech-language pathologists who provide public clinical services. Written conversational turns in an exchange were limited to 100 words each. When that written dialogue was concluded, each participant provided 200 words of final reflection about the issue.

Result: Most differences that emerged centred on the clinical evidence base for early intervention, which emphasises stuttering reduction, and how it should be interpreted.

Conclusion: The evidence base for early intervention has limitations and it should be interpreted cautiously. One interpretation is that reducing stuttering severity is a justifiable core of early management. Another interpretation focuses on ease of communication, anticipation of stuttering, and covert stuttering.

PMID: 39218003 DOI: 10.1080/17549507.2024.2371870

 

 

 

Developmental stuttering in adults - FARMACOLOGIA

Review Ugeskr Laeger. 2024 Aug 26;186(35):V03240229. [Article in Danish]

 

Thomas Bauer Mølgaard, Lone Baandrup

Københavns Universitetshospital; Københavns Universitet.

PMID: 39234893 DOI: 10.61409/V03240229

Free article

 

Developmental stuttering is characterized by early childhood onset with repetition of syllables, prolongations, and blockades as well as secondary behavioural abnormalities. Early therapy is important while there is no approved pharmacological approach. Studies associate developmental stuttering with dopamin surplus in the striatum causing dysfunction of cortical speech areas. Consequently, antidopaminergic agents are being investigated to improve symptoms. The evidence in adults is comprised of few studies of poor quality but might hold promise as a new treatment option, as argued in this review.

 

 

 

Evaluating Stuttering Self-Stigma and Its Relationship to Adverse Impact in Children and Adolescents With the Child Stuttering Self-Stigma Scale - EMOCIONAL

J Speech Lang Hear Res. 2024 Aug 14:1-15 Online ahead of print.

 

Chelsea A Johnson, Katelyn L Gerwin, Seth E Tichenor, Michael P Boyle, Bridget Walsh

Michigan State University, East Lansing; Duquesne University, Pittsburgh, PA; Montclair State University, Bloomfield, NJ.

 

Purpose: Self-stigma occurs when a person internalizes and applies stereotypes, prejudice, and discrimination to themselves. For adults who stutter, self-stigma is linked to negative outcomes and reduced quality of life. The development of self-stigma in people who stutter is not well understood. The aim of this study is to evaluate stuttering self-stigma in school-age children and adolescents and explore potential relationships to stuttering's overall adverse impact.

Method: One hundred one children and adolescents who stutter, aged 10-18 years, completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), a measure of adverse impact related to stuttering, and the Childhood Self-Stigma of Stuttering Scale (Child 4S), our novel adapted version of the Self-Stigma of Stuttering Scale (4S) created for this study. The Child 4S comprises three subscales measuring three stages of self-stigma: Awareness, Agreement, and Application. Each stage was evaluated for relationships with child age and the adverse impact of stuttering.

Results: We found a range of self-stigma scores among children and adolescents who stutter. Child age did not correlate with Awareness and Agreement; however, older children and adolescents reported greater Application. All stages of self-stigma strongly predicted adverse impact as measured by the OASES, and latter stages of the model were stronger predictors than earlier stages.

Conclusions: Children as young as 10 years old may experience stuttering self-stigma, and the application of self-stigma increases in adolescence, a critical period in the development of personal identity. Importantly, all stages of self-stigma predicted adverse impact related to stuttering, with latter stages being stronger predictors than earlier ones consistent with the progressive model of self-stigma being tested. The findings highlight the need for targeted, early intervention to mitigate downstream effects of stuttering self-stigma.

PMID: 39141882 DOI: 10.1044/2024_JSLHR-24-00069

 

 

 

Long-term evaluation of psychosocial impact and stuttering severity after intensive stuttering therapy - TERAPIA

Int J Speech Lang Pathol. 2024 Sep 2:1-15. Online ahead of print.

 

Birte Wiele, Susanne Cook, Erik X Raj, Stefan Heim

Medical Faculty, RWTH Aachen University, Aachen, Germany; Stotterintensivtherapie Cook, Karlsruhe, Germany; Monmouth University, West Long Branch, NJ, USA.; Research Centre Jülich, Jülich, Germany.

 

Purpose: The purpose of this study was to assess the long-term stability of objective and subjective psychosocial improvements and fluency more than 10 years after participation in an intensive stuttering therapy camp.

Method: Ten former participants in intensive stuttering therapy (IST; mean age at time of intervention 14; 2 years) participated in this study. Outcomes of the IST at that time were assessed with the Stuttering Severity Instrument (SSI-3; Riley, 1994) and a questionnaire to measure the psychosocial impact of stuttering. A semi-structured video call and a general questionnaire for the long-term evaluation were used to gauge the participants' perceptions of the IST. These follow-up data were compared to the therapy outcomes reported by Cook (2011, 2013).

Result: Therapy effects on the severity of stuttering and psychosocial impact were stable over the follow-up period of more than 10 years. Moreover, scores for psychosocial impact and severity of stuttering further decreased from the end of the IST to the long-term evaluation. The intensive time and the periodically offered follow-up treatments were described as particularly positive by the participants.

Conclusion: Intensive stuttering therapy in childhood or adolescence can have a long-term positive effect on both internal and external stuttering symptoms.

