www.e-gagueira.com.br - Abstrat 2025 janeiro a julho

Abstract - Janeiro a Julho de 2025

A Biopsychosocial Overview of Speech Disorders: Neuroanatomical, Genetic, and Environmental Insights - TERAPIA

Review Biomedicines. 2025 Jan 20;13(1):239.

Diya Jaishankar et al

University of California, San Diego, CA, USA; Advancement and Research in the Sciences and Arts (ARISA) Foundation, Pune, India; Oklahoma State University Center for Health Sciences, Tulsa, OK, USA; SymphonyTech Biologics, Philadelphia, PA 19143, USA.

Speech disorders encompass a complex interplay of neuroanatomical, genetic, and environmental factors affecting individuals' communication ability. This review synthesizes current insights into the neuroanatomy, genetic underpinnings, and environmental influences contributing to speech disorders. Neuroanatomical structures, such as Broca's area, Wernicke's area, the arcuate fasciculus, and basal ganglia, along with their connectivity, play critical roles in speech production, comprehension, and motor coordination. Advances in the understanding of intricate brain networks involved in language offer insights into typical speech development and the pathophysiology of speech disorders. Genetic studies have identified key genes involved in neural migration and synaptic connectivity, further elucidating the role of genetic mutations in speech disorders, such as stuttering and speech sound disorders. Beyond the biological mechanisms, this review explores the profound impact of psychological factors, including anxiety, depression, and neurodevelopmental conditions, on individuals with speech disorders. Psychosocial comorbidities often exacerbate speech disorders, complicating diagnosis and treatment and underscoring the need for a holistic approach to managing these conditions. Future directions point toward leveraging genetic testing, digital technologies, and personalized therapies, alongside addressing the psychosocial dimensions, to improve outcomes for individuals with speech disorders. This comprehensive overview aims to inform future research and therapeutic advancements, particularly in treating fluency disorders like stuttering.

PMID: 39857822 PMCID: PMC11762365 DOI: 10.3390/biomedicines13010239

A discussion of topics related to teaching a graduate stuttering course - OUTRAS ÁREAS

J Fluency Disord. 2025 Feb 1:83:106103. Online ahead of print.

Julia S Kerrigan, Shelley B Brundage, Christopher D Constantino, Derek E Daniels, Naomi H Rodgers

University of Iowa, USA; George Washington University, USA; Florida State University, USA; Wayne State University, USA; University of Iowa, USA.

Purpose: To discuss instruction of graduate stuttering courses with a particular focus on contemporary issues such as the pseudostuttering, counting stuttering, and engaging with materials within the classroom and in clinical practice.

Methods: At a panel discussion at the World Stuttering and Cluttering Organization Congress in May 2024, attendees submitted their questions to a panel of experts in stuttering pedagogy. To document and continue the discussion, each expert responded in turn to the most frequently asked questions.

Results: While the included experts frame key learning activities differently within their respective courses, each takes care to center lived experiences of people who stutter and contextualize learning activities within their clinical purposes.

Conclusions: The pedagogical insights shared in this discussion offer guidance to instructors of stuttering courses to equip students with tools to assess, treat, and counsel their clients who stutter from a humanistic approach.

PMID: 39921936 DOI: 10.1016/j.jfludis.2025.106103

A pilot study of stuttering treatment for older children (STOC) - INFANTIL / TERAPIA

J Fluency Disord. 2025 Jan 26:83:106102. Online ahead of print.

Jóhanna T Einarsdóttir et al

University of Iceland, Iceland; Talþjálfun Mosfellsbæjar (Speech Clinic in Mosfellsbær), Iceland; Charles Sturt University, Australia.

Purpose: This pilot study explored an operant treatment for school-age children, Stuttering Treatment for Older Children (STOC), in increasing quality of life and the fluency of school-aged children who stutter.

Method: The participants were seven children 9-13 years old. A single-case experimental design using multiple baselines was utilized, with participants randomly assigned to baselines of different lengths. STOC is a home-based treatment program that combined time-out with a specific performance-based criteria. Recordings of children's speech were collected routinely as monthly samples (n = 653) and during treatment sessions (n = 1551). Clinicians immediately reviewed and provided feedback on recordings of sessions. Fidelity was measured in terms of dosage, adherence, quality of the delivery, and responsiveness.

Results: For all participants, the STOC intervention showed promising results. Participant-reported quality of life significantly increased for those participants who completed the STOC program. The frequency of stuttering (percentage of syllables stuttered) decreased by an average of 72 % between the initial baseline measurement and later stages. Additionally, the quantity of speech increased by 18 %, speech sounded more natural, with naturalness scores increased by 50 %, and the severity of stuttering decreased by 56 %. Only four participants finished the intervention. This suggests that the benefits of the intervention include both overall greater well-being and less disfluencies.

Conclusions: This pilot study showed increased speech fluency and quality of life among participants who completed the intervention. However, further investigation is crucial, and we encourage the academic community to engage in this research area.

PMID: 39892195 DOI: 10.1016/j.jfludis.2025.106102

A year in stuttering research: A systematic review of global representation and sociodemographic reporting practices in English-language journals in 2020 - CONCEITO

Review J Commun Disord. 2025 Jan 31:114:106500. Online ahead of print.

Free article: https://www.sciencedirect.com/science/article/pii/S0021992425000073?via%3Dihub

Ryan A Millager et al

Vanderbilt University, Nashville, TN, USA; Boston University, Boston, MA, USA; Vanderbilt University Medical Center, Nashville, TN, USA.

Purpose: Demographic data is inconsistently reported and defined in communication sciences and disorders research, yet gender, ethnicity, and socioeconomic status (SES) may be critical considerations for investigations of stuttering. Therefore, the purpose of this study is to evaluate the global scope and sociodemographic reporting practices among stuttering research published in the year 2020.

Methods: Article searches were conducted in February 2023 in PsycINFO, PubMed, and ASHAWire for studies sampling participants with developmental stuttering or cluttering. Further inclusion criteria for systematic review were that articles must: (a) be published in the year 2020, (b) be published in a peer-reviewed journal, and (c) present original empirical research. Participant gender, ethnicity, and SES were extracted via a manualized coding scheme.

Results: The total corpus for review included k = 92 articles, representing a total n = 7,342 participants recruited from 26 different countries. The majority of articles (k = 36) were based in the United States (US), with all other countries contributing between 1 and 5 articles each. Gender (or sex) was reported in 93.5% of included studies, ethnicity in 22.8%, and SES in 41.3%. Reporting practices did not significantly differ between US and non-US countries. Of note, only one article in 2020 recruited participants who clutter, with all others recruiting participants who stutter.

Conclusion: This is the first systematic review of diversity and reporting practices in the global stuttering research literature. Our results revealed a narrow global distribution of research participants, with limited reporting and analyses regarding participant ethnicity or SES. Consequently, we have identified opportunities to improve research participant transparency and to further consider sociocultural variables toward the advancement of global and inclusive stuttering research.

PMID: 39921930 DOI: 10.1016/j.jcomdis.2025.106500

An Exploratory Comparison of Attitudes Toward Stuttering and Cluttering of Chinese Practicing Speech and Language Therapists (SLTs) and SLT Students - SOCIAL

Folia Phoniatr Logop. 2025 Mar 3:1-25. Online ahead of print.

Yu-An Chen et al

This study aimed to compare attitudes toward stuttering and cluttering among speech and language therapists (SLTs) and speech and language therapy students in China and how they differ from those in other countries. It also seeks to explore factors that may influence these attitude differences. We utilized online versions of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) and Public Opinion Survey of Human Attributes-Cluttering (POSHA-Cl) instruments to conduct surveys of 54 SLTs and 99 SLT students at six Chinese universities offering speech and language therapy programs. Chinese SLTs had more positive attitudes than did SLT students. For example, rejecting learning and emotional trauma as a cause of stuttering or cluttering (a positive response) was more likely in SLTs than in SLT students. Both groups expressed more positivity about their knowledge sources than the average ratings from international samples. Increased positive exposure opportunities with stuttering or cluttering will likely positively impact on attitudes toward stuttering and cluttering in China. It is crucial for speech and language professionals in China to recognize the widespread misinformation in various sources and actively combat misconceptions about stuttering and cluttering.

