SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Many children who stutter initially seek guidance from their pediatricians. Pediatricians often do not refer stutterers for speech therapy. We present a brief analysis of pediatricians' views regarding stuttering, as well as their exposure to patients who stutter. We present a practical approach to children who stutter.
In a study designed to cross-check a previous finding that females who stutter suffer from markedly low self-esteem and low levels of aspiration, 21 female stutters and 35 female controls were compared on the Rotter Level of Aspiration Board. For the female stutterers, the mean D score was +1.46, while for the female nonstutterers, it was +3.11 (t = 2.75; p less than 0.005). It was concluded that females who stutter do indeed suffer from low self-esteem, as reflected in their greater reluctance to bid for scores promising higher achievement. Comparison of the 1979 sample with a 1955 sample indicated that female stutterers may be making some generational gains in self-esteem perhaps reflecting improved status of females in our society.
The purpose of this paper is to present clinical considerations regarding the speaking behavior, nature, and environment of young children who stutter. The speech of these children contains more within-word speech disfluencies (sound/syllable repetitions, sound prolongations, and within-word pauses) than that of their normally fluent peers. Although the physical, mental, social, psychological, and communicative nature of these children is not grossly different than that of unaffected children, some youngsters who stutter do exhibit subtle delays or deviancies in speech sound articulation, expressive language, and fine/gross motor coordination skills. The young stutterer's environment is as variable as that of the average child. Careful observation reveals subtle, and some not so subtle, parental attitudes which seem to foster the child's belief that speaking is a difficult task, requiring mental and physical effort, and that it must be produced precisely, quickly, and maturely. Information is provided to clinicians working with children between 2 and 6 years of age (the time period when stuttering usually begins) which should assist in objective identification of childhood stuttering, recognition of those symptoms which most strongly suggest referral, as well as an understanding of basic "facts" about this most complex of communication disorders.
Cerebral lateralization in visual perception was investigated in 9 severe stuttering, 11 mild stuttering and 48 fluent speakers. The subjects were asked to identify words presented in the left or right visual field for 20 ms. Children responded by pointing to the exposed test word on a response card which contained four different words. Errors committed in the left and right visual fields were analyzed. The data showed a left hemisphere superiority in the processing of words in both the mild stutterers and the fluent speakers, but a right hemisphere advantage in the severe stutterers. The results suggest a close relationship between the severity of stuttering and functional brain organization.
We reported a 73-year-old man with pure akinesia syndrome who showed severe acquired stuttering and paradoxical kinesia on speech. He was evaluated in another hospital for bradykinesia and frozen gait at age of 67 when his cranial MRI disclosed ischemic changes in bilateral basal ganglia and periventricular deep white matter. The treatment with L-dopa and L-threo DOPS was not effective. His symptoms were slowly progressive and got worse gradually. At age of 72, he began to have difficulty in speech due to severe acquired stuttering, and one year later, he visited our hospital. The diagnosis of pure akinesia syndrome was made because of akinesia, micrographia, marked frozen gait with paradoxical kinesia and disturbance of postural reflex without tremor and rigidity. His speech showed severe acquired stuttering with marked blocking and repetition of initial phonemes at the beginning of speech. But intelligible speech recurred with pointing the characters by his finger or with writing an initial letter of word, although his speech was small and monotonous. Surface EMG findings of muscles participating speech in acquired stuttering showed the similar tonic discharge to those of muscles of lower extremity in frozen gait. These results implied that freezing phenomenon and festination of muscles participating speech in our patient may result in acquired stuttering.
The etiology of stuttering is controversial. The prevailing theories point to measurable neurophysical dysfunctions that disrupt the precise timing required to produce speech. Stuttering is a common disorder that usually resolves by adulthood. Almost 80 percent of children who stutter recover fluency by the age of 16 years. Mild stuttering is self-limited, but more severe stuttering requires speech therapy which is the mainstay of treatment. Delayed auditory feedback and computer-assisted training are currently used to help slow down speech and control other speech mechanisms. Pharmacologic therapy is seldom used, although haloperidol has been somewhat effective.
A continuing program of research, which is concerned with identifying brain mechanisms underlying stuttering through an analysis of manual motor control, is described. Clear evidence has been found that the neural mechanisms associated with sequential responding (and, by implication, with speech) are lateralized in stutterers as they are in nonstutterers. Although no gross or general incoordination has been found in motor performance by most stutterers, their left hemisphere mechanisms appear to be inefficient for organizing and initiating new sequences of responses and vulnerable to interference from other neural activities. Results of research on bimanual coordination in stutterers are consistent with a model that attributes the interference, in part, to interhemispheric processes, possibly involving the supplementary motor area. One implication of the research is that the disfluency of stuttering is only one manifestation of a more general disfunction in motor and cognitive organization and planning.
