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PubMed1995

The topography of beginning stuttering.

Presently, there are a number of protocols available to assist speech-language pathologists in the identification of early stuttering (Gordon and Luper, 1992). While such protocols offer guidelines for differentiating children who stutter from those who are normally disfluent, the criteria for doing so is frequently based on clinical observation, and often suffers from limited empirical support. The purpose of this paper is to provide an update and "recalibration" of what we currently know to be the salient behaviors of beginning stuttering, and how specific features of these behaviors distinguish stuttering children form their normally disfluent counterparts. Specifically, studies examining (1) frequency, (2) type, and (3) duration of disfluency, including number of repeated units and additional temporal aspects of instances of sound, syllable, and whole-word repetition, as well as (4) associated speech and nonspeech behaviors produced by children who stutter will be reviewed, and comparisons to normally speaking children will be made when possible. With a few exceptions, discussion will be limited to those studies which specifically examined the speech of preschool children, or which purported to include children close to the onset of stuttering, regardless of age.

Child↗
PubMedDate not supplied

The interaction of bilingualism and stuttering in an adult.

The relation between bilingualism and stuttering was examined in a bilingual adult who stutters. Language ability in English and Afrikaans was assessed through the use of cloze and language proficiency tests. Anticipation, adaptation and consistency of stuttering were investigated. Frequency, distribution and nature of disfluencies on narrative and procedural tasks were analyzed according to a modified version of the Systematic Disfluency Analysis (SDA) (Campbell & Hill, 1987). Results indicated that language ability influenced frequency, distribution and nature of disfluencies. The subject was more proficient and stuttered less in his predominant language. Implications for the interaction of language and stuttering were discussed. Clinical strategies for dealing with bilingual stutterers were considered.

Humans↗
PubMed1992

Stuttering acquired from subcortical pathologies and its alleviation from thalamic perturbation.

Acquired stuttering subsequent to subcortical pathology of mesothalamus was observed in four neurosurgical subjects. The patients suffered from chronic pain, seizures, and somatosensory disorders. They also exhibited unpredictable and uncontrollable speech, spasmodic blocks which were devoid of accessory features, and adaptation effect. Therapeutic mesothalamic stimulation, used as a treatment of last resort to relieve the pain and associated symptoms, also had an ameliorating effect on the stuttering. Spontaneously occurring focal abnormal EEG discharges were anatomically delineated and used as a guide for therapeutic stimulation electrode placement. Attentuation of the abnormal discharges was followed by alleviation of symptoms. This investigation examines the clinical characteristics of stuttering in four neurosurgical patients and suggests an electropathologic basis for their mesothalamic-generated speech dysfluencies. The cooccurrence of pain, seizures, somatosensory disorders, and stuttering, and their concurrent amelioration, suggests that both chronic pain and stuttering may be implicated by similar or related reticular electropathologic generators, couched in overlapping reticular networks extending from the brain stem to the thalamus, and that the acquired stuttering may be recruited as one component of a larger syndrome complex.

Adult↗
PubMed2006

Identification of traits associated with stuttering.

UNLABELLED: Stuttering has been considered a heritable disorder since the 1930s. There have been different models of transmission that have been proposed most involving a polygenic component with or without a major locus. In spite of these models, the characteristics being transmitted are not known. This study used two different tasks-a tapping task that is thought to probe hemispheric differences and a Stroop task, which appears to create interferences in speech motor programming and/or execution. The 48 participants in this study included individuals who stutter, high risk family members and controls for each group. Results indicated that for tapping at a comfortable rate, the experimental groups were significantly different from their control groups and for tapping at a fast rate, the stuttering and high risk groups were different from each other. The results of the Stroop test were not statistically significant. LEARNING OUTCOMES: Readers will learn about: (1) genetic aspects of stuttering; (2) hemispheric dominance in stuttering and high risk subjects; (3) understanding traits that may be associated with stuttering.

Adult↗
PubMed2006

Relation of emotional reactivity and regulation to childhood stuttering.

