Eliana Maria Nigro Rocha

 e-gagueira.com.br

 

Abstract  - Janeiro a Julho de 2024

 

 

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

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

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

 

Yael Neumann

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

 

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

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

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

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

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

 

 

 

A prospective 14-year follow-up study of the persistence and recovery of stuttering - INFANTIL / CONCEITO

J Fluency Disord. 2024 Apr 5:80:106058. Online ahead of print.

 

Jóhanna T Einarsdóttir, Brynja Hermannsdóttir, Kathryn Crowe

University of Iceland, Reykjavik, Iceland; Charles Sturt University, Bathurst, Australia.

 

Purpose: To document the trajectory of early childhood stuttering longitudinally for 14. years with a consideration on the features of overt and covert stuttering related to recovery status.

Method: Thirty-eight participants were observed longitudinally at three different time points: early childhood (Occasion 1), middle childhood (Occasion 2), and late adolescence (Occasion 3). Data collection involved speech samples and reports of stuttering experiences. Recovery on Occasion 3 was estimated through analysis of speech samples, parent and expert judgments, and self- judgement. Two categories of persistence were used: persistent-subjective (no observable stuttering) and persistent-objective (observable stuttering).

Results: The recovery rate was 65.6%. The majority of the participants showed minimal disfluent speech with 88% showing less than 1% syllables stuttered and 97% showing less than 3% syllables stuttered in the collected speech samples. All participants classified as persistent reported covert symptoms of stuttering. No relapses in recovery were observed between Occasion 2 and Occasion 3. Late recovery was only observed for those classified as persistent-subjective on Occasion 2. About 64% of the participants showing observable stuttering (persistent-objective) on Occasion 2 showed no observable stuttering (persistent-subjective) on Occasion 3.

Conclusions: Children continue to recover from early childhood stuttering as they age.The inclusion of self-reports adds to the understanding of recovery especially concerning the covert stuttering behaviours. The presence of overt symptoms of stuttering in the speech samples of children aged 7 to 13 years seems to be associated with the likelihood of late recovery of stuttering.

PMID: 38636390 DOI: 10.1016/j.jfludis.2024.106058

 

 

 

A Study of Emotion Regulation Difficulties, Repetitive Negative Thinking, and Experiential Avoidance in Adults with Stuttering: A Comparative Study - EMOCIONAL

Iran J Psychiatry. 2024 Jan;19(1):79-88.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10896752/pdf/IJPS-19-79.pdf

 

Jafar Sarani Yaztappeh et al

Shahid Beheshti University of Medical Sciences, Tehran, Iran; Tarbiat Modares University, Tehran, Iran; Iran University of Medical Sciences, Tehran, Iran; Specialized Center of Psychology and Psychotherapy, Kermanshah, Iran; Kermanshah University of Medical Sciences, Kermanshah, Iran; Azad University, Kermanshah, Iran; University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Zahedan University of Medical Sciences, Zahedan, Iran.

 

Objective: Stuttering is a type of communication and fluency disorder that hurts mental and emotional health. It is also associated with a significant increase in both trait and social anxiety. Studies on stuttering in adults have indicated the nature and impact of this phenomenon. In addition, some psychological aspects of this phenomenon remain vague and need further investigation. Therefore, the present study aimed to compare emotion regulation difficulties, repetitive negative thinking, and experiential avoidance between people who stutter and healthy individuals.

Method : In this study, 101 people who stutter (43 females and 58 males, with a mean age of 29.55 ± 18,7 years), as well as 110 healthy individuals (74 females and 36 males, with a mean age of 25.57 ± 4,89 years) as participants were chosen using the convenience sampling method among those who referred to the speech therapy clinics of Tehran, Iran. Research instruments including the repetitive negative thinking inventory, Difficulties in Emotion Regulation Scale, and Acceptance and Action Questionnaire (AAQ-I) were used for data collection. Data were analyzed using multivariate ANOVA test and Multiple Regression Analysis.

Results: The mean age of the participants was 29.55 years in the people who stutter and 25.57 years in the healthy individuals (P < 0.01). The present results indicated that the mean score of experiential avoidance was higher in the people who stutter (M ± SD: 35.74 ± 9.24) compared to the healthy individuals (M ± SD: 8.89 ± 31.11). Additionally, the mean score of emotion regulation difficulties was higher in the people who stutter (M ± SD: 88.75 ± 20.59) compared to the healthy individuals (M ± SD: 64.14 ± 94.94) (P < 0.001). However, there was no significant difference in the mean score of repetitive negative thinking between the people who stutter (M ± SD: 98.45 ± 25.85) and healthy individuals (M ± SD: 93.71 ± 25.24) groups (P > 0.05). There was a significant correlation between experiential avoidance and emotion regulation difficulties in people who stutter (P < 0.01). Experiential avoidance and repetitive negative thinking can significantly predict emotion regulation difficulties in people who stutter (R = 0.65, P < 0.01).

Conclusion: People who stutter obtained higher emotion regulation difficulties and experiential avoidance scores than those without stuttering and A significant correlation between experiential avoidance and emotion regulation difficulties was found. Future studies should consider the role of emotion regulation difficulties and experiential avoidance in people who stutter.

PMID: 38420285 PMCID: PMC10896752 DOI: 10.18502/ijps.v19i1.14341

 

 

 

Abnormal cerebral blood flow in children with developmental stuttering - INFANTIL / NEUROCIÊNCIAS

Pediatr Res. 2024 Jun 24. Online ahead of print.

 

Wanqing Liuet al

West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China; The Fourth People's Hospital of Chengdu, Chengdu, China.

 

Background: Stuttering affects approximately 5% of children; however, its neurological basis remains unclear. Identifying imaging biomarkers could aid in early detection. Accordingly, we investigated resting-state cerebral blood flow (CBF) in children with developmental stuttering.

Methods: Pulsed arterial spin labelling magnetic resonance imaging was utilised to quantify CBF in 35 children with developmental stuttering and 27 healthy controls. We compared normalised CBF between the two groups and evaluated the correlation between abnormal CBF and clinical indicators.

Results: Compared with healthy controls, the stuttering group exhibited decreased normalised CBF in the cerebellum lobule VI bilaterally, right cuneus, and left superior occipital gyrus and increased CBF in the right medial superior frontal gyrus, left rectus, and left dorsolateral superior frontal gyrus. Additionally, normalised CBF in the left cerebellum lobule VI and left superior occipital gyrus was positively correlated with stuttering severity.

Conclusions: Children who stutter display decreased normalised CBF primarily in the cerebellum and occipital gyrus, with increased normalised CBF in the frontal gyrus. Additionally, the abnormal CBF in the left cerebellum lobule VI and left superior occipital gyrus was associated with more severe symptoms, suggesting that decreased CBF in these areas may serve as a novel neuroimaging clue for stuttering.

Impact: Stuttering occurs in 5% of children and often extends into adulthood, which may negatively affect quality of life. Early detection and treatment are essential. We used pulsed arterial spin labelling magnetic resonance imaging to visualise the resting-state cerebral blood flow (CBF) in children who stutter and healthy children. Normalised CBF was decreased in stutterers in the cerebellum and occipital gyrus and increased in the frontal gyrus. Stuttering severity was linked to abnormal normalised CBF in the left cerebellum lobule VI and left superior occipital gyrus, suggesting that CBF may serve as a novel neuroimaging clue for stuttering.

PMID: 38914760 DOI: 10.1038/s41390-024-03359-1

 

 

 

Allergies, asthma, and sleep problems in adults who stutter - AVALIAÇÃO

J Fluency Disord. 2024 Jun 4:81:106063. Online ahead of print.

 

Sandra Merlo, Patrick M Briley

Brazilian Fluency Institute, Sao Paulo, SP, Brazil. Electronic address: merlo.sandra@gagueira.org.br; East Carolina University, Greenville, NC, United States.

 

Purpose: Previous studies have suggested that allergies, asthma, and sleep problems are prevalent in those who stutter. This study analyzed similar data for a broad age group of adults who stutter (AWS).

Method: Data from the 2012 National Health Interview Survey were analyzed. Adults from 18 to 60 + years of age reported a) to have stuttered, b) to have had any allergy, asthma, or acid reflux, c) to have had insomnia/trouble sleeping and daytime negative consequences, and d) average sleeping hours per day in the past 12 months.

Results: The sample included 320 AWS and 33,043 controls. AWS were at greater odds of respiratory, food, and skin allergies (OR = 2.38, 2.36, and 2.09, respectively), as well as asthma and acid reflux (OR = 2.30 and 2.01, respectively) than controls. AWS were at greater odds of insomnia/trouble sleeping, oversleeping, excessive sleepiness, and fatigue than controls (OR = 2.11, 1.71, 2.67, and 1.81, respectively). The subgroup of AWS with no allergy, asthma, and acid reflux were also at greater odds of insomnia/trouble sleeping and excessive sleepiness than controls (OR = 2.13 and 3.11, respectively). Differences were found in specific age groups: younger/middle-aged AWS reported more allergies, asthma, and acid reflux than controls, while older AWS did not; younger/middle-aged AWS reported more insomnia/trouble sleeping than controls, while older AWS reported more oversleeping.

Conclusions: Findings on younger and middle-aged AWS are similar to previous ones on children and adolescents who stutter. Differences regarding younger/middle-aged and older AWS could be consequence of environmental variables.

PMID: 38851135 DOI: 10.1016/j.jfludis.2024.106063

 

 

 

[Analysis of language and influencing factors of children with speech disorder in Beijing] - OUTROS

Zhonghua Er Ke Za Zhi. 2024 Apr 16;62(5):438-443. Online ahead of print.

 [Article in Chinese] Abstract in English, Chinese

 

J H Wang et al

Children's Hospital, Capital Institute of Pediatrics, Beijing, China; Minzu University of China, Beijing, China; Hainan Boao Bethel International Medical Center, Qionghai, China.

 

Objective: To investigate the features and influencing factors of language in children with various types of speech disorders.

Methods: A case-control study was carried out, 262 children with speech disorder had been diagnosed at the language-speech clinic of the Center of Children's Healthcare, Children's Hospital, Capital Institute of Pediatrics from January 2021 to November 2023, the children with speech sound disorder as the speech sound disorder group, the children with developmental stuttering as the stuttering group. There were 100 typically-developed children who underwent physical checkups at the Center of Healthcare during the same period as the healthy group. All children experienced a standardized evaluation of language with diagnostic receptive and expressive assessment of mandarin-comprehensive(DREAM-C) and questionnaire, One-way ANOVA and LSD test were conducted to compare the differences in overall language, receptive language, expressive language, semantics, and syntax scores among 3 groups of children. According to the results of DREAM-C, the children with speech disorder were divided into language normal group and language delay group. Chi-square test and multivariate Logistic regression were implemented to analyze the association between the linguistic development of children with speech disorder and potential influential factors.

Results: There were 145 children in the speech sound disorder group, including 110 males and 35 females respectively, with an age of (5.9±1.0) years; 117 children in the stuttering group, including 91 males and 26 females, with an age of (5.8±1.0) years; 100 children in the healthy group, including 75 males and 25 females, with an age of (5.7±1.2) years. The variations in overall language, expressive language, and syntax scores among 3 groups of children were statistically significant (92±18 vs.96±11 vs. 98±11, 81±18 vs. 84±14 vs. 88±13, 87±16 vs. 89±11 vs. 91±10, F=5.46, 4.69, 3.68, all P<0.05). Pairwise comparison revealed that the speech sound disorder group had lower scores in overall language, expressive language, and syntactic compared to the healthy group, and the differences were statistically significant (all P<0.01) and the overall language score was lower than that of children with stuttering (P<0.05). In terms of overall language and expressive language, there was a statistically significant difference in the incidence of language delay among the three groups of children (15.9% (23/145) vs. 20.5% (24/117) vs. 7.0% (7/100), 46.2% (67/145) vs. 39.3% (46/117) vs. 26.0% (26/100); χ2=7.93, 10.28; both P<0.05). In terms of overall language, the stuttering group took up the highest proportion. In terms of expressive language, the speech sound disorder group accounted for the highest amount. The incidence of language delay in children with speech disorder was 44.3% (116/262). Non-parent-child reading, daily screen time ≥1 hour and screen exposure before 1.5 years of age are risk factors for the development of language in children with speech disorder (OR=1.87, 2.18, 2.01; 95%CI 1.07-3.27, 1.23-3.86, 1.17-3.45; all P<0.01). Negative family history are protective factors for the progress of language ability (OR=0.37, 95%CI 0.17-0.81, P<0.05).

Conclusions: Children with speech disorder tend to have easy access to language delay, especially in expressive language and syntax. The occurrence of language delay in children with speech disorder is tightly connected with factors such as the family medical history, parent-child reading, screen time, etc. Attention should be paid to the development of language in children who suffer from speech disorder.

PMID: 38623011 DOI: 10.3760/cma.j.cn112140-20240105-00015

 

 

 

Associations between social anxiety, physiological reactivity, and speech disfluencies in autistic young adults and controls - OUTRAS ÁREAS

J Commun Disord. 2024 Apr 2:109:106425. Online ahead of print

Free article: https://www.sciencedirect.com/science/article/pii/S0021992424000212?via%3Dihub

 

Veera Pirinen, Kurt Eggers et al

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

 

Introduction: The aim of this study was to examine possible associations of social anxiety (SA) and speaking-related physiological reactivity with the frequencies of a) total disfluencies, b) typical disfluencies, and c) stuttering-like disfluencies, as well as d) stuttering-severity in autistic young adults and controls.

Methods: Thirty-two autistic young adults and 35 controls participated in this study. Participants were presented with video clips (viewing condition) and were then asked to talk about the videos (narrating condition). SA was measured by the self-report Social Phobia and Anxiety Inventory (SPAI). Speaking-related physiological reactivity was measured by the electrodermal activity (EDA), an index of emotional arousal. The speech samples from the narrating condition were analyzed for type and frequency of speech disfluencies and used for determining the stuttering severity. SA and speaking-related physiological reactivity were compared between the groups. Correlation between SA, physiological reactivity, disfluency frequencies, and stuttering severity were tested separately for both groups.

Results: No between-group differences were found in the overall SA, yet differences were found in SPAI subscales of social interaction, group interaction, and avoidance, as well as in agoraphobia. Both groups had higher physiological arousal in narrating condition in comparison to the video viewing condition, yet there was no between-group difference in the reactivity. No associations were found between SPAI measures, physiological reactivity, disfluency frequencies, and stuttering severity in the autistic group. In the control group, a negative association was found between physiological reactivity and total and typical disfluency frequencies.

Conclusions: SA or speaking-related physiological reactivity were not associated with disfluency frequencies or stuttering severity in autistic persons. Negative association between physiological reactivity and disfluency frequencies found in the control group may indicate that the physiological arousal may impact the speech production process by reducing the overt disfluencies.

PMID: 38593561 DOI: 10.1016/j.jcomdis.2024.106425

 

 

 

Attention networks in multilingual adults who do and who do not stutter - PSICOMOTOR

Clin Linguist Phon. 2024 Feb 29:1-23. Online ahead of print.

 

Gizem Aslan, Theo Marinis, Kurt Eggers

Ghent University, Ghent, Belgium; University of Konstanz, Konstanz, Germany; Thomas More, Antwerp, Belgium; University of Turku, Turku, Finland.

 

This study investigated whether multilinguals who stutter differ from multilinguals who do not stutter in terms of attention networks. Towards that end, it measured (a) performance differences in attention networks between multilinguals who stutter and those who do not stutter and (b) the correlation between stuttering characteristics and attention networks. Twenty-four multilingual Dutch-English speaking adults (20-46y), half of whom were diagnosed with stuttering, completed the Attentional Network Task (ANT) that evaluates the attention networks of alerting, orienting, and executive control. A language and social background questionnaire and a lexical decision task (LexTALE) assessed the participants' language proficiency. The Stuttering Severity Instrument 4th Ed. and the Brief Version of the Unhelpful Thoughts and Beliefs About Stuttering Scale were used to evaluate stuttering characteristics. The two groups did not differ in the ANT in terms of reaction time and error rate scores. Furthermore, no differences were observed in the three attention networks between the groups. Lastly, no correlation was found between stuttering characteristics and attention networks. The results suggest that the attention abilities of multilinguals who stutter do not differ from multilinguals who do not stutter.

PMID: 38423006 DOI: 10.1080/02699206.2024.2316288

 

 

 

Attitudes of Malaysian Speech-Language Pathologists and Speech-Language Pathology Students Toward Stuttering - SOCIAL

Folia Phoniatr Logop. 2024 Jan 8. Online ahead of print.

 

Ying Qian Ong, Annette Lim, Hye Ran Park, Elisabeth Harrison, Grace McConnell, Jaehoon Lee, Lay Shi Ng, Shin Ying Chu

 

Introduction: Attitudes of speech-language pathologists (SLPs) toward stuttering play an important role in managing stuttering cases. Yet, such studies had not been studied in Malaysia, a country that is still developing the profession of speech-language pathology. This study aimed to explore the attitudes of Malaysian SLPs and speech-language pathology students toward stuttering.

Methods: A total of 50 SLPs and 67 speech-language pathology students completed the Clinician Attitudes Towards Stuttering (CATS) inventory. There were eight domains of attitudes toward stuttering: (a) etiology, (b) early intervention, (c) therapeutic efficacy, (d) personalities of PWS, (e) clinician expertise and roles, (f) teacher/counsellor roles and client/public reactions, (g) therapy strategies, and (h) parent attitudes. Descriptive data were presented and Multivariate Analysis of Variance was conducted to examine the effects of clinical certification on the eight domains of attitudes toward stuttering.

Results: Participants who possessed a clinical certification were more accepting toward the personalities of people who stutter (PWS) and therapy strategies. On the other hand, participants without a clinical certification were more accepting toward clinician expertise and roles.

Conclusions: Current curriculum and professional training should be re-evaluated to remediate less accepting stereotypes held by SLPs and students toward PWS and to enhance essential skills such as counselling.

