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PubMed2004

Results of a genome-wide linkage scan for stuttering.

We performed a linkage study of stuttering using 392 markers distributed across the genome in a series of 68 families identified in the general outbred population of North America and Europe. Standardized diagnosis was performed using recorded samples of both conversation and reading, in which stuttering dysfluencies were scored as percentage of dysfluent words and syllables. Analysis was first performed using non-parametric methods implemented in GENEHUNTER, where we obtained maximum statistical support for markers of chromosome 18, with a maximum NPL (Sall) of 1.51 at D18S976. The single largest pedigree within our sample (pedigree 0006) alone gave an NPL of 4.72 at D18S976. For fine mapping, we analyzed 18 markers on chromosome 18 across all families using ALLEGRO. Overall NPL (Srobdom) scores >5 were obtained with markers on 18p, and Z(lr) scores >/=2.5 on 18p and proximal 18q. Furthermore, pedigree 0006 alone gave an NPL (Srobdom) of 5.35. Overall our results suggest chromosome 18 may harbor a predisposing locus for this disorder, and additional genes may exist.

Chromosome Mapping↗
PubMed1976

Cognitive conditioning therapy in the treatment of stuttering.

A therapy is described in which clients vividly imagine the cognitions that usually trigger their stuttering, and then contingently experience a painful shock. With the cessation of shock, alternate desirable cognitions are imagined that are designed to facilitate fluent speech. A case study illustrating the treatment is presented. Stuttering is compared with addictive behaviors such as smoking, and it is concluded that cognitive commonalities exist among seemingly disparate behaviors. The cognitive conditioning framework provides an integrative model that can be usefully applied in a variety of situations.

Adolescent↗
PubMed1976

Perceptual and acoustic analysis of repetitions in stuttered speech.

This study presents perceptual and acoustic data on a carefully selected set of part-word repetitions from the speech of adult stutters. Results indicated that the schwa vowel was perceived in only 25% of the repetitions, far less than previously indicated. Spectrographic analysis showed that although abnormal consonant duration and C-V formant transitions characterized the initial segment of the stuttered word, the remainder of the word is identical to its identical to its fluently produced counterpart. The results were interpreted to mean that for the type of dysfluency selected, the articulatory breakdown is confined to the initial consonant, and it is likely that abnormal formant transitions from initial consonant to vowel, when present, are due to deviant formation of the consonant rather than to faulty transition dynamics.

Acoustics↗
PubMed1978

Fundamental frequencies in the oral reading behavior of stuttering and nonstuttering male children.

The fundamental frequencies of the voices during oral reading of 12 stuttering and 12 nonstuttering 7-to-12-year-old males matched according to age, height, weight, and race were studied. No statistically significant differences were found between the stutterers and nonstutterers with respect to the mean fundamental frequency, the lowest fundamental frequency, the highest fundamental frequency, and the difference between the lowest and highest fundamental frequency values.

Child↗
PubMed1979

Language performance of stuttering and nonstuttering children.

This study investigated the syntactic and semantic language performance of typically dysfluent nonstuttering children, stuttering children, and highly dysfluent nonstuttering children. The three groups of children did not differ on Developmental Sentence Analysis scores. The stuttering and highly dysfluent nonstuttering children obtained significantly lower receptive vocabulary scores, made significantly more grammatical errors, and obtained significantly higher incorrect response scores on the semantic tasks.

Child↗
PubMed1983

Parameters of the influence of self-initiated time-out from speaking on stuttering.

The influence of two parameters of self-initiated time-out from speaking were investigated with 33 adolescent and adult stutterers. Subjects were assigned at random to one of three conditions which compared experimenter-administered time-out of fixed duration, experimenter-administered time-out of duration determined by the subject, and self-initiated time-out of fixed duration. When given the opportunity to determine time-out duration, subjects chose a relatively brief period. In addition, when given responsibility for self-initiating time-out contingent on stuttering, subjects were significantly less reliable than was the experimenter in administering the procedure. Nevertheless, significant improvements in fluency were observed during all three time-out conditions, and the improvements were comparable across the three conditions.

Behavior Therapy↗
PubMed1995

Effect of single and combined altered auditory feedback on stuttering frequency at two speech rates.

