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PubMed2001

Producing the vowel/a/ prior to speaking inhibits stuttering in adults in the English language.

This study investigated the effects of producing and listening to the vowel /a/ on the frequency of overt stuttering moments in eight people who stuttered. Stuttering frequency counts were made for the speech produced in the control condition, and after each of these four experimental conditions: (a) producing a vowel /a/ for 4 s; (b) producing a vowel /a/ for 4 s and waiting for 4 s; (c) listening to a recording of the vowel /a/ for 4 s; and (d) listening to a recording of the vowel /a/ for 4 s and waiting for 4 s. A significant reduction in the stuttering frequency was only observed following production of the vowel /a/ without a 4 s delay (P=0.02), suggesting that the vowel production prior to speech, serves as a temporary fluency enhancer. Its similarity to the occurrence of overt stuttering moments (e.g. discrete part-word repetitions and prolongation's) and its relationship to the fundamental nature of the pathology are discussed.

Adolescent↗
PubMed2004

The role of hemispheral asymmetry and regional activity of quantitative EEG in children with stuttering.

We investigated the role of delayed cerebral maturation, hemisphere asymmetry and regional differences in children with stuttering and healthy controls during resting state and hyperventilation, using conventional EEG techniques and quantitative EEG (QEEG) analysis. This cross-sectional case control study included 26 children with stuttering and age-sex matched 21 children with no history of stuttering. Visual EEG revealed significantly higher parieto-occipital slow waves and slower fronto-central asynchronic waves in the stutterers than in the controls. QEEG analysis showed significantly increased delta activity, especially in the right frontal and parietal regions and decreased alpha frequency in the bi-frontal regions of the stutterers, compared to the controls. Results are discussed interms of if the maturation hypothesis, especially nondominant frontal lobe (possibly supplementar motor area) and parietal lobe functioning.

Adult↗
PubMed2005

Changing perspectives for practice in stuttering: echoes from a Celtic past, when wordlessness was entitled to time.

Changing perspectives for practice in stuttering therapy are informed by the changes in knowledge, social values, and belief systems of a society. The International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001) has a sociological emphasis with a focus on the ability and functioning of the person, and it is currently fostering changes in perspectives for working with those who stutter. These perspectives are reflected in Irish social mores in the 7th and 8th centuries, when social and legal codes enshrined the rights of people with speech disabilities in law and recognized the dignity and integrity of people with such disabilities. The society of the time showed awareness and acceptance of people with disabilities, and it provided the supports to enable their participation in society. To a large extent, these principles contrast with the predominantly impairment-based focus that has been the heritage of the speech-language pathology profession in the 20th century. In order to review changing emphases in stuttering therapy and to consider applications of a sociological approach to stuttering, an outline of historical perspectives of the profession of speech-language pathology is presented. The evolution of the ICF is also outlined, moving from an impairment-based focus to a more sociological perspective. Both perspectives provide a historical context for consideration of approaches to working with stuttering, reflecting the ICF and echoing principles that were practiced in an ancient Celtic society.

Disability Evaluation↗
PubMed2001

The modification of speech naturalness during rhythmic stimulation treatment of stuttering.

This study investigated the modification of speech naturalness during stuttering treatment. It systematically replicated an earlier study (Ingham & Onslow, 1985) that demonstrated that unnatural-sounding stutter-free speech could be shaped into more natural-sounding stutter-free speech by using regular feedback of speech-naturalness ratings during speaking tasks. In the present study, the some procedure was used with three persons who stutter-2 adolescent girls and 1 adult man-during rhythmic stimulation conditions. The two adolescent participants spoke only English, but Spanish was the first and English the second language (ESL) of the adult participant. For the 2 adolescents, it was demonstrated that their unnatural-sounding rhythmic speech could be shaped to levels found among normally fluent speakers without losing the fluency-inducing benefits of rhythmic speech. The findings indicate that speech-naturalness feedback may be a powerful procedure for overcoming a problematic aspect of rhythmic speech treatments of stuttering. However, it was not possible to deliver reliable speech-naturalness feedback to the adult ESL speaker, who also displayed a strong dialect. The study highlights the need to find strategies to improve interjudge agreement when using speech naturalness ratings with speakers who display a strong dialect.

