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PubMed1995

Parents' speech and children's stuttering: a critique of the literature.

The role of parents in relation to their children's stuttering has been of great interest to speech-language pathologists for more than 50 years. As part of treatment, speech-language pathologists frequently advise parents to modify their speech behaviors when talking with their children. For example, parents are often told to speak more slowly and to refrain from interrupting or questioning the child excessively. Given the commonness of this advice, it is important to examine the research upon which it is based. This article contains a critical review of the literature concerning the role of parents' speech behaviors (e.g., rate, interruptions, question-asking) in relation to their children's stuttering. Published studies are reported and analyzed in order to determine the extent to which parents may affect their children's stuttering through their own speech behaviors. The review indicates that there is little convincing evidence to support the view that parents of children who stutter differ from parents of children who do not stutter in the way they talk with their children. Similarly, there is little objective support for the argument that parents' speech behaviors contribute to children's stuttering or that modifying parents' speech behaviors facilitates children's fluency. Implications for treatment and for future research are discussed.

Adolescent↗
PubMed1997

The effects of life stressors and daily stressors on stuttering.

This study systemically documented the effect of perceived daily stress on subjective and objective measures of disfluencies in 12 adults who stuttered and 12 adults who did not stutter. Subjects participated in a prospective research study for 22 consecutive days. Measures of life stress, daily stress, and self-ratings of fluency were obtained. Subjects were trained in rating their fluency levels (self-ratings of fluency) and perceived daily stress levels (frequency and perceived impact of daily stressors). Results revealed a significantly higher number of daily stressors endorsed by subjects who stutter. Subjects who stuttered also displayed a significantly greater number of disfluencies and higher self-ratings of disfluencies on "high-stress" days. No significant differences were found between the mean total scores for life stress or impact scores for daily stress for the two groups. These data suggest that day-to-day variations in stuttering could be related to multiple, minor, daily stressors in some persons who stutter. Implications for treatments involving cognitive restructuring and desensitization are discussed.

Adolescent↗
PubMed1997

Lexicalization in adults who stutter.

Three recent theories have implicated lexical processing failures as a possible source of fluency disruption in persons who stutter. Two experiments that bear upon these theories are reported. Both evaluate the effects on speech response latency of picture naming tasks designed to place selective demands on lexicalization: Experiment I, effects of one-word versus two-word responses; Experiment II, effects of a word's frequency of occurrence versus its number of syllables. Twelve adults who stutter and 12 with normally fluent speech participated in each experiment. In Experiment I, increases in naming latency for two-word (noun + verb) versus one-word (noun or verb) responses showed that demands for parallel processing did not differentiate the experimental groups. However, the between-group difference, showing longer latencies among those who stutter, was six times greater for the verb, than for the noun, task. Moreover, the group difference for verbs fully accounted for the size of the difference in the two-word task. Experiment II showed that the relative increase in naming latency associated with the word frequency effect versus the syllable latency effect was significantly greater in the stuttering than the nonstuttering group. Outcomes of the two experiments suggest that during lexicalization, as early as the L1 stage and first phase of L2, slow processing could serve to disrupt fluency in some persons who stutter. Under certain conditions, as specified in the three theories cited, such disruptions could set the occasion for stutter events.

Adult↗
PubMed1998

Stuttering, stressed syllables, and word onsets.

The relationship of syllabic stress, word onsets, and stuttering was examined on selected words within a set of 40 carefully controlled sentences containing bisyllabic words with contrastive stress. Ten stuttering adults displayed significantly more stuttering on the word-initial syllables than on the subsequent (word-final) syllables, whereas stressed syllables were not stuttered significantly more than unstressed syllables. Participants displayed a greater tendency to stutter on word-onsets than stressed syllables within words. These findings are discussed with respect to potential relationships of stutter events to layers of metrical structure associated with speech production.

Adult↗
PubMed1998

Adaptation of stuttering frequency during repeated readings: associated changes in acoustic parameters of perceptually fluent speech.

This study is part of a series investigating the hypothesis that stuttering adaptation is a result of motor learning. Previous investigations indicate that nonspeech motor learning typically is associated with an increase in speed of performance. Previous investigations of stuttering, on the other hand, indicate that improvements in fluency during most fluency-enhancing conditions or after stuttering treatment tend to be associated with decreased speech rate, increased duration of specific acoustic segments, and decreased vowel duration variability. The present acoustic findings, obtained from 8 individuals who stutter, reveal that speech adjustments occurring during adaptation differ from those reported for other fluency-enhancing conditions or stuttering treatment. Instead, the observed changes are consistent with those occurring during skill improvements for nonspeech motor tasks and, thus, with a motor learning hypothesis of stuttering adaptation. During the last of 6 repeated readings, a statistically significant increase in articulation rate was observed, together with a decrease in word duration, vowel duration, and consonant-vowel (CV) transition extent. Other adjustments showing relatively consistent trends across individual subjects included decreased CV transition rate and duration, and increased variability of both CV transition extent and vowel duration.