The purpose of this study was to determine if combining delayed auditory feedback (DAF) and frequency altered feedback (FAF) would enhance fluency more than either DAF or FAF alone. Ten stutterers read at normal and fast speech rates under nonaltered auditory feedback (NAF), DAF (i.e., a 50 ms delay), FAF (i.e., a one half octave downward shift), and a combination of DAF and FAF [(COMBO), i.e., a 50 ms delay plus a one half octave downward shift]. Results indicated that stuttering frequency was significantly reduced under all altered auditory conditions at high speech rates relative to the NAF condition. There were, however, no significant differences between the altered auditory feedback conditions (i.e., DAF, FAF, and COMBO). It is suggested that further studies be undertaken to explore the combination of altered auditory feedback conditions, as it may be the case that a floor effect was demonstrated with the singular presentations of DAF and FAF and further improvements in fluency enhancement could not be exhibited in the combined condition. Finally, these findings support the notion that a slowed rate of speech is not necessary for fluency enhancement under conditions of altered auditory feedback.

Adult↗
PubMed1987

Anomalous dominance in sibling stutterers: evidence from CT scan asymmetries, dichotic listening, neuropsychological testing, and handedness.

Two left-handed siblings with developmental stuttering are comprehensively described. The methods of study included speech and language evaluation, neurological and neuropsychological examinations, dichotic listening, auditory evoked responses, electroencephalogram, and CT scan asymmetry measurements. The data from each sibling showed evidence of anomalous cerebral dominance on many of the variables investigated. The CT scan measurements showed atypical asymmetries, especially in the occipital regions. These findings support the theory that stuttering may be related to anomalous cerebral dominance, both on functional as well as structural bases. Implications of anomalous dominance and the resultant effect of hemispheric rivalry on speech fluency are discussed.

Adolescent↗
PubMed1991

On valid and reliable identification of normal disfluencies and stuttering disfluencies: a response to Aram, Meyers, and Ekelman (1990)

Aram, Meyers, and Ekelman (1990, Brain and Language, 38, 105-121) recently reported finding that children with unilateral brain lesions produced more stuttering-type nonfluencies than their neurologically normal peers. However, they did not report inter- or intrajudge agreement for the nonfluency types or for their method of measuring speech rate. The speech rates they reported were also unusually fast. We argue that these problems with Aram et al.'s study imperil both their results and their conclusions regarding developmental stuttering.

Brain Damage, Chronic↗
PubMed1995

A radically new, yet simple, treatment for stuttering.

Stuttering still has no known cause or causes. We hypothesize, on the basis of speech phonation in normal and abnormal cases, that it could be due to developmental incompetence of the velopharyngeal isthmus. With continued cortical imposition of normality on this incompetent isthmus, phonetic aberration, such as stuttering, results. We suggest that palatal rise or a cervical collar be used so as to hyperextend the neck and adequately correct this articulatory deficit.

Child↗
PubMed2005

Evidence-based practice in stuttering: Some questions to consider.

UNLABELLED: A recent forum in JFD (28/3, 2003) evaluated the status of evidence-based practice in fluency disorders, and offered recommendations for improvement. This article re-evaluates the level of support available for some popular approaches to stuttering therapy and questions the relative value placed on some types of programs endorsed by the forum. Evidence-based practice is discussed within the context of emerging concerns over its application to non-medical interventions and suggestions are made for grounding fluency interventions by reference to empirically supported principles of change. A popular, evidence-based intervention for stuttering in young children (the Lidcombe program) is evaluated within the suggested parameters. EDUCATIONAL OBJECTIVES: After reading this article, the reader will be able to: (1) evaluate the status of evidence-based practice in fluency disorders; (2) list concerns about the impact of narrow interpretation of EBP on research and practice in the field of fluency disorders and other non-medical domains; (3) articulate the role of theory and basic research in selecting among and evaluating therapy approach options.

Evidence-Based Medicine↗
PubMed2005

Treatment with medications affecting dopaminergic and serotonergic mechanisms: effects on fluency and anxiety in persons who stutter.

