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PubMedDate not supplied

The Behavior Assessment Battery: a preliminary study of non-stuttering Pakistani grade-school children.

BACKGROUND: In recent years, the importance of a multimodal approach to the assessment of the person who stutters (PWS) has become increasingly recognized. The Behavior Assessment Battery (BAB), which is a normed test procedure developed by G. Brutten, makes it possible to assess the multidimensional facets of this disorder. The emotional and speech-disruptive components that differentiate one who stutters from one who does not (PWNS) are evaluated by means of the Speech Situation Checklist (SSC), their use of behaviours secondary to stuttering are assessed through the Behavior Checklist (BCL) and the person's speech-related attitude is determined via the Communication Attitude Test (CAT). Each of these BAB tests has been shown to be a reliable and valid measure whose obtained normative data are essentially equivalent in Western countries. AIMS: Because of the lack of normative data on children from non-Western cultures, the present preliminary study was aimed to investigate if the affective, behavioural and cognitive reports of non-stuttering Pakistani children on the BAB measures are like those of their Western peers. METHODS & PROCEDURES: Forty-five non-stuttering Pakistani children between the ages of 8 and 11 were administered the SSC, BCL and CAT. OUTCOMES & RESULTS: As in previous studies, the mean score of the normally fluent children on each of the BAB tests fell into the lower end of the possible distribution of scores. Intercorrelations between the different tests were statistically significant. CONCLUSIONS: Although the BCL and CAT results were similar to those found in Western-based investigations, the emotional reaction and speech disruption scores on the SSC reported by Pakistani children sampled were numerically higher to an extent that is noteworthy. The latter finding suggests that this particular BAB measure might be affected by cultural differences. It points to the possibility that the norms of test procedures, such as the BAB, might not be fully appropriate for use in other than Western cultures.

Adaptation, Psychological↗
PubMedDate not supplied

Connecting stuttering management and measurement: I. Core speech measures of clinical process and outcome.

BACKGROUND: There will always be a place for stuttering treatments designed to eliminate or reduce stuttered speech. When those treatments are required, direct speech measures of treatment process and outcome are needed in clinical practice. AIMS: Based on the contents of published clinical trials of such treatments, three 'core' measures of treatment outcome are presented for consideration by clinicians: measures of stuttering rate, speech rate and speech naturaleness. MAIN CONTRIBUTION: In contrast to clinical trials, however, clinicians are at liberty to have as many outcome measures as thought necessary, and to design non-standard ones to suit their needs and those of their clients. In that context, the merits of severity ratings of stuttering are considered. It is argued that the prime source of guidance of suitable measures of treatment process are the manuals of the treatments that have figured in clinical trials. CONCLUSIONS: Although there are independent data sources that contradict the axiom that treatment outcomes should be measured beyond the clinic, it is argued that it is premature to dispense with beyond-clinic process outcome measures for clinical practice. It is argued that for clinicians who conduct treatments in non-research contexts, one pretreatment outcome measurement occasion is sufficient, along with post-treatment measures at each maintenance visit. More than anything else, the numerous advantages of severity ratings of stuttering facilitate clinical measurement of treatment outcome and treatment process in several settings and on several occasions.

Adolescent↗
PubMed2001

Public awareness of stuttering in Shanghai, China.

This study reports the results of an investigation of knowledge and public awareness of stuttering among laypersons in Shanghai, China. A total number of 1968 respondents answered a questionnaire including questions about prevalence, onset, gender distribution and occurrence in different cultures, cause, treatment, intelligence and heredity of stuttering. Stuttering appears to be a disorder that most people in the Shanghai area are familiar with, and for several aspects a considerable number of respondents held views that are in line with current knowledge about stuttering. For some aspects though knowledge is limited, indicating a need for disseminating scientific information on stuttering. The results of the present study are compared with a similar Belgium study.

Adult↗
PubMed1993

Familial relationship between Gilles de la Tourette's syndrome, attention deficit disorder, learning disabilities, speech disorders, and stuttering.

OBJECTIVE: This study examined the familial relationship between Gilles de la Tourette's syndrome (GTS) and attention deficit disorder (ADD), learning problems, speech disorders, and stuttering. METHOD: This family study consisted of 338 first degree relatives of 85 GTS probands and 113 controls. All available relatives were personally assessed using structured interviews, and family history information was collected from all family members. Best-estimate diagnoses were assigned for GTS, ADD, learning problems, speech disorders, and stuttering. Analyses examined whether ADD, learning problems, speech disorders, and stuttering by themselves represent genetically variant expressions of GTS. RESULTS: There was no evidence that ADD, learning problems, speech disorders, or stuttering represent variant expressions of GTS. However, relatives with GTS were at increased risk for ADD regardless of the ADD diagnosis of the GTS proband. CONCLUSIONS: ADD, learning problems, stuttering, and speech problems by themselves are not variant forms of GTS. However, GTS and ADD may be etiologically related in some persons. There may be two types of individuals with GTS and ADD: ones in whom ADD is independent of GTS, and others in whom ADD is secondary to occurrence of GTS.

