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PubMed1981

Vertical transmission of susceptibility to stuttering with sex-modified expression.

Stuttering is not usually considered genetic, although it has long been known to be familial. Data collected on 2035 relatives of 397 unrelated adult stutterers confirm and quantify the strong familial concentration. Our analytic approach to these family data, one that does not require specification of a genetic hypothesis, shows that stuttering among relatives occurs in a pattern indicating vertical transmission of a susceptibility to stuttering with sex-modified expression. Although simple Mendelian hypotheses are not sufficient to explain the observed pattern of stuttering in families, more complex genetic models can explain the pattern. In the past, such evidence has been considered sufficient, because it does not preclude the possibility of cultural transmission. However, certain cultural transmission hypotheses previously proposed for stuttering are excluded by these data. The findings in this study support a growing opinion among speech pathologists that most stuttering is a genetically inherited neurologic disorder.

Adult↗
PubMed2006

Investigations of the impact of altered auditory feedback in-the-ear devices on the speech of people who stutter: one-year follow-up.

PURPOSE: This study examined objective and subjective measures of the effect of a self-contained ear-level device delivering altered auditory feedback (AAF) for those who stutter 12 months following initial fitting with and without the device. METHOD: Nine individuals with developmental stuttering participated. In Experiment 1, the proportion of stuttering was examined during reading and monologue. A self-report inventory inquiring about behaviour related to struggle, avoidance and expectancy associated with stuttering was examined in Experiment 2. In Experiment 3, naïve listeners rated the speech naturalness of speech produced by the participants during reading and monologue. RESULTS: The proportions of stuttering events were significantly ( p < 0.05) reduced at initial fitting and remained so 12 months post follow-up. After using the device for 12 months, self-reported perception of struggle, avoidance and expectancy were significantly (p < 0.05) reduced relative to pre-fitting. Naïve listeners rated the speech samples produced by those who stutter while wearing the device significantly more natural sounding than those produced without the device for both reading and monologue (p < 0.0001). CONCLUSIONS: These findings support the notion that a device delivering AAF is a viable therapeutic alternative in the treatment of stuttering.

Adolescent↗
PubMed1992

The effects of carbamazepine on stuttering.

No pharmacological treatment protocol has proven generally useful for all patients who stutter. Various medications, behavior therapy, relaxation, suggestion, and social-based therapies have been used. For this drug treatment study, two groups of adult stutterers were followed in an 8-week open label protocol. All subjects had in the past received speech therapy; none had been treated previously with medication for stuttering. The first group (N = 12) received a maximum dose of 800 mg of carbamazepine; the second group (N = 8) received a maximum dose of 400 mg of carbamazepine. Each patient served as his or her own control. A series of systematic speech tests was given weekly to determine the variability of fluency for each subject. A statistically significant change occurred for a number of "expectancy to stutter" characteristics. Subjects felt that they stuttered less often while taking carbamazepine. Subjective effects began before medication and continued after patients discontinued the medication. Struggle characteristics also subjectively decreased. However, no objective improvement was found. No change was found in percentage of words stuttered, reading improvement, or improvement in spontaneous speech rate. Interrater reliability showed a correlation of .996. Three carbamazepine serum level therapeutic windows were inspected with negative results. Interestingly, naive listener ratings did show a statistically significant improvement on carbamazepine versus placebo. Future anecdotal reports of pharmacological improvement of stuttering should be subjected to rigorous objective testing before general acceptance.

Adult↗
PubMed2006

A new antistuttering device: treatment of stuttering using bone conduction stimulation with delayed temporal feedback.

OBJECTIVES: Stuttering is a communication disorder affecting approximately 1% of the adult population, some with severe manifestations. Speech therapy improves stuttering, but many do not receive enough benefit to communicate fluently. Antistuttering devices have been available for several years, but available technology has been limited in long-term success and reliability. The current study evaluates the effects of a prototype device using a modification of a currently used bone conduction hearing device with delayed auditory feedback on adult patients with significant stuttering problems. STUDY DESIGN: A prospective nonrandomized study evaluating effects of a prototype device on stuttering in adult subjects. METHODS: Ten stutterers > or=18 years of age were fit with a bone conduction device on a headband with temporal feedback delayed according to patient preference between 5 and 130 msec. Patients were asked to wear the device at least 4 hours per day for 4 weeks. Stuttering Severity Index-3 (SSI-3) tests were completed at prefit, immediate postfit, and at 2-week, 4-week, and 6-week intervals. Questionnaires were also completed at each visit. RESULTS: : Nine patients completed the entire study. A statistically significant decline in SSI-3 scores was documented from prefit compared with immediate postfit and 4 weeks follow up (P < .001) using the Tukey test method. Statistical significance was approached but not reached at 2 weeks. There was no significant difference between prefit and the 6-week follow up when patients had returned the device. Patients subjectively noted improvement in their speech and confidence using the device. CONCLUSIONS: A new antistuttering prototype using a modification of a bone conduction device with delayed temporal feedback is effective in decreasing stuttering in patients over a short time course. Further studies need to be completed to evaluate the long-term effects of the device.