Recently it has been suggested that speech and manual timing tasks share a common central process (Franz, Zelaznik, & Smith, 1992): Because stuttering is thought to be related to deficits in motoric processes such as timing, stutterers (n = 15) were compared with a set of age-, education-, and sex-matched nonstutterers on timing and isometric force-production tasks. In the timing tasks, subjects flexed and extended the right index finger at the metacarpophalangeal joint at cycle durations of 600, 500, 400, 300, and 200 ms. In the force-production tasks, subjects generated isometric forces to match target force levels displayed on a cathode-ray tube (CRT) screen. There were five levels of force, ranging from.11 to 7.85 newtons. Overall, there were no differences in timing and force-production performance between stutterers and nonstutterers. These results are similar to those obtained recently by Hulstijn, Summers, van Lieshout, and Peters (1992). We suggest that stuttering is not characterized by a general deficit in rhythmic timing. Instead, the motor deficit associated with stuttering should be viewed as speech specific.
Paramyxoviruses cotranscriptionally edit their P gene mRNAs by expanding the number of Gs of a conserved AnGn run. Different viruses insert different distributions of guanylates, e.g., Sendai virus inserts a single G, whereas parainfluenza virus type 3 inserts one to six Gs. The sequences conserved at the editing site, as well as the experimental evidence, suggest that the insertions occur by a stuttering process, i.e., by pseudotemplated transcription. The number of times the polymerase "stutters" at the editing site before continuing strictly templated elongation is directed by a cis-acting sequence found upstream of the insertions. We have examined the stuttering process during natural virus infections by constructing recombinant Sendai viruses with mutations in their cis-acting sequences. We found that the template stutter site is precisely determined (C1052) and that a relatively short region (approximately 6 nucleotides) just upstream of the AnGn run can modulate the overall frequency of mRNA editing as well as the distribution of the nucleotide insertions. The positions more proximal to the 5' AnGn run are the most important in this respect. We also provide evidence that the stability of the mRNA/template hybrid plays a determining role in the overall frequency and range of mRNA editing. When the template U run is extended all the way to the stutter site, adenylates rather than guanylates are added at the editing site and their distribution begins to resemble the polyadenylation associated with mRNA 3' end formation by the viral polymerase. Our data suggest how paramyxovirus mRNA editing and polyadenylation are related mechanistically and how editing sites may have evolved from poly(A)-termination sites or vice versa.
Past studies have shown that stuttering is eliminated when speech is synchronized with a metronomic beat, but the speech sounds artificial. The present study investigated the effect of increasing the duration of these individual stimulus beats with the stimulus-off period constant at 1 sec. When subjects were instructed to speak during the stimulus-on period, stuttering was an inverse function of stimulus duration, indicating that the known metronome effect on stuttering is one point on a continuum of effective rhythm procedures. The "naturalness" of speech increased as the stimulus duration increased up to durations of about 2 sec, and then decreased. At optimal values, stuttering was greatly reduced and naturalness and rapidity of speech were retained. These optimal values effectively controlled stuttering in a field test that used two types of specially designed portable instruments, one of which produced a tactual stimulus and the other an auditory stimulus.
INTRODUCTION: This study investigates the impact of anodal transcranial direct current stimulation (tDCS) on non-speech sequential motor practice in adults who stutter (AWS), compared to non-stuttering controls (ANS). Recent research has explored the effects of tDCS on speech fluency in stuttering. However, its effect on non-speech motor tasks has not yet been studied. METHODS: 20 AWS and 30 ANS right-handed participants were randomly assigned to anodal or sham tDCS conditions, performing a sequential finger tapping task. We targeted over the right primary motor cortex, stimulating at 2 mA for 20 min. Sequence duration and reaction time were analyzed. RESULTS: AWS analysis revealed that the anodal condition had significantly slower reaction times in the second half of the task compared to sham. For sequence durations, AWS in the anodal condition had slower overall sequence durations than the sham condition. However, there were no block-by-block differences in sequence duration. When comparing AWS and ANS, no significant differences were observed for sequence duration. However, there were significant differences in reaction time between AWS and ANS, specifically in earlier blocks. Additionally, there was no significant Group × Condition interaction. DISCUSSION: The findings suggest that anodal stimulation impeded finger sequencing in AWS, showing overall slower sequence durations and a diminishing effect on reaction times in the second half of the experiment, suggesting anodal tDCS may interact uniquely with the neural mechanisms in stuttering. Future studies should explore the effects of anodal tDCS on non-speech motor tasks to gain a broader understanding of its impact on motor control and motor learning.
Stuttering is a broad behavioral phenotype with an adult prevalence of 0.7-1.0%. Family, twin, and segregation studies all indicate that stuttering has a large genetic component to its etiology. The relatively simple phenotype, the early onset, and the apparent rarity of phenocopies of adult stuttering all make stuttering a promising model for the study of the genetics of broad behavioral phenotypes.