PMID: 40031890 DOI: 10.1159/000543442

Administering the Lidcombe Program to children who stutter with concomitant disorders: Insights from an exploratory retrospective chart review study – INFANTIL/ TERAPIA

J Fluency Disord. 2025 Jan 26:83:106101. Online ahead of print.

Free text: https://www.sciencedirect.com/science/article/pii/S0094730X25000038?via%3Dihub

Sébastien Finlay et al

Université de Montréal, Montreal, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, Canada; Integrated University Health and Social Service Centres of Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada; Faculty of Dental Medicine and Oral Health Sciences, Université McGill, Montreal, Quebec, Canada.

Purpose: Children who stutter (CWS) in clinical settings may present with concomitant disorders (CDs), which can complexify the delivery of the Lidcombe Program (LP). However, there is limited evidence on how CDs influence treatment outcomes in CWS, leaving clinicians with little guidance regarding best practices with these children. This exploratory study, conducted in partnership with a rehabilitation center's clinical team, aims to understand which CDs and suspected CDs speech-language pathologists document when treating CWS with the LP and their relationship to treatment characteristics and outcomes.

Method: A retrospective chart review was conducted on 47 children diagnosed with developmental stuttering who received the LP between 2016 and 2018.

Results: 38 CWS (80.9 %) had either at least one confirmed (59.6 %) or suspected (21.3 %) CD, of which 61.7 % were language-related and 27.6 % attention-related. CWS with diagnosed and suspected CDs had significantly higher stuttering severity rating (SR) scores post-treatment as compared to CWS without CDs (p =.001), although all groups significantly reduced their stuttering. There were high drop-out rates in all groups. CWS with diagnosed and suspected CDs who dropped out had significantly higher SR scores than CWS without CDs who progressed to Stage 2 (p =.011 and p =.014, respectively).

Conclusion: The LP is effective in improving fluency in both CWS with and without CDs. However, CWS with diagnosed or suspected CDs finished or dropped out of Stage 1 with significantly higher SR scores than CWS without CDs. Future research is needed to confirm these results and investigate the factors underlying the observed differences.

PMID: 39879701 DOI: 10.1016/j.jfludis.2025.106101

Assessment of verbal and nonverbal cognitive abilities in children with stuttering using 5th edition Stanford Binet - INFANTIL / PROCESSUAL

Appl Neuropsychol Child. 2025 Jan 28:1-8. Online ahead of print.

Rasha Sami Abdul-Aziz, Sherine Ramzy, Ghada Tarek Orabi

National Research Center, Giza, Egypt; American University in Cairo, New Cairo, Egypt.

Stuttering is a speech disorder disrupting fluency with implications that could affect psychological, educational, social, and occupational aspects of life. Cognitive functions include mental processes that allows for execution of goal-directed responses in different situations. They are usually referred to as executive functions (EF) which consists of three main components, working memory, cognitive flexibility, and inhibitory control. The Stanford Binet 5th edition (SB5) is an intelligence scale designed to assess various cognitive skills by measuring five main domains that require the administration of these executive skills. Recent research has focused on executive functions skills among children with stuttering (CWS), and how it might affect stuttering development and severity.

Aim of the study: The aim of this study was to compare the cognitive verbal and nonverbal skills using the Stanford Binet intelligence quotient test 5th edition (SB5) between children with stuttering (CWS) and children with no stuttering (CWNS) and to assess which of these skills affected stuttering severity among CWS.

Methods: A total of 70 children, 40 CWS and 30 CWNS, were assessed using the SB5 test. Further assessment of the CWS was done using the stuttering severity index (SSI) to determine the degree of stuttering. Statistical analysis and comparison were used to determine results and differences in cognitive skills, and regressive analysis was used to determine the most predicative factor in stuttering development and severity.

Results: Showed that CWS performed lower scores than CWNS in all SB5 domains except in non-verbal domain, where the two groups did not differ significantly in their performance. Working memory was the weakest skill among CWS and stood out as the only significant predicative factor in stuttering. Children with severe stuttering performed higher in their total IQ, nonverbal IQ, knowledge, and fluid reasoning than moderate stutterers, having the strongest performance in non-verbal IQ, still none of these domains turned out to be of a predicative significance in severity.

Conclusion: Findings suggest that working memory is the weakest executive skill in CWS as well as other executive functions related to cognitive flexibility compared to fluent controls. Working memory skills are significantly lower in CWS but does not correlate with its severity; whereas the strongest skills, among CWS compared to fluent controls, are in the nonverbal domains.

PMID: 39873215 DOI: 10.1080/21622965.2024.2448009

Bilingual Heterogeneity in Speech: "Typical" Trends and "Atypical" Cases in Disfluency - INFANTIL / LINGUAGEM

J Speech Lang Hear Res. 2025 Mar 20:1-20. Online ahead of print.

Sveta Fichman

Hadassah Academic College, Jerusalem, Israel; Talpiot College of Education, Holon, Israel.

Purpose: Bilingual children's speech often contains high percentages of disfluencies in both their languages; however, the distribution of disfluency types and the difference across bilinguals' two languages have received insufficient and inconsistent empirical support. The present research aims to profile "typical" bilingual disfluency phenomena while comparing across the two languages and examining the impact of language exposure as well as proficiency.

Method: The current research analyzed disfluency rates and types among 32 bilingual children aged 4-9 years speaking a heritage language (HL; English or Russian) and a societal language (SL; Hebrew). Children's language proficiency was examined using a receptive vocabulary task and a sentence repetition task in both HL and SL. Analyses of three speech samples (spontaneous speech, narrative telling, and narrative retelling) were conducted examining rates and types of stuttering-like disfluencies (SLDs) and other disfluencies (ODs).

Results: The percentage of SLDs was higher in SL than in HL, which was related to the amount of exposure, whereas the percentage of ODs was associated with the proficiency vocabulary score and age of onset of bilingualism. Analysis of individual profiles revealed that nine children had high SLDs in at least one language. This could lead to stuttering overdiagnosis. Children whose SLD rates were high in both languages showed low performance (1 SD below the group level) on proficiency tasks, whereas children with a high percentage of SLDs only in HL had intact proficiency.

Conclusions: The results reveal high individual variation in disfluencies and support the importance of SLD-OD distinction in research on bilingual disfluency. Clinical implications of the research suggest that assessment of bilingual speech should be conducted applying unique criteria, different from the existing monolingual norms.

PMID: 40112004 DOI: 10.1044/2024_JSLHR-24-00415

Bilingualism as a risk factor for false reports of stuttering in the Early Childhood Longitudinal Study (ECLS-K:2011): Corrigendum

Published Erratum Front Psychol. 2025 Jan 7:15:1481398.

Susanne Gahl

University of California at Berkeley, Berkeley, CA, United States.

[This corrects the article DOI: 10.3389/fpsyg.2023.1155895.].

PMID: 39839931 PMCID: PMC11749021

Brain anatomy differences in Chinese children who stutter: a preliminary study - INFANTIL / NEUROCIÊNCIAS

Front Neurol. 2025 Jan 27:16:1483157.

Dan Ma et al

Sichuan University, Chengdu, Sichuan, China; Ministry of Education, Chengdu, Sichuan, China.

Background and purpose: It is unknown the neural mechanisms of developmental stuttering (DS). The aim of this study was to investigate the changes in the structural morphology of the brain in Chinese children who stutter.

Methods: A case-control study was conducted to collect magnetic resonance imaging data from stuttering and non-stuttering children, thereby analyzing whole-brain gray matter volume and cortical morphological changes in stuttering children.

Results: A total of 108 subjects were recruited (stuttering group: control group = 1:1). Comparing to healthy controls, the gray matter volume was significantly decreased in right temporal gyrus and bilateral cerebellum. Additionally, there was a significant reduction in cortical folds in the right insula and right superior temporal gyrus. Moreover, the gray matter volume of the right cerebellum and right temporal gyrus is related to the severity score of stuttering.

Conclusion: The present study proposes that the neural mechanisms underlying DS are intricately linked to the cortico-basal ganglia-thalamo-cortical loop and the dorsal language pathway. This finding is expected to provide reference value for the clinical treatment of DS.

PMID: 39931552 PMCID: PMC11807804

Conflicting Evidence for a Motor Timing Theory of Stuttering: Choral Speech Changes the Rhythm of Both Neurotypical and Stuttering Talkers, but in Opposite Directions - AUDITIVO

J Speech Lang Hear Res. 2025 Jan 7:1-10. Online ahead of print.

