Abstract  - Agosto a Dezembro de 2024

 

 

 

A scoping review of speech-language pathologists' experiences, practices, attitudes and perspectives of working with people who stutter - TERAPIA

J Fluency Disord. 2024 Nov 29:83:106097. Online ahead of print.

Free article: https://www.sciencedirect.com/science/article/pii/S0094730X24000615?via%3Dihub

 

Kate Bridgman, Shane Erickson

La Trobe University, Australia.

 

Background and purpose: Speech-language pathologists (SLPs) can play an integral role working with people who stutter (PWS) across the lifespan. There is a rich, yet relatively recent, history of research capturing specific aspects of the role, yet no paper has sought to combine the published literature relating to it. This review is intended to: (1) establish key themes related to SLPs' experiences, practices and attitudes of working with PWS; (2) determine how these may have changed over time; and (3) identify what gaps in the knowledge about this topic still exist.

Methods: A scoping review was conducted to synthesise all relevant peer-reviewed literature. Studies were included if they met the following inclusion criteria: a) reported on primary research; b) published in a peer-reviewed journal; c) written in English, and, d) reported on SLPs working with people who stutter.

Results: A total of 897 articles were identified and reviewed, with 27 included in the final analysis. Content analysis of the study results revealed themes relating to SLP factors, SLP attitudes, clinical management and service delivery.

Conclusion: While much has been published on this topic, and considerable change has been observed over time, there is still much to learn. Future investigations may include more in-depth exploration of SLPs' lived experience working with PWS and a systematic approach to increase SLP competency and confidence in working with PWS.

PMID: 39644704 DOI: 10.1016/j.jfludis.2024.106097

 

 

 

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

 

 

 

A Viewpoint on the Ethics of Pseudostuttering Assignments: Guidelines and Best Practices for Their Use - TERAPIA

Am J Speech Lang Pathol. 2024 Nov 22:1-9. Online ahead of print.

 

Katie Gore, Seth E Tichenor

speech IRL, Chicago, IL; Duquesne University, Pittsburgh, PA.

 

Purpose: Pseudostuttering, or the act of voluntarily stuttering or stuttering on purpose, has been both regularly used by clinicians alongside clients in stuttering therapy and taught to students in stuttering courses for decades. However, in recent years, teaching speech-language pathology students how to pseudostutter in stuttering courses has been increasingly questioned by students on grounds that pseudostuttering may be ableist, a disability simulation, and of questionable clinical value. The purpose of this article is to discuss the value and ethics of pseudostuttering assignments as part of graduate clinical education for speech-language pathologists (SLPs).

Method: The history of pseudostuttering and the pseudostuttering assignment within speech-language pathology pedagogy, disability studies literature, and community perspectives are reviewed. In so doing, we incorporate views from the broader disability rights community, the stuttering community, and stuttering research and clinical literature.

Results: Stuttering literature and community perspectives not only confirm the value of pseudostuttering assignments but also underscore the critical importance of assignment purpose, framing, structure, and scope.

Conclusions: Pseudostuttering continues to be a critical clinical skill for SLPs who work with people who stutter, and pseudostuttering assignments are an invaluable learning experience for speech-language pathology graduate students. However, assignments must be designed and implemented according to a specific set of principles and best practices. Assignment design that does not follow these principles and best practices is likely to perpetuate ableist constructs and inadequately prepare students to work with individuals who stutter. Graduate course instructors should educate themselves on these principles and engage with students who express concerns with the assignment.

PMID: 39576823 DOI: 10.1044/2024_AJSLP-24-00139

 

 

 

An Adaptation Effect in Bilingual Adults Who Stutter Suggests Their Motor Learning is Influenced by Language Factors - BILINGUISMO

Percept Mot Skills. 2024 Sep 10:315125241276227. Online ahead of print.

 

Jasper Priences Vedanayagam, Santosh Maruthy

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

 

Stuttering is progressively reduced when persons who stutter repeatedly read the same text. This reduction has been recently attributed to motor learning with repeated practice of speech-motor sequences. In the present study, we investigated the adaptation effect of 17 bilingual adults who stutter (BAWS). We asked these participants to complete a particular paradigm of reading passages with a 30-minute break between them. Participants were Kannada-English speaking BAWS. We split them into two groups of eight and nine participants, respectively who read in counter-balanced order two passages written in the Kannada and English languages. The averaged data from the two groups resulted in a typical adaptation curve for the five readings when read separately in both languages. When there was a switch from readings in Kannada to readings in English, there was a significant increase in the percentage of syllables stuttered. This increase in dysfluencies reduced the adaptation effect from repeated reading. These findings support the hypothesis that motor learning plays a crucial role in stuttering adaptation when participants read the same passage repeatedly in any language, but the shift in the language read suggests an interference in motor learning. Collectively, our results highlight an interaction effect between motor learning and language proficiency, seen by increased dysfluencies and a reduced adaptation effect in bilingual speakers.

PMID: 39254106 DOI: 10.1177/00315125241276227

 

 

 

An exploration of UK speech and language therapists' treatment and management of functional communication disorders: A mixed-methods online survey - TERAPIA

Int J Lang Commun Disord. 2024 Sep 17. Online ahead of print.

 

Kirsty McKenzie, Katerina Hilari, Nicholas Behn

City St George's, University of London, London, UK.

 

Background: Functional Communication Disorders (FCDs) are one specific presentation of Functional Neurological Disorder (FND). FND is characterised by neurological symptoms, such as sensory and motor symptoms, which are not explained by neurological disease. Speech and language therapists (SLTs) have expertise in managing communication disorders, including FCDs, though is not known is what clinicians do in practice to treat and manage FCDs.

Aim: To explore the clinical practices of SLTs who regularly manage FCDs in the UK, including the assessment and intervention approaches taken.

Methods & procedures: An online survey was developed using Qualtrics software and piloted before dissemination. Participants were experienced SLTs working in the UK who managed at least three FCD referrals a year. The survey was developed with a mix of qualitative and quantitative questions. The survey was disseminated via social media and professional networks.

Outcomes & results: There were 73 completed responses to the survey. Participants reported working with a range of FCDs clinically, with functional stuttering and articulation disorders seen most frequently. SLTs reported working with a wide range of multidisciplinary professionals when managing patients with FCDs, though lack of access to mental health professionals was raised as an issue. SLTs reported using a combination of formal and informal communication assessments. Interventions varied, with a wide range of psychological approaches informing treatment. Lack of specific training, evidence base and negative attitudes around functional neurological disorder (FND) were raised as ongoing issues.

Conclusions & implications: Therapists encountered a wide range of FCDs as part of their clinical practice, though there was a significant disparity in the service and interventions offered. SLTs feel their input can be effective, but lack the resources, training and evidence-based interventions to provide adequate care.

PMID: 39287357 DOI: 10.1111/1460-6984.13113

 

 

 

Adult stuttering prevalence I: Systematic review and identification of stuttering in large populations - CONCEITO

J Fluency Disord. 2024 Oct 9:83:106085. Online ahead of print.

Free article: https://www.sciencedirect.com/science/article/pii/S0094730X24000494?via%3Dihub

 

Max Gattie, Elena Lieven, Karolina Kluk

University of Manchester, UK; Northwestern University, Chicago, IL, USA.

 

Purpose: Stuttering epidemiology is reviewed with a primary goal of appraising methods used to identify stuttering in large populations. Secondary goals were to establish a best estimate of adult stuttering prevalence; identify data that could subgroup stuttering based upon childhood versus adult onset and covert versus over behaviour; and conduct a preliminary assessment of the degree to which stuttering features as a co-occurring diagnosis.

Methods: Systematic review followed PRISMA guidelines. Quality assessment was based on the Joanna Briggs Institute Prevalence Critical Appraisal Tool, with criteria adjusted for appraisal of stuttering.

Results: 15 sets of data were assessed for quality, with three meeting criteria for inclusion. These estimated adult stuttering prevalence at 0.67% at age 14-17 years (Taghipour et al., 2013); 0.21% at age 16-20 years (Tsur et al., 2021); and 0.63% when aged over 21 years (Craig et al., 2002).

Conclusion: Systematic review indicates adult stuttering prevalence is between 0.6-0.7%. A false positive paradox follows from the low prevalence of stuttering in the general population, creating a need for very high specificity when measuring stuttering in the general population. Failure to achieve high specificity (99.9% is suggested) leads to loss of statistical power due to presence of false positives. A corollary of the false positive paradox is that sensitivity in measurement of stuttering can be relatively low (90% is suggested) before general population estimates of stuttering prevalence are appreciably affected. Despite this relaxation of measurement requirements regarding sensitivity, covert stuttering is likely to have been underestimated. Covert stuttering might be accounted for using data from prospective cohort studies, however such a revision seems unlikely to exceed the widely-accepted 1% adult stuttering prevalence estimate; see Gattie, Lieven & Kluk (2024 this issue) for an estimate at 0.96 %. When used to estimate stuttering prevalence, data reported by Tsur et al. (2021) are outlying, with the relatively low estimate possibly due to origin as military conscript data and/or generalised healthcare screening.

PMID: 39708697 DOI: 10.1016/j.jfludis.2024.106085

 

 

 

Adult stuttering prevalence II: Recalculation, subgrouping and estimate of stuttering community engagement - CONCEITO

J Fluency Disord. 2024 Sep 27:83:106086. Online ahead of print

Free article: https://www.sciencedirect.com/science/article/pii/S0094730X24000500?via%3Dihub

 

Max Gattie, Elena Lieven, Karolina Kluk

University of Manchester, Manchester, UK; Northwestern University, Chicago, IL

 

Purpose: Epidemiological research of stuttering has frequently focused on children, with a relative paucity of population level data specific to adults. Prevalence data for adults are reassessed here, including a breakdown of whether stuttering is overt or covert, and whether onset was in childhood or adulthood. The engagement of adults who stutter with stuttering communities is also estimated.

Methods: Prevalence calculations were based on data from studies having the strongest designs, following the systematic review of Gattie, Lieven & Kluk (2024, this issue). Original data for engagement with stuttering communities were gathered from English language internet stuttering support groups, a national stuttering charity in the UK and a regional stuttering support group in Manchester, UK.