UNLABELLED: The purpose of the present study was to examine relations between children's emotional reactivity, emotion regulation and stuttering. Participants were 65 preschool children who stutter (CWS) and 56 preschool children who do not stutter (CWNS). Parents completed the Behavior Style Questionnaire (BSQ) [McDevitt S. C., & Carey, W. B. (1978). A measure of temperament in 3-7 year old children. Journal of Child Psychology and Psychiatry and Allied Disciplines, 19, 245-253]. Three groups of BSQ items measuring emotional reactivity, emotion regulation, and attention regulation were identified by experts in children's emotions. Findings indicated that when compared to their normally fluent peers, CWS were significantly more reactive, significantly less able to regulate their emotions, and had significantly poorer attention regulation, even after controlling for gender, age, and language abilities. Findings suggest that the relatively greater emotional reactivity experienced by preschool children who stutter, together with their relative inability to flexibly control their attention and regulate the emotions they experience, may contribute to the difficulties these children have establishing reasonably fluent speech and language. LEARNING OUTCOMES: The reader should be able to (1) define emotional reactivity and emotion regulation, (2) explain how emotional reactivity and emotion regulation relate to preschool stuttering, and (3) understand recent empirical evidence linking reactivity and regulation to preschool stuttering.

Analysis of Variance↗
PubMed2003

A positron emission tomography study of short- and long-term treatment effects on functional brain activation in adults who stutter.

UNLABELLED: Previous studies have shown that fluency-inducing techniques, such as choral speech, result in changes in neural activation as measured by functional neuroimaging. In the present study, positron emission tomography was used to investigate the effects of intensive behavioural treatment, followed by a 1-year maintenance program, on the pattern of cortical and subcortical activation in stuttering adults during silent and oral reading of single words. The results indicate changes in activation lateralisation, as well as a general reduction in over-activation, especially in the motor cortex, following treatment. The results are discussed in light of previous functional imaging studies with stuttering adults. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to describe the: (1) use of functional neuroimaging PET in the study of stuttering; (2) differences in neural activation between stuttering and non-stuttering adults; and (3) effects of behavioural fluency treatment on cortical and subcortical activations in stuttering speakers.

Adult↗
PubMed2003

Common features of fluency-evoking conditions studied in stuttering subjects and controls: an H(2)15O PET study.

UNLABELLED: We used H(2)15O PET to characterize the common features of two successful but markedly different fluency-evoking conditions -- paced speech and singing -- in order to identify brain mechanisms that enable fluent speech in people who stutter. To do so, we compared responses under fluency-evoking conditions with responses elicited by tasks that typically elicit dysfluent speech (quantifying the degree of stuttering and using this measure as a confounding covariate in our analyses). We evaluated task-related activations in both stuttering subjects and age- and gender-matched controls. Areas that were either uniquely activated during fluency-evoking conditions, or in which the magnitude of activation was significantly greater during fluency-evoking than dysfluency-evoking tasks included auditory association areas that process speech and voice and motor regions related to control of the larynx and oral articulators. This suggests that a common fluency-evoking mechanism might relate to more effective coupling of auditory and motor systems -- that is, more efficient self-monitoring, allowing motor areas to more effectively modify speech. These effects were seen in both PWS and controls, suggesting that they are due to the sensorimotor or cognitive demands of the fluency-evoking tasks themselves. While responses seen in both groups were bilateral, however, the fluency-evoking tasks elicited more robust activation of auditory and motor regions within the left hemisphere of stuttering subjects, suggesting a role for the left hemisphere in compensatory processes that enable fluency. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to: (1) compare brain activation patterns under fluency- and dysfluency-evoking conditions in stuttering and control subjects; (2) appraise the common features, both central and peripheral, of fluency-evoking conditions; and (3) discuss ways in which neuroimaging methods can be used to understand the pathophysiology of stuttering.

Adult↗
PubMed2004

Predicting stuttering from phonetic complexity in German.