Sophie Meekings et al

University of York, United Kingdom; All India Institute of Speech and Hearing, Mysore, Karnataka; University College London, United Kingdom.

Purpose: Talking in unison with a partner, otherwise known as choral speech, reliably induces fluency in people who stutter (PWS). This effect may arise because choral speech addresses a hypothesized motor timing deficit by giving PWS an external rhythm to align with and scaffold their utterances onto. This study tested this theory by comparing the choral speech rhythm of people who do and do not stutter to assess whether both groups change their rhythm in similar ways when talking chorally.

Method: Twenty adults who stutter and 20 neurotypical controls read a passage on their own and then a second passage chorally with a neurotypical partner. Their speech rhythm was evaluated using Envelope Modulation Spectrum (EMS) analysis to derive peak frequency, a measure of the dominant rate of modulation in the sound envelope, as well as peak amplitude (the amplitude of the peak frequency), across several octave bands associated with different features of speech.

Results: The two groups displayed opposing patterns of rhythmic change during choral reading. People with a stutter increased their EMS peak frequency when they read chorally, while neurotypical talkers' choral speech was characterized by reduced peak frequency compared to solo reading.

Conclusions: Our findings show that the choral speech rhythm of PWS differs from that of neurotypical talkers. This indicates limited support for the hypothesis that choral speech addresses a motor timing deficit by giving PWS a rhythmic cue with which to align.

PMID: 39772710 DOI: 10.1044/2024_JSLHR-24-00405

Contemporary clinical conversations about stuttering: How to keep up with stuttering treatment research - CONCEITO

Int J Speech Lang Pathol. 2025 Jan 19:1-5. Online ahead of print.

Free text: https://www.tandfonline.com/doi/epdf/10.1080/17549507.2025.2452897?needAccess=true

Julie Anderson, Robyn Lowe, Elaine Yandeau, Marie Parolini, Mark Onslow

Indiana University, IN, USA; University of Technology Sydney, NSW, Australia; Yokohama International School, Yokohama, Japan; Private Practice, Yokohama, Japan; Private Practice, Blois, France; University of Tours, Tours, France.

Purpose: To discuss how speech-language pathologists can keep up with stuttering treatment research. To inform junior clinicians and students of speech-language pathology about this matter.

Method: The issue was discussed by two university researchers and two speech-language pathologists who provide clinical services. Written conversational turns in an exchange were limited to 100 words each.

Result: There was agreement among the group that keeping up to date with stuttering research is essential for speech-language pathologists, and to do so requires a basic understanding of research methods. For treatment research, there are several levels of evidence, and there was agreement that they are all relevant to clinical practice. All in the group agreed that basic research is essential to inform clinical practice, particularly in five domains. The volume of stuttering research is challenging for generalist clinicians to keep up with.

Conclusion: We make recommendations about how speech-language pathologists can keep up with stuttering treatment research in a time-efficient manner. This may be particularly useful for junior clinicians and students of speech-language pathology.

PMID: 39829034 DOI: 10.1080/17549507.2025.2452897

Dysrhythmic Speech Is a Characteristic of Developmental Stuttering in Adults: A Quantitative Analysis Using Duration- and Interval-Based Rhythm Metrics - PSICOMOTOR

J Speech Lang Hear Res. 2025 Mar 13:1-16 Online ahead of print.

Janina Boecher et al

University of Delaware, Newark; Harvard University, Cambridge, MA.

Purpose: Aberrant speech rhythm has previously been identified as a hallmark of stuttering. However, evidence of dysrhythmic speech in adults who stutter (AWS) has largely been limited to qualitative research. Here, we conduct a quantitative analysis of speech rhythm in AWS and adults who do not stutter (AWNS). We also investigate potential differences in speech rhythm as a likely marker of articulatory stability in speech preceding moments of stuttering-like disfluency versus not preceding moments of stuttering-like disfluency. We hope to establish rhythm of speech as a supplementary diagnostic criterion for the assessment of stuttering.

Method: Rhythm metrics were computed for speech produced by 16 self-identified AWS and 16 AWNS. Speech was recorded in reading and spontaneous speaking tasks. Following previous literature, we hypothesized that the nonstuttered utterances of AWS would be less rhythmic than those of AWNS. Furthermore, it was expected that speech rhythm would be disrupted immediately preceding the production of stuttering-like disfluency in AWS. We conducted statistical tests to determine differences in speech rhythm metrics between participant groups (i.e., AWS and AWNS) and utterance types (i.e., preceding stuttering-like disfluency and not preceding stuttering-like disfluency).

Results: Multiple metrics revealed reduced speech rhythmicity in AWS compared to AWNS for both nonstuttered oral reading and spontaneous speech tasks. Furthermore, speech rhythmicity in AWS was significantly reduced immediately preceding stuttering-like disfluency compared to not preceding stuttering-like disfluency in both the reading and spontaneous speech tasks.

Conclusions: We present quantitative evidence of reduced speech rhythm as a characteristic of developmental stuttering. AWS exhibited relatively less rhythmic speech overall and particularly immediately preceding a stuttering-like disfluency. This reduction in the temporal stability of speech may be interpreted as a sign of imminent breakdown in articulatory coordination. The potential significance of rhythm metrics to speech science and clinical diagnostics is discussed.

PMID: 40080872 DOI: 10.1044/2024_JSLHR-24-00076

Effect of delayed auditory feedback on stuttering-like disfluencies - AUDITIVO

Int J Lang Commun Disord. 2025 Mar-Apr;60(2):e70007.

Mazin Alqhazo, Zaidan Alkhamaiseh

Jordan University of Science and Technology, Irbid, Jordan; Al-Ahliyya Amman University, Amman, Jordan.

Background: Delayed auditory feedback (DAF) has been used in the treatment of stuttering, providing different results across different populations and age groups.

Aims: This study examines the impact of delayed auditory feedback (DAF) on stuttering-like disfluencies (SLDs) in the spontaneous speech of Jordanian individuals who stutter.

Methods & procedures: A cross-sectional experimental design was employed to analyse the effects of DAF on the conversational speech of 35 participants (9 females, 26 males) with persistent developmental stuttering, aged 5-29 years (M = 13.1, SD = 6.1). The Stuttering Severity Instrument was used to assess the severity of stuttering. Participants who met the inclusion criteria were asked to talk about general topics of their interests during two different listening conditions (with DAF and without DAF).

Outcomes & results: No significant DAF effects were found on SLDs in terms of duration [p = 0.18] (blocks, prolongations) and repetition [p = 0.22] (sound repetition, syllable repetition, word repetition). Neither severity nor age affected the use of DAF on SLDs.

Conclusions & implications: The study concludes that DAF did not result in a significant decrease in SLDs in the spontaneous speech of participants. These findings highlight the limited effect of DAF in reducing stuttering in this specific population.

What this paper adds: What is already known on the subject Delayed auditory feedback (DAF) has been shown to reduce stuttering frequency by between 60% and 80%. Furthermore, DAF mediates an immediate improvement in the fluency of speech without affecting speech naturalness (Ritto, Juste, and Andrade, 2015). Van Borsel et al. (2003) concluded that DAF offers an effective tool to reduce stuttering when it is applied as the only treatment outside a clinical environment. They also found that fluency is enhanced when DAF is consistently used over a longer period of time.

What this paper adds to existing knowledge This study uses only spontaneous monologue because it was indicated in some previous Arabic studies that the tendency to produce more stuttering in Arabic during oral reading compared to conversational speech may be influenced by a unique, language-specific feature of stuttering in Arabic which is diglossia. (Alshatti, et al., 2022). This means that the coexistence of two varieties of the same language (Modern Standard Arabic versus Dialectical Arabic) could potentially affect the stuttering severity depending on the type of speech sample collected. To remove the impact of the type of speech sample, reading was excluded from the purpose of the current study.

What are the potential or actual clinical implications of this work? Nonetheless, the findings of the current study, along with the individual variability of sample sizes in previous studies, support a cautious approach to the use of DAF as a therapeutic intervention for stuttering. In the study of Buzzeti & Oliveira, 2018, the effects were limited to word repetitions. In another study by Stuart et al. (2008), no reduction was found in any of the three measured core behaviours of stuttering (sound prolongations, sound repetitions, and inaudible blocks) during an oral reading task while using the frequency-altered feedback which is similar to DAF.