Results: Adult stuttering prevalence was estimated at 0.96% (95% CI 0.65, 1.44). This can be broken down to 0.63% overt stuttering (95% CI 0.46, 0.79) comprising 0.53% childhood onset and 0.10% adult onset; and 0.33% covert stuttering (95% CI 0.19, 0.58) comprising 0.28% childhood onset and 0.05% adult onset. Covert stuttering will have been overestimated, and may often be very mild. Engagement with stuttering communities was estimated at 0.99% internationally, 0.63% nationally and 1.01% regionally. Actual engagement will have been lower due to attrition and overcounting.

Conclusion: The adult stuttering prevalence estimate of 0.96% is consistent with the widely-cited all ages stuttering prevalence estimate of 1%. Of adults who stutter, fewer than 1% engage with stuttering communities.

PMID: 39706110 DOI: 10.1016/j.jfludis.2024.106086

 

 

 

Attitudes of Teachers, Students, and the Public Toward Stuttering in India: A Comparison - SOCIAL

Am J Speech Lang Pathol. 2024 Dec 2:1-20. Online ahead of print.

 

Rakesh Chowkalli Veerabhadrappa et al

Manipal Academy of Higher Education, India; All India Institute of Speech and Hearing, Mysore; West Virginia University, Morgantown.

 

Purpose: People who stutter experience societal misconceptions and negative stereotypes due to cultural prejudices. The present study aimed to compare attitudes toward stuttering of Indian teachers, students, and members of the public and to further compare their attitudes to comparable samples regionally and internationally.

Method: Five hundred eighteen adults completed the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S), translated into Kannada, which was analyzed according to standard protocol. Summary and selected item scores were compared from samples of teachers (n = 125), students (n = 233), and the public (n = 160). Additionally, the scores were compared to those from South Asian samples and an international POSHA-S database.

Results: Teachers in the current study had the most positive stuttering attitudes, followed by the public and then by students. The summary attitude scores obtained by all three groups were more positive attitudes compared to other South Asian samples and either similar to or slightly less positive than the international POSHA-S database average sample rating. Education and income were small but significant predictors of more-or less-positive attitudes, but gender, age, and familiarity with stuttering were not.

Conclusions: While teachers demonstrated a greater understanding of stuttering compared to the public and students, the lack of understanding among the latter groups highlights the need for increased awareness and education about stuttering across various segments of society. Negative social reactions toward stuttering, observed in different cultural contexts, further emphasize the need for awareness about stuttering.

PMID: 39620975 DOI: 10.1044/2024_AJSLP-24-00204

 

 

 

Atypical gut microbiota composition in a mouse model of developmental stuttering - CONCEITO

Sci Rep. 2024 Oct 8;14(1):23457.

Free article: https://www.nature.com/articles/s41598-024-74766-x

 

Sayan Nanda et al

University of Delaware, Newark, DE, USA.

 

Developmental stuttering is a complex neurodevelopmental disorder characterized by disfluent speech. It has been associated with mutations in genes involved in lysosomal enzyme trafficking. Mice with mutations in one such gene, Gnptab, exhibit atypical vocalizations analogous to stuttering in humans. This mouse model has enabled the study of various molecular mechanisms related to the disorder. Simultaneously, an increasing number of reports have suggested the role of gut microbiota in altered brain function and development in neurological disorders. In this study, we compared gut microbiota profiles from Gnptab mutant mice to wildtype control mice. Microbiome analysis demonstrated a distinct microbiota profile in Gnptab mutant mice. The most significant alteration was an increased relative abundance of Akkermansia, a genus of mucin degrading bacteria, which has previously been associated with multiple neurological disorders. Moreover, the altered microbiota profile of these mice was predicted to result in differences in abundance of several metabolic pathways, including short chain fatty acid and lipopolysaccharide synthesis. These pathways may play a role in the onset, progression and persistence of developmental stuttering. This is the first study to show a potential link between developmental stuttering and changes in the gut microbiota, laying the groundwork for a new research direction.

PMID: 39379558 DOI: 10.1038/s41598-024-74766-x

 

 

 

Big Girl Words - OUTRAS ÁREAS

US Cardiol. 2024 Sep 9:18:e14. doi: 10.15420/usc.2024.24.

Free Text: https://www.uscjournal.com/articles/big-girl-words

 

Rachel Goodman

Division of Cardiology, Tufts Medical Center Boston, MA, US.

 

No abstract available

PMID: 39494406 PMCID: PMC11526492 DOI: 10.15420/usc.2024.24

 

 

 

Characteristics associated with social anxiety in adults with developmental stuttering: A review - EMOCIONAL

Med Res Arch. 2024 Oct;12(10):5876. Epub 2024 Oct 22.

 

K R Bauerly 1

University of Vermont.

 

People who stutter are at a greater risk for developing symptoms of social anxiety, with up to 22-60% of adults who stutter meeting the criteria for a clinical diagnosis. Negative attitudes and feelings about speaking and stuttering are reported to emerge as early as the preschool years and are suspected to be due to exposure to negative listener reactions, stereotyping and social isolation. Repeated negative experiences lead to feelings of fear, embarrassment and loss of control during speaking which over time, leads to the development of more severe difficulties with speaking and an overall apprehension to speak as they perceive themselves as an incompetent communicator. The present review aims to summarize risk factors, particularly temperament and environmental factors, that are reported to play a role in the emergence and maintenance of social anxiety in people who stutter. Another aim of this review is to summarize the features of social anxiety reported in adults who stutter, some of which, are similar to high socially anxious fluent speakers (e.g., avoidant strategies) while others are specific to stuttering (e.g., muscle tension). The clinical implications of these findings and recommendations for future research are also discussed.

PMID: 39655291 PMCID: PMC11626403 DOI: 10.18103/mra.v12i10.5876

 

 

 

Characterizing drug-induced stuttering in electronic health records - GAGUEIRA ADQUIRIDA

J Commun Disord. 2024 Nov 19:113:106475. Online ahead of print.

 

Dillon G Pruett et al

Vanderbilt University Medical Center, USA; Lipscomb University College of Pharmacy and Health Sciences, USA; Wayne State University, USA.

 

Purpose: Drug-induced stuttering is a phenomenon where the onset of stuttered speech is caused by exposure to pharmaceutical chemical substances. This acquired form of stuttering features many of the same overt speech behaviors as developmental stuttering. Investigations of drug-induced stuttering have been limited to adverse drug reaction reports and case studies. This study leveraged electronic health records (EHRs) at a major university medical center to identify drug-induced stuttering within medical notes, followed by classification of implicated drug types.

Methods: A previous systematic EHR review of approximately 3 million individuals to identify cases of developmental stuttering resulted in 40 suspected cases of drug-induced stuttering. In the present study, these cases were reviewed comprehensively to evaluate: name, class, and mechanism of action of suspected drug, level of evidence for the implicated drug as a causal agent, therapeutic measures taken, and progression or remission of stuttering.

Results: Eighteen different drugs were linked to possible drug-induced stuttering in 22 individuals. Antiseizure agents, CNS stimulants, and antidepressants were the most common drug classes implicated in drug-induced stuttering. topiramate (Topamax) was the most commonly implicated drug across all records reviewed.

Conclusions: This study represents the first analysis of health system data examining drugs implicated in drug-induced stuttering in a clinical setting. Augmenting previous case reports and database reviews, a variety of drugs were identified; however, improved reporting of drug-associated speech fluency changes within the EHR are needed to further amass evidence for suspected drugs and their associated epidemiological and clinical characteristics.

PMID: 39615072 DOI: 10.1016/j.jcomdis.2024.106475

 

 

 

Clinical and Sociodemographic Predictors of Parental Perceptions and Confidence in Managing Child Stuttering: a Cross-Sectional Study - INFANTIL / AMBIENTE

Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5434-5442.

 

Ebrahim Barzegar Bafrooei, Morteza Farazi, Saman Maroufizadeh, Akbar Darouie

University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Guilan University of Medical Sciences, Rasht, Iran.

 

The main aim of the current study was to identify and analyze the most significant clinical and sociodemographic predictors of parents' perceptions regarding their child's stuttering. 139 parents, with at least one child who stutters, completed both the Persian version of the Palin Parent Rating Scale (P-Palin PRS) and a sociodemographic and clinical checklist. To investigate the relationships between scores on the Palin PRS factors and sociodemographic and clinical characteristics, we conducted univariable analyses using Pearson correlation coefficients, independent t-tests, and one-way ANOVA. The study analyzed the P-Palin PRS factors: Impact of Stuttering on the Child, Severity of Stuttering and Impact on the Parents, and Parent's Knowledge and Confidence in Managing it. Mean scores were 5.37, 3.87, and 5.42, respectively, with correlations ranging from 0.371 to 0.507. Higher stutter severity negatively correlated with Impact on the Child (r=-0.364, P < 0.001). History of speech therapy (ST) failure and family history of speech and language disorders (SLDs) showed lower Impact scores (P = 0.053 and P = 0.057). Severity of Stuttering and Impact on the Parents negatively correlated with stutter severity (r=-0.546, P < 0.001) and positively with parents' ages. Parent's Knowledge and Confidence correlated negatively with stutter severity (r=-0.242, P = 0.004) and was lower in those with family history of SLDs (P = 0.008). The high stutter severity, ST failure, and family history of SLDs were associated with lower scores across all PRS factors. In conclusion current study identified key predictors influencing parents' perceptions of their child's stuttering, including stutter severity, speech therapy history, and family background.

PMID: 39559008 PMCID: PMC11569309

 

 

 

Clinical Profile of Neurodevelopmental Disorders in Children at a Tertiary Care Center - CONCEITO

Cureus. 2024 Aug 26;16(8):e67819.

Free ful text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423788/pdf/cureus-0016-00000067819.pdf

 

Mridu Bahal et al

Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

 

Background Neurodevelopmental disorders (NDDs) encompass intricate interactions among genetic, brain, cognitive, emotional, and behavioral processes. These disorders, which are influenced by hereditary and environmental factors, impair personal, social, intellectual, or occupational functioning. Typically emerging early in life, NDDs include conditions such as attention deficit hyperactivity disorder (ADHD), intellectual disability, autism spectrum disorders (ASDs), vision and hearing impairments, motor disorders, and specific learning disabilities. Children from impoverished and low-income neighborhoods are particularly vulnerable. The lack of comprehensive health data and public awareness about these conditions results in limited information regarding the prevalence of neurological illnesses in developing countries. India, with its large and ethnically diverse population, exemplifies this gap.