UNLABELLED: This study investigated how phonetic complexity affects stuttering rate in German and how this changes developmentally. Phonetic difficulty was assessed using Jakielski's index [Motor Organization in the Acquisition of Consonant Clusters, Dissertation/Ph.D. Thesis, University of Texas Austin, 1998] of phonetic complexity (IPC) in which words are scored on eight different characteristics. Stuttering rate was not related to IPC score for German function words, as previously shown for Spanish and English. Significant correlations between stuttering rate and IPC score were found for content words for children over the age of six and adults. It was also found that German content words have a higher mean IPC sum compared to their English counterparts. There was a bigger difference in IPC score between fluent and stuttered words in German than in English. Factor 5 (word shape) influenced stuttering rates in both German age groups. This has also been found for Spanish but does not apply to English. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) describe a method to measure phonetic complexity and how this affects stuttering rates for words of different grammatical classes; (2) explain why this method is suitable for different languages and age groups; (3) detect which phonetic characteristics have most impact on different age groups in English and German; (4) assess possible theoretical reasons for these findings.

Adolescent↗
PubMedDate not supplied

Co-occurring disorders in children who stutter.

UNLABELLED: This study used a mail survey to determine the (a) percentage of children who stutter with co-occurring non-speech disorders, speech disorders, and language disorders, and (b) frequency, length of sessions, and type of treatment services provided for children who stutter with co-occurring disorders. Respondents from a nationwide sample included 1184 speech-language pathologists (SLPs). Of the 2628 children who stuttered, 62.8% had other co-occurring speech disorders, language disorders, or non-speech-language disorders. Articulation disorders (33.5%) and phonology disorders (12.7%) were the most frequently reported co-occurring speech disorders. Only 34.3% of the children who stuttered had co-occurring non-speech-language disorders. Of those children with co-occurring non-speech-language disorders, learning disabilities (15.2%), literacy disorders (8.2%), and attention deficit disorders (ADD) (5.9%) were the most frequently reported. Chi-square analyses revealed that males were more likely to exhibit co-occurring speech disorders than females, especially articulation and phonology. Co-occurring non-speech-language disorders were also significantly higher in males than females. Treatment decisions by SLPs are also discussed. LEARNING OUTCOMES: As a result of this activity, the participant should: (1) have a better understanding of the co-occurring speech disorders, language disorders, and non-speech disorders in children who stutter; (2) identify the speech disorders, language disorders, and non-speech disorders with the highest frequency of occurrence in children who stutter; and (3) be aware of the subgroups of children with co-occurring disorders and their potential impact on assessment and treatment.

Child↗
PubMed2002

A personal construct psychology view of relapse: indications for a narrative therapy component to stuttering treatment.

UNLABELLED: Relapse following treatment for stuttering is a common problem for many clients. It has often been suggested that one factor contributing to relapse is the client's difficulty in adjusting to a new role as a fluent speaker. In this tutorial article, we first present a personal construct view of relapse, which suggests that this difficulty may be addressed by increasing the meaningfulness of the fluent speaker role for the speaker. Section 3 proposes that post-treatment success for persons who stutter may be facilitated by the use of a narrative approach to counseling in which the meaningfulness of the fluent speaker role is elaborated. In this approach, clients are guided through a process of deconstructing their stuttering-dominated personal narrative, followed by the reconstruction of an alternative narrative that is more compatible with being a fluent speaker. EDUCATIONAL OBJECTIVES: The reader will (1) learn about a personal construct psychology perspective on resistance and relapse in stuttering therapy, (2) be able to describe a narrative approach to counseling for people who stutter that is directed toward the long-term maintenance of fluent speech and the steps of deconstruction of the dominant stuttering narrative and reconstruction of a new, more fluent personal narrative, and (3) be able to prepare a series of narrative interview questions with which to engage clients in conversations that may facilitate the deconstruction and reconstruction processes.

Counseling↗
PubMed2002

Speech treatment and support group experiences of people who participate in the National Stuttering Association.

