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PubMedDate not supplied

Recent developments in speech motor research into stuttering.

This paper discusses recent speech motor research into stuttering within the framework of a speech production model. There seems to be no support for the claim that stutterers differ from nonstutterers in assembling motor plans for speech. However, physiological data suggest that stutterers may at least have different ways of initiating and controlling speech movements. It is hypothesized that stuttering may be the result of a deficiency in speech motor skill. Furthermore, objections to the use of stuttering frequency as a severity index are formulated and future developments in the assessment of speech motor behavior in stuttering are described.

Humans↗
PubMed1996

Social phobia in adults with stuttering.

OBJECTIVE: The authors evaluated features of social anxiety in a group of adult stutterers to explore the soundness of the DSM-IV requirement that social phobia not be diagnosed in patients who stutter if their phobia relates to their stuttering. METHOD: They conducted diagnostic interviews and verbal fluency assessments with 16 consecutive adults seeking speech therapy for stuttering. Patients also completed scales measuring social phobia symptoms and associated disability. RESULTS: When DSM-IV criteria were modified to permit a diagnosis of social phobia if phobic symptoms were clearly excessive in relation to the severity of stuttering, seven of the 16 patients were given a diagnosis of social phobia. All seven identified social anxiety as an important source of role impairment. Three of the seven patients entered cognitive-behavioral group therapy and benefited from this intervention. CONCLUSIONS: Many adults seeking treatment for stuttering have salient difficulties with social anxiety that may prove amenable to cognitive-behavioral interventions. By precluding a diagnosis of social phobia in these patients, DSM-IV may hinder the identification of social anxiety as a source of disability and may limit access to treatment.

Adult↗
PubMed2004

Ictal stuttering: a sign suggestive of psychogenic nonepileptic seizures.

OBJECTIVE: To determine if ictal stuttering (IS) is more common among patients with psychogenic nonepileptic seizures (PNES) than patients with epileptic seizures (ES). METHODS: The authors prospectively reviewed the medical records, EEG-video recordings, and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scores of consecutive adults of normal intelligence diagnosed with either PNES or ES. RESULTS: A total of 230 (117 PNES and 113 ES) patients were studied. PNES patients were older (p = 0.029), more likely to be female (p < 0.001), and had a shorter duration of seizure disorder (p < 0.001) than ES cases. Ten (8.5%) PNES subjects and no ES cases demonstrated IS. The proportion of patients with IS in these two groups was significantly different (p = 0.004). PNES patients with IS were of similar age as but had an even shorter (p = 0.010) duration of seizure disorder (mean = 3.0 years) than those without IS. Scores on the hypochondriasis, depression (D), and hysteria scales of the MMPI-2 were significantly higher among PNES subjects than in ES patients (p < or = 0.002). However, seven PNES patients with IS had a lower mean score on the D scale than did 98 PNES cases without stuttering (p = 0.005). This produced a more sharply defined "conversion V" appearance on the MMPI-2 graph in the stutterers. CONCLUSIONS: Ictal stuttering was present in 8.5% of 117 consecutive patients with psychogenic nonepileptic seizures, but was not observed in a consecutive series of 113 adults with epileptic seizures. Patients with psychogenic nonepileptic seizures with ictal stuttering had a shorter duration of seizure disorder and a more prominent conversion profile on the Minnesota Multiphasic Personality Inventory than either patients with psychogenic nonepileptic seizures without stuttering or subjects with epileptic seizures.

Adult↗
PubMed1985

Acquired stuttering from a right hemisphere lesion in a right-hander.

Acquired stuttering in adults may follow bilateral or left hemisphere damage, is more common in men than in women, and is often associated with aphasia. After a right hemisphere infarct, a right-handed woman stuttered without aphasia. She had never stuttered previously, but her father and brother both had developmental stuttering. Her case and others suggest that sexual differences in language lateralization may render men more likely to stutter than women after left hemisphere lesions, whereas women are more likely to stutter than men after right hemisphere lesions.

Adult↗
PubMed1977

Alpha asymmetry over the right and left hemispheres of stutterers and control subjects preceding massed oral readings: a preliminary investigation.

Interhemispheric alpha asymmetry of both stutterers and non-stutterers measured preceding each of five massed oral readings of the same material was investigated. Preliminary results indicated a reduction of alpha over the left hemisphere for non-stutterers, while a reduction for stutterers was found for the right hemisphere. Present results, together with other investigations using dichotic, tachistoscopic, and EEG procedures, suggest right hemispheric processing for the stuttering group as compared with left hemispheric processing for the non-stuttering group.