Adolescent↗
PubMed2004

Self-reported efficacy of an ear-level prosthetic device that delivers altered auditory feedback for the management of stuttering.

Numerous past efficacy studies in stuttering treatment have typically failed to assess generalization of therapeutic gains across speaking environments over time. The purpose of this study was to use a self-report format to gain insight into the improvements of clients who purchased an all in-the-ear device that provides altered auditory feedback to manage stuttering symptoms across everyday speaking situations. A total of 105 participants (age 7-81 years) returned completed questionnaires that examined seven parameters of stuttering behavior before acquiring the prosthetic device and after using the device with minimal clinical intervention for an average of 6 months. Across each parameter, participants rated a significant (P<0.001) improvement of approximately two units on seven-point scales after beginning to use the prosthetic device. In addition, the device received high overall satisfaction ratings, with a median score of 2.0 on the seven-point scale. Self-report is a 'must' for examining clinical efficacy in a disorder such as stuttering, which is so amenable to 'clinic room fluency' yet highly resistant to long-term amelioration. The data suggest that this device is helping to provide its users with functional, effective and efficient management of stuttering without the need for extended clinical follow-up.

Adolescent↗
PubMed2006

Language-induced epilepsy, acquired stuttering, and idiopathic generalized epilepsy: phenotypic study of one family.

PURPOSE: Language-induced epilepsy involves seizure precipitation by speaking, reading, and writing. Seizures are similar to those of reading epilepsy (RE). The nosologic position of language-induced epilepsy is not clear. We performed a clinical and neurophysiological study in a multigenerational family with the association of idiopathic generalized epilepsy (IGE) with ictal stuttering as a manifestation of reflex language-induced epilepsy. METHODS: Nine members on three generations were studied. All patients underwent video-polygraphic EEG recordings (awake and during sleep). A standardized protocol was applied to test the effect of language and non-language-related tasks. RESULTS: Six patients presented language-induced jaw jerking that mimicked stuttering and corresponded to focal myoclonus involving facial muscles. This was associated with an IGE phenotype in four of these patients. Focal EEG spikes were found in all six patients by visual analysis and/or back-averaging techniques. The focal spikes were either asymptomatic (when followed by a slow wave) or symptomatic of facial myoclonia (when isolated). Levetiracetam, used as add-on or monotherapy in four patients, suppressed ictal stuttering. One additional case only had a phenotype of IGE without focal features. CONCLUSIONS: This family study demonstrates the phenotypic heterogeneity of the association of IGE phenotype with ictal stuttering (language-related reflex seizure). Our data suggest that this particular form of reflex epilepsy related to language has more similarities with generalized epilepsies than with focal ones. Neurophysiological investigations should be performed more systematically in patients with acquired stuttering, especially if there is family history of IGE.

Adolescent↗
PubMed1992

A model of the phonatory response time of stutterers and fluent speakers to frequency-modulated tones.

Stutterers and fluent speakers tracked frequency-modulated tones by humming. The response time (RT) to the first corrective change in fundamental frequency in response to linear ramps of increasing and decreasing frequency was measured. The results demonstrate that RT is a function of the stimulus ramp velocity. A model of this dependency is provided which consists of parameters of threshold frequency and a fixed time delay. The estimated threshold frequency for the fluent speakers is 2.029 Hz with 95% confidence interval: (1.70 Hz, 2.35 Hz) whereas that of the stutterers is 3.937 Hz (3.28 Hz, 4.60 Hz). These threshold frequencies are significantly different (p < 0.0001). This implies that stutterers are slower to respond to changes in frequency than are fluent speakers. The fixed time delays for the two groups are not significantly different. This means that it is possible for the stutterers to respond as fast as the fluent speakers (i.e., their basic "reflexes" are the same); however, they spend more time in the detection of the change in a tracking signal. This supports the model of the stuttered event as being triggered by an instability in a multiloop speech motor control system.

Adult↗
PubMed1999

Utterance rate and linguistic properties as determinants of lexical dysfluencies in children who stutter.

Two important determinants of variation in stuttering frequency are utterance rate and the linguistic properties of the words being spoken. Little is known how these determinants interrelate. It is hypothesized that those linguistic factors that lead to change in word duration, alter utterance rate locally within an utterance that then gives rise to an increase in stuttering frequency. According to the hypothesis, utterance rate variation should occur locally within the linguistic segments in an utterance that is known to increase the likelihood of stuttering. The hypothesis is tested using length of tone unit as the linguistic factor. Three predictions are confirmed: Utterance rate varies locally within the tone units and this local variation affects stuttering frequency; stuttering frequency is positively related to the length of tone units; variations in utterance rate are correlated with tone unit length. Alternative theoretical formulations of these findings are considered.