UNLABELLED: Support groups are rapidly becoming an important part of the recovery process for many people who stutter, and a growing number of speech-language pathologists (SLPs) are encouraging their clients to participate in support groups. At present, however, little is known about the individuals who join stuttering support groups and the benefits they derive from their participation. This study surveyed members of the National Stuttering Association (NSA) to learn about their experiences in support groups, as well as their experiences in speech therapy. Respondents were 71 people who attended the 1999 NSA conference in Tacoma, WA. The majority of respondents had participated in treatment several times during their lives, using a variety of techniques. Respondents who had participated in fluency-shaping treatments were more likely to report that they had experienced a relapse than those who had participated in stuttering modification or combined treatments. Also, there was a strong positive correlation between respondents' satisfaction with treatment and their judgments of clinicians' competence, suggesting that improved training for SLPs should lead to improved treatment for people who stutter. Results will be used to provide a foundation for further evaluations of the benefits of support group participation for people who stutter. EDUCATIONAL OBJECTIVES: The reader will learn (a) that many people who participate in the NSA have had numerous and varied experiences with speech treatment throughout their lives, (b) which aspects of treatment and support group participation are seen as most beneficial for people who participate in the NSA.

Adolescent↗
PubMed2002

An experimental investigation of the impact of the Lidcombe Program on early stuttering.

Preliminary Phase I and II trials for the Lidcombe Program of early stuttering intervention have found favorable outcomes and that the treatment is safe. Although speech-language pathologists (SLPs) often need to intervene with pre-schoolers' early stuttering, many of these children will recover at some time in the future without such intervention. Consequently, they need to know whether the Lidcombe Program's effect on stuttering is greater than that of natural recovery. Participants were 23 pre-school children who were randomly assigned to either a control group or a treatment group that received the Lidcombe Program for 12 weeks. A repeated measures ANOVA showed no main effect on stuttering for the group (control/treatment), a significant main effect for the measurement occasion (at the start and at the end of the treatment period), and a significant interaction between group and measurement occasion. Stuttering in the treatment group reduced twice as much as in the control group. These results are interpreted to mean that the introduction of the Lidcombe Program has a positive impact on stuttering rate, which exceeds that attributable to natural recovery.

Child↗
PubMed2002

The effect of fast speech rate on stuttering frequency during delayed auditory feedback.

UNLABELLED: Delayed auditory feedback (DAF) has been documented to improve fluency in those who stutter. The increased fluency has been attributed to the slowed speech rate induced by DAF, but recent experiments have suggested that increasing the speech rate may also decrease stuttering under DAF. This investigation described the effect of combining a fast speech rate and DAF on the fluency of four people who stutter. Fluency of the two mildly dysfluent subjects was the same for both no DAF and DAF conditions at normal and at fast oral reading rates. In contrast, the two severely dysfluent subjects improved in fluency from the no DAF to the DAF conditions. They were found to be dysfluent at both normal and fast oral reading rates without DAF. The results of the study point to the need for further research on the relationship between speech rate and stuttering frequency under conditions of DAF and no DAF. EDUCATIONAL OBJECTIVES: Readers will learn about and be able to describe how the frequency of stuttering is affected by: (1) speech rates; (2) DAF; and (3) how stuttering severity influences such effects.

Adolescent↗
PubMed2002

The duration component of the stress effect in stuttering.

UNLABELLED: The purpose of the present study was to investigate whether there is a relationship between stuttering on stressed syllables and the duration of these syllables. Sixteen adults who stutter read a text consisting of 226 syllables. The relative stress of each syllable was rated, and syllables were categorized into long- and short-stressed syllables, unstressed syllables and intermediate syllables lying in-between. In order to isolate effects caused by within-word position from those caused by linguistic stress, syllables in initial and in subsequent positions were analyzed separately. In both word position categories stressed syllables were stuttered more often than unstressed syllables. Stuttering frequency of intermediate syllables seems to be in-between stressed and unstressed syllables, just as their stress level is rated in-between. Results regarding the duration of stressed syllables do not allow final conclusions. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to describe (1) language factors related with stuttering events, (2) the stress effect in adults who stutter, and (3) methods to control for its confounding variables.