Methods It is a prospective study to detect the prevalence and risk factors of neurodevelopmental disorders in children aged six months to nine years at a tertiary care center. Patient details, clinical findings, and relevant history were recorded on a pre-designed pro forma and analyzed statistically.

Results Among the 1000 children in the study, 91 (9.1%) tested positive for NDDs. Among the 91 children who tested positive for NDD, the highest frequency is in the three to four years age group (17.6%), males were found to be in a higher ratio with 75.82%, with the male: female ratio being 3:1. Among the 91 children with NDD, intellectual disability was the most common disorder (20.9%), followed by ADHD (17.6%) and vision impairment (14.3%). Autism spectrum disorders, including autism and Asperger syndrome, and communication disorders, including stuttering and speech disorders, accounted for 13.2% each. Hearing loss was seen in 9.9% of children and multiple disorders were seen in 8.8% of the children from among 91 children.

Conclusion Neurodevelopmental disorders are common and often coexist with other conditions. Children from low-income backgrounds are more affected. This study provides valuable insights into the prevalence and characteristics of NDDs in a specific population.

PMID: 39323725 PMCID: PMC11423788 DOI: 10.7759/cureus.67819

 

 

 

Cognitive processing biases of social anxiety in adults who do and do not stutter - EMOCIONAL

J Commun Disord. 2024 Oct 24:112:106472. Online ahead of print.

Free article: https://www.sciencedirect.com/science/article/pii/S0021992424000686?via%3Dihub

 

Michelle C Swift, Martha Depasquale, Junwen Chen

University of South Australia, Adelaide, Australia; Flinders University, Adelaide, Australia; The Australian National University, , Australia.

 

Purpose: Adults who stutter are at risk of developing high levels of social anxiety, leading to negative outcomes and contributing towards stuttering relapse post treatment. To ensure that psychological treatments for social anxiety in stuttering adults are relevant and effective, a broader empirical understanding of the mechanisms of social anxiety in stuttering populations is required. Four key cognitive processing biases identified as maintenance factors in cognitive behavioral models of social anxiety were examined: self-focused attention, safety behavior use, negative self-imagery, and interpretation bias.

Methods: Adults who stutter and non-stuttering adults (N = 186) were assessed via an online survey. Participants were categorised into two groups based on stuttering: formally diagnosed stuttering and non-stuttering. Within those groups, participants were further categorised as having low or high levels of social anxiety. Cognitive processing bias was assessed in response to two hypothetical social scenarios (i.e., social interaction and social performance).

Results: As predicted, in both adults who stutter and who are non-stuttering, high social anxiety was related to greater self-focused attention, safety behavior use and negative self-imagery compared to low social anxiety. No significant effect of social anxiety or stuttering was found in relation to interpretation bias. A significant effect of social anxiety upon negative self-imagery was observed in formally-diagnosed adults who stutter compared to non-stuttering adults.

Conclusion: The results support the use of cognitive behavioral models of social anxiety as a framework for research and treatment development within stuttering populations.

PMID: 39454539 DOI: 10.1016/j.jcomdis.2024.106472

 

 

 

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

 

 

 

Contemporary clinical conversations about stuttering: Does the cause of stuttering matter to clinicians? - INFANTIL / TERAPIA

Int J Speech Lang Pathol. 2024 Dec 1:1-6. Online ahead of print.

 

Ana Karina Espinoza et al

Private Practice (Fluir+), Santiago, Chile; Private Practice, Zagreb, Croatia; All India Institute of Speech and Hearing, Mysore, India; University of Technology Sydney, New South Wales, Australia.

 

Purpose: To discuss whether stuttering causality matters to clinicians during clinical practice, and how and why it might matter. Additionally, to provide early-career clinicians and students with entry-level assistance with this complex topic.

Method: The issue was discussed by two academics and two experienced speech-language pathologists in private practice. Written conversational turns in an exchange were limited to 100 words each. When that written dialogue was concluded, the moderator summarised the discussion.

Result: All participants agreed that the cause of stuttering does matter to speech-language pathologists during clinical practice.

Conclusion: The following three key points emerged from the conversation. Firstly, no-one referred to a formally stated theory or model when explaining cause to clients. Instead, all in the conversation stayed on the solid ground of current facts about the cause of stuttering. Secondly, explaining the cause of stuttering can benefit clients and parents. It can support them and give them confidence and empowerment during clinical management and increase the credibility of a management plan. Finally, in essence, this topic relates to evidence-based practice, for which there are no fixed rules. Different clinicians may make different judgments about what is and what is not true, useful, and important.

PMID: 39617033 DOI: 10.1080/17549507.2024.2425789

 

 

 

Comparison of performance of automatic recognizers for stutters in speech trained with event or interval markers: Corrigendum

Published Erratum Front Psychol. 2024 Nov 6:15:1507956.

Free Full Text: https://pmc.ncbi.nlm.nih.gov/articles/PMC11577283/pdf/fpsyg-15-1507956.pdf

 

Liam Barrett, Kevin Tang, Peter Howell

University College London, London, United Kingdom; Heinrich Heine University Düsseldorf, Düsseldorf, Germany; University of Florida

 

PMID: 39569093 PMCID: PMC11577283 DOI:

 

 

 

Contemporary clinical conversations about stuttering: How clinically important is mental health during management of early stuttering? - INFANTIL / TEMPERAMENTO

Int J Speech Lang Pathol. 2024 Nov 6:1-5. Online ahead of print.

 

Sarah Delpeche , Ross Menzies, Katerina Ntourou, Ashley Saunders, Mark Onslow

Michael Palin Centre for Stammering, London, UK; University of Technology Sydney, NSW, Australia; The University of Oklahoma, Oklahoma, USA; University of Alberta, Edmonton, Canada.

 

Purpose: To discuss how clinically important mental health is during management of early stuttering. To inform early-career clinicians and students of speech-language pathology about contemporary views on this issue.

Method: The issue was discussed by three speech-language pathologists and a clinical psychologist. Written conversational turns in an exchange were limited to 100 words each. When that written dialogue was concluded, the moderator summarised the discussion.

Result: All agreed that it is essential to take account of mental health during management of early stuttering.

Conclusion: The following key points were raised: a) There is a prominent risk that a child with early stuttering will be or will become socially anxious, b) parent anxiety is a clinical consideration, c) support and counselling of children and parents needs to be within the scope of speech-language pathology practice, and d) referral of a child or parent, or both, to a clinical psychologist may be required, facilitated by formal testing if needed.

PMID: 39506338 DOI: 10.1080/17549507.2024.2420597

 

 

 

Cortical Tracking of Speech Is Reduced in Adults Who Stutter When Listening for Speaking - AUDITIVO

J Speech Lang Hear Res. 2024 Oct 22:1-19. Online ahead of print.

 

Simone Gastaldon, Pierpaolo Busan, Nicola Molinaro, Mikel Lizarazu

University of Padua, Italy; University of Trieste, Italy; Basque Center on Cognition, Brain and Language, Donostia-San Sebastián, Spain; Ikerbasque, Basque Foundation for Science, Bilbao, Spain.

 

Purpose: The purpose of this study was to investigate cortical tracking of speech (CTS) in adults who stutter (AWS) compared to typically fluent adults (TFAs) to test the involvement of the speech-motor network in tracking rhythmic speech information.

Method: Participants' electroencephalogram was recorded while they simply listened to sentences (listening only) or completed them by naming a picture (listening for speaking), thus manipulating the upcoming involvement of speech production. We analyzed speech-brain coherence and brain connectivity during listening.

Results: During the listening-for-speaking task, AWS exhibited reduced CTS in the 3- to 5-Hz range (theta), corresponding to the syllabic rhythm. The effect was localized in the left inferior parietal and right pre/supplementary motor regions. Connectivity analyses revealed that TFAs had stronger information transfer in the theta range in both tasks in fronto-temporo-parietal regions. When considering the whole sample of participants, increased connectivity from the right superior temporal cortex to the left sensorimotor cortex was correlated with faster naming times in the listening-for-speaking task.

Conclusions: Atypical speech-motor functioning in stuttering impacts speech perception, especially in situations requiring articulatory alertness. The involvement of frontal and (pre)motor regions in CTS in TFAs is highlighted. Further investigation is needed into speech perception in individuals with speech-motor deficits, especially when smooth transitioning between listening and speaking is required, such as in real-life conversational settings.

PMID: 39437265 DOI: 10.1044/2024_JSLHR-24-00227

 

 

 

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.

 

 

 

Differential Impacts of Anticipated Success on Employment Outcomes Among Adults Who Stutter - SOCIAL

Am J Speech Lang Pathol. 2024 Nov 15:1-15. Online ahead of print.

 

Molly Jacobs, Hope Gerlach-Houck, Patrick Briley

University of Florida, Gainesville; Western Michigan University, Kalamazoo; East Carolina University, Greenville, NC.

 

Purpose: Stuttering is associated with disparities in labor market outcomes among young adults, but little is known about how labor market outcomes associated with stuttering change over time. Therefore, this study characterized longitudinal associations between stuttering and early life expectations, job satisfaction, receipt of employer-provided insurance benefits, and income.

Method: The analysis used data from three waves of the National Longitudinal Study of Adolescent to Adult Health, which contained 16,653 individuals aged 18-43 years interviewed over 18 years. First, regression models evaluated the likelihood of employment between people who stutter (PWS) and people who do not stutter (PWNS). Second, conditional on employment, two-stage likelihood models quantified differences in their job satisfaction, receipt of employer-provided insurance benefits, and earned income, controlling for age, sex, race, and household characteristics. Finally, the relationship between their reported education and income expectations and these employment outcomes was evaluated.