PMID: 39977721 DOI: 10.1111/1460-6984.70007

Efficacy of Noninvasive Brain Stimulation Techniques in Managing Stuttering Behaviors: A Systematic Review and Meta-Regression Analysis - TERAPIA

J Speech Lang Hear Res. 2025 Mar 18:1-18. Online ahead of print.

Amir Hossein Rasoli Jokar et al

Michigan State University, East Lansing; Green Speech Start-Up, Hamilton, Ontario, Canada; Medical Faculty Mannheim, Heidelberg University, Germany; McMaster University, Hamilton, Ontario, Canada.

Purpose: This systematic review and meta-regression analysis investigated the overall effectiveness of noninvasive brain stimulation (NIBS) techniques in managing stuttering behaviors.

Method: A total of 290 papers were initially identified through a comprehensive database search, and after applying inclusion and exclusion criteria, 15 studies were selected for the final analysis. These studies evaluated NIBS techniques both as standalone interventions and in combination with speech therapy techniques. The random-effects meta-analysis was done to investigate the effect of neuromodulation techniques on reducing severity and frequency of stuttering behaviors. In addition, meta-regression and subgroup analyses were conducted to identify the effective techniques and explore potential moderators, such as intervention type, age group, and outcome measures.

Results: The random-effects meta-analysis revealed a significant positive effect of neuromodulation techniques on reducing stuttering severity and frequency. Meta-regression showed that transcranial direct current stimulation (tDCS) had the most significant effect in reducing stuttering severity and frequency among standalone interventions. Combined therapy approaches, which paired NIBS with speech therapy, resulted in the most substantial improvements overall. Sensitivity analyses confirmed the robustness of the results despite minor heterogeneity across studies.

Conclusions: NIBS, particularly tDCS, shows promise as an effective intervention for stuttering. When combined with behavioral therapies, NIBS offers enhanced benefits, supporting its role as an adjunctive treatment in clinical practice. Further large-scale studies are recommended to confirm the long-term efficacy, refine treatment protocols, and explore optimal stimulation parameters for improved outcomes.

PMID: 40100765 DOI: 10.1044/2025_JSLHR-24-00750

Exploring tele-speech therapy: A scoping review of interventions, applications, benefits, and challenges - TERAPIA

Review Int J Med Inform. 2025 Jan 8:195:105784. Online ahead of print.

Khadijeh Moulaei et al

Iran University of Medical Sciences, Tehran, Iran; Smart University of Medical Sciences, Tehran, Iran; Shiraz University of Medical Sciences, Shiraz, Iran; Qazvin University of Medical Sciences, Qazvin, Iran; Shahid Beheshti University of Medical Sciences, Tehran, Iran; Universal Scientific Education and Research Network (USERN), Tehran, Iran.

Background: Speech disorders can significantly impact communication, social interaction, and overall quality of life, affecting individuals of all ages. Telespeech therapy has emerged as an innovative solution, leveraging technology to provide accessible and effective speech interventions remotely. This approach offers flexibility and convenience, addressing barriers such as geographical limitations and scheduling conflicts. This review aims to explore key interventions, applications, benefits, and challenges of telespeech therapy to enhance understanding of its potential in improving speech and language outcomes.

Methods: The scoping review was carried out in alignment with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Three electronic databases PubMed, Scopus, and Web of Science were searched. Two authors independently screened and selected the studies.

Results: Of the 2,587 papers, 52 articles were included in our review. Telespeech was most commonly used for treating aphasia (n = 17), stuttering (n = 8), and Parkinson's disease (n = 6). The primary interventions included videoconferencing (63 %), web-based platforms (24 %), and mobile applications (13 %), with most services delivered synchronously (63 %) and some asynchronously (37 %). The most common applications were "rehabilitation and treatment" (59 %) and "performance assessment of patients"(35 %). A total of 264 tele-speech benefits and challenges were identified and later consolidated into 40 items (26 benefits, 14 challenges). Key benefits included "reliable access to healthcare services and addressing disparities" (n = 26), "cost savings" (n = 23), and "improving patient outcomes and quality of care" (n = 21). Major challenges were "low-speed internet" (n = 13), "lack of technology skills" (n = 11), and "limited access to technology" (n = 8).

Conclusion: Telespeech therapy can be effectively integrated into routine practice, especially in underserved or remote areas. It offers a flexible, cost-effective solution for rehabilitation and performance assessment, improving patient outcomes and addressing healthcare gaps. Continued technological advancements and targeted training can further enhance its benefits and effectiveness.

PMID: 39793434 DOI: 10.1016/j.ijmedinf.2025.105784

Exploring the nature of stuttering through a behavioral-neuro-modulation intervention program in bilinguals with stuttering - SUPERFICIAL

Randomized Controlled Trial Codas. 2025 Jan 27;37(1):e20240186.

Chanchal Chaudhary, Samir Kumar Praharaj, Gopee Krishnan

Manipal Academy of Higher Education, Manipal, Karnataka, India.

Purpose: Investigations on identifying the nature of stuttering present varying views. The argument remains whether the stuttering dysfluencies have a motor or a linguistic foundation. Though stuttering is considered a speech-motor disorder, linguistic factors are increasingly reported to play a role in stuttering. Current literature points towards deficits in speech-related motor areas of the brain to abnormalities in linguistic planning and phonological memory playing a role in stuttering. Examining cross-linguistic generalization of treatment gains from treated to untreated language in bilinguals who stutter may provide a unique opportunity to explore the motor and linguistic factors in stuttering.

Methods: In the current study, we explored this potential by experimentally controlling the language of treatment in bilinguals with stuttering (BWS). We hypothesized that if the dysfluencies in stuttering arise from the underlying motor deficits, then the language of treatment would not play a significant role in cross-linguistic generalization. Sixteen BWS were given transcranial direct current stimulation (tDCS) along with behavioral intervention for three weeks. The language of treatment was randomized, wherein participants in one group received behavioral intervention in their dominant language and the other in their non-dominant language.

Results: Results showed that participants in both groups showed a reduction in their stuttering dysfluencies (% stuttered syllables) regardless of the language of treatment, and the treatment gains were generalized to the non-treated language.

Conclusion: Linguistic factors such as language dominance and structure of languages did not surface to play a role in the generalization, signaling the motoric nature of dysfluencies in stuttering.

PMID: 39879430 PMCID: PMC11781365

Functional communication disorders: a systematic review of interventions to improve outcomes in adults - SUPERFICIAL

Disabil Rehabil. 2025 Jan 12:1-12. Online ahead of print.

Kirsty McKenzie et al

University of London, London, UK.

Purpose: To determine what evidence there is for the effectiveness/efficacy of interventions to improve outcomes in adults with Functional Communication Disorders (FCDs).

Materials and methods: Seven electronic databases were searched via two platforms. The review was performed according to PRISMA guidelines. Population comprised adults with any specific communication diagnosis with a functional aetiology. We included studies of any type of behavioural intervention which targeted FCD, with any comparator. All outcomes related to communication were included. There were no restrictions on year or language of publication.

Results: Seven studies were included in the review. Studies used different interventions and outcome measures thus meta-analysis was not performed. Six studies described interventions for functional voice disorders and one for functional stuttering. Interventions tended to include elements of patient education, standard voice or speech therapy, and a psychological support component. Study quality was generally poor.

Conclusion: There is a lack of high-quality research to guide clinicians on evidence-based interventions for the full range of FCDs. There were some common themes within the interventions offered, but the overall poor quality of studies makes it difficult to draw conclusions on the effectiveness and efficacy of these interventions.

PMID: 39801144 DOI: 10.1080/09638288.2025.2450776

How Does Prosodic Prominence Impact Articulatory Movement Parameters and Movement Variability in Adults Who Stutter? - FALA

J Speech Lang Hear Res. 2025 Apr 4:1-25. Online ahead of print.

Hailey C Kopera, Maria I Grigos

New York University, NY.

Purpose: This study examined how focus-induced changes in degree of prosodic prominence impact articulatory movement parameters and movement variability in adults who stutter (AWS) and adults who do not stutter (AWNS). AWS were predicted to display greater across-trial variability in closing and opening duration, displacement, and velocity compared to AWNS as prosodic demands (i.e., addition of pitch accent, degree of prosodic strengthening) increased.