Child↗
PubMed1989

Alleviation of acquired stuttering with human centremedian thalamic stimulation.

Despite many investigations, the cerebral mechanism for stuttering remains unknown. Recently, increased attention has been paid to acquired stuttering of adult onset in the hope that the events associated with it might provide clues to the biological mechanism underlying stuttering. This attention has focused exclusively on the cortical substrates. We present our observations of acquired dysfluency, presumably of subcortical origin in a neurosurgical subject with intractable pain. The stuttering was relieved by thalamic electric stimulation. The effect of thalamic stimulation on the stuttering suggests that the pathophysiology of transient asynchronisation in the balancing and sequencing of multiple impulses is amenable to a diffusely orchestrated functional tuning of the thalamic and brainstem implicated subcortical structures and pathways.

Brain Stem↗
PubMed1999

[Bioresonance therapy (biophysical information therapy) in stuttering children].

This study tried to investigate whether bioresonance therapy could have a beneficial effect in stuttering children of school age who showed no progress under other therapies. The 14 patients, age 9-18 years, were randomized in two groups. The first received 10 sessions of bioresonance, the second continued with speech therapy. In the second phase of the study the first group received speech therapy while the second was treated by bioresonance. The intensity of the stuttering was measured at the beginning, at mid-term and at the end of the 9 months experiment. Various established methods were used for that purpose. It was not possible to demonstrate any improvement of the stuttering during or after either of the two therapies. This study showed how difficult it is to investigate stuttering scientifically. It turned out that in reality there is a lack of precise differential diagnosis. This means that true stuttering can hardly be distinguished from other speech disturbances and is under the influence of countless external factors.

Adolescent↗
PubMed2006

Prevalence of stuttering in regular and special school populations in Belgium based on teacher perceptions.

The purpose of this study was to investigate stuttering prevalence in Flanders, the northern part of Belgium. Using questionnaires distributed among teachers, data were collected on 21,027 pupils from regular schools (age between 6 and 20 years) and 1,272 pupils attending special education (age between 6 and 15 years). The overall prevalence in the regular school population was 0.58%. It was 2.28% in the special school population. In agreement with past studies, stuttering prevalence was higher in males than in females, and higher in pupils attending special schools than in pupils from regular schools. The tendency for stuttering prevalence to decrease with increasing age was confirmed too, but not in the pupils of special schools. Additionally, the pupils of regular schools showed a pattern that was contrary to the general belief that the male-to-female ratio in stuttering prevalence increases with age. Results further indicate that the commonly cited stuttering prevalence figure of 1% is a generalization that requires interpretation.

Adolescent↗
PubMed1991

The pharmacology of stuttering: a critical review.

OBJECTIVE: The author critically examines the limited world literature on pharmacologic treatments of stuttering. METHOD: The literature on stuttering and drugs was identified by means of two computer-assisted searches. FINDINGS: A great variety of pharmacologic agents have been used to treat stuttering, reflecting the many theories about the origin and nature of the disorder. In some instances new hypotheses about the nature of stuttering have followed the chance discovery of agents having some efficacy. CONCLUSIONS: Few studies have used adequate experimental designs. Promising avenues of research, both for the treatment of stuttering and for exploring its nature, include the use of calcium channel blocking agents and cholinergic drugs.

Antipsychotic Agents↗
PubMed1999

Speaking in the claustrum: the psychodynamics of stuttering.

The author outlines the psychoanalytic theory of stuttering and, discussing material from the analysis of a stutterer and its transference and countertransference processes, puts forward a new hypothesis of the psychodynamics of stuttering in conjunction with Meltzer's theory of the claustrum. He argues that the stutterer is working out intolerable experiences of separation from the primary object and a resulting catastrophic experience of the oedipal situation through an unconscious fantasy in which anal qualities are conferred on the internal maternal object by a predominating hatred. The intrusive identification of parts of the self in the maternal rectum gives rise to a claustrophobic experiential world in which all obstacles that are encountered between self and object must be eliminated. The anal-sadistic object space of the claustrum is projected on to the external object space and thus also on to the mouth as the origin of the sound envelope, where it produces both a lifeless sound envelope and a torn content, i.e. stuttered sounds, words and sentences. Correspondingly, a dead speech melody and broken words have their parallels in object relations that are characterised by an attack on linking and by psychic withdrawal.

Adult↗
PubMed2004

Alleviating stuttering with pharmacological interventions.