Results: Although stuttering was not related to the likelihood of working or receiving employer-provided benefits, PWS were 20%-22% (SE = 0.06-0.07) less likely to be satisfied with their jobs than PWNS, and dissatisfaction increased with age. Additionally, the odds of earning a higher income were significantly lower for PWS than for PWNS. PWS who anticipated attending college and earning a middle-class income were more likely to be satisfied with their jobs and earn a higher income. However, PWS were less likely to expect that they would earn a middle-class income (PWNS: 46.4%, PWS: 36.3%) or graduate from college (PWNS: 70.9%, PWS: 58.4%) compared to PWNS.

Conclusions: Labor market inequities associated with stuttering persist and increase with age. PWS have significantly lower expectations for their likelihood of future success, and these expectations predict their future occupational outcomes.

PMID: 39546417 DOI: 10.1044/2024_AJSLP-24-00202

 

 

 

"Do dyslexia and stuttering share a processing eficit?", Corrigendum [Journal of Fluency Disorders, 67 (2021) 105827]

Published Erratum J Fluency Disord. 2024 Sep 26:106087. Online ahead of print.

 

Mahmoud M Elsherif, Linda R Wheeldon, Steven Frisson

University of Birmingham, Birmingham, UK; University of Agder, Norway.

 

No abstract available

PMID: 39332982 DOI: 10.1016/j.jfludis.2024.106087

 

 

 

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

 

 

 

Evaluative comparison of machine learning algorithms for stutter detection and classification - AVALIAÇÃO

MethodsX. 2024 Nov 14:13:103050.

Free Full Text: https://methods-x.com/action/showPdf?pii=S2215-0161%2824%2900501-6

 

Ramitha V et al

University Symbiosis Institute of Technology, Pune, Maharashtra, India.

 

Stuttering is a neuro-developmental speech disorder that interrupts the flow of speech due to involuntary pauses and sound repetitions. It has profound psychological impacts that affect social interactions and professional advancements. Automatically detecting stuttering events in speech recordings could assist speech therapists or speech pathologists track the fluency of people who stutter (PWS). It will also assist in the improvement of the existing speech recognition system for PWS. In this paper, the SEP-28k dataset is utilized to perform comparative analysis to assess the performance of various machine learning models in classifying the five dysfluency types namely Prolongation, Interjection, Word Repetition, Sound Repetition and Blocks.•The study focuses on automatically detecting stuttering events in speech recordings to support speech therapists and improve speech recognition systems for people who stutter (PWS).•The SEP-28k dataset is used to perform a comparative analysis of different machine learning models.•The research examines the impact of key acoustic features on model accuracy while addressing challenges such as class imbalance.

PMID: 39650118 PMCID: PMC11625209 DOI: 10.1016/j.mex.2024.103050

 

 

 

Exploring the activation of target words in adults who stutter with and without conscious intention to speak: ERP evidence - LINGUAGEM

J Commun Disord. 2024 Nov 23:113:106486. Online ahead of print.

 

Nathan D Maxfield

University of South Florida, United States.

 

Introduction: The primary aim was to determine whether the activation of target words unfolds differently in adults who stutter (AWS) versus typically-fluent adults (TFA) preparing to name pictures. A secondary aim was to explore the influence of conscious intention to speak on this process.

Method: 18 AWS and 18 TFA completed a picture naming task in which pictures - named at a delay - were followed by auditory probe words that were identical, or unrelated, to the target picture labels. A subset of those participants (15 AWS and 15 TFA) completed a second task in which pictures - judged conceptually at a delay - were followed by auditory probe words that directly named the pictures or were unrelated. Event-related potentials (ERPs) were recorded from probe word onset in each task. It was predicted that the N400 ERP component - an index of lexical processing - would be attenuated to Identity versus Unrelated trials. Between-groups differences in lexical activation (if any) were predicted to result in between-groups differences in the amplitude, latency and/or scalp topography of N400 priming effects.

Results: N400 priming was detected in both tasks for both Groups. In the picture naming task, the N400 priming effect had a more broadly-distributed scalp topography in TFA versus AWS. No between-groups differences were detected in the N400 priming effect in the conceptual judgment task.

Conclusions: A between-groups difference in the scalp topography of the N400 priming effect in the picture naming task points to a between-groups difference in intention-driven lexical access. Discussion considers how the top-down process of intention - if diminished among AWS - might impact lexical selection and speech motor control.

PMID: 39608126 DOI: 10.1016/j.jcomdis.2024.106486

 

 

 

Exploring the impact of stuttering simulation-based learning and personality traits on clinical self-efficacy and professional interest among speech-language pathology students - TERAPIA

Int J Lang Commun Disord. 2024 Sep 12. Online ahead of print.

 

Adi Zloof Golombick, Gil Zukerman, Michal Icht

Ariel University, Ariel, Israel; , Achva Academic College, Shikmim, Israel.

 

Background: Research suggests that participating in a stuttering simulation-based learning (SBL) program could help speech-language pathology (SLP) students feel more at ease, less nervous and more capable while interacting with people who stutter. Personality traits may influence SLP students' self-efficacy beliefs as well as their level of interest in working with clients who stutter. In particular, we suggest that the combination of low neuroticism and high extraversion, previously linked with a more outgoing, emotionally stable and social personality, may enhance self-efficacy.

Aims: To examine the impact of participating in a stuttering SBL program on clinical self-efficacy (CSE) in managing stuttering therapy among SLP students, as well as its influence on their interest in working with fluency disorders and their associations with personality dimensions. The study also evaluated satisfaction with the SBL experience.

Methods & procedures: SLP students (n = 49) underwent a fluency disorders academic course, self-reported on CSE, and had an interest in working in the field of stuttering and NEO-Five-Factor Inventory (NEO-FFI). Post-stuttering SBL program participation, CSE and level of interest in practice of stuttering were reassessed. Satisfaction with the simulation was also gauged.

Outcomes & results: Students interested in working with fluency disorders scored lower in neuroticism and higher in extraversion than their uninterested counterparts. Before the SBL activity, interest ratings were negatively correlated with neuroticism and positively correlated with extraversion. Pre-SBL neuroticism was negatively correlated with CSE. Following the SBL activity, increased CSE and interest in working with fluency disorders were evident, indicating robust and medium effects of the simulation on those indices, respectively. Post-SBL neuroticism was also negatively correlated with CSE. Overall, participants reported high satisfaction with the SBL experience.

Conclusions & implications: The study suggests SBL is an effective tool for enhancing motivation to work with fluency disorders. Consideration of personality traits and professional interests in designing educational interventions for SLP students, along with tailoring approaches to individual differences, may enhance learning outcomes. The study also highlights the need to differentiate between CSE and objectively assessed clinical competence and the fact that professional development is influenced by various factors. Nonetheless, the positive correlations between personality traits, CSE and satisfaction emphasize the potential of SBL programs in shaping not only clinical skills but also the attitudes and preferences of future SLPs.

PMID: 39262379 DOI: 10.1111/1460-6984.13112

 

 

 

Family History of Stuttering among Kurdish Children Who Stutter Near the Age of Onset - GENÉTICA

Adv Biomed Res. 2024 Aug 26:13:68.

 

Hiwa Mohammadi, Parya Bakhtiary

Kermanshah University of Medical Sciences, Kermanshah, Iran.

 

Background: The family history of stuttering is one of the most important factors for the prediction of recovery from stuttering. There is a high controversy about the rate of positive family history of stuttering among people who stutter (PWS). In the present study, the family history of stuttering in the first-, second-, and third-degree relatives was investigated among a group of Kurdish children who stuttered (CWS) close to the onset of the disorder.

Materials and methods: One hundred and seventy-two CWS, including 46 females (24.60%) aged 2-5 years (mean age: 3.71 years, SD = 0.75) were consecutively recruited. They were first examined close to the onset of the stuttering. Data about current and former stuttering among first-, second-, and third-degree relatives were collected using interviews with both parents. Data was described and analyzed by independent sample t test or Chi-square.

Results: Among 172 CWS (mean age: 3.71 years, SD = 0.75), 119 (69.20%) reported a family history of stuttering. According to the result, the most family history of stuttering was reported among third-degree relatives (32.60%). Sixty-five participants (37.80%) reported just one relative with stuttering. CWS with a positive family history of stuttering had no significant difference with CWS without a positive family history of stuttering in sex (P = 0.48) and age of stuttering onset (P = 0.96).

Conclusion: The rate of positive family history of stuttering among Kurdish CWS is similar to previously reported data in the same age group. There was no significant association of family history of stuttering with sex and age on the onset of the disorder.

PMID: 39434952 PMCID: PMC11493213 DOI: 10.4103/abr.abr_233_23

 

 

 

FluencyBank Timestamped: An Updated Data Set for Disfluency Detection and Automatic Intended Speech Recognition - AVALIAÇÃO

J Speech Lang Hear Res. 2024 Oct 8:1-13. doi: 10.1044/2024_JSLHR-24-00070. Online ahead of print.

 

Amrit Romana, Minxue Niu, Matthew Perez, Emily Mower Provost

University of Michigan.

 

Purpose: This work introduces updated transcripts, disfluency annotations, and word timings for FluencyBank, which we refer to as FluencyBank Timestamped. This data set will enable the thorough analysis of how speech processing models (such as speech recognition and disfluency detection models) perform when evaluated with typical speech versus speech from people who stutter (PWS).

Method: We update the FluencyBank data set, which includes audio recordings from adults who stutter, to explore the robustness of speech processing models. Our update (semi-automated with manual review) includes new transcripts with timestamps and disfluency labels corresponding to each token in the transcript. Our disfluency labels capture typical disfluencies (filled pauses, repetitions, revisions, and partial words), and we explore how speech model performance compares for Switchboard (typical speech) and FluencyBank Timestamped. We present benchmarks for three speech tasks: intended speech recognition, text-based disfluency detection, and audio-based disfluency detection. For the first task, we evaluate how well Whisper performs for intended speech recognition (i.e., transcribing speech without disfluencies). For the next tasks, we evaluate how well a Bidirectional Embedding Representations from Transformers (BERT) text-based model and a Whisper audio-based model perform for disfluency detection. We select these models, BERT and Whisper, as they have shown high accuracies on a broad range of tasks in their language and audio domains, respectively.