Adolescent↗
PubMed1999

Utterance length, syntactic complexity, and childhood stuttering.

This study examined relationships among utterance length, syntactic complexity, and stuttering in children's conversational speech. Analyses extended prior research by examining several different aspects of syntactic complexity, including sentence structure, clause structure, and phrase structure. Subjects were 12 boys who stutter, age 40 to 66 months, who produced 75-utterance conversational speech samples during free-play interactions with their mothers. Group analyses revealed significant differences between fluent and stuttered utterances in terms of all measures of utterance length and several measures of syntactic complexity. Analysis of the relationships between utterance length and syntactic complexity identified several measures of syntactic complexity that influenced stuttering and were independent of utterance length. Logistic regression analyses revealed that utterance length was better than syntactic complexity at predicting whether stuttering would occur, though neither utterance length nor syntactic complexity was a particularly strong predictor for individual subjects' data. Thus, findings suggest that utterance length and syntactic complexity cannot, by themselves, adequately account for the occurrence of stuttering in children's conversational utterances.

Child, Preschool↗
PubMed2000

Kinematic correlates of speaking rate changes in stuttering and normally fluent adults.

Articulatory kinematics were analyzed to determine if adults who stutter are generally poorer at speech movement pattern generation and if changing speech rate affects their stability in the same way that it affects normally fluent controls. Adults who stutter (n = 14) and a matched group of controls produced fluent repetitions of a simple phrase at normal, slow, and fast rates. A composite index of spatiotemporal stability (STI), as well as independent measures of timing and spatial variability, revealed that adults who stutter can operate within normal movement parameter ranges under low-demand speaking conditions. However, some of the stuttering participants showed evidence of abnormal instability even when repeating a simple utterance at habitual rate. Also, measures of relative timing indicated that adults who stutter, unlike their matched controls, are not better timers at habitual vs. nonpreferred speech rates. Overall, the results suggest that the kinematic characteristics of the fluent speech of adults who stutter generally overlap that of normally fluent speakers; however, subtle differences in kinematic parameters are interpreted to reveal their susceptibility to speech motor breakdown when performance demands increase.

Adult↗
PubMed2000

Influences of length and syntactic complexity on the speech motor stability of the fluent speech of adults who stutter.

The purpose of the present study was to investigate the impact of utterance length and syntactic complexity on the speech motor stability of adults who stutter. Lower lip movement was recorded from 8 adults who stutter and 8 normally fluent controls. They produced a target phrase in isolation (baseline condition) and the same phrase embedded in utterances of increased length and/or increased syntactic complexity. The spatiotemporal index (STI) was used to quantify the stability of lower lip movements across multiple repetitions of the target phrase. Results indicated: (a) Adults who stutter demonstrated higher overall STI values than normally fluent adults across all experimental conditions, indicating decreased speech motor stability; (b) the speech motor stability of normally fluent adults was not affected by increasing syntactic complexity, but the speech motor stability of adults who stutter decreased when the stimuli were more complex; (c) increasing the length of the target utterance (without increasing syntactic complexity) did not affect the speech motor stability of either speaker group. These results indicate that language formulation processes may affect speech production processes and that the speech motor systems of adults who stutter may be especially susceptible to the linguistic demands required to produce a more complex utterance. The present findings, therefore, support the hypothesis that linguistic complexity is one factor that contributes to the disruptions of speech motor stability characteristic of stuttering.

Adult↗
PubMed2002

Reduction of stuttering: the dual inhibition hypothesis.

Treatment for stuttering attempts to reduce or eliminate the observable core markers of the disorder, specifically repetitions and prolongation. In this hypothesis, it is proposed that stuttering may be inhibited by two distinct yet related procedures: active inhibition and passive inhibition. Active inhibition is brought about when the person who stutters makes volitional changes to his or her speaking pattern, such as when employing behavioral modification techniques. Passive inhibition automatically inhibits the involuntary stuttering block and can be induced from an external source, such as altered auditory feedback, or by the use of sufficient active inhibition. It is suggested that passively inhibiting stuttering results in speech that is more automatic, natural sounding, and truly fluent speech than the speech that is derived primarily from active inhibition. Evidence of passive inhibition resulting from active inhibition can be seen when people who stutter exhibit uncontrolled fluency following behavioral therapy.

Humans↗
PubMed2002

Facing the challenge of treating stuttering in the schools.