Adolescent↗
PubMed1989

Shadowed and simple reaction times in stutterers and nonstutterers.

Stutterers may experience difficulties in preparing and executing responses. This study investigated these possibilities as well as the possibility that stutterers may experience difficulty in the selection of responses. Two reaction-time tasks were investigated: a shadowing response in which speakers exactly repeated vowel sequences they heard, and a simple response in which speakers said [u] regardless of the identity of the vowel stimulus. Two groups of six adult male subjects, stutterers and nonstutterers, participated. Stimuli consisted of vowel-vowel "syllables" whose initial duration (response foreperiod) was randomly varied from 500 to 1500 ms. Electromyographic (EMG) and acoustic measures were obtained for each response condition. The EMG response latencies, acoustic response latencies, and execution times (EMG latency less the acoustic response latency) were examined for the fluent responses. Results indicated stutterers were, on average, 34 ms slower on acoustic responses than nonstutterers regardless of the task or foreperiod. However, stutterers' and nonstutterers' EMG latencies were not significantly different. Further analysis indicated that the overall slower acoustic responses of stutterers were accounted for almost entirely by longer execution times. Stutterers' difficulties thus appear to lie after response initiation suggesting they have problems in coordination of gestures during execution of fluent responses.

Adolescent↗
PubMed1995

Lack of effect of clonidine on stuttering in children.

OBJECTIVE: The authors studied the effects of the alpha 2-receptor agonist clonidine on stuttering in children. METHOD: Using a double-blind crossover study, they gave placebo or 4 micrograms/kg body weight per day to 25 stuttering children who were 6-13 years old. Stuttering was measured by counting the occurrences of four elementary speech difficulties and by asking parents and teachers to give an overall impression of the amount of stuttering, as well as their impression of how troublesome the stuttering was to the children. RESULTS: Clonidine did not improve stuttering. CONCLUSIONS: Clonidine cannot be recommended as a useful drug for treating children who stutter.

Adolescent↗
PubMed1995

Simulations of stuttered speech: numbers and types of dysfluencies.

The purpose of this study was to assess whether stuttered speech could be simulated by normal-speaking individuals and to identify significant parameters used in the simulation process. The subjects were 24 normal-speaking graduate students in speech-language pathology. The subjects were assigned the task of simulating stuttered speech given specific levels of severity. Then they were asked to listen to the simulated samples and identify the number and types of dysfluencies presented. Analysis showed agreement among subjects on the number of dysfluencies, with the exception of samples simulating severe stuttering behavior. Judging the number of dysfluencies in the simulated samples of severe stuttering appeared to be a more difficult task. The types of dysfluencies noted by the listeners were restricted primarily to repetitions and prolongations. Simulated stuttered speech was therefore judged to be composed of fewer types of stuttering behavior than actual stuttered speech is reported to be.

Humans↗
PubMed2001

An operant intervention for early stuttering. The development of the Lidcombe program.

Stuttering is a common speech disorder that causes significant distress and may cause social maladjustment and hinder occupational potential. Treatments for chronic stuttering in adults can control stuttering by teaching the speaker to use a new speech pattern. However, these treatments are resource intensive and relapse prone, and they produce speech that sounds unnatural to the listener and feels unnatural to the speaker. This article describes the development and evaluation of an operant treatment for early stuttering. Parents are trained to present verbal contingencies for stuttered and stutter-free speech during everyday speaking situations with their children. The authors overview outcome data from several studies that suggest that this program produces relapse-free control of stuttered speech in preschool children in the medium and long term in a cost-effective manner.

Behavior Therapy↗
PubMed2003

Relationship between the stuttering severity index and speech rate.