Method: Sixteen AWS and 15 AWNS participated in this study. A question-answer paradigm was used to manipulate the prosodic structure of spoken sentences through changes in semantic focus, and articulatory movement data were collected via a motion capture system. Kinematic analyses included oral closing and opening duration, displacement, and peak velocity, as well as the variability of these measures across repeated productions.

Results: AWS and AWNS demonstrated prosodic strengthening of closing and opening gestures, contributing to the differentiation of non-focused and focused words, as well as different focus types (e.g., broad vs. narrow/contrastive). AWS demonstrated greater variability in closing displacement and velocity for unaccented, non-focused forms compared to other focus types and compared to AWNS, which was not in line with predictions.

Conclusions: This work demonstrates a complex relationship between degree of prosodic prominence and articulatory movement variability. Based on patterns observed in AWS, but not AWNS, it is plausible that processes involved in suppressing default nuclear accents could act as linguistic stressors on the speech motor systems of AWS. Further research is needed to advance our understanding of the role of prosody within a multifactorial view of stuttering.

PMID: 40184601 DOI: 10.1044/2024_JSLHR-24-00358

How I experienced tele-intervention: Qualitative insights from persons who stutter - TERAPIA

S Afr J Commun Disord. 2025 Jan 31;72(1):e1-e9.

Raadhiyah Hoosain et al

Faculty of Humanities, University of Pretoria, Pretoria.

Background: Tele-intervention gained popularity, during the coronavirus disease 2019 (COVID-19) pandemic, prompting healthcare providers to adapt to remote service delivery. Research about stuttering treatment via tele-intervention in South Africa is limited. Speech-language therapists (SLTs) require further insights to deliver a well-supported approach for treatment of stuttering using tele-intervention, despite limitations such as technological disruptions, including loadshedding, that impact service reliability.

Objectives: The study aims to explore clients' experiences with tele-intervention for stuttering therapy, and to provide recommendations to improve service delivery.

Method: Semi-structured interviews were conducted with 11 persons who stutter (PWS) recruited through purposive sampling. Written informed consent was obtained from all participants with experience in both tele-intervention and in-person treatment. Inductive thematic analysis supplemented by descriptive statistics was used to identify patterns and trends.

Results: Four main themes emerged: (1) User experiences and factors shaping perceptions of tele-intervention; (2) technical infrastructure: barriers and facilitators; (3) financial and access considerations and (4) in-person treatment experience compared to tele-intervention user experience. Likert scale ratings indicated no considerable difference in preferences between tele-intervention and in-person treatment.

Conclusion: Participants' diverse experiences highlighted tele-intervention's benefits and challenges for stuttering therapy. While limitations exist, findings inform service enhancement in South Africa, emphasising the importance of users' perspectives in tele-intervention design.Contribution: Insights from PWS can be used in informing clinical practice, aiding SLTs in meeting the needs of PWS and guiding best practice. Tele-intervention should be integrated into a hybrid intervention model that PWS prefer.

PMID: 39935169 PMCID: PMC11830844 DOI: 10.4102/sajcd.v72i1.1068

How reliable and useful are social media videos about stuttering? A comprehensive evaluation of content and credibility - SOCIAL

J Fluency Disord. 2025 Mar 26:84:106116. Online ahead of print.

Derya Çavdar et al

Üsküdar University, Türkiye; Biruni University, Türkiye; Bahçeşehir University, Türkiye.

Adults who stutter (AWS) often turn to social media platforms to connect with others, exchange personal experiences and access informational content. This study aimed to assess the reliability, quality, understandability, and actionability of videos about stuttering on these platforms, evaluating them based on both content and source. The most relevant YouTube keywords related to stuttering were identified using Google Trends, and popular Instagram hashtags were determined through Later Application. Videos from the first three pages for each keyword were analyzed for YouTube, and the top 100 videos with the highest engagement for each hashtag were selected using Python for Instagram. Speech and Language Therapists (SLTs) rated the videos using the Modified Quality Criteria for Consumer Health Information (M-DISCERN), Global Quality Score (GQS), and Patient Education Materials Assessment Tool (PEMAT). The analysis also included the number of ratings and likes on comments. Videos created by SLTs on YouTube and Instagram are more reliable and of higher quality compared to videos on AWS and non-expert sources (p < .001). On YouTube, videos created by SLTs are superior in quality, reliability, comprehensibility compared to videos produced by other healthcare professionals (p < .001). Additionally, videos on AWS receive a greater number of positive comments compared to videos from SLTs and other healthcare professionals (p < .001). AWS should carefully consider the content and source of the videos they watch. There is a need for greater social awareness, and SLTs should be encouraged to produce high-quality content on social media platforms to ensure the dissemination of accurate and helpful information.

PMID: 40164034 DOI: 10.1016/j.jfludis.2025.106116

Improving Stuttering Through Augmented Multisensory Feedback Stimulation - TERAPIA

Brain Sci. 2025 Feb 25;15(3):246.

Giovanni Muscarà et al

Vivavoce Medical Center, 20124 Milan, Italy; Vivavoce Research Department, 20124 Milan, Italy; University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy; Vita-Salute San Raffaele University, 20132 Milan, Italy; The Arctic University of Norway, Tromsø, Norway; Higher School of Economics (HSE University), Moscow, Russia.

Background/objectives: Stuttering is a speech disorder involving fluency disruptions like repetitions, prolongations, and blockages, often leading to emotional distress and social withdrawal. Here, we present Augmented Multisensory Feedback Stimulation (AMFS), a novel personalized intervention to improve speech fluency in people who stutter (PWS). AMFS includes a five-day intensive phase aiming at acquiring new skills, plus a reinforcement phase designed to facilitate the transfer of these skills across different contexts and their automatization into effortless behaviors. The concept of our intervention derives from the prediction of the neurocomputational model Directions into Velocities of Articulators (DIVA). The treatment applies dynamic multisensory stimulation to disrupt PWS' maladaptive over-reliance on sensory feedback mechanisms, promoting the emergence of participants' natural voices.

Methods: Forty-six PWS and a control group, including twenty-four non-stuttering individuals, participated in this study. Stuttering severity and physiological measures, such as heart rate and electromyographic activity, were recorded before and after the intensive phase and during the reinforcement stage in the PWS but only once in the controls.

Results: The results showed a significant reduction in stuttering severity at the end of the intensive phase, which was maintained during the reinforcement training. Crucially, worse performance was found in PWS than in the controls at baseline but not after the intervention. In the PWS, physiological signals showed a reduction in activity during the training phases compared to baseline.

Conclusions: Our findings show that AMFS provides a promising approach to enhancing speech fluency. Future studies should clarify the mechanisms underlying such intervention and assess whether effects persist after the treatment conclusion.

PMID: 40149768 PMCID: PMC11939842 DOI: 10.3390/brainsci15030246

Immune Checkpoint Inhibitor-induced Encephalitis: Pembrolizumab Triggering Seizures, Aphasia, and Personality Change (P12-6.013) - GAGUEIRA ADQUIRIDA

Case Reports Neurology. 2025 Apr 8;104(7_Supplement_1):1836. Epub 2025 Apr 7.

Stella Adetokunbo et al

Einstein Health Network; Thomas Jefferson university hospital Einstein campus; Sidney Kimmel Medical College; Einstein Medical Center Philadelphia.

Background: The use of immune checkpoint inhibitors in cancer management is increasing, and new immune related complications are being recognized as our experience with this new treatment option grows. Rare neurological immune-related adverse effects are no longer rare and should be recognized early.

Design/methods: A 41-year-old female recently diagnosed with triple negative breast cancer on paclitaxel, carboplatin, and pembrolizumab presented with acute onset of confusion and expressive aphasia. A week earlier she was discharged on Keppra 500 mg BID for generalized tonic clonic seizure. Her examination and vital signs were within normal limits except for stuttering speech and difficulty finding words. Her repetition and comprehension were intact. Labs were within normal limits with no leukocytosis and normal electrolytes. She was admitted with broad differentials of autoimmune encephalitis vs pembrolizumab toxicity vs paraneoplastic syndrome. Her pembrolizumab and other immunologic agents were discontinued. MRI revealed no intracranial abnormality or pathologic enhancement. Lumbar puncture showed normal CSF cell count, culture with negative infectious and paraneoplastic panels. Initial EEG reports left temporal polymorphic delta slowing with abundant left temporal sharp waves and she was started on 5 days intravenous Methylprednisolone at 1000 mg/day. She regained spontaneous speech with good eye contact. Repeat EEG showed no sharp waves, and she was discharged home on 80 mg/day Prednisone.