There are many difficult issues facing speech-language pathologists who work with school-age children who stutter; however, the challenges are not insurmountable. Effective treatment for children who stutter is possible, even in school settings. This chapter introduces two issues of Seminars in Speech and Language aimed at helping clinicians improve their treatment of stuttering in school-age children. The first issue addresses basic aspects of evaluation and treatment, including procedures for assessing children's communication abilities, developing appropriate goals for therapy, and utilizing a number of specific treatment strategies. The second issue addresses special topics in the treatment of school-age children who stutter, including multicultural factors, concomitant disorders, and finding and using helpful resources to enhance treatment. Throughout the two issues, the authors will repeatedly emphasize that clinicians can help children who stutter become more successful communicators by drawing upon knowledge and strategies from a variety of perspectives and by taking a broad-based, comprehensive approach to understanding and treating stuttering.

Child↗
PubMed1998

[Auditory speech-evoked cerebral cortex potentials in patients with stuttering syndromes].

BACKGROUND: The cause of stuttering is unknown. For clinical purposes it proved to be useful to assume a multifactorial genesis with organic psychological and social aspects. A longstanding organic theory focussed on the failure to develop left-hemispheric dominance for speech, whereas others favoured deficits of the speech motor system. Positron emission tomography (PET) studies support organic theories for the development of stuttering. The purpose of this study was to find out whether in stutterers auditory cortical potentials evoked by pure tones, noise and words are different to those of healthy controls. PATIENTS AND METHODS: 10 young adults having suffered from stuttering since infancy were examined. The potentials were measured and analysed as previously described. RESULTS: No correlation of clinical and electrophysiological findings were found. In one case the evoked potentials were normal, in all other patients heterogeneous results were obtained in respect of tone-evoked and both noise- and speech-evoked potentials. Cortical hemispheric differences could be detected. CONCLUSIONS: In agreement with PET findings reported in the literature the data obtained in this study indicate an organic, central nervous cause of stuttering. Obviously both speech motoric components and perception elements are affected. These facts have to be taken into account whenever a psychological cause of stuttering is suspected. Nevertheless, psychosomatic aspects of the disturbances must be considered since they influence the patients' ability to cope with their symptom.

Adolescent↗
PubMed2004

Say it with me: stuttering inhibited.

This study examined fluency enhancement in people who stutter via the concomitant presentation of silently mouthed visual speech. Ten adults who stutter recited memorized text while watching another speaker silently mouth linguistically equivalent and linguistically different material. Relative to a control condition, in which no concomitant stimulus was provided, stuttering was reduced by 71% in the linguistically equivalent condition versus only 35% in the linguistically different condition. Despite being an 'incomplete' second speech signal, visual speech possesses the capacity to immediately and substantially enhance fluency when it is linguistically equivalent to the intended utterance. It is suggested that fluency enhancement via concomitantly presented external speech is achieved through the extraction of relevant speech gestures from the external speech signal that compliment the intended production, thereby compensating for possible internal inconsistencies in the matching of speech codes in people who stutter. As visual speech perception relies on fewer redundant cues to demarcate the intended gestures, when used as an external stuttering inhibitor, higher degrees of linguistic equivalence seem to be necessary for optimal stuttering inhibition.

Adolescent↗
PubMed2002

Non-word reading, lexical retrieval and stuttering: comments on Packman, Onslow, Coombes and Goodwin (2001).

A recent study by Packman, Onslow, Coombes and Goodwin (2001) employed a non-word-reading paradigm to test the contribution of the lexical retrieval process to stuttering. They consider that, with this material, the lexical retrieval process could not contribute to stuttering and that either anxiety and/or the motor demand of reading are the governing factors. This paper will discuss possible processes underlying non-word reading and it argues that the conclusion arrived at by Packman et al. does not stand up to close scrutiny. In their introduction, the authors acknowledge that the lexicalization process involves retrieval and encoding of words. In a non-word-reading task, the word retrieval component is eliminated. The possibility that the encoding component of the lexicalization process leads to stuttering is, however, completely ignored by the authors when they attribute stuttering to motor demands. As theories put forward by Postma and Kolk (the Covert Repair Hypothesis, 1993) and Howell and Au-Yeung (the EXPLAN theory, 2002) argue heavily for the role of the phonological encoding processes in stuttering, Packman et al.'s work does not evaluate such theories. Theoretical issues aside, Packman et al.'s arguments about reading rate and stuttering rate based on reading time is also questionable.

Humans↗
PubMedDate not supplied

Effects of self-modelling on stuttering.