PMID: 38190816 DOI: 10.1159/000536112

 

 

 

Attitudes toward stuttering of college students in the USA and China: A cross-cultural comparison using the POSHA-S - SOCIAL

J Fluency Disord. 2024 Jan 19:79:106037. Online ahead of print.

 

Yan Ma, Emmalee M Mason, Evynn M McGinn, Jordan Parker, Judith D Oxley, Kenneth O St Louis

Purdue University Fort Wayne, Fort Wayne, IN, United States; Prosser Memorial Hospital, Prosser, WA, United States; Signature Home Health, Bend, OR, United States; Fort Hays State University, Hays, KS, United States; University of Louisiana at Lafayette, Lafayette, LA, United States; West Virginia University, Morgantown, WV, United States.

 

Purpose: This study compared the attitudes toward stuttering among college students in China and the USA using the POSHA-S survey, which assesses knowledge about stuttering and attitudes toward it. We investigated how cultural and social differences between the two groups influenced these attitudes.

Methods: We collected 199 responses to the POSHA-S survey from various universities in China and the USA. We conducted a statistical analysis of 15 summary scores generated from the POSHA-S to determine if there were significant differences in attitudes toward stuttering between the two groups. Additionally, we retrieved percentile ranks relative to the global POSHA-S database to compare attitudes in both groups with global median scores.

Results: The study revealed that Chinese college students hold more negative attitudes toward stuttering compared to their American counterparts and the global median scores. We discussed the social and cultural factors that may contribute to these attitudes. Furthermore, our findings emphasized the importance of addressing the lack of accurate information about stuttering in China, which could be a key factor driving these negative attitudes.

Conclusion: These results underscore the urgent need to raise awareness about stuttering and promote a shift in public attitudes, especially among college students in China, who play influential roles in society's future.

PMID: 38301423 DOI: 10.1016/j.jfludis.2024.106037

 

 

 

Auditory Processing of Speech and Nonspeech in People Who Stutter - AUDITIVO

J Speech Lang Hear Res. 2024 Jul 26:1-15. Online ahead of print.

 

Matthew C Phillips, Emily B Myers

University of Connecticut, Storrs.

 

Purpose: We investigated speech and nonspeech auditory processing of temporal and spectral cues in people who do and do not stutter. We also asked whether self-reported stuttering severity was predicted by performance on the auditory processing measures.

Method: People who stutter (n = 23) and people who do not stutter (n = 28) completed a series of four auditory processing tasks online. These tasks consisted of speech and nonspeech stimuli differing in spectral or temporal cues. We then used independent-samples t-tests to assess differences in phonetic categorization slopes between groups and linear mixed-effects models to test differences in nonspeech auditory processing between stuttering and nonstuttering groups, and stuttering severity as a function of performance on all auditory processing tasks.

Results: We found statistically significant differences between people who do and do not stutter in phonetic categorization of a continuum differing in a temporal cue and in discrimination of nonspeech stimuli differing in a spectral cue. A significant proportion of variance in self-reported stuttering severity was predicted by performance on the auditory processing measures.

Conclusions: Taken together, these results suggest that people who stutter process both speech and nonspeech auditory information differently than people who do not stutter and may point to subtle differences in auditory processing that could contribute to stuttering. We also note that these patterns could be the consequence of listening to one's own speech, rather than the cause of production differences.

PMID: 39058919 DOI: 10.1044/2024_JSLHR-24-00107

 

 

 

Awareness and Knowledge of Stuttering Among Malaysian School-Aged Children: An Exploratory Study - SOCIAL

Folia Phoniatr Logop. 2024 Jan 17. Online ahead of print.

 

Ying Qian Ong, Nurul Nadia Hasmidi, Jaehoon Lee, Dadang Amir Hamzah, Rachael Unicomb, Shin Ying Chu

 

Introduction: Knowledge and awareness of stuttering are closely associated with attitudes toward stuttering. Few studies have been conducted on the knowledge and awareness of school-aged children, and none have been conducted in Malaysia. This study aimed to: (a) determine knowledge and awareness of stuttering among Malaysian school-aged children, and (b) determine whether there are differences between age group, gender and PWS exposure groups.

Methods: A cross-sectional study was conducted among 192 Malay school-aged children (mean age = 9.47, SD = 1.781) recruited via email and social media platforms. They completed a Malay version of the questionnaire devised by van Borsel et al. (1999) on various aspects of stuttering, including prevalence, onset, gender distribution, occurrence in different cultures, cause, treatment, intelligence, and heredity of stuttering. The chi-square test of independence was performed to compare the distributions of survey responses by age group, gender and PWS exposure group.

Results: Around half of the school-age children had met a person who stutters, but certain aspects of their knowledge were limited. Knowledge also differed according to age and gender. Girls were more knowledgeable about stuttering than boys. Regarding stuttering treatment, younger children had more positive attitudes than older children. Participants who did not know a PWS were more likely to consult their family doctor rather than a speech-language pathologist in relation to stuttering.

Conclusions: Knowledge and awareness of stuttering among Malaysian school-aged children were limited. Findings of this study could be used to develop a stuttering awareness program specific to children to increase their knowledge and awareness about stuttering.

PMID: 38232721 DOI: 10.1159/000536207

 

 

 

Behind the mask: Stuttering, anxiety, and communication dynamics in the era of COVID-19 - EMOCIONAL

Int J Lang Commun Disord. 2024 Jul 30. Online ahead of print.

 

Hamid Karimi, Amir Hossein Rasoli Jokar, Sadaf Salehi, Samira Aghadoost

Faculty of Health, Charles Darwin University, Darwin, Australia; Michigan State University, East Lansing, USA; Wayne State University, Detroit, USA; Tehran University of Medical Sciences, Tehran, Iran.

 

Background: While wearing masks during the pandemic poses communication and social challenges for people in everyday life, those with social anxiety might find them plausible, aligning with contemporary cognitive theories. Social anxiety involves fearing negative assessments and holding a negative self-image. Concealing anxiety symptoms during mask use may contribute to a more positive self-perception.

Aims: Given that up to 60% of adults seeking stuttering treatment also meet criteria for social anxiety disorder, this study aims to investigate the complex relationship between communication freedom, self-perceived stuttering and anxiety in adults who stutter (AWS). The unique context of mandatory mask-wearing during the pandemic provides an opportunity to explore these dynamics and understand the conflicting relationships between stuttering, anxiety-related safety behaviours and the need for open communication in AWS.

Methods and procedures: Twenty AWS participated in interviews, responding to open-ended questions to elucidate their affective, cognitive and behavioural experiences while wearing masks during the COVID-19 pandemic. Thematic analysis was used to identify the emerging themes and subthemes based on information-rich quotes, employing a six-phase recursive process. Various speech and anxiety-related measures were used to describe the characteristics of the study participants.

Outcomes and results: Three main themes and sub-themes emerged. The first theme highlights communication challenges for AWS wearing masks, impacting verbal and nonverbal interactions. The second theme reveals AWS wearing masks to conceal stuttering cues, experiencing reduced stress. The third theme indicates that, despite the comfort in concealment, most AWS prefer speaking freely without a face mask.

Conclusions and implications: The conflict between the desire for authentic, fluent communication and the ease of hiding stuttering symptoms poses a major dilemma for AWS. According to the results of this study, most adults who stutter prioritize open communication. However, there were some individual differences. A major factor influencing their decision was their fear of negative evaluation.

What this paper adds: What is already known on the subject The prevalence of social anxiety is higher among adults who stutter (AWS), possibly stemming from their prior negative experiences with stuttering. In response, AWS may adopt adaptive or maladaptive coping behaviours to manage stuttering and mitigate fears of negative evaluation. Maladaptive strategies, like avoiding certain communication situations, can diminish their satisfaction with everyday speaking situations. What this study adds This study leveraged the mask-wearing mandate during the pandemic to explore the intricate relationship between anxiety-related symptoms and communication. While some participants saw masks as a plausible means to conceal stuttering and anxiety, most preferred open communication without the challenges posed by masks. Our findings offer additional support for the varied emotional, cognitive and behavioural responses that AWS may display in response to changes in daily life, emphasizing the individual differences within this population and highlighting that stuttering goes beyond observable speech dysfluencies. What are the clinical implications of this work? Our study underscores the need for comprehensive therapeutic interventions addressing both the physical and cognitive-emotional aspects of stuttering in AWS. Recognizing the role of safety behaviours and self-focused attention emphasizes the importance of an integrated approach, enhancing communication efficacy and social well-being for AWS. Addressing speech fluency alone, without considering pertinent cognitive-emotional factors, falls short in providing adequate stuttering treatment.

PMID: 39078384 DOI: 10.1111/1460-6984.13096

 

 

 

Can listeners predict whether or not a stutter follows a stretch of fluent speech? - SOCIAL

J Fluency Disord. 2024 Jan 22:79:106038. Online ahead of print.

 

Xena Liu, Peter Howell

University College London, London, UK

 

Purpose: Neurophysiological studies report that people who stutter (PWS) exhibit enhanced motor preparation before they stutter. This motor preparation pattern raises the possibility of detecting upcoming stutter moments before they actually occur. This study examined whether these motor preparation differences are detectable by listeners in the corresponding acoustic signal, thereby allowing them to predict upcoming stuttering moments. If so, features in these acoustic patterns could potentially be employed by computational procedures to automate detection of upcoming stutters and to target auditory feedback alterations specifically on these locations.

Methods: Forty healthy normal-hearing participants (aged 18-30) listened to seemingly fluent speech extracts each of which was either followed by a fluent (control condition) or stuttered (experimental condition) moment after the fluent extract. Participants listened to each extract and rated the likelihood of the speaker stuttering on the next word on a scale of 1 (very unlikely) to 7 (very likely) as to whether they thought there was a subsequent stutter. Several measures were made on the speech extracts which were examined either as control requirements to ensure no differences between experimental and control material or as covariates to assess any effects they had on judgments between the two conditions.

Results: Listeners gave significantly higher stutter-likelihood ratings for speech originally followed by a stuttered moment although effects were small.

Conclusions: Naive listeners rated speech extracts that were subsequently followed by stuttered moments as more likely to be followed by a stutter than those that were followed by fluent words after the effects of significant covariates were excluded.

PMID: 38290224 DOI: 10.1016/j.jfludis.2024.106038

 

 

 

Caregiver Predictions of Their 3- to 6-Year-Old Child Who Stutters' Communication Attitude - INFANTIL / AVALIAÇÃO

J Speech Lang Hear Res. 2024 Jun 18:1-20. Online ahead of print.

 

Katie L Winters, Courtney T Byrd

University of Cincinnati, OH; The University of Texas at Austin.

 

Purpose: Caregivers share critical insight during their child's stuttering evaluation; yet, there have been no empirical studies evaluating whether caregivers provide similar accounts of their 3- to 6-year-old child's communication attitude compared to their child's self-report. This study examined caregiver- and child-reported communication attitude and assessed potential moderators of more comparable caregiver and child ratings (i.e., caregiver confidence, caregiver-child conflict, observer-rated stuttering severity).

Method: One hundred thirteen children who stutter ages 3 through 6 years and a primary caregiver were recruited from clinical settings across the United States. Children completed the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT) and three speaking samples, which were recorded to assess observer-rated stuttering severity using the Stuttering Severity Instrument-Fourth Edition. Caregivers predicted their child's communication attitude (C-KiddyCAT) and provided a confidence rating for their prediction. Caregivers also rated caregiver-child conflict using the Child-Parent Relationship Scale-Short Form (CPRS-SF). Multiple regression was used to (a) evaluate whether caregiver C-KiddyCAT scores predicted child KiddyCAT scores and (b) assess potential moderators of the relationship between C-KiddyCAT and KiddyCAT scores.

Results: Caregiver ratings of their child's communication attitude (C-KiddyCAT) predicted child communication attitude ratings (KiddyCAT). A significant interaction between caregiver-child conflict (CPRS-SF) and caregiver ratings of their child's communication attitude (C-KiddyCAT) suggested caregiver-child conflict changed the underlying relationship between C-KiddyCAT and KiddyCAT scores, such that low conflict resulted in more similar C-KiddyCAT and KiddyCAT scores. Neither caregiver confidence nor observer-rated stuttering severity influenced the relationship between C-KiddyCAT and KiddyCAT scores.

Conclusions: Although many caregivers predicted communication attitude ratings that closely aligned with their child's report, some caregiver-child dyads provided divergent ratings. Clinicians should interpret caregiver predictions of their child's communication attitude within the context of their full evaluation and the caregiver-child relationship. Assessing both self-reported communication attitude and caregiver predictions of their child's communication attitude provides a meaningful starting point to counseling caregivers about cognitive components of stuttering for preschool- and kindergarten-age children who stutter.

PMID: 38889195 DOI: 10.1044/2024_JSLHR-23-00662

 

 

 

Comparison of performance of automatic recognizers for stutters in speech trained with event or interval markers - AVALIAÇÃO

Front Psychol. 2024 Feb 27:15:1155285.

Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10927738/pdf/fpsyg-15-1155285.pdf

 

Liam Barrett, Kevin Tang, Peter Howell

University College London, London, United Kingdom; Heinrich Heine University Düsseldorf, Düsseldorf, Germany; University of Florida, Gainesville, FL, United States.

 

Introduction: Automatic recognition of stutters (ARS) from speech recordings can facilitate objective assessment and intervention for people who stutter. However, the performance of ARS systems may depend on how the speech data are segmented and labelled for training and testing. This study compared two segmentation methods: event-based, which delimits speech segments by their fluency status, and interval-based, which uses fixed-length segments regardless of fluency.

Methods: Machine learning models were trained and evaluated on interval-based and event-based stuttered speech corpora. The models used acoustic and linguistic features extracted from the speech signal and the transcriptions generated by a state-of-the-art automatic speech recognition system.

Results: The results showed that event-based segmentation led to better ARS performance than interval-based segmentation, as measured by the area under the curve (AUC) of the receiver operating characteristic. The results suggest differences in the quality and quantity of the data because of segmentation method. The inclusion of linguistic features improved the detection of whole-word repetitions, but not other types of stutters.

Discussion: The findings suggest that event-based segmentation is more suitable for ARS than interval-based segmentation, as it preserves the exact boundaries and types of stutters. The linguistic features provide useful information for separating supra-lexical disfluencies from fluent speech but may not capture the acoustic characteristics of stutters. Future work should explore more robust and diverse features, as well as larger and more representative datasets, for developing effective ARS systems.

PMID: 38476388 PMCID: PMC10927738 DOI: 10.3389

 

 

 

Communicative practices and perceptions towards stuttering people in South Africa - SOCIAL

S Afr J Commun Disord. 2024 Mar 22;71(1):e1-e11.

 

Rockie Sibanda, Tlou C Mothapo

Faculty of Humanities, University of Johannesburg, Johannesburg.

 

Background: A few studies have explored the life experiences of people who stutter. Research has shown that stuttering affects a significant number of people in the population.

Objectives: The study was designed to explore the experiences of people who stutter and the perception of stuttering in South Africa.

Method: Four people who identified as South Africans who stutter participated in this study. The primary investigator conducted semi-structured interviews with each of the participants. In addition, a questionnaire was administered to 20 acquaintances of all the participants. Transcriptions of interviews and results of questionnaires were analysed for major and minor themes.

Results: Results of this study suggest different perceptions by those who stutter and those acquainted with them. The findings of the study show that people who stutter experience communication barriers, so they adopt certain strategies to manage and cope with their speech disorder. The findings showed that stuttering has a pervasive impact on the lives of people who stutter and how they view themselves, considering negative societal views.

Conclusion: Evaluation of the results from the study reveals that although stuttering is a common speech disorder, many people who are less informed about it harbour various stereotypes and myths that stigmatise stuttering. This study concludes by outlining recommendations for creating awareness of stuttering. It suggests vigorous campaigns aiming at promoting a multilevel approach that extends beyond the mere social and professional understanding of stuttering but addresses the inherent perceptions, myths, and stereotypes around stuttering.
Contribution: Experiences of people who stutter and perceptions towards stuttering can help to better understand the speech disorder and overcome myths and stereotyping of stuttering.

PMID: 38572902 DOI: 10.4102/sajcd.v71i1.1008

 

 

 

Contemporary clinical conversations about stuttering: What does brain imaging research mean to clinicians? - TERAPIA

Int J Speech Lang Pathol. 2024 Mar 26:1-7. Online ahead of print.

 

Soo-Eun Chang, Eric S Jackson, Gissella Santayana, Gillian Zavos, Mark Onslow

University of Michigan, Ann Arbor, MI, USA; Ewha Womans University, Seoul, Korea; New York University, New York, NY, USA; Private Practice, Montreal, Canada; The Stuttering Clinic, Sydney, NSW, Australia; University of Technology Sydney, Ultimo, Australia.

 

Purpose: To discuss among neuroscientists and community speech-language pathologists what brain imaging research means to clinicians.

Method: Two university neuroscientists and two speech-language pathologists in private practice discussed the matter. 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 matter.

Result: For now, neuroscience treatments are not available for clinicians to use. But sometime in the future, a critical mass of neuroscientists will likely produce such treatments. The neuroscientists expressed diverse views about the methods that might be used for that to occur.

Conclusion: Neuroscience does have practical clinical application at present and, in a way, that does not exclude a concurrent influence of the social model of disability. As such, the current practices of clinicians are supported by basic neuroscience research.

PMID: 38530287 DOI: 10.1080/17549507.2024.2327472

 

 

 

Could linguistic and cognitive factors, degree of autistic traits and sex predict speech disfluencies in autistic young adults and controls? - OUTRAS ÁREAS

Clin Linguist Phon. 2024 May 27:1-18. Online ahead of print.