Results: For the transcription task, we calculate an intended speech word error rate (isWER) between the model's output and the speaker's intended speech (i.e., speech without disfluencies). We find isWER is comparable between Switchboard and FluencyBank Timestamped, but that Whisper transcribes filled pauses and partial words at higher rates in the latter data set. Within FluencyBank Timestamped, isWER increases with stuttering severity. For the disfluency detection tasks, we find the models detect filled pauses, revisions, and partial words relatively well in FluencyBank Timestamped, but performance drops substantially for repetitions because the models are unable to generalize to the different types of repetitions (e.g., multiple repetitions and sound repetitions) from PWS. We hope that FluencyBank Timestamped will allow researchers to explore closing performance gaps between typical speech and speech from PWS.

Conclusions: Our analysis shows that there are gaps in speech recognition and disfluency detection performance between typical speech and speech from PWS. We hope that FluencyBank Timestamped will contribute to more advancements in training robust speech processing models.

PMID: 39378266 DOI: 10.1044/2024_JSLHR-24-00070

 

 

 

Functional Roles of Sensorimotor Alpha and Beta Oscillations in Overt Speech Production - LINGUAGEM

 bioRxiv [Preprint]. 2024 Oct 8:2024.09.04.611312.

 

Lydia Z Huang, Yang Cao, Esther Janse, Vitória Piai
Queensland University of Technology, Brisbane, Australia; Radboud University, Nijmegen, Netherlands.

 

Power decreases, or desynchronization, of sensorimotor alpha and beta oscillations (i.e., alpha and beta ERD) have long been considered as indices of sensorimotor control in overt speech production. However, their specific functional roles are not well understood. Hence, we first conducted a systematic review to investigate how these two oscillations are modulated by speech motor tasks in typically fluent speakers (TFS) and in persons who stutter (PWS). Eleven EEG/MEG papers with source localization were included in our systematic review. The results revealed consistent alpha and beta ERD in the sensorimotor cortex of TFS and PWS. Furthermore, the results suggested that sensorimotor alpha and beta ERD may be functionally dissociable, with alpha related to (somato-)sensory feedback processing during articulation and beta related to motor processes throughout planning and articulation. To (partly) test this hypothesis of a potential functional dissociation between alpha and beta ERD, we then analyzed existing intracranial electroencephalography (iEEG) data from the primary somatosensory cortex (S1) of picture naming. We found moderate evidence for alpha, but not beta, ERD's sensitivity to speech movements in S1, lending supporting evidence for the functional dissociation hypothesis identified by the systematic review.

PMID: 39416142 PMCID: PMC11482788 DOI: 10.1101/2024.09.04.611312

 

 

 

Genetic analyses of a large consanguineous south Indian family reveal novel variants in NAGPA and four hitherto unreported genes in developmental stuttering - GENÉTICA

Ann Hum Genet. 2024 Oct 9. Online ahead of print.

 

G Nandhini Devi et al

University of Madras, Chennai, Tamil Nadu, India; University of Delhi, South Campus, New Delhi, India; CommuniKonnect Speech and Language Therapy, Tirunelveli, Tamil Nadu, India; Speech & Hearing Care Center and Integrated Therapy Center for Autism, Chennai, Tamil Nadu, India.

 

Background: Developmental stuttering, a multifactorial speech disorder with remarkable rate of spontaneous recovery pose challenges for gene discoveries. Exonic variants in GNPTAB, GNPTG, and NAGPA involved in lysosomal pathway and AP4E1, IFNAR1, and ARMC3-signaling genes reported till date explain only ∼2.1% - 3.7% of persistent stuttering cases.

Aim: We aimed to identify additional genetic determinants of stuttering in a multiplex family by exome sequencing (n = 27) and further validation on additional extended family members (n = 21).

Materials & methods: We employed hypothesis-free and pathway-based analyses.

Results: A novel heterozygous exonic variant NM_016256.4:c.322G > A in NAGPA with reduced penetrance and predicted pathogenicity segregated with the phenotype in a large subset of the family. Reanalysis to identify additional disease-causing variant(s) revealed exonic heterozygous variants each in RIMS2 and XYLT1 in severely affected members; and IGF2R variant in a small subset of the family. Furthermore, pathway-based analysis uncovered NM_022089.4:c.3529G > A in ATP13A2 (PARK9) in affected members; and variants in GNPTAB and GNPTG of minor significance in a few affected members.

Discussion: Genotype-phenotype correlation efforts suggest that the combined effect of gene variants at multiple loci or variants in a single gene in different subsets of the pedigree (genetic heterogeneity) may be contributing to stuttering in this family. More importantly, variants identified in ATP13A2, a Parkinson's disease gene also implicated in lysosomal dysfunction, and RIMS2 suggests for the first time a likely role of dopamine signaling in stuttering.

Conclusion: Screening for these variants in independent stuttering cohorts would be astute.

PMID: 39382170 DOI: 10.1111/ahg.12579

 

 

 

Higher Frequency of Stuttered Disfluencies Negatively Affects Communicative Participation in Parkinson's Disease - GAGUEIRA ADQUIRIDA

J Speech Lang Hear Res. 2024 Sep 12:1-12. Online ahead of print.

 

Eloïse Gooch et al

University of Canterbury, Christchurch, New Zealand; New Zealand Brain Research Institute, Christchurch, New Zealand.; University of Otago, Christchurch, New Zealand; Christchurch Hospital, Te Whatu Ora Health New Zealand.

 

Purpose: Up to 90% of people with Parkinson's disease (PD) develop communication difficulties over the course of the disease. While the negative effect of dysarthria on communicative participation has been well-documented, the impact of the occurrence of acquired stuttered disfluencies on communication in different speech situations is unknown. This study aimed to determine if the frequency of occurrence of stuttered disfluencies affects communicative participation in individuals with PD, and whether such a relationship is mediated by examiner- and self-rated measures of disease severity.

Method: Conversational speech samples were collected from 100 people with PD aged 53-91 years to calculate the frequency of occurrence of stuttered disfluencies. Participants completed the Communicative Participation Item Bank to assess participation in communicative situations. Information on overall speech, cognitive, and motor performance was collected using both self-rated and examiner-rated methods.

Results: Participants with PD presented with 0.2%-9.9% stuttered disfluencies during conversation. Overall, participants with PD reported their communicative participation to be impacted "a little" (19.5 ± 7.0), but there was considerable interindividual variation. A higher frequency of stuttered disfluencies was associated with significantly lower communicative participation (ρ = -0.32, p < .01). In addition, examiner-rated frequency of stuttered disfluencies (p < .01), speech (p < .01), and motor severity (p = .04) were all significant predictors of communicative participation. Using self-ratings, speech (p < .01) and cognitive (p < .01) measures significantly predicted communicative participation.

Conclusions: In people with PD, communicative participation was significantly worse for those with a higher frequency of stuttered disfluencies. Examiner- and self-rated measures of disease severity contributed different information related to communicative constraints. Together, these results highlight the importance of individualized and holistic speech therapy that considers a wide variety of symptoms, including stuttered disfluencies, to ensure positive functional outcomes.

Supplemental material: https://doi.org/10.23641/asha.26850169.

PMID: 39265100 DOI: 10.1044/2024_JSLHR-24-00018

 

 

 

Influences of Attentional Focus on Across- and Within-Sentence Variability in Adults Who Do and Do Not Stutter - FALA

J Speech Lang Hear Res. 2024 Nov 6:1-13. Online ahead of print.

 

Kim R Bauerly, Eric S Jackson

b, The University of Vermont, Burlington; New York University, NY.

 

Purpose: Research has found an advantage to maintaining an external attentional focus while speaking as an increase in accuracy and a decrease in across-sentence variability has been found when producing oral-motor and speech tasks. What is not clear is how attention affects articulatory variability both across and within sentences, or how attention affects articulatory control in speakers who stutter. The purpose of this study was to investigate the effects of an internal versus external attention focus on articulatory variability at the sentence level.

Method: This study used linear (spatial-temporal index [STI]) and nonlinear (recurrence quantification analysis [RQA]) indices to measure lip aperture variability in 10 adults who stutter (AWS) and 15 adults who do not stutter (ANS) while they repeated sentences under an internal versus external attentional focus, virtual reality task (withVR.app; retrieved December 2023 from https://therapy.withvr.app). Four RQA measures were used to calculate within sentence variability including percent recurrence, percent determinism (%DET), stability (MAXLINE), and stationarity (TREND). Sentence duration measures were also obtained.

Results: AWS' movement durations were significantly longer than those of the ANS across conditions, and the AWS were more affected by the attentional focus shifts as their speech rate significantly increased when speaking with an external focus. AWS' speech patterns were also significantly more deterministic (%DET) and stable (MAXLINE) across attentional focus conditions compared to those of the ANS. Both groups showed an effect from attentional shifts as they exhibited less variability (i.e., more consistent) across sentences (STI) and less determinism (%DET) and stability (MAXLINE) within sentences when repeating sentences under an external attentional focus. STI values were not significantly different between the AWS and ANS for the internal or external attentional focus tasks. There were no significant main effects for group or condition for TREND; however, a main effect for sentence type was found.

Conclusion: Results suggest that AWS use a more restrictive and less flexible approach to movement and that an external focus fosters more flexibility and thus responsiveness to external factors.

PMID: 39504443 DOI: 10.1044/2024_JSLHR-24-00256

 

 

 

Influences of speaking task demands on sensorimotor oscillations in adults who stutter: Implications for speech motor control - LINGUAGEM

Clin Neurophysiol. 2024 Nov 10:S1388-2457(24). Online ahead of print.

 

Edward C Brown et al

University of Tennessee Health Science Center, Knoxville, TN, USA; University of Arkansas, Fayetteville, AR, USA; New Mexico State University, Las Cruces, NM, USA.

 

Objective: Motivated by previous inconsistent findings, this study aims to improve understanding of sensorimotor beta (β; 15-30 Hz) and alpha (α; 8-14 Hz) speech-related power differences between stuttering and non-stuttering adults.

Methods: Electroencephalography was recorded as adults who stutter (AWS) and matched fluent controls answered questions in Quiet and Informational Masked backgrounds. Bilateral sensorimotor β and α power during speech planning and execution were measured from mu (μ) rhythm components.