PMID: 39219356 DOI: 10.1080/17549507.2024.2371869

 

 

 

Perceptions of and beliefs about stuttering in the Hispanic/Latino community - SOCIAL

J Commun Disord. 2024 Aug 13:111:106456. Online ahead of print.

 

Angela M Medina, Jean S Mead, Stefanie Moore

Florida International University, Miami, FL, USA.

 

Purpose: The aim of this exploratory study was to investigate perceptions of people who stutter and beliefs about the causes and cures of stuttering within the Hispanic/Latino community.

Methods: Respondents who were 18 or older and of Hispanic/Latino origin were invited to respond to a 24-question online survey. Questions involved exploring familiarity with and beliefs regarding etiologies, treatment approaches, treatment providers, stereotypes, and perceptions of people who stutter. Data from 151 respondents were analyzed using descriptive statistics.

Results: Results revealed that the most commonly held beliefs regarding the causes of stuttering were being "born with it", an "emotional disturbance or trauma", a "brain disorder", and/ or a "sensory impairment". The most frequently cited beliefs regarding treating stuttering were "therapy", "rehabilitation", and "tell them to slow down". Over 75 % of respondents believed that "speech therapists" can cure or treat stuttering. Respondents' perceptions of people who stutter are that they are generally "nervous" and "shy".

Conclusions: Common beliefs and perceptions relative to stuttering were identified in the Hispanic/Latino community. The beliefs one holds about the cause of stuttering as well as their negative perceptions of stutterers may contribute to the continued stigmatization of people who stutter. Implications are discussed regarding the need for culturally appropriate education for individuals who stutter, their families, and the general public.

PMID: 39154581 DOI: 10.1016/j.jcomdis.2024.106456

 

 

 

Public attitudes toward stuttering and cluttering in Chinese and Japanese speech-language pathology students - SOCIAL

J Fluency Disord. 2024 Aug 24:82:106077. Online ahead of print.

 

Yu-An Chen, Shoko Miyamoto, Kenneth O St Louis

University of Tsukuba, Ibaraki, Japan; West Virginia University, Morgantown, WV, USA.

 

Purpose: This study utilized the Chinese and Japanese translations of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) and Cluttering (POSHA-Cl) to compare the differences in (a) attitudes towards stuttering versus cluttering in speech-language pathology (SLP) students in either China or Japan, (b) attitudes of SLP students in China versus Japan towards either stuttering or cluttering, and (c) attitudes of Chinese and Japanese students versus international databases for stuttering and cluttering.

Method: The POSHA-S and POSHA-Cl were both administered to 99 SLP students from six universities in China and 352 SLP students from two universities in Japan.

Results: Attitudes toward stuttering were markedly different for Chinese versus Japanese students. Overall, stuttering attitudes were slightly more positive than cluttering attitudes in both countries; however, compared to China, Japanese SLP students attitudes toward stuttering and cluttering were more disimilar. In addition, compared with the international database, the attitudes of Chinese and Japanese SLP students toward self-reactions to both disorders were more positive. [?]

Conclusion: Chinese and Japanese SLP students' attitudes toward both stuttering and cluttering are likely to be influenced by geography, culture, education, and the "halo effect." The attitudes of the SLP students in China and Japan are more negative than the attitudes as shown in the global data. [?]

PMID: 39213792 DOI: 10.1016/j.jfludis.2024.106077

 

 

 

The Contributions of the Cerebellar Peduncles and the Frontal Aslant Tract in Mediating Speech Fluency - NEUROCIÊNCIAS

Neurobiol Lang (Camb). 2024 Aug 15;5(3):676-700.

 

Sivan Jossinger, Maya Yablonski, Ofer Amir, Michal Ben-Shachar

Bar-Ilan University, Ramat-Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

 

Fluent speech production is a complex task that spans multiple processes, from conceptual framing and lexical access, through phonological encoding, to articulatory control. For the most part, imaging studies portraying the neural correlates of speech fluency tend to examine clinical populations sustaining speech impairments and focus on either lexical access or articulatory control, but not both. Here, we evaluated the contribution of the cerebellar peduncles to speech fluency by measuring the different components of the process in a sample of 45 neurotypical adults. Participants underwent an unstructured interview to assess their natural speaking rate and articulation rate, and completed timed semantic and phonemic fluency tasks to assess their verbal fluency. Diffusion magnetic resonance imaging with probabilistic tractography was used to segment the bilateral cerebellar peduncles (CPs) and frontal aslant tract (FAT), previously associated with speech production in clinical populations. Our results demonstrate distinct patterns of white matter associations with different fluency components. Specifically, verbal fluency is associated with the right superior CP, whereas speaking rate is associated with the right middle CP and bilateral FAT. No association is found with articulation rate in these pathways, in contrast to previous findings in persons who stutter. Our findings support the contribution of the cerebellum to aspects of speech production that go beyond articulatory control, such as lexical access, pragmatic or syntactic generation. Further, we demonstrate that distinct cerebellar pathways dissociate different components of speech fluency in neurotypical speakers.

PMID: 39175785 PMCID: PMC11338307 DOI: 10.1162/nol_a_00098