 

Veera Pirinen et al

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

 

This study aimed to evaluate the effect of linguistic complexity and individual background variables (i.e. linguistic and cognitive abilities, degree of autistic traits, and sex) on speech disfluencies in autistic young adults and controls. Thirty-two 19- to 33-year-old autistic adults and 35 controls participated in this study. The frequency of disfluencies and stuttering severity were evaluated based on a narrative speech task. Linguistic complexity was assessed by evaluating the syntactic structures of the narratives. Cognitive and linguistic abilities were assessed using the General Ability Index (GAI), Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI) from the Wechsler Adult Intelligence Scale IV. Autistic traits were measured using the Autism Spectrum Quotient (AQ). Multiple-linear regression analyses (syntactic complexity, GAI, AQ, sex, and group status as predictors) showed that (a) syntactic complexity predicted total and stuttering-like disfluencies and stuttering severity, (b) GAI predicted typical disfluencies, and (c) sex predicted total, typical, and stuttering-like disfluencies. Additional correlation analyses revealed negative association between PRI and disfluencies in the control group but not in the autistic group. No connection was found between AQ and disfluencies. It seems that while some connections between disfluencies and individual cognitive features were found, some of the possible contributing factors for greater speech disfluency might differ between autistic and typical speakers.

PMID: 38802330 DOI: 10.1080/02699206.2024.2357158

 

 

 

Designing a Module on Stuttering and Cluttering: A Guide for Speech-Language Pathology Educators - SOCIAL

Am J Speech Lang Pathol. 2024 Feb 16:1-17. Online ahead of print.

 

Amy Connery, Caitríona Ní Shé

Trinity College Dublin, Ireland.

 

Purpose: Due to the scope of practice of speech-language pathology (SLP) expanding considerably in recent times, there is reduced emphasis on certain communication conditions within the curricula of SLP university programs. Stuttering and cluttering are neglected components of such curricula, despite the complex clinical skill set required to work with these client groups. Evaluation of the content and quality of modules on stuttering and cluttering is warranted to ensure that SLP students are graduating with adequate competence and confidence for supporting people with these conditions. This tutorial, based on a review of the literature, aims to provide guidance to educators who are designing or revising such modules.

Method: The All Ireland Society for Higher Education (AISHE) model for module design provides a practical and theoretically underpinned guide to educators in higher education on the design of a new module or the review of an existing one. The model's seven key components are discussed, and their application to a module on stuttering and cluttering is outlined.

Results: The AISHE model provides a systematic and user-friendly approach to module design in SLP university programs. It supports educators who are designing a new module or revising a module currently being taught on stuttering and cluttering.

Conclusions: Educators are encouraged to familiarize themselves with the seven components of the AISHE model and to use it as a tool to design or revise modules on stuttering and cluttering. This will ensure that SLP students are graduating with increased competence and confidence in working with these client groups.

PMID: 38363726 DOI: 10.1044/2024_AJSLP-23-00263

 

 

 

Development and validation of a research version of the Overall Assessment of the Speaker's Experience of Stuttering- Adult (OASES-A-R) - AVALIAÇÃO

J Fluency Disord. 2024 May 19:80:106060. Online ahead of print.

 

Seth E Tichenor, J Scott Yaruss

Duquesne University, USA; Michigan State University, USA.

 

Background: The Overall Assessment of the Speaker's Experience of Stuttering for Adults (OASES-A; Yaruss & Quesal, 2016) is a widely used measurement tool designed to evaluate the adverse impact associated with stuttering. Items examine general perceptions of stuttering, personal reactions to stuttering, functional communication difficulties, and consequences for quality of life. This paper presents a shortened research version of the OASES-A response form (OASES-A-R) that can be used by researchers in scientific studies involving adults who stutter that reflect the Section and Total Scores of the original OASES-A using fewer items.

Method: Previously collected OASES-A data (N = 315) were analyzed via graded response modeling to identify discrimination values of each OASES-A item in measuring each OASES-A Section Total Score. Items with the highest discrimination and items judged by expert clinicians to be more important in measuring adverse impact (N = 27) were used to create a shortened OASES-A-R. The shortened OASES-A-R response form was then validated and compared to the full OASES-A response form in an independent sample (N = 156).

Results: The shortened 25-item OASES-A-R response form demonstrated very high and positive correlations with the full OASES-A response form. Similarly, each OASES-A-R Section demonstrated high internal reliability coefficients similar to those of the OASES-A.

Discussion: The resulting 25-item OASES-A-R response form provides a reflection of the speaker's experience of stuttering as measured by the original 100-item OASES-A that is suitable for use in certain research studies of adults who stutter. Clinical use is not recommended, as the full OASES-A provides additional insights about a client's experience of stuttering that are necessary for effective treatment planning and intervention.

PMID: 38788244 DOI: 10.1016/j.jfludis.2024.106060

 

 

 

Disfluency in speech and language disorders - CONCEITO

Editorial Clin Linguist Phon. 2024 Apr 2;38(4):285-286.

Full Text: https://www.tandfonline.com/doi/epdf/10.1080/02699206.2023.2277122?needAccess=true

 

Ivana Didirková

Université de Paris 8 Vincennes - Saint-Denis.

 

No abstract available

PMID: 38631031 DOI: 10.1080/02699206.2023.2277122

 

 

 

'Do it afraid': An arts-based reflexive collective case study exploring youth responses to post-concussion communication changes in daily life - TERAPIA

Int J Lang Commun Disord. 2024 Jun 26. doi: 10.1111/1460-6984.13082. Online ahead of print.

 

Jessica A Harasym, Douglas P Gross, Andrea A N MacLeod, Shanon K Phelan

University of Alberta, Edmonton, AB, Canada; Dalhousie University, Halifax, NS, Canada.

 

Background: Concussion and communication researchers have yet to study how post-concussion communication changes affect youths' daily lives. The lack of attention paid to how young people respond to communication changes during concussion recovery constitutes a significant gap in current concussion management research and practices.

Aims: To explore how youth respond to the effects of post-concussion communication changes in their daily life, including (1) daily routines, (2) relationships with family members, (3) relationships with peers and (4) participation in school/work and community activities.

Methods & procedures: Five youths (16-25 years) and three family members participated in this arts-based reflexive collective case study. Ecocultural theory provided the theoretical framework for study design, data collection and analysis. Cases consist of (1) pre-interview demographic information, (2) three 60-90-min virtual interviews, (3) optional family member interviews, (4) multi-media arts-based participant-generated materials representing participants' experiences of communication change and concussion, and (5) researcher observations, discussions and reflexive journal entries. Reflexive thematic analysis was used to analyse the data.

Outcomes & results: Analysis yielded four themes that illustrate the ways youth navigated and adapted to post-concussion communication changes: (1) navigating changes in communication tasks, daily roles, and identity; (2) re-negotiating relationships and emotional reactions; (3) seeking control and learning to let go during recovery; and (4) helping youth adapt to post-concussion communication changes.

Conclusions & implications: The study findings deepen our understanding of the impact of post-concussion communication changes on youths' daily lives and underscore considerations critical to the development of communication-focused concussion education programs and interventions tailored specifically for youth.

What this paper adds: What is already known on the subject Youth is a critical period of social and emotional development. Communication is integral to identity, relationships, participation in daily activities and well-being. Concussions can affect speech clarity, fluency, understanding and use of language, and social interactions. Re-engaging in routine activities and pre-injury roles can be challenging for youth experiencing communication changes as part of complex concussion recoveries.

What this paper adds to the existing knowledge Findings from this research illuminate how youth navigate and adapt to communication changes post-concussion and support the development of youth-focused communication education programs, assessments and interventions. Youth participants actively managed their recoveries by developing innovative strategies to support their communication during daily activities, learning about communication, practicing communication tasks sequentially, and facing fears. Youth also reframed and challenged narrow views of 'normal communication'.

What are the potential or actual clinical implications of this work? Findings highlight the need for more youth- and communication-focused education materials and programs within youth concussion management protocols. Information about the specific ecological and sociocultural factors youth encounter during concussion recovery is needed to develop targeted communication-focused education and intervention programs for youth and their families to mitigate risks of isolation, loneliness, and mental health concerns and increase youths' participation in family, community and cultural life. By learning from youth about how communication changes affected their participation in daily activities, identity and relationships, clinicians can provide information and interventions to reduce adverse listener reactions and help young people feel supported and understood.

PMID: 38923742 DOI: 10.1111/1460-6984.13082

 

 

 

Electroencephalographic Classification Reveals Atypical Speech Motor Planning in Stuttering Adults - CONCEITO

J Speech Lang Hear Res. 2024 Jun 26:1-24. Online ahead of print.

 

Sean P Kinahan, Pouria Saidi, Ayoub Daliri, Julie Liss, Visar Berisha

Arizona State University, Tempe.

 

Purpose: This study explores speech motor planning in adults who stutter (AWS) and adults who do not stutter (ANS) by applying machine learning algorithms to electroencephalographic (EEG) signals. In this study, we developed a technique to holistically examine neural activity differences in speaking and silent reading conditions across the entire cortical surface. This approach allows us to test the hypothesis that AWS will exhibit lower separability of the speech motor planning condition.

Method: We used the silent reading condition as a control condition to isolate speech motor planning activity. We classified EEG signals from AWS and ANS individuals into speaking and silent reading categories using kernel support vector machines. We used relative complexities of the learned classifiers to compare speech motor planning discernibility for both classes.

Results: AWS group classifiers require a more complex decision boundary to separate speech motor planning and silent reading classes.

Conclusions: These findings indicate that the EEG signals associated with speech motor planning are less discernible in AWS, which may result from altered neuronal dynamics in AWS. Our results support the hypothesis that AWS exhibit lower inherent separability of the silent reading and speech motor planning conditions. Further investigation may identify and compare the features leveraged for speech motor classification in AWS and ANS. These observations may have clinical value for developing novel speech therapies or assistive devices for AWS.

PMID: 38924389 DOI: 10.1044/2024_JSLHR-23-00635

 

 

 

Erasmus clinical model of the onset and development of stuttering 2.0 - SOCIAL

Review J Fluency Disord. 2024 Mar 8:80:106040. Online ahead of print.

 

Marie-Christine Franken, Leonoor C Oonk, Bert J E G Bast, Jan Bouwen, Luc De Nil

Erasmus University Medical Center, Rotterdam, the Netherlands; StotterFonds, Nijkerk, the Netherlands; University of Applied Sciences, Utrecht, the Netherlands; University of Toronto, Canada.

 

A clinical, evidence-based model to inform clients and their parents about the nature of stuttering is indispensable for the field. In this paper, we propose the Erasmus Clinical Model of Stuttering 2.0 for children who stutter and their parents, and adult clients. It provides an up-to-date, clinical model summary of current insights into the genetic, neurological, motoric, linguistic, sensory, temperamental, psychological and social factors (be it causal, eliciting, or maintaining) related to stuttering. First a review is presented of current insights in these factors, and of six scientific theories or models that have inspired the development of our current clinical model. Following this, we will propose the model, which has proven to be useful in clinical practice. The proposed Erasmus Clinical Model of Stuttering visualizes the onset and course of stuttering, and includes scales for stuttering severity and impact, to be completed by the (parent of) the person who stutters. The pathway of the model towards stuttering onset is based on predisposing and mediating factors. In most children with an onset of stuttering, stuttering is transient, but if stuttering continues, its severity and impact vary widely. The model includes the circle of Engel (1977), which visualizes unique interactions of relevant biological, psychological, and social factors that determine the speaker's experience of stuttering severity and its impact. Discussing these factors and their interaction with an individual client can feed into therapeutic targets. The model is supplemented by a lifeline casus.

PMID: 38493582 DOI: 10.1016/j.jfludis.2024.106040

 

 

 

Evaluation of an Integrated Fluency and Acceptance and Commitment Therapy Intervention for Adolescents and Adults Who Stutter - TERAPIA

J Speech Lang Hear Res. 2024 Feb 15:1-17. Online ahead of print.

 

Alice K Hart, Lauren J Breen, Neville W Hennessey, Janet M Beilby

Curtin University, Bentley, Western Australia, Australia.

 

Purpose: Developmental stuttering is a complex and multifaceted neurodevelopmental disorder that may cause pervasive negative consequences for adults who stutter (AWS). Historically, intervention for AWS has primarily addressed speech fluency, with less focus on the covert psychosocial aspects of the disorder. The purpose of this article is to report on a feasibility trial evaluating a novel integrated intervention that combines traditional stuttering management techniques with Acceptance and Commitment Therapy (ACT) for AWS.

Method: Twenty-nine AWS participated in the feasibility trial. All participants successfully completed a combined fluency and ACT intervention, titled the fluency and Acceptance and Commitment Therapy for Stuttering (fACTS) Program. As this was a feasibility study, no control group was included. Intervention was administered by two certified practicing speech-language pathologists, over eight 60- to 90-min sessions.

Results: Generalized linear mixed modeling was used to determine change from pre- to post-intervention and follow-up. Significant pre- and post-intervention improvements in self-efficacy, psychosocial functioning, and psychological flexibility were observed, along with significant reductions in observable stuttering behaviors (i.e., stuttered speech frequency). Intervention gains for all variables of interest were maintained 3 and 6 months post-intervention.

Conclusions: The fACTS Program was created to be a holistic and flexible intervention to promote self-efficacy beliefs and address stuttering-related psychosocial impacts and speech fluency goals of AWS. Preliminary results indicated positive improvement in all psychosocial outcomes (i.e., self-efficacy, psychosocial impact, and psychological flexibility) and observable speech fluency following completion of the program. Future clinical trials of the fACTS Program with an included control group will further investigate the mechanisms of change for the positive effects observed.

PMID: 38358941 DOI: 10.1044/2023_JSLHR-23-00252

 

 

 

Evidence for planning and motor subtypes of stuttering based on resting state functional connectivity - NEUROCIÊNCIAS

Brain Lang. 2024 May 2:253:105417. Online ahead of print.

 

Hannah P Rowe et al. (+Soo-Eun Chang)

Boston University, Boston, MA, USA; University of Michigan, Ann Arbor, MI, USA; University of Delaware, Newark, DE, USA; Ewha Womans University, Seoul, South Korea.

 

We tested the hypothesis, generated from the Gradient Order Directions Into Velocities of Articulators (GODIVA) model, that adults who stutter (AWS) may comprise subtypes based on differing connectivity within the cortico-basal ganglia planning or motor loop. Resting state functional connectivity from 91 AWS and 79 controls was measured for all GODIVA model connections. Based on a principal components analysis, two connections accounted for most of the connectivity variability in AWS: left thalamus - left posterior inferior frontal sulcus (planning loop component) and left supplementary motor area - left ventral premotor cortex (motor loop component). A k-means clustering algorithm using the two connections revealed three clusters of AWS. Cluster 1 was significantly different from controls in both connections; Cluster 2 was significantly different in only the planning loop; and Cluster 3 was significantly different in only the motor loop. These findings suggest the presence of planning and motor subtypes of stuttering.

PMID: 38703523 DOI: 10.1016/j.bandl.2024.105417

 

 

 

Examining resting state functional connectivity and frequency power analysis in adults who stutter compared to adults who do not stutter - NEUROCIÊNCIAS

Front Hum Neurosci. 2024 Feb 5:18:1338966

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10875099/pdf/fnhum-18-1338966.pdf

 

Atefeh Valaei, Sobhan Bamdad, Arsalan Golfam, Golnoosh Golmohammadi, Hayat Ameri, Mohammad Reza Raoufy

Tarbiat Modares University, Tehran, Iran; Faculty of Engineering, Shahed University, Tehran, Iran; Semnan University of Medical Sciences, Semnan, Iran

 

Introduction: Stuttering is a speech disorder characterized by impaired connections between brain regions involved in speech production. This study aimed to investigate functional connectivity and frequency power during rest in adults who stutter (AWS) compared to fluent adults (AWNS) in the dorsolateral prefrontal cortex (DLPFC), dorsolateral frontal cortex (DLFC), supplementary motor area (SMA), motor speech, angular gyrus (AG), and inferior temporal gyrus (ITG).

Materials and methods: Fifteen AWS (3 females, 12 males) and fifteen age- and sex-matched AWNS (3 females, 12 males) participated in this study. All participants were native Persian speakers. Stuttering severity in the AWS group was assessed using the Persian version of the Stuttering Severity Instrument Fourth Edition (SSI-4). Resting-state electroencephalography (EEG) was recorded for 5 min while participants sat comfortably with their eyes open. We analyzed frequency band power across various frequency bands and investigated functional connectivity within the specified speech region.

Results: Significant between-group differences were found in band powers including alpha, beta, delta, theta, and gamma, specifically in the premotor, SMA, motor speech, and frontal regions. AWS also showed increased coherence between the right motor speech region compared to controls. We demonstrate that the proposed hierarchical false discovery rate (FDR) method is the most effective for both simulations and experimental data. In the expected regions, this method revealed significant synchrony effects at an acceptable error rate of 5%.

Conclusion: The results highlight disrupted functional connectivity in AWS at resting state, particularly in speech-related and associated areas. Given the complex neurological basis of developmental stuttering, robust neural markers are closely linked to this phenomenon. These markers include imbalanced activity within brain regions associated with speech and motor functions, coupled with impaired functional connectivity between these regions. The cortico-basal ganglia-thalamo-cortical system governs the dynamic interplay between cortical regions, with SMA as a key cortical site. It is hypothesized that the aberrant resting state functional connectivity will impact the language planning and motor execution necessary for fluent speech. Examining resting-state metrics as biomarkers could further elucidate the neural underpinnings of stuttering and guide intervention.

PMID: 38375364 PMCID: PMC10875099

 

 

 

Explicit and implicit cognitive processes of the public towards people who stutter - SOCIAL

J Fluency Disord. 2024 Jun 24:81:106073. Online ahead of print.

 

Elise L Rickert, Heather D Salvo Jennifer Roche, Hayley S Arnold

Kent State University, Kent, OH, USA.

 

Purpose: The Public Opinion Survey of Human Attributes - Stuttering (POSHA-S, St. Louis, 2013) was developed as a standard measure of public attitudes about people who stutter. As with any survey-based methods, threats to validity may occur because of social desirability bias. Using computer mouse-tracking, we were interested in observing changes in cognition that are manifested in intentionality through action by evaluating underlying cognitive processes that drive social judgments of people who stutter.