Adolescent↗
PubMed2003

Accuracy and variability of isochronous rhythmic timing across motor systems in stuttering versus nonstuttering individuals.

Ten adults who stutter and ten adults who do not stutter completed speech, orofacial nonspeech, and finger isochronous rhythmic timing tasks in a synchronization-continuation paradigm with auditory stimuli and with 450 ms, 650 ms, and 850 ms interstimulus onset intervals. Responses consisted of bilabial contact in the syllable /pa/ during a speech task, bilabial contact in an orofacial nonspeech task, and thumb-index finger contact in a finger movement task. Effector movements were transduced, and time points associated with minima in the derived lip or finger aperture signals were automatically extracted. Multiple analyses of timing accuracy and variability were completed for both the synchronization and continuation phases, including decomposition of total timing variance into central clock and motor implementation variance according to the Wing-Kristofferson model. The combined results from descriptive comparisons, statistical significance testing, and effect size computations suggest that the stuttering and nonstuttering participants showed highly similar levels of both timing accuracy and timing variability. This was true (a) for all three motor tasks, (b) at all movement rates, and (c) for synchronization as well as continuation movements. As one component of a systematic approach to investigating the role, if any, of timing difficulties in stuttering, these findings extend growing evidence that stuttering individuals do not differ from nonstuttering individuals in the ability to generate temporal movement patterns with a simple isochronous rhythm. We present some hypotheses about the implications that may follow from brain imaging and clinical neurological studies that have investigated the neural substrates recruited by this particular experimental task.

Adult↗
PubMed2005

Coordination of oral and laryngeal movements in the perceptually fluent speech of adults who stutter.

This work investigated whether stuttering and nonstuttering adults differ in the coordination of oral and laryngeal movements during the production of perceptually fluent speech. This question was addressed by completing correlation analyses that extended previous acoustic studies by others as well as inferential analyses based on the within-subject central tendency and variability of acoustic and physiological indices of oral-laryngeal control and coordination. Stuttering and nonstuttering adults produced the target /p/ as the medial consonant in C(1)V(1)#C(2)V(2)C(3) sequences (C = consonant; V = vowel or diphthong; # = word boundary) embedded in utterances differing in length and location of the target movements. No between-groups differences were found for across- or within-subject correlations between acoustic measures of stop gap and voice onset time (VOT). However, the acoustic data did show longer durations for devoicing interval and VOT in the stuttering versus nonstuttering individuals, in the absence of a difference for a proportional measure specifically reflecting oral-laryngeal relative timing. Analyses of combined kinematic and electroglottographic data revealed that the stuttering individuals' speech was also characterized by (a) longer durations from bilabial closing movement onset and peak velocity to V(1) vocal fold vibration offset and (b) greater within-subject variability for dependent variables that were physiological indices of devoicing interval and VOT, but again no between-groups differences were found for specific indices of oral-laryngeal relative timing. Overall, findings suggest that, for the production of voiceless bilabial stops in perceptually fluent speech, stuttering and nonstuttering adults differ in the duration of intervals defined by events within as well as across the oral and laryngeal subsystems, but the groups show similar patterns of relative timing for the involved oral and laryngeal movements.

Adult↗
PubMed1978

Stuttering therapy: the relation between attitude change and long-term outcome.

Previous research has indicated that attitude change generally follows behavior change in operant stuttering therapy programs. This study sought to examine the longterm therapy outcome of stutterers whose communication attitudes were not substantially normalized after fluency establishment and generalization. Posttransfer attitude scores of 20 stutterers were used to classify them into one of two groups: those whose communication attitudes had been modified to show less abnormality than the mean level for normal speakers, and those whose attitudes had not. Follow-up interviews with the 20 stutterers one year later indicated that those whose posttransfer attitudes were not substantially normalized stuttered significantly more. Theoretical and clinical implications are discussed.

Attitude to Health↗
PubMed1980

Motoric and linguistic variables among children who stutter: a factor analysis.

Seventy-six children who stuttered, aged 5-12, were administered tests of motor coordination, psycholinguistic abilities, and stuttering severity. A factor analysis of 19 selected variables yielded four statistically useful factors that implicate linguistic integration, oral motor ability, and auditory processing abilities as underlying components among the sample population. These components are assumed to affect a child's threshold for fluency and to permit stuttering development. Stuttering frequency or severity was not related to any of the four factors. The implications for diagnosing and treating children who stutter are discussed.