Adult↗
PubMed2003

Two paradoxes in stuttering treatment.

UNLABELLED: The premise of this article is that effective communication should be a central, overarching goal in the treatment of stuttering. Not focusing on communication may have some unintended negative consequences on treatment. The negative consequences are the result of two paradoxes that confront clinicians and clients: the listener paradox and the communication paradox. The listener paradox concerns the different ways that typical listeners and clinicians respond to stuttering. The communication paradox concerns the use of treatment procedures that may have negative consequences on communication. Clinicians and clients need to evaluate treatment procedures in terms of the effect they may have on communication. Understanding these two paradoxes and making effective communication the focus of treatment may improve the long-term treatment outcomes of people who stutter. EDUCATIONAL OBJECTIVES: The reader will learn about (1) why effective communication should be the central goal in the treatment of stuttering; (2) how the listener and communication paradoxes may negatively impact on communication; and (3) how understanding these paradoxes may improve the long-term outcomes of people who stutter and also improve the comfort level clinicians have in treating individuals who stutter.

Communication↗
PubMed2003

Speaking with a mirror: engagement of mirror neurons via choral speech and its derivatives induces stuttering inhibition.

'Choral speech', 'unison speech', or 'imitation speech' has long been known to immediately induce reflexive, spontaneous, and natural sounding fluency, even the most severe cases of stuttering. Unlike typical post-therapeutic speech, a hallmark characteristic of choral speech is the sense of 'invulnerability' to stuttering, regardless of phonetic context, situational environment, or audience size. We suggest that choral speech immediately inhibits stuttering by engaging mirror systems of neurons, innate primitive neuronal substrates that dominate the initial phases of language development due to their predisposition to reflexively imitate gestural action sequences in a fluent manner. Since mirror systems are primordial in nature, they take precedence over the much later developing stuttering pathology. We suggest that stuttering may best be ameliorated by reengaging mirror neurons via choral speech or one of its derivatives (using digital signal processing technology) to provide gestural mirrors, that are nature's way of immediately overriding the central stuttering block.

Humans↗
PubMed1999

Management of child and adolescent stuttering with olanzapine: three case reports.

Vast arrays of medications have been used, with limited success, to manage stuttering. Haloperidol and risperidone are the only two medications that have shown efficacy via double-blind studies in controlling stuttering symptoms. We present the first case reports of olanzapine in the management of stuttering. Three case histories are presented: a 10-year-old boy, a 16-year-old male adolescent with developmental stuttering, and a 9-year-old boy with medication-induced stuttering whose symptoms are successfully controlled with olanzapine. These case studies suggest that olanzapine may be a pharmacologic option in the management of stuttering.

Adolescent↗
PubMed1990

Concurrent cognitive processing and letter sequence transcription deficits in stutterers.

Previous research has indicated that men who stutter transcribe rapidly presented sequences of letters more slowly and less accurately than nonstutterer controls. Experiment 1 demonstrated that the transcription deficit is not limited to task conditions that demand concurrent monitoring and responding. This was evidenced by comparable deficits on a successive response condition that required subjects to write letters after the presentation was complete. The results of Experiment 2 indicated that the deficit is not due to a difficulty by stutterers in parsing streams of stimulus information internally. Their performance did not differentially improve when letters were grouped with brief pauses, nor with experience in transcribing preparsed letter sequences. This experiment also demonstrated that the phenomenon is generalizable to women. In related testing, stutterers were slower than controls in writing internally generated sequences of letters, those of the alphabet forwards and backwards, but not in writing the same two letters, A and B, repetitively nor in the cognitively more demanding task of writing numbers backwards by three's. These results parallel those obtained with finger tapping of same versus unique sequences by stutterers and were interpreted as being consistent with the idea that while stutterers are not generally slower motorically than nonstutterers, they experience difficulty when required to organize and carry out tasks with new multiple response transitions. The two experiments have replicated and extended, under different conditions, the earlier findings of a letter sequence transcription deficit in stutterers, but the nature of the interference still remains to be clarified.

Adolescent↗