Methods: Twenty-two women, 1 non-binary person, and 47 men reported using a computer mouse to complete an online, remote, and modified version of the POSHA-S. Responses were categorized as correct/helpful or incorrect/unhelpful relative to each component of the POSHA-S and were used as measures of explicit cognitive processes. Computer-mouse trajectory metrics, including area under the curve (AUC) and reaction time (RT), were used to measure implicit cognitive processes.

Results: Although participants' explicit responses were significantly more likely to be correct/helpful than incorrect/unhelpful, with endorsement of correct/helpful prompts 77 % of the time, participants also endorsed incorrect/unhelpful prompts more than half (i.e., 52 %) of the time. Familiarity with people who stutter was associated with disagreeing with incorrect/unhelpful prompts. As indicated by greater AUC, participants exhibited significantly more implicit cognitive processes indicating competition when responding "disagree" compared to "agree", regardless of whether the prompts were correct/helpful or incorrect/unhelpful. Similarly, participants took significantly longer to respond to prompts with "disagree" rather than "agree".

Conclusion: The findings of this study offer evidence of participants reporting cognitive processes that are overall more correct/helpful than incorrect/unhelpful, in their explicit responses to the dichotomous response tasks of the POSHA-S. However, these findings are tempered by evidence of a tendency to agree with statements in the measure and suggest the need for further research to increase understanding of how to measure and improve explicit and implicit cognitive processes related to people who stutter.

PMID: 38971016 DOI: 10.1016/j.jfludis.2024.106073

 

 

 

Exploring international advances and collaborative scholarship: A preface to the Special Issue of the 2022 Joint World Congress on Stuttering and Cluttering

Editorial J Fluency Disord. 2024 Feb 23:80 Online ahead of print.

 

Stacy A Wagovich, Evan R Usler

University of Texas at El Paso, United States; University of Delaware, United States.

 

No abstract available

PMID: 38428044 DOI: 10.1016/j.jfludis.2024.106049

 

 

 

Exploring the Activation of Target Words in Picture Naming in Children Who Stutter: Evidence From Event-Related Potentials - INFANTIL / LINGUAGEM

J Speech Lang Hear Res. 2024 Jul 26:1-17. Online ahead of print.

 

Nathan D Maxfield

University of South Florida, Tampa.

 

Purpose: Target word activation in picture naming was explored in children who stutter (CWS) and typically fluent children (TFC) using event-related potentials (ERPs).

Method: A total of 18 CWS and 16 TFC completed a task combining picture naming and probe word identification. On each trial, a picture-to-be-named was followed by an auditory probe word-to-be-identified; the probe was identical (Identity condition) or Unrelated to the picture name. ERPs were recorded from probe onset. Attenuation of the N400 ERP component was predicted to Identity versus Unrelated trials (N400 priming). Between-groups differences in amplitude, timing, and topography of N400 priming were explored.

Results: Naming was more accurate on Identity versus Unrelated trials. Probe word identification accuracy was not affected by Condition. N400 priming was detected, indicating that self-generated picture names facilitated semantic processing of identical probes. This effect was larger in amplitude in CWS versus TFC. Unexpectedly, an N400-preceding, frontally maximal, positive-going ERP component-associated with expectancy processing-was larger in amplitude to Unrelated versus Identity trials. This effect was smaller in CWS versus TFC.

Conclusions: A larger N400 priming effect in CWS versus TFC reflects a tendency toward more extensive semantic processing in picture naming in CWS. A smaller Condition effect on frontally maximal, positive-going, N400-preceding ERP activity in CWS versus TFC indicates a reduced ability to form expectancies about the lexical and/or phonological identity of probe words in CWS. Both effects may point to inefficient activation of target words in picture naming in CWS.

PMID: 39058928 DOI: 10.1044/2024_JSLHR-23-00570

 

 

 

FreDESS: a clinical tool for perceptual evaluation of stuttering - AVALIAÇÃO

Logoped Phoniatr Vocol. 2024 Apr 21:1-8.. Online ahead of print.

 

Elisabeth Lindström et al

Karolinska Institutet, Stockholm, Sweden; Åbo Akademi University, Turku, Finland; Lund University, Lund, Sweden; Danderyd Hospital, Stockholm, Sweden.

 

Aim: Stuttering is a communication disorder that involves both manifest speech disfluencies and associated symptoms. The purpose of the present study was to introduce an easily administered and ecologically valid assessment tool designed for perceptual evaluation of stuttered speech, FreDESS (frequency of stuttering events, duration of events, effort, secondary behaviours, and severity). More specifically, we wanted to study its reliability and validity.

Method: Video recordings of conversations with 38 people who stutter (PWS), 19 females and 19 males aged 13-25, were assessed by three speech language pathologists (SLP). Inter- and intrajudge reliability was estimated with intraclass correlation, standard error of measurement, and agreement between listeners. Internal consistency for the FreDESS parameters was estimated with Cronbach's alpha (α). To test the validity of FreDESS, the relationships between the average estimated parameters of frequency, duration, secondary behaviours, and severity of FreDESS and the Stuttering Severity Instrument (SSI-3), were analysed using intraclass correlation.

Results: The interjudge reliability was good, especially for the frequency, duration, and severity parameters (90 per cent + agreement given 1 scale point difference). All parameters of the FreDESS had strong intrajudge reliability (ICC = 0.86-0.94) and the overall internal consistency was high (α = 0.98). The average ratings on the two assessment scales were in line with each other (r = 0.90-0.96), indicating high concurrent validity.

Conclusion: The FreDESS scale for the assessment of stuttered speech may be a valuable tool in clinical and research contexts. It is a valid and more time-efficient assessment instrument than the more commonly used SSI.

PMID: 38644572 DOI: 10.1080/14015439.2024.2338084

 

 

 

Functional and structural abnormalities of the speech disorders: a multimodal activation likelihood estimation meta-analysis - NEUROCIÊNCIAS

Meta-Analysis Cereb Cortex. 2024 Mar 1;34(3):bhae075.

 

Hao Cai et al

Xi'an International Studies University, Xi'an, China; South China Normal University); School of Psychology; Xi'an GEM Flower Changqing Hospital, Xi'an, China; Shaanxi Provincial Rehabilitation Hospital, Xi'an 710065, China.

 

Speech disorders are associated with different degrees of functional and structural abnormalities. However, the abnormalities associated with specific disorders, and the common abnormalities shown by all disorders, remain unclear. Herein, a meta-analysis was conducted to integrate the results of 70 studies that compared 1843 speech disorder patients (dysarthria, dysphonia, stuttering, and aphasia) to 1950 healthy controls in terms of brain activity, functional connectivity, gray matter, and white matter fractional anisotropy. The analysis revealed that compared to controls, the dysarthria group showed higher activity in the left superior temporal gyrus and lower activity in the left postcentral gyrus. The dysphonia group had higher activity in the right precentral and postcentral gyrus. The stuttering group had higher activity in the right inferior frontal gyrus and lower activity in the left inferior frontal gyrus. The aphasia group showed lower activity in the bilateral anterior cingulate gyrus and left superior frontal gyrus. Across the four disorders, there were concurrent lower activity, gray matter, and fractional anisotropy in motor and auditory cortices, and stronger connectivity between the default mode network and frontoparietal network. These findings enhance our understanding of the neural basis of speech disorders, potentially aiding clinical diagnosis and intervention.

PMID: 38466117 DOI: 10.1093/cercor/bhae075

 

 

 

Genetic architecture of childhood speech disorder: a review - GENÉTICA

Review Mol Psychiatry. 2024 Feb 16. Online ahead of print.

 

Angela T Morgan, David J Amor, Miya D St John, Ingrid E Scheffer, Michael S Hildebrand

Murdoch Children's Research Institute, Melbourne, VIC, Australia; University of Melbourne, Melbourne, VIC, Australia;  Royal Children's Hospital, Melbourne, VIC, Australia.; Austin Health, Melbourne, VIC, Australia.

 

Severe speech disorders lead to poor literacy, reduced academic attainment and negative psychosocial outcomes. As early as the 1950s, the familial nature of speech disorders was recognized, implying a genetic basis; but the molecular genetic basis remained unknown. In 2001, investigation of a large three generational family with severe speech disorder, known as childhood apraxia of speech (CAS), revealed the first causative gene; FOXP2. A long hiatus then followed for CAS candidate genes, but in the past three years, genetic analysis of cohorts ascertained for CAS have revealed over 30 causative genes. A total of 36 pathogenic variants have been identified from 122 cases across 3 cohorts in this nascent field. All genes identified have been in coding regions to date, with no apparent benefit at this stage for WGS over WES in identifying monogenic conditions associated with CAS. Hence current findings suggest a remarkable one in three children have a genetic variant that explains their CAS, with significant genetic heterogeneity emerging. Around half of the candidate genes identified are currently supported by medium (6 genes) to strong (9 genes) evidence supporting the association between the gene and CAS. Despite genetic heterogeneity; many implicated proteins functionally converge on pathways involved in chromatin modification or transcriptional regulation, opening the door to precision diagnosis and therapies. Most of the new candidate genes for CAS are associated with previously described neurodevelopmental conditions that include intellectual disability, autism and epilepsy; broadening the phenotypic spectrum to a distinctly milder presentation defined by primary speech disorder in the setting of normal intellect. Insights into the genetic bases of CAS, a severe, rare speech disorder, are yet to translate to understanding the heritability of more common, typically milder forms of speech or language impairment such as stuttering or phonological disorder. These disorders likely follow complex inheritance with polygenic contributions in many cases, rather than the monogenic patterns that underly one-third of patients with CAS. Clinical genetic testing for should now be implemented for individuals with CAS, given its high diagnostic rate, which parallels many other neurodevelopmental disorders where this testing is already standard of care. The shared mechanisms implicated by gene discovery for CAS highlight potential new targets for future precision therapies.

PMID: 38366112 DOI: 10.1038/s41380-024-02409-8

 

 

 

How perceived communication skills needed for careers influences vocational stereotyping of people who stutter - SOCIAL

J Fluency Disord. 2024 Feb 3:80:106039. Online ahead of print.

 

Cody W Dew, Rodney M Gabel

Binghamton University, Binghamton, NY, USA.

 

Purpose: Prior research has revealed people who stutter experience role entrapment in which they are discouraged from pursuing certain careers over others. The Vocational Advice Scale (VAS; Gabel et al., 2004) is a reliable survey previously used to investigate this phenomenon. This study used the VAS to determine if communication skills required for careers influences reports of role entrapment.

Method: An online survey which included the VAS and perceptions of communication skills needed for each career listed on the VAS was distributed. Correlations between items on the two surveys were completed to investigate how communication skills influences the presence of role entrapment. In addition, a one-way analysis of variance was completed to explore differences between individuals who regularly provide career advice with those who do not.

Results: Analysis found a significant correlation between perceived communication skills required for a career and the advice provided. As the perceived communication skills needed for a career increases, the likelihood of someone advising a person who stutters to pursue that career decreases. A one-way analysis of variance further revealed participants who regularly provide career advice did not differ from those participants who do not.

Conclusion: Perceived communication abilities needed for a career is a significant indicator of role entrapment towards people who stutter. Results agree with previous studies which found differences in advisability of certain careers over others for people who stutter, especially those which require communication within challenging situations (e.g., judge, attorney).

PMID: 38359501 DOI: 10.1016/j.jfludis.2024.106039

 

 

 

Identification of the Biomechanical Response of the Muscles That Contract the Most during Disfluencies in Stuttered Speech - PSICOMOTOR

Sensors (Basel). 2024 Apr 20;24(8):2629.

 

Edu Marin et al

Pontificia Universidad Católica del Perú, Lima, Peru.

 

Stuttering, affecting approximately 1% of the global population, is a complex speech disorder significantly impacting individuals' quality of life. Prior studies using electromyography (EMG) to examine orofacial muscle activity in stuttering have presented mixed results, highlighting the variability in neuromuscular responses during stuttering episodes. Fifty-five participants with stuttering and 30 individuals without stuttering, aged between 18 and 40, participated in the study. EMG signals from five facial and cervical muscles were recorded during speech tasks and analyzed for mean amplitude and frequency activity in the 5-15 Hz range to identify significant differences. Upon analysis of the 5-15 Hz frequency range, a higher average amplitude was observed in the zygomaticus major muscle for participants while stuttering (p < 0.05). Additionally, when assessing the overall EMG signal amplitude, a higher average amplitude was observed in samples obtained from disfluencies in participants who did not stutter, particularly in the depressor anguli oris muscle (p < 0.05). Significant differences in muscle activity were observed between the two groups, particularly in the depressor anguli oris and zygomaticus major muscles. These results suggest that the underlying neuromuscular mechanisms of stuttering might involve subtle aspects of timing and coordination in muscle activation. Therefore, these findings may contribute to the field of biosensors by providing valuable perspectives on neuromuscular mechanisms and the relevance of electromyography in stuttering research. Further research in this area has the potential to advance the development of biosensor technology for language-related applications and therapeutic interventions in stuttering.

PMID: 38676246 PMCID: PMC11053464 DOI: 10.3390/s24082629

 

 

 

Identifying stuttering in Arabic speakers who stutter: development of a non-word repetition task and preliminary results - Corrigendum

Published Erratum Front Pediatr. 2024 Jul 22:12:1280806.

Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326223/

 

Roaa Alsulaiman, John Harris, Sarah Bamaas, Peter Howell

University College London, London, United Kingdom; Hearing and Medical Rehabilitation, Jeddah, Saudi Arabia.

 

[This corrects the article DOI: 10.3389/fped.2022.750126.]. artigo de março de 2022

PMID: 39149539 PMCID: PMC11326223 DOI: 10.3389/fped.2024.1280806

 

 

 

Inhibitory Control, Cognitive Flexibility, and the Production of Disfluencies in Children Who Do and Do Not Stutter - INFANTIL / PSICOMOTOR

Am J Speech Lang Pathol. 2024 Mar 7:1-12. Online ahead of print.

 

Maria Paphiti, Michael A Talias, Kurt Eggers

University of Turku, Finland; Open University of Cyprus, Nicosia, Cyprus; Ghent University, Ghent, Belgium; Thomas More University College, Antwerp, Belgium.

 

Purpose: Differences in inhibitory control and cognitive flexibility between children who stutter (CWS) and children who do not stutter (CWNS) have been previously demonstrated. The aim of the current study was to investigate whether the previously reported inhibitory control- and cognitive flexibility-related performance costs for CWS are associated with the number of speech disfluencies that they produce.

Method: Participants were 19 CWS (Mage = 7.58 years, range: 6.08-9.17) and 19 CWNS matched on age and gender (Mage = 7.58 years, range: 6.08-9.33). Gamma regression models were used to investigate possible associations between performance costs in speed and accuracy measured during a computer task evaluating inhibitory control and cognitive flexibility and the number of speech disfluencies during video-recorded speech samples (story retelling and casual conversation).

Results: Two significant interactions were observed. For both inhibitory control and cognitive flexibility, we identified a significant group and inhibitory control/cognitive flexibility performance-cost interaction in stuttering-like disfluencies (SLDs), indicating that the performance-cost effects on SLD production were significantly higher in the CWS group, compared to the CWNS group.

Conclusions: CWS with reduced inhibitory control or cognitive flexibility produce more SLDs, but not other disfluencies. These results are partly in line with some previous findings in nonstuttering and stuttering populations linking inhibitory control and cognitive flexibility weaknesses to the production of speech disfluencies.

PMID: 38451741 DOI: 10.1044/2024_AJSLP-23-00242

 

 

 

Investigation of central auditory processing performance in individuals with and without stuttering - AUDITIVO

J Fluency Disord. 2024 Feb 28:80:106048. Online ahead of print.

 

Tuğçe Koca, Erol Belgin, Gül Ölçek

Uskudar University, Turkey; Istanbul Medipol University, Turkey; Ankara Medipol University,

 

Background: Differences in core auditory processing abilities, such as sound timing, frequency discrimination, auditory perception, and auditory memory, have been suggested in stutterers, despite the fact that the precise origin of stuttering is not entirely understood. It is suggested that these differences may play a role in the development of stuttering. The aim of our study is to assess the temporal central auditory processing performance in individuals with stuttering and compare it to individuals without stuttering to uncover potential differences stuttering and compare it to individuals without stuttering to reveal potential differences.

Method: In current study, a total of 60 right-handed participants between the ages of 8 and 17 were included, divided into two balanced groups based on age, education, and gender: individuals with stuttering (n = 30) and individuals without stuttering (n = 30). All participants underwent the Frequency Pattern Test, Duration Pattern Test, and Gaps-In-Noise test.

Results: Individuals who stutter showed lower performance in the gap detection threshold and the percentage of total correct gap identification parameters of the Frequency Pattern Test, Duration Pattern Test, and Gaps-In-Noise test compared to fluent speakers.

Conclusions: The findings indicate a potential relationship between stuttering and central auditory processing. In this context, incorporating central auditory processing measures into the assessment and therapy processes for stuttering may enhance the likelihood of obtaining more accurate results.

PMID: 38452446 DOI: 10.1016/j.jfludis.2024.106048

 

 

 

Italian normative data for the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) Scales for adults who stutter - EMOCIONAL

J Fluency Disord. 2024 Jun 25:81:106074. Online ahead of print.

 

Simona Bernardini, Sara Onnivello, Silvia Lanfranchi

ABC BALBUZIE, Padova, Italy; University of Padova, Padova, Italy.

 

Purpose: This study aimed to assess the reliability and validity of the Italian translation of the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) scales for adults who stutter, as there are no assessment tools currently available in Italy. The UTBAS scales provide a comprehensive stuttering-specific measure of the unhelpful thoughts and beliefs that can be used to screen for indicators of social anxiety in adults who stutter. Additionally, the UTBAS scales also allow the identification of negative thoughts and beliefs that negatively impact speech treatment outcomes.

Method: The translation of the UTBAS scales into Italian (UTBAS-ITA) was completed using the forward-backward translation process and it was administered to 98 adults who stutter (AWS) and 98 adults who do not stutter (AWNS). Both groups were matched for gender and age. We also administered the UTBAS-ITA to 76 AWS a second time within a two-week interval to assess test-retest reliability. Additionally, we administered the State-Trait Anxiety Inventory and the Fear of Negative Evaluation Scale to 20 AWS to assess concurrent validity.