Results: Compared to controls, AWS exhibited reduced left hemisphere β and α power in both speaking conditions during speech planning and execution. AWS displayed reduced left α power in the Informational Masking compared to Quiet. Within AWS β and α power, which were tightly coupled, oppositely predicted stuttering severity and β-α dissociation (β minus α) was the strongest predictor.

Conclusion: Neither β nor α power are reliable markers of speech motor stability due to their sensitivity to speech task automaticity. However, relationships between these two sensorimotor rhythms warrant further investigation for understanding motor control.

Significance: Data help explain previous mixed findings in reference to extant models of speech motor control in stuttering and may have clinical implications for developing neurostimulation protocols targeting improved speech fluency.

PMID: 39580313 DOI: 10.1016/j.clinph.2024.10.017

 

 

 

Linguistic factors associated with stuttering-like disfluencies in Japanese preschool and school-aged children who stutter - INFANTIL / LINGUAGEM

J Commun Disord. 2024 Oct 14:112:106473. Online ahead of print.

 

Saburo Takahashi, Daichi Iimura, Osamu Ishida

Tokyo Gakugei University, Tokyo, Japan; University of Tsukuba, Ibaraki, Japan; Ibaraki University, Ibaraki, Japan.

 

Introduction: Stuttering is influenced by different linguistic factors, such as sentence- and word-level factors. However, its developmental differences remain unclear. Thus, this study examined the developmental differences in the linguistic factors associated with stuttering-like disfluencies (SLD) among Japanese preschool and school-aged children who stutter.

Methods: We analyzed utterances from 30 Japanese-speaking children who stutter aged 5-10 years. Participants were divided into three groups according to their age (5-6, 7-8, and 9-10 years old).

Results: Significant effects of sentence length, bunsetsu length, syllable weight, and bi-mora frequency on SLD frequency were observed across the age groups. In contrast, there was not a significant effect of mora frequency on SLD frequency.

Conclusions: Both sentence- and word-level factors affected SLD in children who stutter aged 5-10 years. Future research should be conducted with children below 5 years of age to observe detailed developmental differences in the linguistic factors that affect stuttering.

PMID: 39426102 DOI: 10.1016/j.jcomdis.2024.106473

 

 

 

Lived experiences of children who stutter in their own voices - INFANTIL / CONCEITO 

J Commun Disord. 2024 Sep 11:112:106468. Online ahead of print.

 

Julia S Kerrigan, Shelley B Brundage

George Washington University, USA.

 

Introduction: Significant research has explored the lived experiences of adults who stutter, but less research exists regarding the lived experiences of children who stutter. The opinions and ideas of children who stutter may differ from those of adults, making it important for clinicians and researchers to obtain information directly from children who stutter. Asking children directly can lead to treatment outcomes and research questions that better align with the children's needs and values.

Method: Interviews with 18 children who stutter (9 girls/9 boys) ages 8-17 were sourced from the Voices of Children Who Stutter database located at Talkbank.org. Interview questions asked the children about living with a stutter, participating in stuttering support organizations (SSOs), and their perspectives on treatment. Qualitative, phenomenological analysis was performed on their answers following standardized qualitative procedures.

Results: Analysis of 910 total utterances yielded 7 themes and 9 subthemes. Themes indicated that the children: (a) had significant knowledge regarding their own stuttering, (b) had opinions regarding what constituted worthwhile treatment outcomes, (c) were clear about desirable clinician characteristics for working with kids who stutter, and (d) saw the benefits of being part of a community.

Conclusions: Themes revealed that overall, children who stutter exhibit deep understanding regarding their experiences with stuttering, which clinicians can harness in person-centered goal setting. Additionally, the participants express the importance of participating in stuttering support organizations.

PMID: 39298865 DOI: 10.1016/j.jcomdis.2024.106468

 

 

 

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

 

 

 

Multidimensional Individualized Stuttering Therapy Outcomes At 24 Months Post Clinic: An Embodiment and Awareness Perspective - TERAPIA

Am J Speech Lang Pathol. 2024 Oct 30:1-12. Online ahead of print.

 

Hilda Sønsterud, Kirsten Costain, David Ward

Nord University, Bodø, Norway; National Service for Special Needs Education, Oslo, Norway; University of Reading, United Kingdom.

 

Purpose: Multidimensional Individualized Stuttering Therapy (MIST) is based on proactive collaborative work and shared decision making between client and clinician with the goal of identifying individual case-appropriate procedures and therapy elements in a manner that is meaningful and context-sensitive for each person. MIST combines value- and awareness-based elements from acceptance and commitment therapy (ACT) with stuttering and speech modification interventions. In keeping with the principles of ACT, we locate mindfulness as part of an embodied practice facilitated through a collaboration between the person who stutters and the speech-language therapist.

Method: The aim of this study was to see whether the positive results of MIST recorded at 12 months post-therapy remained stable at 24 months post-therapy and to consider the role of embodiment and awareness within MIST. Fifteen of 18 adults already enrolled in a treatment study (2015/FO12451) took part in a single-group repeated-measures design. They completed measures of stuttering severity, impact of stuttering, unhelpful thoughts and beliefs about stuttering, general anxiety symptoms, and fear of negative evaluation.

Results: There was a significant reduction of stuttering severity and negative impact of stuttering from pre-therapy to 24 months post-therapy. Unhelpful thoughts and beliefs about stuttering, symptoms of general anxiety, and fear of negative evaluation were reduced at 12 months post-therapy, and these values remained stable at 24 months post-therapy.

Conclusions: MIST was associated with positive outcomes at 24 months post-therapy, suggesting a possible connection between the person-centered approach and longer-term benefit. Findings are discussed within the context of mindfulness and embodied adjustment, and shared client-clinician decision making. The absence of a control group is a limiting factor regarding certainty of interpretation. Future research is therefore needed on collaborative and individualized approaches to stuttering therapy that include embodiment and awareness perspectives.

PMID: 39475631 DOI: 10.1044/2024_AJSLP-24-00074

 

 

 

No evidence of altered language laterality in people who stutter across different brain imaging studies of speech and language - PSICOMOTOR

Brain Commun. 2024 Sep 13;6(5):fcae305.

Free Full Text: https://academic.oup.com/braincomms/article/6/5/fcae305/7756778

 

Birtan Demirel et al

University of Oxford, Oxford, UK; University College Dublin, Dublin, Ireland; University of Reading, Reading, UK; University College London, London, UK.

 

A long-standing neurobiological explanation of stuttering is the incomplete cerebral dominance theory, which refers to competition between two hemispheres for 'dominance' over handedness and speech, causing altered language lateralization. Renewed interest in these ideas came from brain imaging findings in people who stutter of increased activity in the right hemisphere during speech production or of shifts in activity from right to left when fluency increased. Here, we revisited this theory using functional MRI data from children and adults who stutter, and typically fluent speakers (119 participants in total) during four different speech and language tasks: overt sentence reading, overt picture description, covert sentence reading and covert auditory naming. Laterality indices were calculated for the frontal and temporal lobes using the laterality index toolbox running in Statistical Parametric Mapping. We also repeated the analyses with more specific language regions, namely the pars opercularis (Brodmann area 44) and pars triangularis (Brodmann area 45). Laterality indices in people who stutter and typically fluent speakers did not differ, and Bayesian analyses provided moderate to anecdotal levels of support for the null hypothesis (i.e. no differences in laterality in people who stutter compared with typically fluent speakers). The proportions of the people who stutter and typically fluent speakers who were left lateralized or had atypical rightward or bilateral lateralization did not differ. We found no support for the theory that language laterality is reduced or differs in people who stutter compared with typically fluent speakers.

PMID: 39346021 PMCID: PMC11430911

 

 

 

Parental communication dynamics with children who stutter: A scoping review - INFANTIL / AMBIENTE

Review Int J Lang Commun Disord. 2024 Nov 6. Online ahead of print.

 

Idillette Hartman, Daleen Klop, Leslie Swartz

Stellenbosch University, Cape Town, Parow, South Africa.

 

Background: Parents of children who stutter (CWS) are often uncertain, hesitant and uncomfortable to communicate openly with their CWS and other people on the topic of the stutter and disclosing the stutter to the child and/or other people.

Aims: To map and understand the dynamics involved when parents communicate with their CWS and other people on the topic of their child's stuttering and disclosure of the stutter to the child and/or other people.

Methods: This scoping review was conducted in accordance with Joanna Briggs Institute methodology. The following platforms and search engines were identified and searched: Google Scholar, PubMed, ProQuest Databases and EBSCOhost: Academic Search Premier, Africa-Wide Information, CINAHL (Cumulative Index to Nursing and Allied Health Literature), ERIC (Educational Resources Information Center), Health Source Nursing/Academic Edition and MEDLINE. The search was limited to studies pertaining to parents of CWS, instead of people who stutter. The first two authors screened titles and abstracts of identified records, and thereafter, full-text screening was conducted of the selected articles as well as the reference lists.

Results: The scoping review yielded 14 records that included data from 12 different countries representing five continents. The 14 records comprised one systematic review, four expert opinions, two studies with mixed methods, five with qualitative designs and two with quantitative designs. The review content provided information about the nature, advantages and disadvantages of open communication and disclosure as well as reasons why parents of CWS are reluctant or willing to communicate in an open way.

Conclusions: There is limited information available about parental communication with CWS on the topic of their stuttering and disclosure of the child's stuttering to the child and/other people. The complexity of communication dynamics between CWS and their parents requires further in-depth research.

Contribution: This study highlights the lack of empirical evidence about disclosure and the dynamics of open communication between parents and their CWS and the need for research to gain insight into this topic.

PMID: 39502044 DOI: 10.1111/1460-6984.13129

 

 

 

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

 

 

 

Predicting attitudes related to stuttering from an international database - SOCIAL

J Commun Disord. 2024 Sep 7:112:106457. Online ahead of print.

 

Kenneth O St Louis

West Virginia University, Morgantown, WV, United States

 

Purpose: A vast number of studies over the past 50 years have explored public and professional attitudes toward stuttering, and many of them have identified variables that predict more-or less-positive attitudes. Part I of this study summarized 91 studies in terms of consistency of prediction of stuttering attitudes. Part II sought to compare a considerable number of potential predictors and to quantify their prediction strengths.