Results: One week after discharge, she demonstrated hypomanic symptoms, and her prednisone was tapered to 40 mg/day. She made a slow but definite improvement in her mental status and mood.

Conclusions: Neurological complications in patients with immune therapies have been thought to be rare but with increasing usage of these therapies, neurologists should be prepared to diagnose and treat these accompanying neurological complications. Future treatment guidelines to specify the duration of steroid treatment would be useful, as it can be difficult to determine complete recovery of psychiatric symptoms. Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.

PMID: 40194100 DOI: 10.1212/WNL.0000000000208775

Is there any room for ChatGPT AI bot in speech-language pathology? OUTRAS ÁREAS

Eur Arch Otorhinolaryngol. 2025 Mar 1. Online ahead of print.

Namık Yücel Birol et al

Tarsus University, Mersin, Türkiye; İstanbul Medipol University, İstanbul, Türkiye; Çağlayan Speech and Language Therapy Center, İzmir, Türkiye; İstinye University, İstanbul, Türkiye.

Purpose: This study investigates the potential of the ChatGPT-4.0 artificial intelligence bot to assist speech-language pathologists (SLPs) by assessing its accuracy, comprehensiveness, and relevance in various tasks related to speech, language, and swallowing disorders.

Method: In this cross-sectional descriptive study, 15 practicing SLPs evaluated ChatGPT-4.0's responses to task-specific queries across six core areas: report writing, assessment material generation, clinical decision support, therapy stimulus generation, therapy planning, and client/family training material generation. English prompts were created in seven areas: speech sound disorders, motor speech disorders, aphasia, stuttering, childhood language disorders, voice disorders, and swallowing disorders. These prompts were entered into ChatGPT-4.0, and its responses were evaluated. Using a three-point Likert-type scale, participants rated each response for accuracy, relevance, and comprehensiveness based on clinical expectations and their professional judgment.

Results: The study revealed that ChatGPT-4.0 performed with predominantly high accuracy, comprehensiveness, and relevance in tasks related to speech and language disorders. High accuracy, comprehensiveness, and relevance levels were observed in report writing, clinical decision support, and creating education material. However, tasks such as creating therapy stimuli and therapy planning showed more variation with medium and high accuracy levels.

Conclusions: ChatGPT-4.0 shows promise in assisting SLPs with various professional tasks, particularly report writing, clinical decision support, and education material creation. However, further research is needed to address its limitations in therapy stimulus generation and therapy planning to improve its usability in clinical practice. Integrating AI technologies such as ChatGPT could improve the efficiency and effectiveness of therapeutic processes in speech-language pathology.

PMID: 40025183 DOI: 10.1007/s00405-025-09295-y

Life Impact of Cluttering: The Adult Perspective - TAQUIFEMIA

Am J Speech Lang Pathol. 2025 Jan 24:1-13. Online ahead of print.

Lisa A Giuffre, Kathleen Scaler Scott

Misericordia University, Dallas, PA.

Introduction: Though the research on the quality of life of people who stutter is extensive, there is minimal research on cluttering's life impact. Anecdotal reports from people who clutter and their significant others have described some elements of cluttering's impact and advocated for these components to be addressed in treatment. Three formal studies have used semistructured interviews to document cluttering's impact. These non-peer-reviewed studies make important contributions; however, more research is needed to add to this existing information. The current study adds perspectives of adults who clutter related to cluttering's impact upon the specific contexts of work, school, and social situations.

Method: In this phenomenological study, 10 adults who clutter participated in a semistructured interview. Through grand tour, mini tour, and example questions, participants were asked to provide their perspective on the life impact of cluttering. Each interview was orthographically transcribed, and transcripts were coded for themes. Triangulation and member checking were conducted to establish reliability and validity of themes.

Results: Results revealed the following themes: Social impact of cluttering leads to avoidance, misunderstanding, and feelings of isolation; cluttering impacts natural tendencies; educational impact of cluttering results in misunderstanding and struggle; occupational impact of cluttering leads to role entrapment and difficulty maintaining employment.

Conclusions: This study adds perspectives of adults who clutter regarding specific aspects of quality of life such as social isolation, frequent misunderstandings, and negative educational and occupational impact. As more voices are heard within the cluttering community, more support is presented for the importance of understanding the negative life impact cluttering can have. Further understanding of these perspectives adds to the information needed to inform holistic cluttering assessment and treatment.

PMID: 39853130 DOI: 10.1044/2024_AJSLP-24-00262

Musical pitch and timbre perception in stuttering children - AUDITIVO

Int J Pediatr Otorhinolaryngol. 2025 Jan 2:189. Online ahead of print.

Emel Arslan-Sarımehmetoğlu, Mustafa Yüksel

Ankara Medipol University Faculty of Health Sciences, Ankara, Turkey.

Objectives: This study aims to evaluate musical pitch and timbre perception in children who stutter and compare the results with typically developing children.

Methods: A total of 50 participants were included in the study, consisting of 25 children with stuttering (mean age = 10.06 years; range 6-17 years) and 25 typically developing children (mean age = 10.38 years; range 7-16 years). Participants were administered Pitch Direction Discrimination (PDD) and Timbre Recognition (TR) tests in the original form of The Clinical Assessment of Music Perception. Both subtests were administered in a quiet room, and the children used headphones to receive auditory stimuli.

Results: The mean PDD score of the stuttering group was 3.60 semitones (SD = 2.71), while the mean score of the typically developing children was 2.26 semitones (SD = 1.43). In the TR test, the mean accuracy of the stuttering group was 53.17 % (SD = 21.69), while the mean accuracy of the non-stuttering group was 65.33 % (SD = 19.64). The difference between the two groups was statistically significant in the PDD (t(48) = 2.17, p = 0.03) and TR (t(48) = -2.08, p = 0.04) tests.

Conclusions: The study found that children who stuttered had poorer pitch and timbre musical perception skills than age-matched peers who were typically developing children. The lower success rates of the stuttering group on both tests may indicate general deficits in auditory processing, which could be related to attention and short-term memory processing.

PMID: 39761608 DOI: 10.1016/j.ijporl.2025.112214

Online indirect group treatment for preschool children who stutter-Effects on stuttering severity and the impact of stuttering on child and parents - INFANTIL / AMBIENTE

Int J Lang Commun Disord. 2025 Mar-Apr;60(2):e70008.

Cecilia Gembäck et al

Health Care Services Stockholm County (SLSO), Region Stockholm, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden; Danderyd University Hospital, Stockholm, Sweden.University of Gothenburg, The Sahlgrenska Academy, Gothenburg, Sweden.

Background: Stuttering development in preschool children might be influenced by parents' concern, awareness and knowledge. Indirect treatment may therefore be appropriate. Intervention in a group format has been shown to be positive for stuttering and an online procedure increases the accessibility of the intervention.

Aims: The aim of this study was to investigate whether an online indirect group treatment for children who stutter could increase parents' knowledge and confidence in managing the stuttering, reduce the impact of stuttering on the child and parents as well as reduce stuttering severity.

Methods and procedures: All children having an ongoing contact with a speech-language pathologist at the included clinics and meeting the inclusion criteria were invited to participate in the study. The participants were five families with children, aged 3:7-4:5, who had been stuttering for at least 12 months. Treatment consisted of six weekly online group sessions for parents, followed by 15 weeks of home consolidation. A single-subject research design replicated across participants was used to investigate changes over baseline, treatment and consolidation phase. The outcome measures were Palin Parent Rating Scales and severity ratings of stuttering reported by parents. Mean values of each week's daily parent ratings of stuttering were used and converted to defined scale steps. Changes in all variables were visually analysed for each participant. Scale steps representing the mean values from baseline measurements were compared with those from the consolidation phase to analyse changes in scale steps (clinical relevance).