Results: The UTBAS-ITA showed good power of discrimination between AWS and AWNS, high internal validity, high internal consistency, good construct validity, and good test-retest reliability.

Conclusion: Since there is a scarcity of clinical assessment tools for adults who stutter in Italy, the UTBAS-ITA could serve as an assessment tool and outcome measure for clinical and research environments.

PMID: 38968740 DOI: 10.1016/j.jfludis.2024.106074

 

 

 

Knowns and unknowns about the neurobiology of stuttering - INFANTIL / NEUROCIÊNCIAS

PLoS Biol. 2024 Feb 22;22(2):e3002492.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10883586/pdf/pbio.3002492.pdf

 

Nicole E Neef, Soo-Eun Chang

University Medical Center Göttingen, Göttingen, Germany; University of Michigan, Ann Arbor, Michigan, United States of America; Ewha Womans University, Seoul, Korea.

 

Stuttering occurs in early childhood during a dynamic phase of brain and behavioral development. The latest studies examining children at ages close to this critical developmental period have identified early brain alterations that are most likely linked to stuttering, while spontaneous recovery appears related to increased inter-area connectivity. By contrast, therapy-driven improvement in adults is associated with a functional reorganization within and beyond the speech network. The etiology of stuttering, however, remains enigmatic. This Unsolved Mystery highlights critical questions and points to neuroimaging findings that could inspire future research to uncover how genetics, interacting neural hierarchies, social context, and reward circuitry contribute to the many facets of stuttering.

PMID: 38386639 PMCID: PMC10883586

 

 

 

Lidcombe Program telehealth treatment for children 6-12 years of age: A Phase II trial - INFANTIL / TERAPIA

J Fluency Disord. 2024 Apr 7:80:106057. Online ahead of print

Free article: https://www.sciencedirect.com/science/article/pii/S0094730X24000214?via%3Dihub

 

Georgina Johnson, Mark Onslow, Brenda Carey, Mark Jones, Elaina Kefalianos

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

 

Background: For children older than 6 years who stutter, there is a gap in clinical research. This is an issue for speech-language pathologists because the tractability of stuttering decreases and the risk of long-term psychological consequences increase with age.

Purpose: To report a Phase II trial of a telehealth version of the Lidcombe Program with school-age children.

Methods: Participants were 37 children who stuttered, 6-12 years of age, from Australia, New Zealand, Hong Kong, and Singapore. Parents were trained by video telehealth how to deliver the Lidcombe Program to their child. Primary and secondary outcomes were stuttering severity and psychosocial functioning measured pre-treatment and at 6 months and 12 months after starting treatment. Parents submitted two 10-minute recordings of their child speaking in conversation, and three measures of anxiety, impact of stuttering, and communication attitude.

Results: Six months after starting treatment, seven children (18.9%) attained Lidcombe Program Stage 2 criteria, 25 children (67.6%) showed a partial response to treatment, and five children (13.5%) showed no response. By 12 months, 12 children (32.4%) had reached Stage 2 criteria. Psychosocial improvements were observed 6 and 12 months after starting treatment.

Conclusions: The Lidcombe Program may eliminate or nearly eliminate stuttering for about one third of children 6-12 years of age. Randomized controlled trials with this age group involving the Lidcombe Program are warranted. In the interim, the Lidcombe Program is a clinical option clinicians can implement with this age group to reduce stuttering and its psychosocial impacts.

PMID: 38613876 DOI: 10.1016/j.jfludis.2024.106057

 

 

 

Linguistic biomarkers of neurological, cognitive, and psychiatric disorders: verification, analytical validation, clinical validation, and machine learning [Editorial] - CONCEITO
Editorial Front Psychol. 2024 Jul 26:15:1454225. doi: 10.3389/fpsyg.2024.1454225. eCollection 2024.

Acesso: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11312370/

 

Ratree Wayland, Kevin Tang, Si Chen

University of Florida, Gainesville, FL, United States; Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany; Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.

 

No abstract available

PMID: 39131860 PMCID: PMC11312370

 

 

 

Localization of stuttering based on causal brain lesions - NEUROCIÊNCIAS

Brain. 2024 Jun 3;147(6):2203-2213.

 

Catherine Theys, Luc F De Nil et al

University of Canterbury, New Zealand; New Zealand Brain Research Institute, New Zealand; University of Turku, Turku, Finland; University of Helsinki and Helsinki University Hospital,Helsinki, Finland; University of Otago, New Zealand; Pacific Radiology Canterbury, New Zealand; University of Toronto, Toronto, ON, Canada; Boston University, Boston, USA; The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, USA; Boston Children's Hospital, Boston, MA, USA; Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Turku University Hospital, Turku, Finland.

 

Stuttering affects approximately 1 in 100 adults and can result in significant communication problems and social anxiety. It most often occurs as a developmental disorder but can also be caused by focal brain damage. These latter cases may lend unique insight into the brain regions causing stuttering. Here, we investigated the neuroanatomical substrate of stuttering using three independent datasets: (i) case reports from the published literature of acquired neurogenic stuttering following stroke (n = 20, 14 males/six females, 16-77 years); (ii) a clinical single study cohort with acquired neurogenic stuttering following stroke (n = 20, 13 males/seven females, 45-87 years); and (iii) adults with persistent developmental stuttering (n = 20, 14 males/six females, 18-43 years). We used the first two datasets and lesion network mapping to test whether lesions causing acquired stuttering map to a common brain network. We then used the third dataset to test whether this lesion-based network was relevant to developmental stuttering. In our literature dataset, we found that lesions causing stuttering occurred in multiple heterogeneous brain regions, but these lesion locations were all functionally connected to a common network centred around the left putamen, including the claustrum, amygdalostriatal transition area and other adjacent areas. This finding was shown to be specific for stuttering (PFWE < 0.05) and reproducible in our independent clinical cohort of patients with stroke-induced stuttering (PFWE < 0.05), resulting in a common acquired stuttering network across both stroke datasets. Within the common acquired stuttering network, we found a significant association between grey matter volume and stuttering impact for adults with persistent developmental stuttering in the left posteroventral putamen, extending into the adjacent claustrum and amygdalostriatal transition area (PFWE < 0.05). We conclude that lesions causing acquired neurogenic stuttering map to a common brain network, centred to the left putamen, claustrum and amygdalostriatal transition area. The association of this lesion-based network with symptom severity in developmental stuttering suggests a shared neuroanatomy across aetiologies.

PMID: 38797521 PMCID: PMC11146419 DOI: 10.1093/brain/awae059

 

 

 

Lower nonword syllable sequence repetition accuracy in adults who stutter is related to differences in audio-motor oscillations - FALA

Neuropsychologia. 2024 May 11. Online ahead of print.

 

Andrew Bowers, Daniel Hudock

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

 

Objective: The goal of this study was to use independent component analysis (ICA) of high-density electroencephalography (EEG) to investigate whether differences in audio-motor neural oscillations are related to nonword syllable repetition accuracy in a group of adults who stutter compared to typically fluent speakers.

Methods: EEG was recorded using 128 channels from 23 typically fluent speakers and 23 adults who stutter matched for age, sex, and handedness. EEG was recorded during delayed, 2 and 4 bilabial nonword syllable repetition conditions. Scalp-topography, dipole source estimates, and power spectral density (PSD) were computed for each independent component (IC) and used to cluster similar ICs across participants. Event-related spectral perturbations (ERSPs) were computed for each IC cluster to examine changes over time in the repetition conditions and to examine how dynamic changes in ERSPs are related to syllable repetition accuracy.

Results: Findings indicated significantly lower accuracy on a measure of percentage correct trials in the AWS group and for a normalized measure of syllable load performance across conditions. Analysis of ERSPs revealed significantly lower alpha/beta ERD in left and right μ ICs and in left and right posterior temporal lobe α ICs in AWS compared to TFS (CC p<.05). Pearson correlations with %CT for frequency across time showed strong relationships with accuracy (FWE<.05) during maintenance in the TFS group and during execution in the AWS group.

Conclusions: Findings implicate lower alpha/beta ERD (8-30Hz) during syllable encoding over posterior temporal ICs and execution in left temporal/sensorimotor components. Strong correlations with accuracy and interindividual differences in ∼6-8Hz ERSPs during execution implicate differences in motor and auditory-sensory monitoring during syllable sequence execution in AWS.

PMID: 38740180 DOI: 10.1016/j.neuropsychologia.2024.108906

 

 

 

Major discrimination due to stuttering and its association with quality of life - SOCIAL

J Fluency Disord. 2024 Mar 5:80:106051. Online ahead of print.

 

Michael P Boyle, Madeline R Cheyne

Montclair State University, United States.

 

Purpose: This study aimed to identify what types of major discrimination have been experienced by adults who stutter throughout their lives, and investigate the association between the number of different types of major discrimination events experienced and quality of life.

Methods: Measures of quality of life (Kemp Quality of Life Scale) and major discrimination (adapted Major Experiences of Discrimination Scale) were completed by 303 adults who stutter. Correlational and regression analyses were conducted with these variables.

Results: A majority (56%) of the participants had experienced at least one episode of major discrimination due to stuttering during their lives. The major discrimination experiences most commonly reported included not being hired for a job and being discouraged by a teacher or advisor from pursuing certain careers or jobs because of stuttering. There was a significant negative relationship between quality of life and major discrimination. Increased major discrimination predicted lower quality of life even after taking into account demographic variables and severity of physical speech disruption.

Conclusions: The findings of a negative association between major discrimination and quality of life add support to the notion that reducing societal stigma related to stuttering should be a priority of the field. Discriminatory practices of listeners constitute a social-environmental barrier to communicative participation and quality of life in people who stutter and should be addressed by professionals in the field of speech-language pathology and other stakeholders.

PMID: 38503059 DOI: 10.1016/j.jfludis.2024.106051

 

 

 

Malingering in Adolescent Psychiatry: A Case Report of Fabricated Symptoms to Avoid Legal Consequences

Case Reports Cureus. 2024 May 10;16(5):e60039. eCollection 2024 May.

Free Full Text: https://assets.cureus.com/uploads/case_report/pdf/249004/20240609-16590-148a7of.pdf

 

Taylor F Faust, Jeremy W Shiver, Patrick G Dickinson, Elizabeth Vandervort, Maria Hamilton

 

Malingering is characterized by the deliberate fabrication and/or exaggeration of symptoms for secondary gain, posing a diagnostic challenge in healthcare settings. In this report, we present a 15-year-old male with a history of psychiatric disorders who attempted suicide to avoid legal sentencing, subsequently developing a stutter following an altercation with another patient. Despite initial concern for a concussion, further evaluation revealed malingering as the underlying motive. This case highlights the importance of identifying malingering in adolescents, which calls for a careful approach and thorough assessment for it to be distinguished from an authentic illness. Early identification of malingering optimizes resource allocation and ensures appropriate care for patients who have genuine medical needs.

PMID: 38854334 PMCID: PMC11162819 DOI: 10.7759/cureus.60039

 

 

 

Manifestation of speech disfluencies in preschool Cantonese-English speaking bilingual children - INFANTIL / BILINGUISMO

Clin Linguist Phon. 2024 Jan 25:1-17. Online ahead of print.

 

Mehdi Bakhtiar

The University of Hong Kong, Hong Kong SAR, China.

 

Stuttering is characterised by disruptions in speech fluency that normally emerges between the ages of 2 to 5 when children start to formulate sentences. Current stuttering identification in children is largely based on speech disfluency criteria (>3% stuttering-like disfluencies, SLDs) developed for monolingual English-speaking children. Research in a Western language context shows that application of the criteria for monolingual to bilingual children may result in false positive diagnosis of stuttering. The applicability of these criteria to children speaking languages typologically distinct from English remains unclear. This preliminary study focused on bilingual Cantonese-English-speaking children, aiming to explore the manifestations of the speech disfluencies in Cantonese (a syllable-timed language) and English (a stress-timed language) while accounting for language dominance/proficiency and speaking task. Nineteen typically fluent Cantonese-English bilingual preschoolers were recruited for this study and their speech samples were collected across different speaking tasks (i.e. conversation and narration), and languages (i.e. Cantonese and English). The types and frequency of speech disfluencies were compared across both languages and the speaking tasks. The results showed that between 21-68% of children showed higher than 3% SLDs across different languages and speaking tasks. Linear mixed-effect analysis revealed that the prevalence of SLDs is higher in English (less dominant language) than Cantonese (more dominant language), and the prevalence is also higher in narration than conversation. These findings suggest the need for tailored stuttering identification criteria for bilingual children speaking diverse languages and emphasise the importance of considering language dominance/proficiency and speaking task when assessing stuttering in bilingual populations.

PMID: 38272017 DOI: 10.1080/02699206.2024.2305645

 

 

 

Mental state verb use in play by preschool-age children who stutter and their mothers - INFANTIL / LINGUAGEM

J Fluency Disord. 2024 Apr 16:80:106059. Online ahead of print.

Full text: https://www.sciencedirect.com/science/article/abs/pii/S0094730X24000238?via%3Dihub

 

Stacy A Wagovich et al

University of Texas at El Paso, USA; University of Missouri, USA; Indiana University, USA.

 

Introduction: Preschool-age children use mental state verbs (MSVs; e.g., think, know) to reference thoughts and other cognitive states. In play-based language, MSV use requires conversational flexibility, as speakers shift from discussion of actions happening in the here-and-now to more abstract discussion of mental states. Some evidence suggests that children who stutter (CWS) demonstrate subtle differences in shifting on experimental tasks of cognitive flexibility, differences which may extend to conversational flexibility. This study explored MSV use in conversational language between CWS and their mothers.

Methods: Thirty-five preschool-age CWS and 35 age- and gender-matched children who do not stutter (CWNS), all performing within the typical range on standardized language testing, conversed with their mothers during play. Samples were transcribed and coded for MSV use.

Results: No between-group differences were observed in MSV use, either between the CWS and CWNS or between the groups of mothers. Age and language skills were positively associated with MSV use in the CWNS group only. For both groups of dyads, mothers' MSV use corresponded at least to some extent to their children's language skills. Finally, correspondence between CWNS and their mothers was observed for two conversational language measures, representing lexical diversity and morphosyntax; this overall pattern was not observed in the CWS dyad group.

Conclusions: Although these findings point to similar use of MSVs among the groups of children and their mothers, for the CWS group, the patterns of use in relation to age and language skills are somewhat different from developmental expectations.

PMID: 38640516 DOI: 10.1016/j.jfludis.2024.106059

 

 

 

Mitigating stuttering self-stigma: How do we start and where do we go? Using a Participative Concept Mapping Approach to develop a local framework of principles - TERAPIA

J Fluency Disord. 2024 Jul 19:81:106075. Online ahead of print

 

Geneviève Lamoureux, Sébastien Finlay, Anne Moïse-Richard, Lucie Ménard, Ingrid Verduyckt

Université de Montréal, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada; Marie Enfant Rehabilitation Centre of Sainte-Justine University Hospital Centre, Montreal, Canada; Université du Québec à Montréal, Canada.

 

Purpose: This study aims to create a stigma reduction framework for stuttering in the local context of Québec, Canada using the Participative Concept Mapping Approach (PCMA), focusing on both self and societal stigma.

Method: Employing a mixed-methods approach, this study engaged 17 experts-people who stutter, clinicians and health innovation specialists-in PCMA workshops. Via diverse steps, including generation, sorting and rating of ideas in response to the focus prompt, "To effectively address stuttering (self-)stigma, an intervention should…" these sessions led to a framework depicted in visual maps, then refined into actionable principles through qualitative analysis. Mixed-methods data analysis used the open-source R-CMap software to generate visual maps illustrating the relationships among ideas as well as importance and feasibility ratings.

Results: The collaborative workshops identified 95 ideas in response to the focus prompt, reunited in 7 clusters, evolving into 16 principles to mitigate stuttering stigma and self-stigma. At the therapy level, these principles emphasize personalized therapy, thorough assessments, stigma-free therapeutic environment, empowerment, and the importance of group inclusivity and educating the relational circles. Societally, they advocate for initiatives such as improved educational outreach, empathy enhancement, and better representation. This dual approach targets individual experiences and societal views on stuttering, stressing the need for an all-encompassing intervention framework.

Conclusion: The findings demonstrate PCMA's usefulness in crafting local, culturally sensitive, tailored interventions for stigma reduction. The study emphasizes the necessity of holistic approaches that address individual experiences and societal perceptions, offering a model to conduct similar exercises in diverse local settings.

PMID: 39067312 DOI: 10.1016/j.jfludis.2024.106075

 

 

 

Mobile version of the Battery for the Assessment of Auditory Sensorimotor and Timing Abilities (BAASTA): Implementation and adult norms - AVALIAÇÃO

Behav Res Methods. 2024 Mar 8. Online ahead of print.

 

Simone Dalla Bella et al

University of Montreal, Montréal, Canada; Centre for Research on Brain, Language and Music Montreal, Canada; University of Economics and Human Sciences in Warsaw, Warsaw, Poland; Centre for Research on Brain, Language and Music (CRBLM), Montreal, Canada; Euromov, University of Montpellier, Montpellier, France; University of Quebec at Trois-Rivières, Trois-Rivières, Canada; Maastricht University, MD, Maastricht, The Netherlands; Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.

 

Timing and rhythm abilities are complex and multidimensional skills that are highly widespread in the general population. This complexity can be partly captured by the Battery for the Assessment of Auditory Sensorimotor and Timing Abilities (BAASTA). The battery, consisting of four perceptual and five sensorimotor tests (finger-tapping), has been used in healthy adults and in clinical populations (e.g., Parkinson's disease, ADHD, developmental dyslexia, stuttering), and shows sensitivity to individual differences and impairment. However, major limitations for the generalized use of this tool are the lack of reliable and standardized norms and of a version of the battery that can be used outside the lab. To circumvent these caveats, we put forward a new version of BAASTA on a tablet device capable of ensuring lab-equivalent measurements of timing and rhythm abilities. We present normative data obtained with this version of BAASTA from over 100 healthy adults between the ages of 18 and 87 years in a test-retest protocol. Moreover, we propose a new composite score to summarize beat-based rhythm capacities, the Beat Tracking Index (BTI), with close to excellent test-retest reliability. BTI derives from two BAASTA tests (beat alignment, paced tapping), and offers a swift and practical way of measuring rhythmic abilities when research imposes strong time constraints. This mobile BAASTA implementation is more inclusive and far-reaching, while opening new possibilities for reliable remote testing of rhythmic abilities by leveraging accessible and cost-efficient technologies.