Developmental stuttering (DS) may be related to the extrapyramidal motor system and shares many clinical similarities with Tourette's syndrome (TS), which is widely believed to be associated with extrapyramidal dysfunction. Twenty-two stutterers were examined for neuropsychiatric features commonly seen in TS, including tics, obsessive-compulsive behaviors (OCB), and attention deficit disorders. Eleven stutterers displayed motor tics, and symptoms of OCB were observed at rates similar to those seen in persons with TS. Few stutterers demonstrated significant attentional deficits. Findings are consistent with models suggesting extrapyramidal involvement in DS and raise the possibility that DS and TS are pathogenetically related.
According to reports in the literature and our own observations, which are reported in this paper, acquired stuttering may occur in conjunction with focal or diffuse damage to the central nervous system. When the lesion is focal, it may be in the right or in the left hemisphere. When the left hemisphere is injured, acquired stuttering may be concomitant with aphasia. Indeed, in some cases the stutter-like repetitions appear to be an integral part of the aphasic syndrome. In other cases, on the contrary, the two disorders seem to be relatively independent of one another. Occasionally, stuttering is the only observable disorder in the linguistic-cognitive sphere.
Stuttering is often viewed as a problem in coordinating the movements of different muscle systems involved in speech production. From this perspective, it is logical that efforts be made to quantify and compare the strength of neural coupling between muscle systems in persons who stutter (PS) and those who do not stutter (NS). This problem was addressed by correlating the speeds of different orofacial structures with vowel fundamental frequency (F0) and intensity as subjects produced fluent repetitions of a simple nonsense phrase at habitual, high, and low intensity levels. It is assumed that resulting correlations indirectly reflect the strength of neural coupling between particular orofacial structures and the respiratory-laryngeal system. An electromagnetic system was employed to record movements of the upper lip, lower lip, tongue, and jaw in 43 NS and 39 PS. The acoustic speech signal was recorded and used to obtain measures of vowel F0 and intensity. For each subject, correlation measures were obtained relating peak orofacial speeds to F0 and intensity. Correlations were significantly reduced in PS compared to NS for the lower lip and tongue, although the magnitude of these group differences covaried with the correlation levels relating F0 and intensity. It is suggested that the group difference in correlation pattern reflects a reduced strength of neural coupling of the lower lip and tongue systems to the respiratory-laryngeal system in PS. Consideration is given to how this may contribute to temporal discoordination and stuttering.
INTRODUCTION: A wide range of pathologies can cause cerebellar dysfunction but there have been few reports of transient dysfunction after mild head injury. There are none describing stuttering as an acute symptom after such injuries. CASE REPORT: We report a 12-year-old boy who presented with headache, stuttering speech and truncal and bilateral peripheral cerebellar dysfunction after falling prone from his skateboard. Computed tomographic brain imaging showed normal results. All clinical symptoms and signs had resolved within 24 h obviating further investigation. A follow up clinical interview and examination 4 weeks later revealed no recurrence of cerebellar or speech dysfunction. CONCLUSION: This is the first reported case of acute transient cerebellar dysfunction and stuttering after mild closed head injury. Neurogenic causes for stuttering are increasingly being recognised.
The regulated-breathing method appears to be one of the most promising techniques for the treatment of stuttering in adults. In the original experiment reported by Azrin and Nunn (1974), only two children were included. The present experiment was conducted in order to evaluate the efficacy of this therapeutic method with and without direct parental assistance. Twenty-one stuttering children were assigned to two treatment groups and one control group. The first group received the regulated-breathing treatment package, the second group was treated by their parents, trained to apply the regulated-breathing method, and the third group was a waiting-list control group. Obtrusive and unobtrusive measures of speech were recorded. At one month follow-up, although the frequency of stuttering in the two treatment groups was not statistically less than the results obtained by the control group, a 50% decrease occurred from baseline to follow-up periods. On the other hand, the control group showed an increase of stuttering of about 20%. Such results are discussed in relation to those reported by Azrin and Nunn and ways to improve the efficacy of the regulated-breathing method are suggested.
Two student groups, one of speech pathology majors and one a class of mixed background fulfilling a humanities requirement, listened to the same set of sentences spoken first in nonstuttered and then in stuttered form. Subjects rated each replication along a set of 114 semantic differential-type adjectives but on 10-point unipolar scales. These scales had previously been factor analyzed and represented 31 positive and 29 negative perceptual factors. The results indicate that all college students react favorably to stuttered speech. However, six factor differences significant at the 0.05 level or above emerged between the two groups when evaluating the stuttered version. These results suggest that pathology students do not perceive stuttered speech as do nonpathology students; they are more favorably disposed on every dimemsion.