CONTEXT: The speech rate is one of the parameters considered when investigating speech fluency and is an important variable in the assessment of individuals with communication complaints. OBJECTIVE: To correlate the stuttering severity index with one of the indices used for assessing fluency/speech rate. DESIGN: Cross-sectional study. SETTING: Fluency and Fluency Disorders Investigation Laboratory, Faculdade de Medicina da Universidade de São Paulo. PARTICIPANTS: Seventy adults with stuttering diagnosis. MAIN MEASUREMENTS: A speech sample from each participant containing at least 200 fluent syllables was videotaped and analyzed according to a stuttering severity index test and speech rate parameters. RESULTS: The results obtained in this study indicate that the stuttering severity and the speech rate present significant variation, i.e., the more severe the stuttering is, the lower the speech rate in words and syllables per minute. DISCUSSION AND CONCLUSION: The results suggest that speech rate is an important indicator of fluency levels and should be incorporated in the assessment and treatment of stuttering. This study represents a first attempt to identify the possible subtypes of developmental stuttering. DEFINITION: Objective tests that quantify diseases are important in their diagnosis, treatment and prognosis.

Adolescent↗
PubMed2001

A study of the self-talk of adults who do and do not stutter.

This is a preliminary investigation of the differences in positive and negative self-talk reported by groups of people who do and do not stutter. 10 people who stutter, all who had experience with stuttering therapy, were matched with 10 participants who did not stutter. Each participant, in both groups, was engaged in a session to evaluate speech in a format similar to a professional diagnostic session for stuttering. Each participant was asked to stop at specific times during the session and describe thoughts of that moment as either positive or negative. This procedure is similar to thought sampling and in vivo cognitive assessment used in cognitive-behavioral treatments and research. The participants' reports were taken during a baseline period, during a period in which they were thinking about their speech, and during three different speaking tasks. The reports given by the group of people who stutter were compared to the reports given by the group of individuals who did not stutter. Statistical analyses showed no differences between the thoughts reported by the two groups during the entire session, and no differences between groups during the three separate tasks (baseline, thinking about their speech, and the speaking tasks). Possible explanations and suggestions for research are discussed.

Adult↗
PubMed2004

[Fifty years of treating stuttering in young children].

Developmental stuttering involves a disruption in the smooth connection of sounds or syllables that is characterised by multiple interruptions within a word, such as repetitions of sounds, syllables and parts of words, elongation of words and blockades. During the course of the past fifty years, three phases can be distinguished in the management of developmental stuttering, characterised by a shift in stress from the environmental factors to the role of the organic, i.e. non-psychological, factors. Initially, the parents of toddlers and pre-school children were advised to pay no attention to stuttering behaviour. Then the problem would disappear the quickest of its own accord. After 1985, the stress came to be placed on reducing the level of expectations, for example by speaking to the child more slowly and using shorter and less complex sentences. Another new aspect was that the parents learned to discuss stuttering with the child in a sympathetic and accepting manner. Since 2000, an approach has been introduced in the Netherlands in which parents are taught to respond verbally to both fluent and non-fluent speech. Emphasis is given to rewarding fluent speech, such as in the Australian Lidcombe Program, but the parents are also taught to react to stuttered speech once in a while. At present, early treatment is accepted as a way of preventing chronic stuttering, even if this means that some children will be treated that would have recovered in any case and even though the exact yield is not yet clear. Clinical practice shows that early treatment almost always succeeds in limiting the severity of stuttering to a mild form.

Behavior Therapy↗
PubMed1990

Stuttering: can research unravel the riddle?

In spite of decades of research on stuttering there are few unequivocal findings. Several reasons for this are offered and discussed. Particular attention is paid to the lack of one accepted definition of stuttering. Other issues concern the unit of stuttering, inter- and intra-stutterer variability, the overt and covert features of stuttering, objective and subjective measures in stuttering research and the sampling of material for study. These are some of the problems which pertain to study of the nature of stuttering. They apply also to research on therapy, which presents additional challenges to the researcher.

Female↗
PubMed1993

Transient neurogenic stuttering.

The occurrence of a transient neurogenic stutter in a male anorexic patient is described. The stutter developed following a prolonged period of starvation, and during refeeding the patient recovered from the stuttering behavior. The patient was not receiving any drugs known to cause stuttering, and it is postulated that the stutter developed as a result of the gross impairment of brain function secondary to chronic starvation. A review of the literature has failed to reveal any information on anorexia nervosa as a cause of neurogenic (acquired) stuttering.

Adult↗
PubMed2005

Deep brain stimulation of the subthalamic nucleus reversibly deteriorates stuttering in advanced Parkinson's disease.