Auditory Perception↗
PubMed1988

The prevalence of stuttering in the hearing-impaired school age population.

The purpose of this study was to determine the prevalence of stuttering in the current hearing-impaired school age population. Backus (1938) and Harms and Malone (1939) found a low incidence of stuttering in the hearing-impaired population in surveys conducted almost 50 years ago. Those surveys asked for information only on speech disfluency and did not collect information on disfluency in manual communication. The present survey was sent to 150 regional, private, and state schools for the hearing impaired. Seventy-seven schools responded, representing a total of 9,930 students enrolled. Twelve hearing-impaired students were reported who stutter: 3 were reported to stutter in the oral mode only, 6 in manual communication only, and 3 in both modes. The results indicate that the prevalence of stuttering in the hearing-impaired population is 0.12% and that perceived manual disfluency is more prevalent than oral disfluency.

Adolescent↗
PubMed1989

Nonfluencies of preschool stutterers and conversational partners: observing reciprocal relationships.

Nonfluencies produced by 12 stutterers (2-6 years old) interacting in three dyadic sessions were analyzed. A stutterer played with his own mother, own father, and a familiar peer for 10 min. Results indicated that the total frequencies and types of nonfluency observed were very similar in each of the play situations. Although stutterers exhibited more part-word repetitions and prolongations than any other type of nonfluency, they did not differ in the amount and type of nonfluency when talking to their three conversational partners. Because children have more breakdowns in fluency than adults, it was not surprising that peers were more nonfluent when talking to the stutterer than were the parents. Peers used significantly more part- and whole-word repetitions, tense pauses, and interjections than the parents did. The nonfluency levels of the parent partners were quite similar when talking to the stutterers.

Child, Preschool↗
PubMed1990

Direct early intervention with stuttering: some preliminary data.

Many clinicians recognize a need for direct intervention with cases of early stuttering. However, this recognition is not supported by adequate empirical information about how such cases should be managed. One possibility is that early stuttering might be controllable by parent-administered, operant, verbal stimulation procedures. The purpose of this paper is to present preliminary data that depict the results of such an intervention procedure with four cases of early stuttering. Speech measures were gathered in a variety of speaking situations, within and beyond the clinic, over a 2-month pretreatment period and a 9-month posttreatment period. Results showed that the 4 subjects achieved reductions in stuttering comparable to those reported for adult treatment programs. However, the present results were obtained in far fewer clinical hours than normally needed in the treatment for older subjects. The treatment times in the present study also compare favorably to those published in other reports of operant intervention procedures with children. These findings suggest that cases of early stuttering might be managed effectively by parents, with limited expenditure of clinical time. Findings are discussed in terms of their implications for the development of early intervention programs that are more efficient and effective than existing intervention procedures for older clients.

Child, Preschool↗
PubMed1976

Stuttering and sentence length.

The purpose of this study was to determine whether sentence length influences the frequency of stuttering. Fourteen stutterers read, in random order, 20 long and 20 short sentences. The long sentences were constructed by means of additions to the short ones: for example, She learned to swim and She learned to swim in the clear water of the lake. Only the words that the pairs of sentences had in common were compared for occurrence of stuttering. Significantly more stuttering was found on the same words when they served as the initial segments of long sentences than when they stood alone as short sentences. The results seem to give evidence of the role of motor planning, or anticipated motor complexity in stuttering.

Adolescent↗
PubMed1978

Effects of noise and rhythmic stimulation on the speech of stutterers.

This study was designed to investigate the effects of noise and rhythmic stimulation on stutterers' vocal fundamental frequency, vowel duration, and vocal level, and the relation these variables have to one another and to stuttering during noise and rhythmic stimulation. Measurements of speech variables were obtained from audio and graphic-level recordings and from narrow- and broad-band spectrograms. Results indicated that stuttering was significantly reduced during noise and rhythmic stimulation with the reduction during rhythmic stimulation being significantly greater than the reduction during noise. Decreases in stuttering were correlated with increases in vowel duration during both conditions for seven of nine subjects. We interpret our findings to suggest that temporal changes in speech production are related to the decrease in stuttering that occurs during noise and rhythmic stimulation.