Method: Thirty-seven predictors were analyzed in linear regression models using a retrospective analysis of a database consisting of 22,413 respondents from 44 countries who had filled out the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) in 26 different languages. Dependent variables were two POSHA-S subscores, Beliefs about stuttering and Self Reactions to people who stutter, as well as the mean of these two subscores, the Overall Stuttering Score.

Results: All 37 predictors were statistically significant for most-but at least one-of the three scores. The strongest predictors related to regions of the world and related variables of countries and languages, with greater strength for Beliefs than for Self Reactions. Knowing persons who stutter, or knowing about stuttering, were moderate predictors of Self Reactions but weak predictors of Beliefs. Different populations, such as the public, students, or speech-language pathologists, moderately predicted attitudes on all three dependent variables while education level and self-ratings of ability to speak were weak predictors. Sex (gender), age, income, parental or marital status, and most of 12 life priorities (e.g., get things done; be safe and secure) had very weak and practically insignificant predictive potential.

Conclusions: The study confirmed previous research showing ambiguous results for such predictors as sex and age but consistent differences from various geographic regions. Beliefs and Self Reactions measure different constructs that are often predicted differently by variables.

PMID: 39426101 DOI: 10.1016/j.jcomdis.2024.106457

 

 

 

Prevalence of Smoking Among School Students in Iraq - CONCEITO

Cureus. 2024 Aug 16;16(8):e67048.
Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403287/pdf/cureus-0016-00000067048.pdf

 

Omaima A Zubair Jr

College of Medicine, University of Mosul, Mosul, IRQ.

 

Background Developing communities like Iraq are critical to building a good community environment. Many complex patterns of behaviors like smoking among adolescents have been exacerbated rapidly in the current era which led to changes in the Iraqi community's perspectives and life expectancy. This study aims to find out the prevalence of smoking among secondary school students in Iraq and their perceived contributing factors. Methods A cross-sectional study design was used with a representative sample of Iraqi school students recruited through a multistage cluster randomization from the Nineveh Governorate's intermediate and secondary schools to ensure the representation of the general public strata. A total of 330 students were randomly selected from eight schools distributed all over Mosul city (the center of Nineveh Governorate) and its boundaries semi-rural areas. Data collection utilized a standardized, anonymous questionnaire based on the Global Youth Tobacco Survey (GYTS) administered within classrooms with the researcher's presence. The questionnaire included questions related to sociodemographic characteristics of the students, smoking state, smoking types, frequency of smoking, relative smoking state, opinion on predisposing factors for initiation of smoking, and knowledge about hazards of smoking. Data analysis was done using SPSS version 26 to calculate frequency distribution with further logistic regression analysis was performed to identify statistically significant factors contributing to initiation of smoking among the student participants with p-value estimation of any compares considered significant below 0.05.

Results Prevenance of all types of smoking was 24.5% from 330 students with 30% from 246 males and 7% from 84 females has been encountered. Hookah (Shisha) was the most prevalent type of smoking. About a third of the smoker sample reported smoking at least once daily. Peer pressure (OR=3.49, P< 0.001) or family smoking (OR=1.769, P=0.019) emerged as the strongest influence for initiation of smoking, besides stress (OR=2.23, P= 0.04) and personality traits like stammering and jealousy (OR=2.58, P= 0.013), (OR=2.22, P= 0.017, respectively) have also significant odds. Interestingly, media (movie star) influence played a significant role also. (OR=1.492, P= 0.045).

Conclusion The prevalence of smoking among the study sample was 24.5 % out of 330 participating students. Significant influencing factors were found that raised the concern and necessitated the development of targeted interventions. Implementing evidence-based strategies, such as comprehensive school-based educational programs and smoke-free indoor air policies, can significantly improve public health outcomes.
PMID: 39286692 PMCID: PMC11403287 DOI: 10.7759/cureus.67048

 

 

 

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

 

 

 

Reduced resting-state periodic beta power in adults who stutter is related to sensorimotor control of speech execution - NEUROCIÊNCIAS

Cortex. 2024 Oct 24:181:74-92. Online ahead of print.

 

Andrew Bowers, Daniel Hudock

University of Arkansas, Fayetteville, AR, USA; Idaho State University, Pocatello, ID, USA.

 

Objective: The primary aim of the current study was to determine whether adults who stutter (AWS) present with anomalous periodic beta (β) rhythms when compared to typically fluent adults in the eyes-open resting state. A second aim was to determine whether lower β power in the RS is related to a measure of β event-related desynchronization (ERD) during syllable sequence execution.

Methods: EEG data was collected from 128 channels in a 5 min, eyes-open resting state condition and from a syllable sequence repetition task. Temporal independent component analysis (ICA) was used to separate volume conducted EEG sources and to find a set of component weights common to the RS and syllable repetition task. Both traditional measures of power spectral density (PSD) and parameterized spectra were computed for components showing peaks in the β band (13-30 Hz). Parameterization was used to evaluate separable components adjusted for the 1/f part of the spectrum.

Results: ICA revealed frontal-parietal midline and lateral sensorimotor (μ) components common to the RS and a syllable repetition task with peaks in the β band. The entire spectrum for each component was modeled using the FOOOF algorithm. Independent samples t-tests revealed significantly lower periodic β in midline central-parietal and lateral sensorimotor components in AWS. Regression analysis suggested a significant relationship between left periodic sensorimotor β power in the RS and ERD during syllable sequence execution.

Conclusions: Findings suggest that periodic β peaks in the spectrum are related to hypothesized underlying pathophysiological differences in stuttering, including midline rhythms associated the default mode network (DMN) and lateral sensorimotor rhythms associated with the control of movement.

PMID: 39509758 DOI: 10.1016/j.cortex.2024.09.016

 

 

 

Self-inefficacy's impact on well-being indices in students self-identifying with cluttering characteristics - TAQUIFEMIA

J Commun Disord. 2024 Sep 13:112:106469. Online ahead of print.

 

Gil Zukerman, Michal Icht, Avi Zigdon, Liat Korn

Ariel University, Ariel, Israel.

 

Introduction: Cluttering, a fluency disorder characterized by fast and irregular speech patterns, receives relatively limited research attention. Consequently, the association between cluttering and measures of well-being remains unexplored. In contrast, stuttering, another fluency disorder, has been associated with anxiety and depression. The present study examines whether an individual's experience of cluttering characteristics is related to alterations in both positive and negative measures of well-being. To achieve this, we assessed the relationship between Self-Identified Cluttering Characteristics (SICC) and measures of well-being in a sizeable sample of 1201 university students. Our main objective was to explore the potential impact of self-inefficacy on the association between SICC and well-being.

Methods: Consistent with prior research, participants identified themselves as having cluttering characteristics (SICC) or no-cluttering characteristics (SINCC) based on a verbal and written explanation of the disorder. They also completed questionnaires on psychological well-being indices and self-inefficacy.

Results: In total, 276 respondents identified themselves as having cluttering characteristics. In regression models, both SICC and self-inefficacy were predictive of greater negative well-being, increased depressive symptoms, and heightened psychosomatic symptoms. Interestingly, ADHD diagnosis was associated with less negative well-being. Positive well-being indicators (positive future orientation and subjective happiness) were solely predicted by self-inefficacy. Supporting these findings, supplementary regressions including only 56 SICC participants who reported being treated for cluttering yielded similar results. Utilizing Hayes's PROCESS computational procedures to test moderation revealed that self-inefficacy significantly moderated the association between SICC and negative well-being (depressive symptoms) as well as the association between SICC and positive well-being (positive future orientation).

Conclusions: The findings underscore alterations in well-being among individuals who identify themselves as experiencing cluttering characteristics. Primarily, heightened negative well-being was noted in those with SICC, yet individual self-inefficacy reports mitigated this effect. Overall, SICC exacerbates negative well-being rather than diminishing positive well-being. These findings point to the importance of integrating mental health assessment and intervention into clinical practice for individuals with cluttering symptoms and the potential benefits of interventions targeting self-inefficacy to improve overall well-being in this population.

PMID: 39303662 DOI: 10.1016/j.jcomdis.2024.106469

 

 

 

Speaking to a metronome reduces kinematic variability in typical speakers and people who stutter - FALA

PLoS One . 2024 Oct 16;19(10):e0309612.

Free full text: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0309612

 

Charlotte E E Wiltshire et al

University of Oxford, Oxford, United Kingdom; Bangor University, Bangor, United Kingdom; Ludwig-Maximilian-University, Munich, Germany;  University of Washington, Seattle, Washington, United States of America; University of Toronto, Toronto, Canada; Sunnybrook Research Institute, Toronto, Canada; University of Cambridge, Cambridge, United Kingdom.

 

Background: Several studies indicate that people who stutter show greater variability in speech movements than people who do not stutter, even when the speech produced is perceptibly fluent. Speaking to the beat of a metronome reliably increases fluency in people who stutter, regardless of the severity of stuttering.

Objectives: Here, we aimed to test whether metronome-timed speech reduces articulatory variability.

Method: We analysed vocal tract MRI data from 24 people who stutter and 16 controls. Participants repeated sentences with and without a metronome. Midsagittal images of the vocal tract from lips to larynx were reconstructed at 33.3 frames per second. Any utterances containing dysfluencies or non-speech movements (e.g. swallowing) were excluded. For each participant, we measured the variability of movements (coefficient of variation) from the alveolar, palatal and velar regions of the vocal tract.

Results: People who stutter had more variability than control speakers when speaking without a metronome, which was then reduced to the same level as controls when speaking with the metronome. The velar region contained more variability than the alveolar and palatal regions, which were similar.

Conclusions: These results demonstrate that kinematic variability during perceptibly fluent speech is increased in people who stutter compared with controls when repeating naturalistic sentences without any alteration or disruption to the speech. This extends our previous findings of greater variability in the movements of people who stutter when producing perceptibly fluent nonwords compared with controls. These results also show, that in addition to increasing fluency in people who stutter, metronome-timed speech also reduces articulatory variability to the same level as that seen in control speakers.