Stuttering is a speech disorder characterised by frequent prolongations, repetitions or blocks of spoken sounds and/or syllables. Stuttering is very common and is classified by the Diagnostic and Statistical Manual of Mental Disorders -- Fourth Edition (DSM-IV) as an Axis I disorder. In spite of this, stuttering treatment is sporadically addressed by a practicing physician, especially in the US. Much has recently been learned of the neurophysiological basis of this disorder, which has provided insight into novel treatment strategies, thus helping to guide the practising clinician. Stuttering is likely to be associated, at least in part, to dopamine hyperactivity in the brain. Novel dopamine antagonists such as risperidone and olanzapine, have recently been shown to improve the symptoms of stuttering providing a strong foundation for physicians to more effectively treat this disorder.

Benzodiazepines↗
PubMedDate not supplied

[Experience and personal report about an international cooperation research--Brazil, Bulgaria and Turkey--Attitudes Toward Stuttering].

BACKGROUND: People typically regard stutterers as shy, nervous, introverted, and fearful, a so-called "stuttering stereotype". Many stutterers are also subjected to teasing and bullying or to illegal discrimination. AIM: Currently, there are no widely-accepted, standardized instruments used to measure public attitudes toward stuttering around the world. Accordingly, an International Project on Attitudes Toward Stuttering (IPATS) initiative was launched in 1999 to develop such an instrument, named the Public Opinion Survey of Human Attributes (POSHA). METHOD: This study compares selected results from three groups of adults from countries in South America (Brazil), Eastern Europe (Bulgaria), and the Middle East (Turkey). Respondents were pooled into three groups according to place-of-residence variable by country and a survey language variable. All of the respondents completed the questionnaire in the primary language of their countries. RESULTS AND CONCLUSION: This pilot study suggests that some attitude differences among respondents may be explained by an interaction of national, cultural, ethnic, religious, or language differences, although the relative contribution of each component cannot be determined. In a subsequent tier of survey analyses, ratings by these respondents will be compared with the ratings of respondents from other countries completing the survey in English.

Biomedical Research↗
PubMedDate not supplied

[Typology of speech disruptions and grammatical classes in stuttering and fluent children].

BACKGROUND: Developmental stuttering is a pathology which begins during childhood. during the phase of language acquisition and development and is characterized as being chronic. AIM: To verify the influence of typology and grammatical classes on the occurrence of speech disruptions of stuttering and fluent children. METHOD: Participants of this study were 80 children, with ages between 4.0 and 11.11 years, residents in the city of São Paulo. Participants were divided in two groups: GI (research group) was composed by 40 children (29 male and 11 female) with the diagnosis of stuttering, and with no other associated communication. neurologic and cognitive deficits: GII (control group) was composed by 40 fluent children, paired by age and gender with the participants of GI. RESULTS: The data indicate that the groups do not differ regarding the occurrence of typical disfluencies. Less typical disflucncies occurred predominantly for GI. As for the grammatical class, speech disruptions were more frequent in function words for both groups. CONCLUSION: These results indicate that the analyses of speech disruptions, in terms of typology and grammatical classes, bring several information that are necessary for the assessment and diagnosis of childhood stuttering. This analysis points the differences and similarities between stuttering and fluent children.

Analysis of Variance↗
PubMed1993

Analysis of a simplified treatment for stuttering in children.

We investigated the effectiveness of a simplified program for the treatment of stuttering in children. The simplified treatment included awareness training, in which the subjects learned to detect every occurrence of stuttering; training a response incompatible with stuttering, which involved relaxation and regulation of air flow over the larynx when speaking; and social support, which involved parent-delivered prompts and praise of children's use of the techniques in everyday environments. Eight children were treated in their homes with the simplified treatment, in a multiple baseline across subjects design, and all reached the criterion level of less than 3% words stuttered. In addition, the reduction in stuttering generalized to the school setting and was maintained at posttreatment (10 to 13 months). The subjects' rates of speech remained stable throughout baseline and treatment. Pretreatment and posttreatment ratings by the parents showed that they found treatment to be both acceptable and credible. Finally, social validity measures revealed a noticeable improvement in the subjects' speech to parents and speech pathologists.

Behavior Therapy↗
PubMed2005

Effect of reading with reversed speech on frequency of stuttering in adults.

This study explored the effect of reading with reversed speech on the frequency of stuttering. Eight adults who stutter served as participants and read four 300-syllable passages while listening to three types of speech stimuli: normal speech (choral reading), reversed speech at normal speed, reversed speech at half speed, and a control condition of no auditory feedback. A repeated-measures analysis of variance showed a significant decrease in stuttering frequency in the choral reading condition but not in reversed speech at normal and half speed. However, the reversed speech at half-speed condition showed a large effect size (omega2 = 0.32). Data suggest that a forward moving speech feedback is not essential to decrease the frequency of stuttering in adults who stutter.

Acoustic Stimulation↗