The etiology of developmental stuttering is still unknown. In some patients, stuttering re-emerges or is aggravated with the onset of Parkinson's disease (PD). We here report on a patient with PD treated by deep brain stimulation of the subthalamic nucleus and severe deterioration of stuttering under effective stimulation. Positron emission tomography (PET) of regional cerebral blood flow (rCBF) in stimulation on- and off-conditions showed overactivation of cerebral and cerebellar motor systems during speech activation and was in line with recent PET studies investigating brain activation during stuttering. The abnormal rCBF pattern increased in the stimulation on-condition and was associated with a marked worsening of stuttering. Clinical and imaging findings in this patient support the hypothesis that the basal ganglia circuitry plays an important role in the pathophysiology of stuttering.

Antiparkinson Agents↗
PubMed1978

Does the stigma shape the stutterer?

The Woods and Williams' (1976) study of Iowans' stereotypes about stuttering males was replicated using 11 speech clinicians and 16 classroom teachers in Virginia. Ratings of 23 possible characteristics were obtained for four hypothetical concepts (typical 8-year-old male, typical 8-year-old male stutter, typical adult male, and typical adult male stutterer) using a semantic differential format. The results of the Woods and Williams' (1976) research were confirmed. Stutters were expected by all rating groups to be more nonassertive, tense, insecure, and afraid to talk than nonstutterers. Not only were stereotype differences within professional groups quite small from one geographical region to the other, but classroom teachers held particularly unfavorable stereotypes of the stuttering boy in both studies. These results suggest the possibility that listener reactions could shape the stutterer's behavior.

Adult↗
PubMed1982

Speaking fundamental frequency characteristics of stutterers and nonstutterers.

This study examined certain parameters of speaking fundamental frequency (SFF) associated with stutterers' and nonstutterers' fluent production of a declarative and an interrogative utterance. Ten adult male stutterers were matched according to age and average SFF with 10 adult male nonstutterers. Analysis of the waveform data from the experimental utterances showed that the nonstutterers produced a significantly greater range of frequencies than did the stutterers across both utterances. The parameters of mean SFF, mean rate of frequency change, and mean number of frequency shifts were not significantly different between the groups. The findings of this study are in general agreement with the results of previous investigations in this area. The consistency of the findings across several studies seems to indicate that reductions in stutterers' SFF variability may be one vocal tract behavior that could serve to distinguish between stutterers' and non stutterers' fluency.

Adult↗
PubMed1992

Assessment of sensitivity to interpersonal stress in stutterers.

The Willoughby Personality Schedule-R was administered to adult male Yugoslav stutterers who were not yet in treatment. Internal consistency of the WPS-R was assessed by computing item-scale score correlations. Twenty-two of 25 items were significantly correlated with WPS-R total score. Confirmatory factor analysis revealed three separate and reliable dimensions: Social Isolation (ssca .85), Social Confidence (ssca .74), and Social Sensitivity (ssca = .62), that were identical to those previously found for American stutterers. Although WPS-R scores were unrelated to several measures of stuttering severity, analysis of extreme scores suggested support for the hypothesis that general anxiety moderates stuttering severity. Overall the results are consistent with the contention that hypersensitivity to interpersonal stress is manifested in stutterers as general anxiety, which is better conceptualized as occurring along a continuum than as reflecting generic "overwhelming anxiety" in stutterers.

Adult↗
PubMed1993

Temporal relations within repetitions of preschool children near the onset of stuttering: a preliminary report.

The purpose of this study was to compare duration characteristics of single repetitions of single-syllable words in the speech of preschool children who stutter (N = 15) recorded near the onset of their stuttering to those of control nonstuttering children (N = 18). Disfluent episodes were identified in audio tape recordings of the subjects' conversational speech. The digitized signals were analyzed by means of the CSpeech computer software (Milenkovic, 1987). Using visual displays of the sound-pressure waveforms, as well as spectrography, the durations of the first production of the word (1st Unit), the second production (2nd Unit), the silent interval, and the total disfluency were measured. There were no statistically significant differences between the two groups on any of these segments although there was a tendency for the stutters to exhibit shorter silent intervals between repeated units. Relative measures, however, indicated that the ratio of the 2nd Unit to the total disfluency was significantly larger for the stutterers than the controls. For both groups, the ratio of the 1st to the 2nd Unit was positive, that is, the first production of the word was longer than the second. There was also a tendency for the ratio of the silent interval to total disfluency to be smaller for the stutterers. Overall, there appears to be a tendency for repetitions of very early stutterers to be faster than repetitions of nonstuttering children.

Child, Preschool↗