PMID: 38459221 DOI: 10.3758/s13428-024-02363-x

 


 

Morphological deficits of glial cells in a transgenic mouse model for developmental stuttering - OUTRAS ÁREAS

bioRxiv. 2024 Jan 5:2024.01.04.574051. Preprint

Free PMC article: https://www.biorxiv.org/content/10.1101/2024.01.04.574051v1.full.pdf

 

Afuh Adeck, Marissa Millwater, Camryn Bragg, Ruli Zhang, Shahriar SheikhBahaei

 

Vocal production involves intricate neural coordination across various brain regions. Stuttering, a common speech disorder, has genetic underpinnings, including mutations in lysosomal-targeting pathway genes. Using a Gnptab-mutant mouse model linked to stuttering, we examined neuron and glial cell morphology in vocal production circuits. Our findings revealed altered astrocyte and microglia processes in these circuits in Gnptab-mutant mice, while control regions remained unaffected. Our results shed light on the potential role of glial cells in stuttering pathophysiology and highlight their relevance in modulating vocal production behaviors.

PMID: 38260402 PMCID: PMC10802298 DOI: 10.1101/2024.01.04.574051

 

 

 

Multiple-community-based epidemiological study of stuttering among 3-year-old children in Japan - INFANTIL / CONCEITO

Folia Phoniatr Logop. 2024 May 2. Online ahead of print.

 

Naomi Sakai, Shoko Miyamoto, Yuki Hara, Yoshikazu Kikuchi, Hiroaki Kobayashi, Takaaki Takeyama, Jiro Udaka, Daisuke Sudo, Koichi Mori

 

Introduction: Many epidemiological studies of the disorder of stuttering have been conducted during the 20th century, continuing during the current one. Unfortunately, only a few were carried out in Japan. This study aimed at assessing (1) the incidence and prevalence of stuttering in 3-year-old children in multiple Japanese communities, and (2) factors associated with the onset of stuttering among these children.

Methods: A questionnaire aimed at screening for the presence of stuttering was employed for 2,055 children aged 3 years, who underwent a standard nationwide health checkup. Positive responses were confirmed in several ways: (1) direct interviews and assessment of the child's speech, (2) confirmatory questionnaire, or (3) telephone interviews by licensed Speech Language Hearing Therapists.

Results: Approximately 6.5% of the children were found to exhibit stuttering at the time of their health checkup. This figure rose to 9.0% after including individuals who previously, but not currently, were reported to have exhibited stuttering. Among the putative risk factors, higher stuttering odds (odds ratio, OR = 3.26) were detected in those with a family history of stuttering, those whose guardians had concerns about their child's development (OR = 1.77), and those with diagnosed diseases or disabilities (OR = 2.14).

Discussion/conclusions: It was concluded that, in Japan, both the risk of stuttering incidence (8.9%) in children up to, and including, the age of 3 years, as well as its prevalence (6.5%) in this population, was similar to those reported by recent studies in other countries. Additionally, our findings also confirmed that an increased risk for stuttering at age 3 is associated with a family history of stuttering.

PMID: 38697051 DOI: 10.1159/000539172

 

 

 

Novel FOXP2 variant associated with speech and language dysfunction in a Chinese family and literature review - GENÉTICA

J Appl Genet. 2024 Feb 28. Online ahead of print.

 

Fengyu Che et al

Xi'an Children's Hospital, Xi'an, China; Medical School of Chinese PLA, Beijing, China; Southern Medical University, Guangzhou, China.

 

Since its initial identification, the Forkhead Box P2 gene (FOXP2) has maintained its singular status as the archetypal monogenic determinant implicated in Mendelian forms of human speech and language impairments. Despite the passage of two decades subsequent to its discovery, extant literature remains disproportionately sparse with regard to case-specific instances and loci of mutational perturbations. The objective of the current investigation centers on furnishing an enriched delineation of both its clinical manifestations and its mutational heterogeneity. Clinical phenotypes and peripheral blood samples were assiduously amassed from familial subjects. Whole-exome sequencing and Sanger sequencing methodologies were deployed for the unambiguous identification of potential genetic variants and for corroborating their co-segregation within the family pedigree. An exhaustive review of published literature focusing on patients manifesting speech and language disorders consequent to FOXP2 genetic anomalies was also undertaken. The investigation yielded the identification of a novel heterozygous variant, c.661del (p.L221Ffs*41), localized within the FOXP2 gene in the proband, an inheritance from his symptomatic mother. The proband presented with an array of symptoms, encompassing dysarthric speech, deficits in instruction comprehension, and communicative impediments. In comparison, the mother exhibited attenuated symptoms, including rudimentary verbalization capabilities punctuated by pronounced stuttering and dysarthria. A comprehensive analysis of articles archived in the Human Gene Mutation Database (HGMD) classified under "DM" disclosed the existence of 74 patients inclusive of the subjects under current examination, sub-divided into 19 patients with null variants, 5 patients with missense variants, and 50 patients with gross deletions or complex genomic rearrangements. A conspicuous predominance of delayed speech, impoverished current verbal abilities, verbal comprehension deficits, and learning difficulties were observed in patients harboring null or missense FOXP2 variants, as compared to their counterparts with gross deletions or complex rearrangements. Developmental delays, hypotonia, and craniofacial aberrations were exclusive to the latter cohort. The elucidated findings augment the existing corpus of knowledge on the genetic architecture influencing both the proband and his mother within this specified familial context. Of critical importance, these discoveries furnish a robust molecular framework conducive to the prenatal diagnostic evaluations of prospective progeny within this familial lineage.

PMID: 38418803 DOI: 10.1007/s13353-024-00849-0

 

 

 

Observer-rated outcomes of communication-centered treatment for adults who stutter: A social validation study

PLoS One. 2024 May 16;19(5):e0303024.

Free Full Texthttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098369/pdf/pone.0303024.pdf

 

Courtney T Byrd, Geoffrey A Coalson, Danielle Werle

The University of Texas at Austin, Austin, Texas, United States of America; Atlanta Satellite, Atlanta, Georgia, United States of America.

 

Previous studies have reported that adults who stutter demonstrate significant gains in communication competence, per self-ratings and clinician-ratings, upon completion of a communication-centered treatment, or CCT. The purpose of this social validation study was to determine whether communication competence ratings reported by untrained observers are consistent with client and clinician judgments of communication competence gains following CCT. Eighty-one untrained observers completed an online survey that required each to view one of two videos depicting an adult who stutters during a mock interview recorded prior to CCT or after CCT. Observers were then asked to rate the communication competence of the interviewee on a 100-point visual analog scale and provide additional demographic information. Communication competence of the adult who stutters who had completed CCT was rated significantly higher in their post-treatment video. Upon controlling for two demographic factors found to be associated with observer ratings (years of education, years the observers had known an adult who stutters), significantly higher ratings of communication competence for the post-treatment video were maintained. These preliminary findings provide social validity for CCT by demonstrating that the gains in communication competence reported in previous studies through clinician and client observations are also reported by untrained observers who are not familiar with CCT.

PMID: 38753611 PMCID: PMC11098369 DOI: 10.1371/journal.pone.0303024

 

 

 

Psychedelics in developmental stuttering to modulate brain functioning: a new therapeutic perspective? - FARMACOLOGIA

Front Hum Neurosci. 2024 Jun 19:18:1402549
Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221540/pdf/fnhum-18-1402549.pdf

 

Giuseppe Pasculli, Per A Alm, Gerald A Maguire et al

La Sapienza University, Rome, Italy; Italian Society of Psychedelic Medicine, Bari, Italy; IRCCS Ospedale San Camillo, Venice, Italy; New York University, New York, NY, United States; Uppsala University, Uppsala, Sweden; San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; American University of Health Sciences, Signal Hill, CA, United States; CenExel CIT Research, Riverside, CA, United States; University of Oxford, Oxford, United Kingdom; McGill University, Montreal, QC, Canada; Imperial College London, London, United Kingdom; University of California, San Francisco, CA, United States.

 

Developmental stuttering (DS) is a neurodevelopmental speech-motor disorder characterized by symptoms such as blocks, repetitions, and prolongations. Persistent DS often has a significant negative impact on quality of life, and interventions for it have limited efficacy. Herein, we briefly review existing research on the neurophysiological underpinnings of DS -specifically, brain metabolic and default mode/social-cognitive networks (DMN/SCN) anomalies- arguing that psychedelic compounds might be considered and investigated (e.g., in randomized clinical trials) for treatment of DS. The neural background of DS is likely to be heterogeneous, and some contribution from genetically determinants of metabolic deficiencies in the basal ganglia and speech-motor cortical regions are thought to play a role in appearance of DS symptoms, which possibly results in a cascade of events contributing to impairments in speech-motor execution. In persistent DS, the difficulties of speech are often linked to a series of associated aspects such as social anxiety and social avoidance. In this context, the SCN and DMN (also influencing a series of fronto-parietal, somato-motor, and attentional networks) may have a role in worsening dysfluencies. Interestingly, brain metabolism and SCN/DMN connectivity can be modified by psychedelics, which have been shown to improve clinical evidence of some psychiatric conditions (e.g., depression, post-traumatic stress disorder, etc.) associated with psychological constructs such as rumination and social anxiety, which also tend to be present in persistent DS. To date, while there have been no controlled trials on the effects of psychedelics in DS, anecdotal evidence suggests that these agents may have beneficial effects on stuttering and its associated characteristics. We suggest that psychedelics warrant investigation in DS.

PMID: 38962146 PMCID: PMC11221540

 

 

 

Psychometric properties of the Persian version of the stuttering generalization self-measure tool in adults who stutter - AVALIAÇÃO

J Fluency Disord. 2024 Mar 14:80:106056. Online ahead of print.

 

Ebtesam Hozeili et al

Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Babol University of Medical Sciences, Babol, Iran.

 

Purpose: Our study aimed to translate the Stuttering Generalization Self-Measure (SGSM) into Persian and investigate its validity, reliability, and internal responsiveness in the Iranian population.

Method: This study was conducted on 30 adults who stutter (AWS) and 30 adults who do not stutter (AWNS). The International Quality of Life Assessment protocol (IQOLA) was applied to translate SGSM into Persian. The face and content validity were determined. Also, the discriminant validity was evaluated by comparing the scores of two groups. In addition, the internal consistency test-retest, and inter-judge reliability were assessed with Cronbach's alpha and intra-class correlation coefficients (ICC). Moreover, the mean standardized response (MSR) and the standardized effect size were measured to determine the internal responsiveness using pre- and post-treatment data.

Results: All the items were comprehensible and clear. The content validity ratio (CVR) and content validity index (CVI) for all nine questions were obtained higher than.62 and.9, respectively. The internal consistency value was high (Cronbach's alpha =.98). For the test-retest reliability, ICC values were excellent, ranging from.93 to.99. The discriminant validity results revealed a significant difference between AWS and AWNS (p < .001). Pre- and post-treatment results indicated high internal responsiveness to changes for percentage of syllable stuttered (SS%) (MSR = 1.09).

Conclusion: The Persian version of SGSM (P-SGSM) benefits from the high values for validity and reliability. Furthermore, it distinguishes the AWS and AWNS and reflects the treatment changes significantly.

PMID: 38503058 DOI: 10.1016/j.jfludis.2024.106056

 

 

 

Reactive Inhibitory Control Precedes Overt Stuttering Events - PROCEDURAL

Neurobiol Lang (Camb). 2024 Jun 3;5(2):432-453.

Free full text: https://direct.mit.edu/nol/article/5/2/432/119560/Reactive-Inhibitory-Control-Precedes-Overt

 

Joan Orpella, Graham Flick, M Florencia Assaneo, Ravi Shroff, Liina Pylkkänen, David Poeppel, Eric S Jackson

Georgetown University Medical Center, Washington, DC, USA; New York University, New York, NY, USA; National Autonomous University of Mexico, Mexico City, Mexico; New York University Abu Dhabi, Abu Dhabi, United Arab Emirates; Ernst Strüngmann Institute (ESI) for Neuroscience, Frankfurt, Germany.

 

Research points to neurofunctional differences underlying fluent speech between stutterers and non-stutterers. Considerably less work has focused on processes that underlie stuttered vs. fluent speech. Additionally, most of this research has focused on speech motor processes despite contributions from cognitive processes prior to the onset of stuttered speech. We used MEG to test the hypothesis that reactive inhibitory control is triggered prior to stuttered speech. Twenty-nine stutterers completed a delayed-response task that featured a cue (prior to a go cue) signaling the imminent requirement to produce a word that was either stuttered or fluent. Consistent with our hypothesis, we observed increased beta power likely emanating from the right pre-supplementary motor area (R-preSMA)-an area implicated in reactive inhibitory control-in response to the cue preceding stuttered vs. fluent productions. Beta power differences between stuttered and fluent trials correlated with stuttering severity and participants' percentage of trials stuttered increased exponentially with beta power in the R-preSMA. Trial-by-trial beta power modulations in the R-preSMA following the cue predicted whether a trial would be stuttered or fluent. Stuttered trials were also associated with delayed speech onset suggesting an overall slowing or freezing of the speech motor system that may be a consequence of inhibitory control. Post-hoc analyses revealed that independently generated anticipated words were associated with greater beta power and more stuttering than researcher-assisted anticipated words, pointing to a relationship between self-perceived likelihood of stuttering (i.e., anticipation) and inhibitory control. This work offers a neurocognitive account of stuttering by characterizing cognitive processes that precede overt stuttering events.

PMID: 38911458 PMCID: PMC11192511 DOI: 10.1162/nol_a_00138

 

 

 

Risk of sleep problems in a clinical sample of children who stutter - INFANTIL / AMBIENTE

J Fluency Disord. 2024 Jan 6:79:106036. Online ahead of print.

 

Maria Clara Helena do Couto, Cristiane Moço Canhetti de Oliveira, Sandra Merlo, Patrick M Briley, Luciana Pinato

São Paulo State University (UNESP), Marilia, SP, Brazil; Brazilian Fluency Institute, Av. Brg. Faria Lima, 1811, conj 822, São Paulo, SP,Brazil. merlo.sandra@gagueira.org.br; East Carolina University, Greenville, NC, United States.

 

Purpose: Previous studies have shown increased prevalence of sleep problems among people who stutter. However, there is a lack of knowledge about what these sleep problems may specifically be.

Method: Fifty children who stutter (CWS) from 6;0 to 12;9 years of age and 50 age- and gender-matched controls participated in this study. Parents did not report coexisting conditions, excepting stuttering and/or sleep problems. Sleep problems were investigated using a standardized questionnaire answered by parents. The questionnaire shows cut-off scores to identify the risk of sleep problems as a whole and on each one of the six subscales (i.e., disorders of initiating and maintaining sleep; sleep breathing disorders; disorders of arousal; sleep-wake transition disorders; disorders of excessive somnolence; and sleep hyperhidrosis). Scores above the cut-off are suggestive of sleep problems.

Results: Twenty-one CWS scored higher than the cut-off on the sleep questionnaire compared to only two controls (p < 0.00001). Specifically, CWS scored higher than controls in disorders of initiating and maintaining sleep, sleep-wake transition disorders (especially jerking, sleep talking, and bruxism), and disorders of excessive somnolence (p < 0.0083, corrected for multiple comparisons).

Discussion: Compared to controls, CWS are at greater risk for sleep problems, which are not consequences of coexisting disorders. Present findings confirm and expand current knowledge about sleep problems in CWS. Directionality possibilities and clinical implications are discussed.

PMID: 38241960 DOI: 10.1016/j.jfludis.2023.106036

 

 

 

Screening for Speech and Language Delay and Disorders in Children 5 Years or Younger: Evidence Report and Systematic Review for the US Preventive Services Task Force - OUTRAS ÁREAS

JAMA. 2024 Jan 23;331(4):335-351. doi: 10.1001/jama.2023.24647.

 

Cynthia Feltner et al

RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, University of North Carolina at Chapel Hill; RTI International, Research Triangle Park, North Carolina; Oregon Health & Science University.

 

Importance: Children with speech and language difficulties are at risk for learning and behavioral problems.

Objective: To review the evidence on screening for speech and language delay or disorders in children 5 years or younger to inform the US Preventive Services Task Force.

Data sources: PubMed/MEDLINE, Cochrane Library, PsycInfo, ERIC, Linguistic and Language Behavior Abstracts (ProQuest), and trial registries through January 17, 2023; surveillance through November 24, 2023.

Study selection: English-language studies of screening test accuracy, trials or cohort studies comparing screening vs no screening; randomized clinical trials (RCTs) of interventions.

Data extraction and synthesis: Dual review of abstracts, full-text articles, study quality, and data extraction; results were narratively summarized.

Main outcomes and measures: Screening test accuracy, speech and language outcomes, school performance, function, quality of life, and harms.

Results: Thirty-eight studies in 41 articles were included (N = 9006). No study evaluated the direct benefits of screening vs no screening. Twenty-one studies (n = 7489) assessed the accuracy of 23 different screening tools that varied with regard to whether they were designed to be completed by parents vs trained examiners, and to screen for global (any) language problems vs specific skills (eg, expressive language). Three studies assessing parent-reported tools for expressive language skills found consistently high sensitivity (range, 88%-93%) and specificity (range, 88%-85%). The accuracy of other screening tools varied widely. Seventeen RCTs (n = 1517) evaluated interventions for speech and language delay or disorders, although none enrolled children identified by routine screening in primary care. Two RCTs evaluating relatively intensive parental group training interventions (11 sessions) found benefit for different measures of expressive language skills, and 1 evaluating a less intensive intervention (6 sessions) found no difference between groups for any outcome. Two RCTs (n = 76) evaluating the Lidcombe Program of Early Stuttering Intervention delivered by speech-language pathologists featuring parent training found a 2.3% to 3.0% lower proportion of syllables stuttered at 9 months compared with the control group when delivered in clinic and via telehealth, respectively. Evidence on other interventions was limited. No RCTs reported on the harms of interventions.