Acoustic Stimulation↗
PubMed1979

A further evaluation of the speech of stutterers during chorus- and nonchorus-reading conditions.

The claim that stutterers change their customary way of speaking during chorus-reading conditions was assessed in a single subject experimental design on the speech of three stutterers. A number of pairs of speech samples of identical prose were obtained from chorus- and nonchorus-reading conditions for each stutterer. Observers judged whether the pairs were composed of samples drawn from same (chorus/chorus or nonchorus/nonchorus) or different (chorus/nonchorus) oral reading conditions. The findings aligned with those obtained in an earlier group study. They indicated that there may be changes in the speech pattern of some stutterers during chorus-reading conditions, but this change may not occur in the speech pattern of all stutterers who respond to chorus reading conditions.

Adolescent↗
PubMed1980

Dimensions of improvement in stuttering.

This paper presents a first approximation of the dimensional structure of stuttering improvement and its hierarchical organization. A set of 288 statements obtained from stutterers, indicating ways in which they felt their stuttering problems had improved, were assigned to dimensions by three clinicians who had considerable experience in the area of stuttering. They also were rated for the amount of improvement the changes reported usually represent by 26 clinicians who were regarded as authorities in the area of stuttering. The statements are ordered on the improvement continuum, by dimension, based upon the medians of the ratings assigned to them. The ordering of the statement set appears to be highly reliable.

Adolescent↗
PubMed1980

Vocal characteristics of normal speakers and stutterers during choral reading.

It is well known that stutterers experience significant decrements in their stuttering when they read or speak in unison with another person. Recently, Wingate suggested that the act of choral reading or speaking prompts the individual who is following the model speaker to emphasize vocalization and its continuity throughout the utterance. This modified vocalization may then be viewed as the immediate cause of the stutterers' reduced disfluency. To evaluate this hypothesis, ten stutterers and ten normal speakers were tested in a control and choral reading condition. In the former, subjects read in their habitual manner. In the latter, subjects read in unison with a recording of a normal adult male. Subjects' oral readings were audio-taped and then submitted to spectrographic analysis. Measures of vowel duration, peak vocal SPL and continuity of phonation were made and then treated statistically. The major findings of this study indicated that across the two conditions, both groups failed to modify their vocal SPL and continuity of phonation. They did, however, alter their vowel durations. The normal speakers increased theirs by a statistically insignificant amount, while the stutterers significantly shortened theirs. The results that pertained to vocal SPL and vowel durations seemed a function of each group's scores for these measures in the control condition as compared to the values for the same measures that were generated by the model speaker with whom subjects read in unison in the experimental condition. These and other findings and interpretations are discussed further relative to Wingate's "modified vocalization" hypothesis.

Adolescent↗
PubMed1980

Modification of maintenance and generalization during stuttering treatment.

A procedure designed to maintain and generalize the gains achieved during a stuttering treatment was assessed. A performance-contingent schedule of decreasing within-clinic assessments was evaluated when it was programmed with either contingent or noncontingent schedule conditions. The effect of these schedules on stuttering was assessed within BAB and ABA experimental conditions which were applied to nine stutterers divided into two groups. Assessments were made on the speech behavior of subjects within and outside of clinic conditions as well as covertly. The percentage of syllables stuttered and syllable-per-minute data from both groups of subjects indicated that the performance-contingent schedule was associated with both maintained and generalized reductions in stuttering. The clinical validity of this finding is limited, however, because covert assessment data were consistent with outside-clinic performance for only six of the nine subjects.

Adolescent↗
PubMed1981

The influence of the onset of phonation on the frequency of disfluency among children who stutter.

This study was designed to assess the effects of on-off voice adjustments on the frequency of stuttering in children. Essentially, this is a replication of the experimental paradigm used by Adams and Reis (1971, 1974) with adult stutterers who were asked to read two passages: one contained a normal distribution of voiced and voiceless sounds; the other contained nearly all voiced sounds. The latter passage was associated with less stuttering and more rapid adaptation. In this study, 15 childhood stutterers in the third through the seventh grades were asked to read these same two passages. Contrary to the previous results with adults, however, the children did not stutter less nor adapt more rapidly with the all-voiced passage. These results are discussed with reference to previous literature and to the influence of pausing.

Child↗