Adult↗
PubMed1981

Awareness training and regulated-breathing method in modification of stuttering.

Awareness has been shown to be an important variable in various types of learning in humans. Its role in the modification of different clinical disorders is promising. It is hypothesized that systemic awareness training prior to the introduction of regulated-breathing method would significantly improve fluency in stutterers. 16 stutterers (mean age 25.1 yr.) were randomly assigned to one of two groups, awareness training plus regulated-breathing method or regulated-breathing method only. All clients were seen individually during two 90-min. sessions and were informed that their speech was being recorded. The percentage of stuttering and the rate of speech were analyzed. Awareness training significantly reduced stuttering compared to a control procedure. But the most significant improvement appeared after the introduction of the regulated-breathing method. At a 1-mo. follow-up, although the frequency of stuttering was significantly less than during baseline, the level of disfluency was around 5%. From a clinical perspective, such results are far from satisfactory and no further follow-ups were conducted. The theoretical and practical implications of these results are discussed to improve the efficacy of our therapeutic methods used to counteract stuttering.

Adolescent↗
PubMed1991

Defining clinically significant changes in the treatment of child stutterers.

This study established a clinically significant criterion to evaluate outcomes of children's stuttering therapy. 30 stutterers, ages 6 to 15 years, and 30 non-stutterers served as subjects. Speech samples were recorded and the percentage of stuttered syllables and rate of speech analyzed. According to Jacobson and Revenstorf's procedure, 3% of stuttered syllables and 160 syllables per minute should become the target behaviors in the treatment of children's stuttering.

Adolescent↗
PubMed1998

Quantitative electroencephalogram of posterior cortical areas of fluent and stuttering participants during reading with normal and altered auditory feedback.

In the left and right hemisphere, posterior quantitative electroencephalogram Beta band activity (13.5-25.5 Hz) of seven adult participants who stutter and seven age-matched normal controls was obtained while subjects read text under three experimental conditions of normal auditory feedback, delayed auditory feedback, and frequency-altered feedback. Data were obtained from surface electrodes affixed to the scalp using a commercial electrode cap. Electroencephalogram activity was amplified, band-pass analog-filtered, and then digitized. During nonaltered auditory feedback, stuttering participants displayed Beta band hyperreactivity, with the right temporal-parietal lobe region showing the greatest activity. Under conditions of delayed auditory feedback and frequency-altered auditory feedback, the stuttering participants displayed a decrease in stuttering behavior accompanied by a strong reduction in Beta activity for the posterior-temporal-parietal electrode sites, and the left hemisphere posterior sites evidenced a larger area of reactivity. Such findings suggest than an alteration in the electrical fields of the cortex occurred in the stuttering participants under both conditions, possibly reflecting changes in neurogenerator status or current dipole activity. Further, one could propose that stuttering reflects an anomaly of the sensory-linguistic motor integration wherein each hemisphere generates competing linguistic messages at hyperreactive amplitudes.

Adolescent↗
PubMed2001

Perceptions of people who stutter: re-assessing the negative stereotype.

A common finding of past research is that people who stutter are stereotyped as being more guarded, nervous, self-conscious, tense, sensitive, hesitant, introverted, and insecure than nonstutterers. Using an innovative survey method, two questions studied were (1) whether individuals who have on-going contact with the same stutterer share the negative stereotype identified by past research, and (2) whether there are differences in perceptions of speech fluency between stutterers and their listeners. Responses of 114 friends and colleagues of stutterers found those who had on-going contact with at least one stutterer have less stereotypical attitudes than the general population, and significant differences in perceptions about normalcy of speech were noted for people who stutter and those with whom they interact.

Adolescent↗
PubMed2004

Bridging the divide between laboratory and "real world" in stuttering.

Stutterers stutter significantly less in the laboratory and the clinic than in everyday speaking situations. This paper reviews pertinent literature to show that, in the outside world, stutterers have a stake in what they say and therefore message content and interpersonal dynamics command attention-relegating speech-motor planning and execution to an automatic, memory-based process called speech concatenation. In the laboratory and the clinic, content of communication and interpersonal dynamics are less important, allowing stutterers to concentrate on the motor planning of articulation and prosody. Evidence reviewed here suggests that speech construction (real time preparation of an utterance motor plan) is incompatible with stuttering. Evidence also suggests that a slight delay in retrieving motor plans from memory during speech concatenation is the immediate source of stuttering.

Communication↗
PubMed1998

Outcome measurement in adult stuttering therapy: a self-rating profile.