BACKGROUND: The paper reports on a laboratory investigation of the effects of self-modelling on stuttering rate in adolescents and adults. Self-modelling refers to a therapeutic or training method, usually involving videotape, that uses exposure to oneself performing selected error-free behaviours as the conduit for promoting behaviour change. AIMS: To investigate self-modelling in single-subject experiments to determine whether any reductions in stuttering could be directly attributable to watching self-modelling videotapes and to ascertain whether instruction to focus attention on the target behaviour, namely stutter-free speech, was necessary for experimental effects. METHODS & PROCEDURES: A single-subject withdrawal design was employed with two adult men and an adolescent boy. Speaking sessions during all phases of the study were of 3-min duration. During the B Phase, subjects watched one of their self-modelling videotapes, which had been edited to remove all stuttered speech, before each speaking session. In the B + C Phases, subjects continued to watch the self-modelling videotapes before each speaking session and, in addition, were instructed to attempt to speak during the session as they had spoken on the videotape. OUTCOMES & RESULTS: Stuttering reduced under self-modelling conditions for one of the three subjects. This effect was observed during the B + C Phases, which included instruction to attend to the target behaviour. CONCLUSIONS: The study provides laboratory evidence that self-modelling can ameliorate stuttering. The clinical implications of this finding are that treatments for adults may well benefit from the inclusion of self-modelling procedures, and self-modelling procedures may form a part of relapse prevention and management strategies.

Adolescent↗
PubMedDate not supplied

Connecting stuttering measurement and management: III. Accountable therapy.

BACKGROUND: This paper is intended to contribute to the current debate in relation to persistent stuttering and evidence-based clinical practice. AIMS: The paper will describe the authors' intervention framework for persistent stuttering, which is guided by evidence from the fields of stuttering and clinical psychology. It supports the opinion that the components of therapy should be grounded in empirically based theories that offer an explanation for the nature of stuttering, its persistence and its individual complexity. It will argue that the goals of therapy should reflect the client's personal values and experience of stuttering, as well as the knowledge and skills of the therapist. MAIN CONTRIBUTION: The paper maintains that therapy for this disorder needs to account for the highly individual nature of the overt and covert dimensions of persistent stuttering and identify the formal and informal methods that measure progress and outcome. Current research and future directions will be touched on briefly.

Affect↗
PubMed1988

Kinematic analysis of multiple movement coordination during speech in stutterers.

This study addresses the long-standing claim that stuttering reflects an impairment in the neuromotor coordination of multiple speech movements. Upper lip (UL), lower lip (LL), and jaw (J) kinematics for nonstuttered speech behaviours in stutterers and normal speakers were examined using quantitative indices of normal multiple movement coordination reported in recent studies of gait, reaching, grasping, and speech. While two measures of coordination--dynamic movement composition and intermovement motor equivalence--did not distinguish between stutterers and normals, stutterers manifested striking differences from normal on a third measure, the sequencing of UL, LL, and J movement onsets and velocity peaks. These findings suggest that, contrary to previous hypotheses, stutterers do not manifest general problems of coordination of speech movement. Instead, stuttering appears to be associated with a specific impairment in multiple movement coordination associated with sequencing of those movements.

Adult↗
PubMed1996

A comparison of speech envelopes of stutters and nonstutterers.

A new parameter, the area under the speech envelop, was used to evaluate the degree of speech dysfluency in stutterers. This parameter has been measured for 100-s utterances of 30 fluent speakers and 30 stutterers speaking with simultaneous auditory feedback (SAF) and delayed auditory feedback (DAF). A correlation was found between the area under the speech envelope and the severity of stuttering. Thus for stutterers, this parameter can be used to evaluate the degree of the disturbance of fluency. The values of this parameter were significantly higher in fluent utterances than in nonfluent ones. The reduction of stuttering observed in stutterers under DAF was accompanied by an increase of the area under the speech envelope, making it comparable to the one measured for the utterances of fluent speakers.

Adolescent↗
PubMed1997

Effect of monaural and binaural altered auditory feedback on stuttering frequency.

The effect of monaural and binaural alterations in auditory feedback on stuttering frequency was investigated. Eleven participants who stutter read aloud under nonaltered auditory feedback (NAF) and monaural and binaural conditions of frequency altered feedback [(FAF), on-quarter octave shift upward] and delayed auditory feedback [(DAF), 50-ms delay] at a normal speech rate. Relative to the NAF condition, reductions in stuttering frequency of approximately 60%-75% were found with the altered auditory feedback conditions. Post hoc single-df comparisons revealed a reduction in stuttering frequency with altered auditory feedback versus NAF (p < 0.0001), a greater reduction in stuttering frequency for binaural compared to monaural altered auditory feedback (p = 0.028), and nonsignificant differences in stuttering frequencies for right versus left monaural conditions (p = 0.54) and DAF versus FAF (p = 0.70).

Adolescent↗