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

 

 

 

[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

 

 

 

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

 

 

 

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

 

 

 

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

 

 

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

 

 

 

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

 

 

 

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

 

 

 

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

 

 

 

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

 

 

 

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

 

 

 

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

 

 

 

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

 

 

 

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

 

 

 

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

 

 

 

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

 

 

 

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

 

 

 

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

 

 

 

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-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

 

 

 

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

 

 

 

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

 

 

 

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 Stuttering in Preschool-Age Children: A Qualitative Document Analysis of Treatment Programs - 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

 

 

 

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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