The speech and language therapy profession is committed to the use of outcome measurement to maximise both efficiency and efficacy. However, measuring change in adult stuttering therapy is particularly problematic. It is proposed that outcomes of therapy should include stuttering behaviours, reactions to stuttering and handicap resulting from stuttering. Current methods of measuring change are reviewed. The Wright & Ayre Stuttering Self-Rating Profile (WASSP) is described which includes clients' perceptions of stuttering behaviours, avoidance, feelings and disadvantage. Issues of reliability and validity are considered.

Adult↗
PubMed2003

Self-reported efficacy of an all in-the-ear-canal prosthetic device to inhibit stuttering during one hundred hours of university teaching: an autobiographical clinical commentary.

This manuscript outlines the lifelong battle with severe stuttering and describes a new modality of effective amelioration of the disorder from the standpoint of a university professor and researcher in the field of stuttering. Childhood reactions to stuttering are discussed, along with the educational and vocational impact of stuttering. Ongoing therapy was received throughout the formative years and into adulthood, emphasizing reduced rates of speech. The use of Delayed Auditory Feedback (DAF) was found to induce fluent speech, but was considered only as a tool for decreasing the speech rate to achieve fluency. When fluency under DAF was discovered to be possible at faster speech rates, the possibility that the use of DAF and other forms of altered auditory feedback could themselves have an inhibitory effect on stuttering, without concomitant rate reduction was investigated. An In-The-Canal (ITC) fluency-enhancing device was used that provided DAF and Frequency Altered Feedback (FAF) to produce more fluent speech. After 10 months of use, the author was relatively free from stuttering. Speech was natural sounding, relatively spontaneous and unlaboured with an absence of fear. However, further testing (that is currently underway at various centres) is necessary before generalizations can be made.

Autobiographies as Topic↗
PubMed2004

Report on the course of study BZ-1003-BR following the changes in airways in stutterers with the help of pulse oscillometry (MasterScreen IOS).

Stuttering affects people all over the world. At the age of six years, about 1.5 percent of children suffers from stuttering. Although stuttering resolves spontaneously upon reaching adulthood in approximately 80% of those affected, it continues to have significant health and social consequences. So far, its etiology remains unknown. The organic differences in those with stuttering and those free of speech problems have been evaluated. As a result of these examinations, it has been hypothesized that stuttering results from functional pneumoobstruction of the tracheobronchial tree in the peripheral respiratory passages. As for now, no similar therapeutic procedure, using a bronchodilating agent in the treatment of stuttering, has been described. Preliminary findings of a pilot study are surprisingly positive. In October of 2003, a multicenter open clinical trial (Stage III) to verify the effect of a sympathomimetic agent formoterol was initiated. The study is being realized in six centers in Moravia and enrolls approx. 40 patients (children, adolescents and young adults). First experience and initial evaluation of the cohort are presented here.

Adolescent↗
PubMed1984

Stuttering.

Stuttering has been with us throughout time. It is global, pan-cultural, and is noted in all languages. Of the adult population, 1-2% stutter; 4% of children stutter. Any theory purporting to explain stuttering must explain the co-contraction of laryngeal agonist and antagonists, genetic findings of stuttering, the male sexual bias, and the fluency evoking paradigms of singing, speaking while inhaling, white noise, and delayed auditory feedback. This paper presents a neuro-laryngeal analysis of stuttering that attempts to correlate these phenomena. Various neurophysiologic mechanisms of cerebral/laryngeal/auditory systems will be discussed.

Auditory Pathways↗
PubMed1982

Stuttering: speech pattern characteristics under fluency-inducing conditions.

Speech samples were collected from three adult male stutterers under six baseline conditions and 15 conditions believed to increase fluency. After moments of stuttering and filled pauses had been deleted from the samples, a speech pause analysis technique developed by Goldman-Eisler was used to measure the following speech pattern characteristics: mean phonation duration (i.e., the duration between pauses), pause proportion, articulation rate, fluent speech rate, mean sentence length, and percentage of syllables stuttered. Greater than 50% reduction in stuttering occurred in all but three conditions (Speak and Write, Relaxed, Alone with cards). Greater than 90% reduction occurred under Prolonged/DAF speech, Singing, Chorus reading, Shadowing, Slowing, Syllable-timed speech, and Response contingent stimulation. The data were examined for evidence of speech pattern characteristic changes which were associated with reduced stuttering. Lengthened mean phonation duration occurred consistently under four conditions: Chorus reading, Shadowing, Singing, and Prolonged/DAF. Slowed speech (lower overall rate, lower articulation rate, or increased pause proportion) occurred consistently in seven conditions: Prolonged/DAF, Slowing, Syllable-timed speech, Arm swing, Speak and write, Relaxed, and Singing. Only in Prolonged/DAF speech did lengthened phonation duration occur in conjunction with slowed speech. The results of this exploratory study suggest that stuttering may be reduced under different conditions by means of different strategies. Lengthened phonation and slowing were the predominant strategies used in those conditions investigated in this study. The results are consistent with those of effective treatment techniques. Theoretical accounts of the association between change in fluency and change speech pattern characteristics are discussed.