Conclusions and relevance: No studies directly assessed the benefits and harms of screening. Some parent-reported screening tools for expressive language skills had reasonable accuracy for detecting expressive language delay. Group parent training programs for speech delay that provided at least 11 parental training sessions improved expressive language skills, and a stuttering intervention delivered by speech-language pathologists reduced stuttering frequency.

PMID: 38261038 DOI: 10.1001/jama.2023.24647

 

 

 

Self-Perceived Communication Competence of Adults Who Stutter Following Communication-Centered Treatment - TERAPIA

Am J Speech Lang Pathol. 2024 May 31:1-21. Online ahead of print.

 

Geoffrey A Coalson, Courtney T Byrd, Danielle Werle, Robyn Croft, Michael Mahometa

The University of Texas at Austin.

 

Purpose: The purpose of this study was to assess self-perceived communication competence of adults who stutter following participation in a non-ableist treatment for which one of the core components focuses on communication - with no direct or indirect goals designed to reduce or modify stuttered speech.

Method: Thirty-three adults who stutter completed the Self-Perceived Communication Competence scale (McCroskey & McCroskey, 1988) pre- and posttreatment.

Results: Findings indicate significant gains in self-perceived communication competence posttreatment. Pre- to posttreatment changes in stuttering did not predict posttreatment gains in self-perceived communication competence.

Conclusion: The present study demonstrates that improvement in communication can be achieved independent of improvement in fluency, lending further support to the notion that stuttering and communication competence are distinct constructs.

PMID: 38820237 DOI: 10.1044/2024_AJSLP-23-00234

 

 

 

Self-reported musculoskeletal pain, headache, jaw pain and swallowing dysfunction in a sample of young Saudi adults who stutter - AVALIAÇÃO

J Pak Med Assoc. 2024 Jan;74(1):32-37.

Free article: https://ojs.jpma.org.pk/index.php/public_html/article/view/7264

 

Abdulaziz Almudhi , Hamayun Zafar

King Khalid University, Abha, Saudi Arabia; King Saud University, Riyadh, Saudi Arabia.

 

Objectives: To report the prevalence of musculoskeletal pain, headache, jaw pain and difficulty in swallowing among people who stutter (PWS).

Methods: The cross-sectioal study was conducted from October 3, 2021, to March 21, 2022, after approval from the ethics review committee of King Khalid University, Abha, Saudi Arabia, and comprised adult people who stutter belonging to different regions of Saudi Arabia. They were divided into five groups based on stuttering severity as estimated by Stuttering Severity Instrument-4. Data was collected on musculoskeletal pain in different body areas using a questionnaire.. Data ws analysed using SPSS 22.

Results: Of the 101 Arabic-speaking subjects, 63(62.4%) were males and 38(37.6%) were females. The overall mean age was 27±7 years (range: 18-39 years). The largest group was of subjects with moderate severity of stuttering 31(30.6%); 21(68%) males and 10(32%) females. The increase in number of musculoskeletal pain locations was related to the severity of stuttering (p<0.05). The most common musculoskeletal pain sites were the lower back 31(31%), neck 26(26%) and shoulder 26(26%). Frequent headaches and difficulty chewing hard food due to jaw pain were reported by 49(49%) and 22(22%) participants, respectively (p<0.05). Swallowing difficulty was reported by 9(9%) participants (p>0.05).

Conclusions: Widespread chronic musculoskeletal pain of low intensity was found to be common among people who stuttered, and the number of pain locations was positively related to stuttering severity.

PMID: 38219161 DOI: 10.47391/JPMA.7264

 

 

 

Speech Disfluencies in Bilingual Lebanese Children Who Do and Do Not Stutter - INFANTIL / LINGUAGEM

Am J Speech Lang Pathol. 2024 Jun 18:1-20. Online ahead of print.

 

Selma Saad Merouwe, Raymond Bertram, Kurt Eggers

Saint Joseph University of Beirut, Lebanon; Turku University, Finland; Ghent University, Belgium; Thomas More University College, Antwerp, Belgium.

 

Purpose: Prior studies have shown that bilingual children who do not stutter (CWNS) exhibit a high number of disfluencies in both languages, increasing the risk of misidentification by speech-language pathologists as children who stutter (CWS). Conversely, there is a risk of misidentifying CWS with a relatively low incidence of disfluencies as CWNS. This study aims to explore the qualitative and quantitative distinctions in speech disfluency profiles between CWNS and CWS. The assessment covers both the dominant and nondominant language to examine the impact of language dominance on disfluency patterns.

Method: A total of 92 Lebanese bilinguals (70 CWNS and 22 CWS) from 4;06 to 7;06 (years;months) were included. Language dominance was determined based on parental assessments. Spontaneous and narrative speech samples were collected for each child in both languages and all stuttering-like disfluencies (SLD) and other disfluencies (OD) were coded.

Results: On average, CWNS showed a significantly lower percentage of total SLD, weighted SLD, SLD subtypes, and iterations compared to CWS. However, the number of disfluencies of CWNS exceeded monolingual clinical standards. Language dominance did not impact SLD and OD percentages, but some differences for SLD subtypes emerged. Binary logistic regression analyses showed that repetitions and dysrhythmic phonations are good predictors for correct CWS or CWNS classification, in contrast to OD. A combination of predictors from both languages led to better classification than using predictors from either language alone.

Conclusions: The current study shows that speech disfluency percentages in bilingual CWNS typically surpass monolingual standards and can be at par with those of CWS. However, through careful consideration of disfluency characteristics, ideally in both languages, an accurate differential diagnosis of stuttering in bilingual children can be achieved.
PMID: 38889203 DOI: 10.1044/2024_AJSLP-23-00311

 

 

 

Streptococcal Serology in Children With Stuttering - INFANTIL / AVALIAÇÃO

Ear Nose Throat J. 2024 Apr 9.  Online ahead of print.

Free article: https://journals.sagepub.com/doi/epub/10.1177/01455613241244946

 

Tulin Fidan, Serkan Ceyhan, Vural Fidan

Eskisehir Osmangazi University Hospital, Eskisehir, Turkey.

 

Introduction: Stuttering is a pronunciation disorder represented by repetitive perpetuations, duplications, or freezes of spoken words or syllables, as well as nervousness and cognitive shunning. Group A beta-hemolytic Streptococcus (GABHS) can lead to pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). Many case reports have proposed that stuttering is the result of a PANDAS, and that it can be identified together with Tourette syndrome, which shares many clinical characteristics with stuttering.

Aim: The purpose of this study was to examine the association between streptococcal serology and stuttering in children.

Method: The participants in this study are 26 children who stutter (CWS; mean age = 8.3 + 3.1 years) and 25 children who do not stutter (CWNS; mean age = 9.2 + 2.9 years). Participants were matched in terms of age (±3 months) and gender. We analyzed serum antistreptococcal antibodies [antistreptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and antistreptokinase] in both groups.

Results: In the CWS group, ASO, anti-DNase B, and antistreptokinase were significantly higher than in the CWNS group (P < .0001, P < .0001, P < .0001).

Conclusion: The higher serum antistreptococcal antibody amounts in CWS suggest that an increased autoimmune response against GAHBS may be the etiology of childhood stuttering. It has been suggested that CWS should be examined for autoimmune reactions, especially to GAHBS.

PMID: 38591779 DOI: 10.1177/01455613241244946

 

 

 

Stutterers' experiences on classic psychedelics: A preliminary self-report study - FARMACOLOGIA

J Fluency Disord. 2024 May 19:81:106062. Online ahead of print.

 

Eric S Jackson, Noam Goldway, Hope Gerlach-Houck, Noah D Gold

New York University, USA; Western Michigan University, USA.

 

Stuttering poses challenges to social, occupational, and educational aspects of life. Traditional behavioral therapies can be helpful but effects are often limited. Pharmaceutical treatments have been explored but there are no FDA-approved treatments for stuttering. Interest has grown in the potential use of classic psychedelics, including psilocybin and LSD, which have shown effectiveness in treating disorders with similar symptoms (e.g., anxiety, depression, PTSD). The potential effects of psychedelics on stuttering have not been explored. We conducted a preliminary investigation of self-identified stutterers who report their experiences taking classic psychedelics on the online messaging forum, Reddit. We qualitatively analyzed 114 publicly available posts, extracting meaningful units and assigning descriptor codes inductively. We then deductively organized responses into an established framework of psychedelics which includes behavioral, emotional, cognitive, belief-based, and social effects. These effects were subsequently grouped under organizing themes (positive, negative, neutral). Descriptive statistics revealed that the majority of users (74.0%) reported positive overall short-term effects particularly related to behavioral and emotional change (e.g., reduced stuttering and anxiety), but negative (9.6%), mixed (positive and negative; 4.8%), and neutral overall experiences (11.6%) were also reported. The results support the possibility that psychedelics may impact stuttering, but caution must be applied in their interpretation given the entirely uncontrolled research setting and potential adverse health effects of psychedelics as reported elsewhere. While these results do not encourage the use of psychedelics by stutterers, they suggest that future work could examine the impact of psychedelics on stuttering under supervised and in clinically controlled settings.

PMID: 38833909 DOI: 10.1016/j.jfludis.2024.106062

 

 

 

Stuttering in adolescence and the risk for dysglycemia in early adulthood - AVALIAÇÃO

Diabetes Metab Res Rev. 2024 Jul;40(5):e3828.

 

Alexandra Rabotin et al

The Israel Defense Forces Medical Corps, Ramat Gan, Israel; Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel; Sheba Medical Center, Ramat Gan, Israel; Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel; Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel; Maccabi Healthcare Services, Tel Aviv, Israel; Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel.

 

Aims: To investigate the association between stuttering during adolescence and the onset of dysglycemia (prediabetes or type 2 diabetes) in early adulthood among men and women.

Materials and methods: This cohort study included Maccabi Health Services members assessed for mandatory military service at ages 16-19 during 1990-2019 and followed until 31 December 2020. Stuttering status was recorded in the baseline medical evaluation. Incident cases of dysglycemia were identified systematically using prediabetes and diabetes registries. Cox proportional hazard models were applied for men and women separately, adjusting for sociodemographics and medical status.

Results: The study cohort comprised 866,304 individuals (55% men; 0.21% with stuttering) followed for a total of 12,696,250 person-years. During the study period, 7.6% (n = 36,603) of men and 9.0% (n = 34,723) of women were diagnosed with dysglycemia. The mean ages at diagnosis were 34 and 32 years for men and women, respectively. Women with stuttering exhibited the highest dysglycemia incidence rate (102.3 per 10,000 person-years) compared with the other groups (61.4, 69.0, and 51.9 per 10,000 person-years for women without stuttering, men with stuttering, and men without stuttering, respectively). For both men and women, those with stuttering showed an increased risk of being diagnosed with dysglycemia compared with those without (adjusted hazard ratios 1.18 [1.01-1.38] and 1.61 [1.15-2.26], respectively). The associations persisted in extensive sub-analyses.

Conclusions: Stuttering in adolescence is associated with a higher risk of dysglycemia in early adulthood for men and women. Screening and targeted prevention in this population, especially women, may be beneficial.

PMID: 38859687 DOI: 10.1002/dmrr.3828

 

 

 

Stuttering in individuals with Down syndrome: a systematic review of earlier research - Corrigendum - OUTRAS ÁREAS

Published Erratum Front Psychol. 2024 Jul 3:15:1440913.

 

Silje Hokstad, Kari-Anne B Næss

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

 

Erratum for:

Front Psychol. 2023 Nov 29;14:1176743.

PMID: 39021652 PMCID: PMC11253503

 

 

 

Subtle Patterns of Altered Responsiveness to Delayed Auditory Feedback during Finger Tapping in People Who Stutter - AUDITIVO

Brain Sci. 2024 May 7;14(5):472.

Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11120293/pdf/brainsci-14-00472.pdf

 

Giorgio Lazzari, Robert van de Vorst, Floris T van Vugt, Carlotta Lega

University of Pavia, Pavia, Italy; Centre for Research on Brain, Language and Music (CRBLM), Montreal, Canada; McGill University, Montreal, QC, Canada.; University of Montreal, Montreal, Canada.; International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC, Canada.

 

Differences in sensorimotor integration mechanisms have been observed between people who stutter (PWS) and controls who do not. Delayed auditory feedback (DAF) introduces timing discrepancies between perception and action, disrupting sequence production in verbal and non-verbal domains. While DAF consistently enhances speech fluency in PWS, its impact on non-verbal sensorimotor synchronization abilities remains unexplored. A total of 11 PWS and 13 matched controls completed five tasks: (1) unpaced tapping; (2) synchronization-continuation task (SCT) without auditory feedback; (3) SCT with DAF, with instruction either to align the sound in time with the metronome; or (4) to ignore the sound and align their physical tap to the metronome. Additionally, we measured participants' sensitivity to detecting delayed feedback using a (5) delay discrimination task. Results showed that DAF significantly affected performance in controls as a function of delay duration, despite being irrelevant to the task. Conversely, PWS performance remained stable across delays. When auditory feedback was absent, no differences were found between PWS and controls. Moreover, PWS were less able to detect delays in speech and tapping tasks. These findings show subtle differences in non-verbal sensorimotor performance between PWS and controls, specifically when action-perception loops are disrupted by delays, contributing to models of sensorimotor integration in stuttering.

PMID: 38790451 PMCID: PMC11120293 DOI: 10.3390/brainsci14050472

 

 

 

The acute effects of nonsleep deep rest on perceptual responses, physical, and cognitive performance in physically active participants - TERAPIA

Appl Psychol Health Well Being. 2024 Jul 2. Online ahead of print.

 

Omar Boukhris, Haresh Suppiah, Shona Halson, Suzanna Russell, Anthea Clarke, Mary C Geneau, Luke Stutter, Matthew Driller

La Trobe University, Melbourne, Victoria, Australia;  Australian Catholic University, Brisbane, Queensland, Australia; Australian Capital Territory, Australia; Queensland Academy of Sport, Nathan, Queensland, Australia.

 

This study aimed to examine the effect of nonsleep deep rest (NSDR) on physical and cognitive performance, as well as sleepiness, acute readiness, recovery, stress, and mood state in physically active participants. A total of 65 physically active participants (42 male, 23 female) were randomly assigned into two groups: an experimental group (NSDR, n = 34), in which participants completed a 10-min NSDR intervention, and a control group (CON, n = 31), whereby participants sat passively for 10 min. Testing measures were assessed immediately pre and 10 min post each condition and comprised completing a hand grip strength dynamometer test and a countermovement jump test on force plates, cognitive function measures via a psychomotor vigilance task (PVT-B), and a Simon task test, along with four questionnaires to assess sleep, recovery, and mood state. A significant Group × Time interaction favored the NSDR condition for handgrip strength, median reaction time during the PVT-B, and accuracy percentage during the Simon task. Questionnaire responses demonstrated NSDR to be associated with significant benefits to physical readiness, emotional balance, overall recovery, negative emotional state, overall stress, and tension in comparison to CON (p < .05). The NSDR intervention could be a valuable strategy for acutely enhancing overall well-being and readiness.

PMID: 38953770 DOI: 10.1111/aphw.12571

 

 

 

The application of neuronavigated rTMS of the supplementary motor area and rhythmic speech training for stuttering intervention - NEUROCIÊNCIAS

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

 

Mehdi Bakhtiar, Tegan Wai Yee Yeung, Angela Choi

Speech and Neuromodulation Laboratory, Unit of Human Communication; The University of Hong Kong, Hong Kong.

 

Background: Stuttering, a neurodevelopmental speech fluency disorder, is associated with intermittent disruptions of speech-motor control. Behavioural treatments for adults who stutter (AWS) concentrate on adopting speech patterns that enhance fluency, such as speaking rhythmically or prolonging speech sounds. However, maintaining these treatment benefits can be challenging. Neuroimaging studies suggest that supplementary motor area (SMA) which play a crucial role in speech initiation, planning and internal timing shows aberrant activation in speech production of AWS and may contribute to stuttering. Preliminary evidence suggests that brain stimulation may impact responsiveness to behavioural treatments.

Aims: The present study aims to investigate whether excitatory repetitive transcranial magnetic stimulation (rTMS) of the SMA and rhythmic speech can consistently reduce stuttering severity across various measures.

Methods and procedures: Ten self-identified Cantonese-speaking AWS participated in this double-blinded, sham-controlled clinical trial study (NCT05472181). The participants underwent 10 sessions of rhythmic speech training across two phases, combined with either neuronavigated rTMS or sham, with a 2-week washout period between phases. The stuttering severity was assessed through various outcome measures, including the percentage of syllables stuttered, self-perceived stuttering severity, and the brief version of Unhelpful Thoughts and Beliefs About Stuttering before and after each treatment phase.

Outcomes and results: Results demonstrated improved speech fluency in various speaking contexts, with no significant difference between rTMS and sham conditions immediately and 1 week post-treatment. Notably, rTMS specifically led to less stuttering in tongue twister production (d = -0.70). Both treatment conditions effectively reduced self-perceived stuttering severity and negative thoughts and beliefs about stuttering.

Conclusions and implications: The findings of this study indicate that stimulating the SMA reduced stuttering, only in the production of tongue twisters that may require greater motor control and coordination. Furthermore, it indicates that rhythmic speech might help alleviate negative beliefs and anxiety related to stuttering. This research contributes to our understanding of neuromodulation in stuttering treatment and the role of the SMA in speech motor control and emphasises the need for more research on the potential benefits and limitations of applying rTMS in this condition.

PMID: 38711376 DOI: 10.1111/1460-6984.13039

 

 

 

The Association Between Stuttering Burden and Psychosocial Aspects of Life in Adults - EMOCIONAL

J Speech Lang Hear Res. 2024 Apr 16:1-15. Online ahead of print.