Outcome and results: The findings indicate increased parents' knowledge about stuttering and confidence in how to support their child, as well as a positive trend in the impact of stuttering on child and parents, and stuttering severity, during the intervention. The size of the changes in the included outcome measures (e.g., from low to high or very high) varied between participants. The changes were clinically relevant in one to three, out of four, outcome measures for each child, also for those at risk of persistent stuttering.

Conclusions and implications: The online group format can be an effective way to increase parents' ability to handle the child's stuttering at an early stage. Further studies are needed to ensure what treatment effects can be expected, following this indirect online format.

PMID: 39977729 PMCID: PMC11842012 DOI: 10.1111/1460-6984.70008

Palin Stuttering Therapy for School aged Children and usual treatment: A randomised controlled trial feasibility study - INFANTIL / TERAPIA

J Fluency Disord . 2025 Mar 1:84:106114. Online ahead of print.

S K Millard et al

The Michael Palin Centre, Whittington Hospital NHS Trust, London, UK;

University of Befordshire, UK; Norwich Clinical Trials Unit, University of East Anglia, UK; City, University of London, UK; University of Essex, UK.

Background: Despite a clear need for and evidence-based therapy for some children who stutter aged 8-14, there is no high-level evidence of effectiveness, with Speech and Language Therapists rating knowledge and confidence low. One programme which might address these needs, increase availability of services and improve outcomes, is Palin Stammering Therapy for School aged Children (Palin STSC(8-14)).

Aim: To investigate the feasibility of conducting a definitive randomised controlled trial comparing Palin STSC(8-14) with usual treatment. Objectives were to establish: recruitment and retention rates; appropriateness of the outcome measures; acceptability of the research and Palin STSC(8-14) therapy; treatment fidelity; and, appropriateness of the cost-effectiveness measures.

Method: A two-arm, cluster-randomised trial, with randomisation of therapists, stratified by service. Children aged 8;0-14;11, and their parent(s), were allocated to therapist and completed questionnaires pre-therapy and six months later. Assessments were selected for their potential to measure or predict therapy outcome. Therapists completed measures at the start and end of the trial. A process analysis was conducted, incorporating semi-structured interviews and treatment fidelity examination.

Results: Recruitment targets were exceeded (Children n = 67; SLTs n = 37). Research processes were largely acceptable, as was Palin STSC(8-14) therapy. Treatment fidelity was high, with SLT adherence at 85.7 % Mean number of sessions per child for Palin STSC(8-14) was 6.9 compared to 3.5 for usual treatment.

Conclusions: The feasibility targets were met. Based on recruitment, retention and adherence rates and our outcome measures, a full-scale randomised controlled trial appears feasible and warranted to assess the effectiveness of Palin STSC(8-14).

PMID: 40068403 DOI: 10.1016/j.jfludis.2025.106114

Psychometric Evaluation of the Stuttering Anticipation Scale in Turkish (SAS-TR) - AVALIAÇÃO

Folia Phoniatr Logop. 2025 Feb 5:1-15. Online ahead of print.

Halil Tayyip Uysal et al

Ankara Yildirim Beyazit University, Ankara, Turkey; Ondokuz Mayis University, Samsun, Turkey; Hacettepe University, Ankara, Turkey; New York University, New York, New York, USA.

Introduction: Anticipation is a covert aspect of stuttering that plays a crucial role in the lives of adults who stutter (AWS). It can influence anxiety levels or provide an opportunity for self-regulation. For assessing anticipation in stuttering, The Stuttering Anticipation Scale (SAS) was developed. This study aims to develop a Turkish version of the SAS (SAS-TR) and evaluate its validity and reliability.

Method: Ninety-four AWS (aged 18-40 years) participated in the study. They completed SAS-TR and demographic information form either face-to-face or online. The internal consistency, test-retest reliability, and construct validity of the SAS-TR were assessed. Exploratory factor analysis (EFA) was also conducted as part of the construct validity evaluation.

Results: The SAS-TR scale demonstrated high internal consistency (Cronbach's alpha = 0.947) and high test-retest reliability (ICC = 0.973). SAS-TR total score and its sub-dimensions showed acceptable to high positive correlations among themselves (ranging from r = 0.209 to r = 0.962). Factor loadings for the SAS-TR items ranged between 0.572 and 0.899, exceeding 0.300 and indicating suitability for EFA.

Conclusion: The SAS-TR exhibits valid and reliable properties for Turkish-speaking AWS. It is recommended for use in both research and clinical settings to enhance understanding of anticipatory behaviors in this population.

PMID: 39907994 DOI: 10.1159/000543912

Pragmatic Language Skills of Turkish Speaking Children Who Stutter - INFANTIL / LINGUAGEM

Folia Phoniatr Logop. 2025 Jan 3:1-19. Online ahead of print.

Deniz Asal, Maviş Emel Kulak Kayıkcı, Tuğçe Karahan Tığrak

Introduction: The study aims to investigate the relationship between pragmatic language skills of children who stutter (CWS) and the frequency of stuttering, with a focus on the development of these skills through peer interaction in the school years. It is well-known that CWS may face social disadvantages at school due to their limited peer interaction, which may pose a risk to the development of their pragmatic language skills.

Method: The study involved 64 CWS aged between 60 and 106 months. Stuttering frequency was determined by analysing children's spontaneous speech recordings during playtime with their parents. The children's language development was assessed using the Turkish School Age Language Development Assessment Test (TODİL), while speech sound disorders were evaluated using the Turkish Articulation and Phonology Test (SST). Teachers of children whose language and speech sound development were typical development were contacted to evaluate the pragmatic language skills of the children using the Pragmatic Language Skills Inventory (PLSI).

Results: The results of the evaluation showed that 51.6% of the children had below average pragmatic language skills. Additionally, a negative correlation was observed between the frequency of stuttering and PLSI (p<0.05), suggesting that as the frequency of stuttering increased, pragmatic language skills scores decrease.

Conclusion: Children who stutter may face challenges in communicating effectively, despite their formal language assessment results falling within the normal range. The findings support that pragmatic language skills should be considered when treating stuttering due to their critical role in academic and social outcomes.

PMID: 39756392 DOI: 10.1159/000543382

Reimagining stuttering therapy and outcomes through an acceptance and collaborative lens - CONCEITO

J Fluency Disord. 2025 Jan 31:83:106105. Online ahead of print.

Farzan Irani et al

Texas State University, Round Rock, TX; University of Louisiana at Lafayette, Lafayette, LA, USA; Montclair State University, Bloomfield, NJ, USA; The University of Texas at Austin, Austin, TX, USA; University of Akron, Akron, OH, USA; Texas A&M University-Kingsville, Kingsville, TX, USA.

The purpose of this paper is to summarize a panel discussion at the 2024 World Stuttering and Cluttering Organization Congress that aimed to explore and reflect on the shifting landscape of stuttering therapy across the lifespan. The panel comprised of speech-language pathologists who have experience in stuttering therapy as clients, professionals, and researchers. The panel members reflect on the research, their professional experiences, and their own personal journey toward a more acceptance-based therapy and its outcomes. The paper concludes with the panel's reflections on the future of stuttering therapy across the lifespan.

PMID: 39893974 DOI: 10.1016/j.jfludis.2025.106105

Reliability and validity of the Turkish version of the test of childhood stuttering (TOCS) - AVALIAÇÃO

J Commun Disord. 2025 Mar 13:115:106524. Online ahead of print.

Ayşe İlayda Mutlu et al

Lokman Hekim University, Ankara, Türkiye; Hacettepe University, Ankara, Türkiye; Gazi University, Faculty of Health Sciences, Ankara, Türkiye.

Propose: This study aimed to evaluate the reliability and validity of the Turkish version of the Test of Childhood Stuttering (TOCS).

Methods & procedure: The TOCS was translated into Turkish, then back into English by a linguist, and reviewed by an evaluation committee. The translated version was administered to 50 children who stutter (CWS) and 50 who do not (CWNS). After 7-10 days, 12 randomly selected children were re-evaluated. Reliability was assessed using Cronbach's alpha, test-retest methods, and inter-rater reliability. Content validity was confirmed through a pilot study and expert feedback. Construct validity was examined by analyzing test performance, comparing scores between CWS and CWNS, correlating modality test scores, and performing factor analysis. Criterion validity was assessed by correlating TOCS-TR scores with the Stuttering Severity Instrument-4 Turkish Version (SSI-4-TR).