Humans↗
PubMed1997

Semiautomated resolution of overlapping stutter patterns in genomic microsatellite analysis.

Microsatellites are polymorphic, short nucleotide repeating units scattered more or less randomly throughout the genome. They are readily detectable by polymerase chain reaction (PCR) and often used as genomic markers. One problem in the analysis of microsatellite data is the appearance of secondary bands during PCR that result in extended banding patterns. These "stutter" patterns may overlap in heterozygous alleles and obscure the overall pattern, severely interfering with analysis. This paper develops a model that successfully predicts the general shape of stutter patterns. It then presents techniques for measuring the intensity of the individual contributing alleles. The model is based on the assumption that there is a certain probability of losing or gaining a microsatellite repeat unit during each PCR cycle. The effect is cumulative, with the chance of losing a repeat unit being much greater than that of gaining one, which leads to a gradual reduction in the mean length of the pattern with increased PCR cycles. This can be modeled quantitatively to predict the shape of the stutter pattern, a prediction borne out by experiment. Next, a least-squares technique is presented that is used to analyze the overlapping stutter patterns and determine the relative concentration of each microsatellite in heterozygous alleles. The technique is based on the observation that, at least for microsatellites of approximately the same length, the relative intensity of each band in the stutter pattern is approximately the same for each allele. The stutter shape is most easily determined from homozygous alleles. It can also be approximated from heterozygous samples if the difference between the lengths of the primary microsatellite bands can be determined.

Algorithms↗
PubMed1996

Sequence analysis and characterization of stutter products at the tetranucleotide repeat locus vWA.

The PCR amplification of tetranucleotide short tandem repeat (STR) loci typically produces a minor product band 4 bp shorter than the corresponding main allele band; this is referred to as the stutter band. Sequence analysis of the main and stutter bands for two sample alleles of the STR locus vWA reveals that the stutter band lacks one repeat unit relative to the main allele. Sequencing results also indicate that the number and location of the different 4 bp repeat units vary between samples containing a typical verses low proportion of stutter product. The results also suggest that the proportion of stutter product relative to the main allele increases as the number of uninterrupted core repeat units increases. The sequence analysis and results obtained using various DNA polymerases appear to support the slipped strand displacement model as a potential explanation for how these stutter products are generated.

Alleles↗
PubMed1996

A mutant RNA polymerase reveals a kinetic mechanisms for the switch between nonproductive stuttering synthesis and productive initiation during promoter clearance.

During transcription initiation from galP2, one of the two promoters of the Escherichia coli galactose operon with an initially transcribed sequence of pppAUUUC, RNA polymerase (RNAP) is known to engage nonproductive stuttering synthesis, which is sensitive to the concentration of UTP. This study examines the effect of this nonproductive synthesis on promoter clearance and determines other parameters that might affect stuttering synthesis by analyzing a mutant RNAP, RpoB3449, that has altered its function at this process at galP2. RpoB3449 has dramatically diminished stuttering synthesis, and consequently, it has increased the rate of productive initiation due to its enhanced rate of promoter clearance of galP2 compared with wild-type RNAP. Thus, a direct linkage between promoter clearance and productive transcription is demonstrated. The mechanism by which the mutant RNAP has altered the switch between nonproductive stuttering synthesis and productive initiation during promoter clearance is studied. Apparently, RpoB3449 has increased its efficiency in incorporating CTP at the +5 position of the galP2 transcript leading to its reduced stuttering synthesis, indicating that the rate of an RNAP incorporating the CTP after a stretch of uridine residues is important for promoter clearance at galP2. Because RpoB3449 demonstrates "wild-type" stuttering synthesis at the mutant galP2 promoter, which contains the 6 residue at the +5 position, it indicates that the mutant RNAP has altered in binding CTP at this context. Further experiments indicate that it is the +5 position per se of the galP2 sequence rather than a particular nucleotide at that position that is critical in determining the switch between the two alternate pathways during transcription initiation. A checkpoint model for the switch between nonproductive and productive initiations during promoter clearance is discussed.

Base Sequence↗