 

Marscha M Engelen, Marie-Christine J P Franken et al

Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands; Erasmus University Medical Center, Rotterdam, the Netherlands; Murdoch Children's Research Institute, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia; Griffith University, Southport, Australia; Royal Children's Hospital, Melbourne, Victoria, Australia; Radboud University, Nijmegen, the Netherlands; NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands; Radboud University Medical Center, Nijmegen, the Netherlands; University of Borås, Sweden.

 

Purpose: Stuttering is a speech condition that can have a major impact on a person's quality of life. This descriptive study aimed to identify subgroups of people who stutter (PWS) based on stuttering burden and to investigate differences between these subgroups on psychosocial aspects of life.

Method: The study included 618 adult participants who stutter. They completed a detailed survey examining stuttering symptomatology, impact of stuttering on anxiety, education and employment, experience of stuttering, and levels of depression, anxiety, and stress. A two-step cluster analytic procedure was performed to identify subgroups of PWS, based on self-report of stuttering frequency, severity, affect, and anxiety, four measures that together inform about stuttering burden.

Results: We identified a high- (n = 230) and a low-burden subgroup (n = 372). The high-burden subgroup reported a significantly higher impact of stuttering on education and employment, and higher levels of general depression, anxiety, stress, and overall impact of stuttering. These participants also reported that they trialed more different stuttering therapies than those with lower burden.

Conclusions: Our results emphasize the need to be attentive to the diverse experiences and needs of PWS, rather than treating them as a homogeneous group. Our findings also stress the importance of personalized therapeutic strategies for individuals with stuttering, considering all aspects that could influence their stuttering burden. People with high-burden stuttering might, for example, have a higher need for psychological therapy to reduce stuttering-related anxiety. People with less emotional reactions but severe speech distortions may also have a moderate to high burden, but they may have a higher need for speech techniques to communicate with more ease. Future research should give more insights into the therapeutic needs of people highly burdened by their stuttering.

Supplemental material: https://doi.org/10.23641/asha.25582980.

PMID: 38625147 DOI: 10.1044/2024_JSLHR-23-00562

 

 

 

The clinical and genetic spectrum of paediatric speech and language disorders in 52,143 individuals - INFANTIL / CONCEITO

This is a preprint.

It has not yet been peer reviewed by a journal.

medRxiv

 [Preprint]. 2024 Apr 23:2024.04.23.24306192.

 

Jan Magielski et al

 

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 (EMR) 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 twenty-six broad speech and language diagnoses. We used Natural Language Processing to assess to which degree clinical diagnosis in full-text notes were reflected in ICD-10 diagnosis codes. We found that aphasia and speech apraxia could be easily retrieved through ICD-10 diagnosis codes, while stuttering as a speech phenotype was only coded in 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 EMR analysis 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 x 10 -7 , CI=18.62-130.39) and MYO7A with speech and language development delay due to hearing loss ( P =1.24 x 10 -5 , CI=17.46-Inf). Finally, in a sub-cohort of 726 individuals with whole exome sequencing data, we identified an enrichment of rare variants in synaptic protein and neuronal receptor pathways and associations of UQCRC1 with expressive aphasia and WASHC4 with abnormality of speech or vocalization. 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: 38712155 PMCID: PMC11071575

 

 

 

The experience of stuttering in everyday life among adults who stutter: The impact of trait social anxiety and the social situations - EMOCIONAL

J Fluency Disord. 2024 May 21:80:106061. Online ahead of print.

 

Xiaofan Lei, Jayanthi Sasisekaran, Viann N Nguyen-Feng

University of Minnesota, Pillsbury Drive SE, Minneapolis, MN, USA.

 

Purpose: The purpose of this study was to investigate the emotional and stuttering experience of adults who stutter (AWS) in everyday life, and how that experience may be shaped by personal (i.e., trait social anxiety) and situational factors (i.e., social partner reaction, communication channel type, social closeness, stuttering knowledge).

Method: AWS completed ecological momentary assessments on their smartphones multiple times a day for up to three weeks. Data (n = 62) were analyzed with multilevel models to determine how situational factors and trait social anxiety influence the Negative Affect (NA), Positive Affect (PA), and self-reported stuttering severity of AWS.

Results: Results indicated that having high (vs. low) trait social anxiety was associated with a tendency to experience high NA, low PA, and high self-reported stuttering severity among AWS. A range of situational factors significantly influenced the within-person variation of NA, PA, and self-reported stuttering severity in everyday life. In addition, interacting with distant social partners relative to being alone heightened NA, and the effect was more prominent among AWS with high (vs. low) trait social anxiety.

Conclusions: Overall, the findings suggest that the variation of affects and stuttering severity among AWS can be partly accounted for by factors from both the situational and personal levels. Clinicians should be aware of the low PA experienced by AWS who have high (vs low) trait social anxiety in everyday life.

PMID: 38788243 DOI: 10.1016/j.jfludis.2024.106061

 

 

 

Therapeutic potential of robots for people who stutter: a preliminary study - OUTRAS ÁREAS

Front Psychiatry. 2024 Jan 12:15:1298626.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10811234/pdf/fpsyt-15-1298626.pdf

 

Yuichiro Yoshikawa et al

Osaka University, Osaka, Japan; Kanazawa University, Kanazawa, Japan; Research Institute, Saitama, Japan; Nagasaki University, Nagasaki, Japan.

 

Introduction: Growing anecdotal evidence suggests the feasibility of robotic intervention for people who suffer from disorders related to state anxiety. Few studies have been conducted on utilizing robots for persons who stutter (PWS). The present study examines the feasibility of using a robot for speech therapy for PWS.

Methods: We prepared four settings (i.e., interviews with unfamiliar persons, interviews with unfamiliar communication robots, reading sentences aloud with a tandem robot that can utter the same words as a user by repeating the user's voice after a short delay, and reading sentences aloud while being alone). We assessed the potential of the robots as both interlocutors and practice partners in training with delayed auditory feedback (DAF) for PWS. Moreover, we assessed the relationship between the trait of stuttering and the participants' affinity to the robots.

Results: Eleven PWS participated in the study. Eight (72.7%) participants had fewer stuttering-related psychological symptoms when they communicated with robots than when they communicated with humans. Spearman's rank correlation analysis revealed that there was a significant negative correlation between the Modified Erickson Communication Attitude scale (S-24) and the difference between the scores for stuttering-related psychological symptoms pertaining to the communication robot and humans (p < 0.01). Six participants (54.5%) had fewer stuttering-related psychological symptoms when they read aloud with the tandem robot than when they read aloud alone. There were significant positive correlations between S-24 and the differences between the scores for stuttering-related psychological symptoms when reading aloud with the tandem robot and those when reading aloud alone (p < 0.01).

Discussion: The communication robot and tandem utterance robot can sometimes be burdensome, although both robots were always easier to talk to for PWS in this preliminary study. The participants with positive speech-related attitudes were more inclined to decrease stuttering-related psychological symptoms when communicating with CommU than when communicating with humans. The participants whose speech-related attitudes were negative were more inclined to show a decrease in stuttering-related psychological symptoms when reading aloud with the tandem robot. Further studies are needed to provide more detailed information.

PMID: 38283848 PMCID: PMC10811234 DOI: 10.3389/fpsyt.2024.1298626

 

 

 

Treatment for preschool age children who stutter: Protocol of a randomised, non-inferiority parallel group pragmatic trial with Mini-KIDS, social cognitive behaviour treatment and the Lidcombe Program-TreatPaCS - INFANTIL / TERAPIA

Randomized Controlled Trial PLoS One. 2024 Jul 11;19(7)

Anne-Lise Leclercq, Kurt Eggers et al

 

University of Liège, Liège, Belgium; Artevelde University of Applied Sciences, Ghent, Belgium; Antwerp University Hospital (UZA), Antwerp, Belgium; Thomas More University of Applied Sciences, Antwerp, Belgium; Ghent University, Ghent, Belgium; Turku University, Turku, Finland.

 

Stuttering is a speech disorder in which the flow of speech is disrupted by involuntary repetitions of sounds, syllables, words or phrases, stretched sounds or silent pauses in which the person is unable to produce sounds and sound transitions. Treatment success is the highest if stuttering is treated before the age of 6 years, before it develops into "persistent" stuttering. Stuttering treatment programs that focus directly on the speech of the child, like the Lidcombe Program, have shown to be effective in this age group. Mini-KIDS is also a treatment that focuses directly on the speech of the child. It is possible that capturing the increased brain plasticity at this age in combination with creating optimal conditions for recovery underlie these treatments' success rate. A treatment focusing on the cognitions, emotions and behaviour of the child, the social cognitive behaviour treatment (SCBT), is also frequently delivered in Belgium. In this study we want to compare, and collect data on the effectiveness, of these three treatment programs: Mini-KIDS, SCBT and the Lidcombe Program (protocol registered under number NCT05185726). 249 children will be allocated to one of three treatment groups. Stuttering specialists will treat the child (and guide the parents) with Mini-KIDS, the SCBT or the Lidcombe Program. They will be trained to deliver the programs meticulously. At 18 months after randomisation, the speech fluency of the child and the attitude of the child and parent(s) towards speech will be measured. It is expected that the three programs will achieve the same (near) zero levels of stuttering in nearly all children and a positive attitude towards speech at 18 months after the start of treatment. The amount of treatment hours to reach the (near) zero levels of stuttering will be compared between the different programmes. For families as well as for the health system this could generate important information.

PMID: 38990808 PMCID: PMC11239023

 

 

 

Treatment for Stuttering in Preschool-Age Children: A Qualitative Document Analysis of Treatment Programs - INFANTIL / TERAPIA

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

 

Åse Sjøstrand, Kari-Anne Bottegård Næss, Ane Hestmann Melle, Karoline Hoff, Elisabeth Holm Hansen, Linn Stokke Guttormsen

University of Oslo, Norway;The National Service for Special Needs Education, Oslo, Norway; University of South-Eastern Norway, Porsgrunn, Norway; Oslo Metropolitan University, Norway.

 

Purpose: The purpose of this study was to identify commonalities and differences between content components in stuttering treatment programs for preschool-age children.

Method: In this document analysis, a thematic analysis of the content was conducted of handbooks and manuals describing Early Childhood Stuttering Therapy, the Lidcombe Program, Mini-KIDS, Palin Parent-Child Interaction Therapy, RESTART Demands and Capacities Model Method, and the Westmead Program. First, a theoretical framework defining a content component in treatment was developed. Second, we coded and categorized the data following the procedure of reflexive thematic analysis. In addition, the first authors of the treatment documents have reviewed the findings in this study, and their feedback has been analyzed and taken into consideration.

Results: Sixty-one content components within the seven themes-interaction, coping, reactions, everyday life, information, language, and speech-were identified across the treatment programs. The content component SLP providing information about the child's stuttering was identified across all treatment programs. All programs are multithematic, and no treatment program has a single focus on speech, language, or parent-child interaction. A comparison of the programs with equal treatment goals highlighted more commonalities in content components across the programs. The differences between the treatment programs were evident in both the number of content components that varied from seven to 39 and the content included in each treatment program.

Conclusions: Only one common content component was identified across programs, and the number and types of components vary widely. The role that the common content component plays in treatment effects is discussed, alongside implications for research and clinical practice.

PMID: 38557114 DOI: 10.1044/2024_JSLHR-23-00463

 

 

 

Validation of the Persian Version of the Palin Parent Rating Scales - INFANTIL / AVALIAÇÃO

Folia Phoniatr Logop. 2024 Apr 30. Online ahead of print.

 

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

 

Introduction: The Palin Parent Rating Scales (Palin PRS) is a structured questionnaire filled out by parents of children who stutter. It is designed to assess the effects of stuttering on both the children and their parents. The goal of this study was to translate the Palin PRS into Persian and to evaluate its validity and reliability for application in preschool children who stutter.

Methods: This research was conducted from August 2021 to December 2022, involving 139 parents of children who stutter. The parents completed the Palin PRS and provided their demographic data. Descriptive statistics were used to examine the floor and ceiling effects on all subscales of the Palin PRS. The internal consistency of the scale was assessed using Cronbach's alpha method, while the Intraclass Correlation Coefficient (ICC) was calculated to determine its test-retest reliability. An Exploratory Factor Analysis was also performed to clarify the factor structure of the scale.

Results: The Exploratory Factor Analysis results were highly consistent with the factor structure found in the original version. No floor or ceiling effects were observed for the factors of the Palin PRS. The three factors of the Persian version of the Palin PRS (P-Palin PRS) showed good internal consistency (Cronbach's alpha&gt;0.8) and excellent test-retest reliability (ICC&gt;0.9). Additionally, normative scores were derived by converting raw scores into Stanine scores.

Conclusion: The P-Palin PRS showed strong reliability, thereby establishing it as a suitable instrument for evaluating how parents perceive the effects of stuttering on their children and themselves. Further research may explore its application in diverse clinical settings and populations.

PMID: 38688239 DOI: 10.1159/000539119

 

 

 

Validity and utility of the Japanese version of the brief unhelpful thoughts and beliefs about stuttering scale: UTBAS-6-J - AVALIAÇÃO

Front Psychol. 2024 Jun 11:15:1382673. doi: 10.3389/fpsyg.2024.1382673. eCollection 2024.

Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196822/

 

Shuta Tomisato, Yasuto Yada, Koichiro Wasano, Takeyuki Kono, Hiroyuki Ozawa

Keio University School of Medicine, Tokyo, Japan; Nippon Koukan Hospital, Kawasaki, Kanagawa, Japan; Tokyo Metropolitan University, Tokyo, Japan; Tokai University School of Medicine, Isehara, Kanagawa, Japan.

 

Do adults who stutter have abnormally high social anxiety? Is it related to maladaptive cognition? As these are persistent, unresolved questions in stuttering research, it behooves clinicians to at least assess and attempt to identify social anxiety in patients who stutter and its basis before decisions are made about stuttering treatment. The Unhelpful Thoughts and Beliefs About Stuttering (UTBAS) scale is a self-administered questionnaire that measures the degree of non-adaptive cognition in people who stutter (PWS) due to social anxiety. The 66-item UTBAS is time-consuming to complete, prompting the development of a shorter 6-item version, the UTBAS-6, which is in English. Here, we aimed to assess some psychometric properties of the Japanese version of the UTBAS-6, the UTBAS-6-J, which has not been done to date. In 56 adult patients (mean 32.6 ± 11.1 years) who stutter, we quantified the reliability, the internal consistency, and the concurrent validity of the UTBAS-6-J. Along with the UTBAS-6-J, patients also were administered the Overall Assessment of the Speaker's Experience of Stuttering - Japanese version (OASES-A-J), the Modified Erickson Communication Attitude Scale - Japanese version (S-24-J), and the Liebowitz Social Anxiety Scale - Japanese version (LSAS-J). Cronbach's alpha for UTBAS-6-J total scores was 0.974, indicating excellent internal consistency. UTBAS-6-J scores were significantly correlated with scores on the OASES-A-J, the S-24-J, and the LSAS-J (all p < 0.005). Concurrent validity of the UTBAS-6-J with these three questionnaires was confirmed. The UTBAS-6-J has good internal consistency and concurrent validity, which will aid clinical decision-making about stuttering treatments.

PMID: 38919794

 

 

 

Visualising the dynamic morphology of stuttering using real-time MRI - NEUROCIÊNCIAS

Case Reports Lancet. 2024 May 4;403(10438):1789-1790.

 

Daniela Ponssen et al.

University Medical Center Göttingen, Göttingen, Germany; Max-Planck-Institute for Multidisciplinary Sciences, Göttingen, Germany.

 

No abstract available

PMID: 38704173 DOI: 10.1016/S0140-6736(24)00624-X

 

 

 

What works, how and in which contexts when supporting parents to implement intensive speech and language therapy at home for children with speech sound disorder? A protocol for a realist review - INFANTIL / AMBIENTE

BMJ Open. 2024 Jan 6;14(1):e074272.

Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773357/pdf/bmjopen-2023-074272.pdf

 

Naomi Leafe, Emma Pagnamenta, Laurence Taggart, Mark Donnelly, Angela Hassiotis, Jill Titterington

Ulster University, Belfast, UK leafe-n@ulster.ac.uk; University of Reading, Reading, UK; Royal Free and University College Medical School, London, UK.

 

Introduction: Speech and language therapists (SLTs) worldwide report challenges with providing recommended, evidence-based intervention intensity for children with speech sound disorder (SSD). Challenges such as service constraints and/or family contexts impact on access to optimal therapy intensity. Existing research indicates that empowering and training parents to deliver intervention at home, alongside SLT support, offers one possible solution to increasing the intensity of intervention children with SSD receive. Digital health could increase accessibility to intensive home practice and help sustain engagement with therapy activities. Further exploration is needed around what makes parent-implemented interventions for children with SSD effective, for who and in which situations. This paper outlines the protocol for a realist review which aims to explore the active ingredients and contextual factors of effective digital parent-led interventions.

Methods and analysis: A realist review will explore the research question, following six stages. The scope of the review will be determined, and initial programme theories will be developed about what works in digital parent-implemented interventions for SSD, for whom, how, why and in what circumstances. Relevant secondary data, identified through a formal search strategy, will be selected, appraised, analysed and synthesised using realist principles to test and further refine the initial programme theories. This process will develop refined underpinning explanatory theories which capture the interaction between contexts, mechanisms and outcomes of the intervention. An expert steering group will provide insight to inform explanatory theories, searches, and dissemination.

PMID: 38184311 PMCID: PMC10773357 DOI: 10.1136

 

 

 

Why do people who stutter attend stuttering support groups? - Erratum

S Afr J Commun Disord. 2024 Mar 22;71(1):1046.

 

Nicola E Bloye, Shabnam S Abdoola, Casey J Eslick

Faculty of Humanities, University of Pretoria, Pretoria.

 

No abstract available.

PMID: 38572903 DOI: 10.4102/sajcd.v71i1.1046

 

 

 

 

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                                      janeiro a julho de 2012

                                      agosto a dezembro de 2012