Results: Internal consistency was high, with Cronbach's alpha at .89. The test-retest correlation coefficient for Speech Fluency Measure subtest were .95, the Speech Fluency Rating Scale subtest was .91, and the Disfluency-Related Consequences Rating Scale Index was .91. Inter-rater reliability showed excellent agreement. Content validity was culturally appropriate. Construct validity indicated an 82% positive predictive value, 100% sensitivity, and 78% specificity for the Speech Fluency Rating Scale and Disfluency-Related Consequences Rating Scale. Criterion validity showed 80% agreement with SSI-4-TR.

Conclusions & implications: The TOCS-TR demonstrated strong reliability and validity, making it a valuable tool for assessing stuttering severity in children and distinguishing between CWS and CWNS.

PMID: 40158268 DOI: 10.1016/j.jcomdis.2025.106524

Reliability and validity of the unhelpful thoughts and beliefs scale for Persian-speaking adults who stutter (UTBAS-P): A cross-cultural examination of social anxiety in people who stutter - AVALIAÇÃO

J Fluency Disord. 2025 Jan 13:83:106099. Online ahead of print.

Free article: https://www.sciencedirect.com/science/article/pii/S0094730X25000014?via%3Dihub

Sima Farpour, Bijan Shafie, Ross Menzies, Hamid Karimi

Shiraz University of Medical Sciences, Shiraz, Iran; Isfahan University of Medical Sciences, Isfahan, Iran; University of Technology Sydney, New South Wales, Australia; Charles Darwin University, Australia. PMID:

Background and aim: An increasing body of research indicates that many adults who stutter (AWS) experience anxiety in social and verbal situations. The Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) scales were developed to assess speech-related anxiety and negative cognitions associated with stuttering. This study aimed to translate the UTBAS into Persian, investigate its psychometric properties for Persian-speaking AWS, and compare the results with previously published UTBAS scores across various cultures.

Method: The UTBAS scales were translated into Persian according to the protocols of the International Quality of Life Assessment Project and the World Health Organization. Sixty-two adults with developmental stuttering, aged between 18 and 51 years, participated in this study. The psychometric properties of UTBAS-P were investigated using similar measures to those used in previous studies where valid and reliable versions were available. Additionally, UTBAS-P scores were compared to UTBAS scores previously reported for Australian, Japanese, and Turkish participants.

Results: The results showed that UTBAS-P had an acceptable face, content, and construct validity. It was significantly correlated with other anxiety-related measures. Additionally, its low and negative correlations with unrelated constructs, such as the NEO-PI-R domains of openness, agreeableness, and conscientiousness, confirmed its divergent validity. Regarding reliability, the significant test-retest reliability score (Pearson r = 0.87, p < 0.001) confirmed the stability of UTBAS-P scores over time, and its internal consistency was confirmed by Cronbach's alpha of 0.99. Similarities and differences were found between participants' UTBAS scores across different cultures.

Conclusion: All four currently translated versions of the UTBAS have demonstrated high levels of validity and reliability, showing strong correlations with well-known anxiety measures. These findings suggest that the UTBAS has potential for use both clinically and in cross-cultural studies.

39823702 DOI: 10.1016/j.jfludis.2025.106099

Repetitive Negative Thinking as a Mechanism of Stuttering Anticipation - TERAPIA

J Speech Lang Hear Res. 2025 Apr 7:1-23. Online ahead of print.

Seth E Tichenor, Bridget Walsh, Katelyn L Gerwin, J Scott Yaruss

Duquesne University, Pittsburgh, PA; Michigan State University, East Lansing.

Purpose: In the context of stuttering, anticipation refers to the sensation that one may soon stutter. Although anticipation is widely reported, much is still unknown about how the phenomenon develops and how people respond to it as they live their lives. To address these gaps, this study specified the relationship between repetitive negative thinking (RNT), anticipation, and anticipation responses. This study also determined whether individual differences in a person's goal when speaking (i.e., speaking fluently or not stuttering vs. stuttering openly) predicted the different ways people respond to anticipation.

Method: Five hundred and ten stutterers (427 adults who stutter, ages 18-86 years, and 83 adolescents who stutter, ages 10-18 years) answered questions about anticipation, their responses to anticipation, how frequently they engage in RNT, and what their goals when speaking are.

Results: Exploratory factor analysis revealed that responses to anticipation can be described in terms of two factors: avoidance and acceptance. Avoidance responses to anticipation were more common than acceptance in both groups. Adults and adolescents were more likely to experience anticipation and respond with avoidance behaviors if they more frequently engage in RNT or less often have the goal when speaking of openly stuttering. Data also supported and extended evidence that anticipation is commonly experienced in adolescents and adults who stutter.

Discussion: Findings extend the understanding of how anticipation and anticipation responses may develop based on an individuals' engagement with RNT and goals when speaking. The relationship between RNT and anticipation underscores the need for future investigations focusing on preventing the development of negative responses to anticipation via holistic therapy.

PMID: 40193346 DOI: 10.1044/2025_JSLHR-24-00175

Self-perception of stuttering: association with self-perception of hearing, fluency profile, and contextual aspects - AUDITIVO

Observational Study Codas. 2025 Jan 20;37(1):e20240103.

Camila Eduarda Elias Silva, Denise Brandão de Oliveira Britto, Stela Maris Aguiar Lemos

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

Purpose: This study investigated the association between self-perception of stuttering and self-perception of hearing, speech fluency profile, and contextual aspects in Brazilian adults who stutter.

Methods: Fifty-five adults who stutter (ages 18 to 58 years), speakers of Brazilian Portuguese speakers, participated in an observational study that included: (a) a clinical history survey to collect identification, sociodemographic, clinical, and assistance data; (b) the Brazil Economic Classification Criteria (CCEB); (c) a hearing self-perception questionnaire (Speech, Spatial and Qualities of Hearing Scale - SSQ, version 5.6); (d) self-perception of the impact of stuttering (Brazilian Portuguese version of the Overall Assessment of the Speaker's Experience of Stuttering - Adults - OASES-A); and (e) an assessment of speech fluency (Fluency Profile Assessment Protocol -- PAPF). Data analysis consisted of descriptive and bivariate analysis using Pearson's chi-square, Mann-Whitney, Kruskal-Wallis, and Spearman correlation coefficient.

Results: Most participants were classified as moderate to severe in the total classification of the impact of stuttering. There were moderate and weak negative correlations between the participants' self-perception of stuttering and self-perception of hearing.

Conclusion: Self-perception of auditory abilities was greater to the extent that self-perception of the impacts of stuttering on quality of life was lower.

PMID: 39841741 PMCID: PMC11758850

Sleep parameters in children who stutter: A comparison with children who do not stutter using actigraphy - INFANTIL / SONO

J Fluency Disord. 2025 Mar 22:84:106115. Online ahead of print.

Maria Clara Helena Couto et al

São Paulo State University (UNESP), Marilia, SP, Brazil; Syracuse University, New York, United States.

Purpose: This study aimed to compare objective sleep parameters in children who stutter (CWS) with those in children who do not stutter (CWNS) using actigraphy. Previous research, mainly relying on subjective methods such as questionnaires and sleep diaries, has highlighted the high prevalence of sleep disorders in individuals who stutter.

Methods: Sleep parameters, including sleep onset latency, sleep efficiency, sleep duration, and total sleep time, were objectively measured using actigraphy over 14 consecutive days. The study included 30 CWS (aged 4-12 years) and 21 CWNS (also aged 4-12 years). Data were analyzed with SPSS Statistics 28.0 software, expressed as medians with interquartile ranges (25-75 %). Group comparisons were conducted using the Mann-Whitney test. The significance level for all statistical tests was set at p < 0.05.

Results: CWS exhibited significantly longer sleep onset latency (p < 0.001) and lower sleep efficiency (p = 0.01) compared to CWNS. No significant differences were observed in total sleep time or sleep duration between the groups.

Discussion: This study provides objective evidence that CWS experience specific alterations in sleep parameters, particularly in sleep onset latency and sleep efficiency. This suggests a higher prevalence of sleep disturbances within this population. These findings highlight the importance of integrating sleep assessments into the clinical management of stuttering to improve therapeutic outcomes.

PMID: 40157137 DOI: 10.1016/j.jfludis.2025.106115

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