PMID: 39413058 PMCID: PMC11482672

 

 

 

Speech characteristics that differentiate stuttering and cluttering in Japanese speakers - TAQUIFEMIA

Front Psychol. 2024 Nov 14:15:1408929

Free Full Text: https://pmc.ncbi.nlm.nih.gov/articles/PMC11602310/pdf/fpsyg-15-1408929.pdf

 

Shuta Tomisato et al

Keio University School of Medicine, Shinjuku, Tokyo, Japan; University of Tsukuba, Ibaraki, Japan; Tokyo Metropolitan University, Hachioji, Tokyo, Japan; Sumiyoshi Elementary School, Tokyo, Japan; Tokai University School of Medicine, Isehara, Japan.

 

Background: Cluttering is a speech disorder distinct from stuttering. Despite this distinction, there is no established method to clearly differentiate the two disorders. This study aimed to use objective criteria to differentiate cluttering from stuttering in Japanese speakers.

Methods: Participants were 32 consecutive native-Japanese speakers who visited the Keio University Hospital between July 2020 and January 2023 with a chief complaint of speech disfluency. One physician and two speech-language-hearing therapists concurred on a stuttering or cluttering diagnosis of the 32 patients based on recordings of the Kitsuon kensa-ho test. The frequencies of stuttering-like disfluencies (SDF) and normal disfluencies (NDF) were calculated from the Kitsuon kensa-ho, and the ratio of disfluencies (RDF) was calculated as the ratio of SDF to NDF. Differences between the cluttering and stuttering groups in the RDF and the mean articulatory rate (MAR) for oral reading and a monologue task were tested using the Mann-Whitney U test. ROC curves were used to determine the sensitivity and specificity that well-distinguished subjects with cluttering from those with stuttering; the experts' diagnosis was the gold standard.

Results: Of the 32 participants, 12 (38%) were diagnosed with cluttering and 20 (62%) with stuttering. The cluttering and stuttering groups were comparable in demographic characteristics. The RDF on monologue task had the highest sensitivity in diagnosing cluttering, and the MAR on monologue task had the highest specificity. Adopting provisional criteria of a monologue RDF greater than 1.2 and a monologue MAR greater than 7.5 produced a sensitivity of 0.92 and a specificity of 0.95.

Conclusion: We conclude that combining monologue RDF and monologue MAR well-distinguished cluttering from stuttering. This method provides new objective diagnostic criteria, which can aid clinicians, therapists, and basic researchers.

PMID: 39610452 PMCID: PMC11602310 DOI: 10.3389/fpsyg.2024.1408929

 

 

 

The clinical and genetic spectrum of paediatric speech and language disorders - GENÉTICA

Brain. 2024 Oct 16:awae264. Online ahead of print.

 

Jan H Magielski et al

Children's Hospital of Philadelphia, Philadelphia, PA , USA; University of Pennsylvania, Philadelphia, PA 19104, USA, Murdoch Children's Research Institute, Parkville, VIC , Australia; University of Melbourne, Parkville, VIC , Australia.

 

Speech and language disorders are known to have a substantial genetic contribution. Although frequently examined as components of other conditions, research on the genetic basis of linguistic differences as separate phenotypic subgroups has been limited so far. Here, we performed an in-depth characterization of speech and language disorders in 52 143 individuals, reconstructing clinical histories using a large-scale data-mining approach of the electronic medical records from an entire large paediatric healthcare network. The reported frequency of these disorders was the highest between 2 and 5 years old and spanned a spectrum of 26 broad speech and language diagnoses. We used natural language processing to assess the degree to which clinical diagnoses in full-text notes were reflected in ICD-10 diagnosis codes. We found that aphasia and speech apraxia could be retrieved easily through ICD-10 diagnosis codes, whereas stuttering as a speech phenotype was coded in only 12% of individuals through appropriate ICD-10 codes. We found significant comorbidity of speech and language disorders in neurodevelopmental conditions (30.31%) and, to a lesser degree, with epilepsies (6.07%) and movement disorders (2.05%). The most common genetic disorders retrievable in our analysis of electronic medical records were STXBP1 (n = 21), PTEN (n = 20) and CACNA1A (n = 18). When assessing associations of genetic diagnoses with specific linguistic phenotypes, we observed associations of STXBP1 and aphasia (P = 8.57 × 10-7, 95% confidence interval = 18.62-130.39) and MYO7A with speech and language development delay attributable to hearing loss (P = 1.24 × 10-5, 95% confidence interval = 17.46-infinity). Finally, in a sub-cohort of 726 individuals with whole-exome sequencing data, we identified an enrichment of rare variants in neuronal receptor pathways, in addition to associations of UQCRC1 and KIF17 with expressive aphasia, MROH8 and BCHE with poor speech, and USP37, SLC22A9 and UMODL1 with aphasia. In summary, our study outlines the landscape of paediatric speech and language disorders, confirming the phenotypic complexity of linguistic traits and novel genotype-phenotype associations. Subgroups of paediatric speech and language disorders differ significantly with respect to the composition of monogenic aetiologies.

PMID: 39412438 DOI: 10.1093/brain/awae264

 

 

 

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

 

 

 

Transient Stuttering as a Sole Presentation in a Patient With a Subcentimeter Left Frontal Cortical Ischemic Infarct - GAGUEIRA ADQUIRIDA

Case Reports Cureus. 2024 Sep 15;16(9):e69466

Free Full Text: https://assets.cureus.com/uploads/case_report/pdf/282891/20240916-1034241-1ba9ki.pdf

 

Ethan Salter et al

Adventist Health White Memorial, Los Angeles, USA; University of Central Florida, Orlando, USA.; Loma Linda University School of Medicine, Loma Linda, USA.

 

Stuttering is a complex speech disorder that is associated with a variety of etiologies, including psychological factors, metabolic disorders, and structural abnormalities. While stuttering is typically not caused by stroke, it is important to include it in the diagnostic evaluation, especially in patients with a history of neurological conditions. Of the clinical presentations of stroke-induced stuttering, transient stuttering following stroke has seldom been documented, as most patients who develop a stutter following a stroke end up developing permanent speech deficits. Additionally, as most cases of stroke-induced stuttering are part of a broader neurological presentation, stuttering generally does not present as an isolated symptom. Furthermore, although strokes of various sizes have been implicated in stuttering, it is quite uncommon for the affected lesion to be smaller than 1 cm. We present a rare case of transient, isolated stuttering following a subcentimeter stroke and a subsequent review of relevant literature. Our case report highlights the diversity of stroke-related speech disorders and the importance of considering even minor strokes in the differential diagnosis of stuttering.
PMID: 39286472 PMCID: PMC11405082 DOI: 10.7759/cureus.69466

 

 

 

Usefulness of automated tractography for outcome prediction in patients with recurrent stroke - NEUROCIÊNCIAS

J Phys Ther Sci. 2024 Oct;36(10):677-683. Epub 2024 Oct 1.

 

Tetsuo Koyama, Midori Mochizuki, Yuki Uchiyama, Kazuhisa Domen

Nishinomiya Kyoritsu Neurosurgical Hospital: Hyogo, Japan; Hyogo Medical University, Japan; Showa University Hospital, Japan.

 

[Purpose] To examine the usefulness of automated tractography for predicting outcomes in patients with recurrent stroke. [Participants and Methods] Diffusion tensor imaging was performed in the second week after stroke, and fractional anisotropy was calculated using automated tractography. Three patients with recurrent strokes were included in this study. [Results] Initial computed tomography findings of a 62-year-old man with stuttering speech revealed a hemorrhage in the left thalamus. Fractional anisotropy indicated slight neural damage in the association fibers of both hemispheres. The patient returned to work with mild attention deficit and aphasia. Initial diffusion-weighted imaging of a 75-year-old man with right upper extremity paresis showed high-intensity areas in the left corona radiata. Fractional anisotropy indicated bilateral neural damage to the corticospinal tract. The patient was discharged with severe right upper extremity impairment and a modified gait. Initial diffusion-weighted imaging of a 60-year-old woman with moyamoya disease who experienced a sudden loss of consciousness showed high-intensity areas in the left anterior circulation territories. Fractional anisotropy indicated severe damage to the right hemisphere, the corticospinal tract, and the superior longitudinal fasciculus of the left hemisphere. She was transferred to a nursing home and remained bedridden. [Conclusion] The symptoms identified in this study agreed with automated tractography findings, which suggests that this methodology is useful for predicting recurrent stroke outcomes.

PMID: 39354929 PMCID: PMC11441893 DOI: 10.1589/jpts.36.677

 

 

 

When adults with speech-language impairment meet law enforcement: A qualitative analysis of client experiences - AMBIENTE

J Commun Disord. 2024 Oct 6:112:106471. Online ahead of print.

 

Margaret L Greenwald, Derek E Daniels

Wayne State University, Detroit, MI, USA.

 

Introduction: Members of law enforcement and the general public who have limited knowledge of persons with communication impairments (PCI) may misinterpret their communication behaviors. Few studies exist about communication between PCI and law enforcement, and data are lacking about the factors that may influence their interactions. Considering this need, we addressed the following research questions: How will PCI describe their attitudes and experiences related to interacting with law enforcement? What individual characteristics may influence these attitudes and experiences?

Methods: In individual semi-structured interviews, we asked 10 adults with speech-language differences (aphasia, dysarthria, or stuttering) to describe their experiences of interacting with members of law enforcement, the communication strategies they would use when interacting with law enforcement, and what they would like members of law enforcement to know about their communication needs. In qualitative analyses, we generated themes from the data.

Results: Three main themes and four subthemes were evident in participant responses. Participant emotions and communication behavior were affected in complex ways during their interactions with a person of authority in uniform. In this sample of PCI, levels of confidence about communicating with strangers were lower for participants with no visible characteristics versus those who exhibited these signs. The participants recommended communication strategies for use by members of law enforcement.

Conclusions: These findings extend the limited literature on this topic to include factors that appear to influence the attitudes and experiences of PCI during their interactions with law enforcement. In clinical application, speech-language pathologists have an important role to play in assisting clients to practice individualized communication strategies for interactions with law enforcement in various contexts. Further research is needed into the perspectives of PCI and the attitudes and experiences of law enforcement when interacting with PCI.

PMID: 39405771 DOI: 10.1016/j.jcomdis.2024.106471