UNLABELLED: Medications with dopamine antagonist properties, such as haloperidol, and those with serotonin reuptake inhibitor properties, such as clomipramine, have been shown to improve fluency. To examine the degree to which each of these two pharmacological mechanisms might independently affect fluency, a selective serotonin reuptake inhibitor, paroxetine, and a selective dopamine (D-2) antagonist, pimozide, were evaluated. Both types of medications also affect mood and anxiety, factors that could influence fluency levels. Therefore, we also evaluated the medications' effects on generalized and speech-related anxiety and the relationships between changes in anxiety and changes in fluency in 11 subjects with a history of developmental stuttering. The randomized, double blind, placebo-controlled crossover study that was designed had to be terminated prior to completion due to severe side effects following withdrawal from paroxetine. Even with a reduced sample size (n=6), significant improvement in percent fluent speaking time (p=0.02) was found using a telephone task between baseline and pimozide (n=6), with average duration of dysfluencies significantly shorter (p=0.04) but no significant difference in the estimated number of dysfluencies per minute. This significant improvement was associated with non-significant increases in generalized anxiety, but non-significant decreases in speech-related anxiety. No significant differences were found in fluency between baseline and paroxetine (n=5). These preliminary results suggest that fluency improvement is more likely to be mediated by dopaminergic rather than serotonergic mechanisms. Due to its side effects, however, pimozide may be considered a risk for treatment of stuttering. EDUCATIONAL OBJECTIVES: As a result of reading this paper the reader will describe and explain: (1) how medications may affect fluency and the rationale for selecting medications for treatment trials; (2) the interrelationship between fluency and anxiety; and (3) factors important in developing clinical trials using medications.

Adult↗
PubMedDate not supplied

Preliminary information on stuttering characteristics contrasted between African American and white children.

There is a lack of studies looking at variation of behavioral stuttering among various cultures. This study compared verbal disfluency and accessory characteristics of 15 African American and 15 White male stutterers between the ages of 8 and 12. In addition to a speaking attitude scale for each of the subjects, conversational and reading samples were gathered. Good intra- and inter-judge reliability was found in assessing the various tasks. Overall results revealed no statistically significant differences in verbal or visual disfluency behaviors on either the reading or conversation tasks between the African American and White groups of children. In addition, no differences in attitudes toward speaking situations was found between the two groups of children. Implications for the diagnosis and treatment of disfluent African American elementary school aged children are discussed. Specific suggestions are made for additional disfluency research with African American children.

Black or African American↗
PubMed2002

Recasts in parents' language to their school-age children who stutter: a preliminary study.

UNLABELLED: Language samples collected from 13 school-age children diagnosed as stutterers (CWS) in conversation with a parent and a similar corpus of data collected from a matched control group of 13 normally-fluent children (CWNS) were analyzed for the quality and quantity of recast usage in the parents' language. Recasts, a frequently studied type of child-directed language (CDL) pattern hypothesized to increase the length and complexity of young children's expressive language, have not been studied typically in older children's conversations with parents nor have they been studied in the CDL of parents of CWS. Comparisons of these samples revealed that both groups of parents were frequent users of imitations, as well as simple and complex type recasts. Indeed, the rank order of recast types used was identical for the two groups of caregivers. When parents' conversations with the CWS were analyzed further, it was noted that they were not more likely to focus on stuttered utterances as the utterances on which to base their recasts (i.e., "platform utterances") than on the child's fluently-produced utterances. These results suggest there is one additional conversation parameter for which there are evident similarities in the CDL used by parents of CWS and CWNS. Clinical implications gleaned from this preliminary study are discussed, as are suggestions for future study. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to describe (1) the role of recasts in young children's language development; (2) the types of recasts that were observed in the conversations of parents of CWS and CWNS; and (3) the similarities observed in the recasts produced by parents of CWS and CWNS.

Child↗
PubMed2003

Evidence-based treatment of stuttering: III. Evidence-based practice in a clinical setting.

UNLABELLED: At the heart of evidence-based practice in stuttering treatment are four issues: (1) the collection of data to inform treatment; (2) the long standing concern with maintenance of treatment gains; (3) the need to demonstrate accountability to clients, payers and our profession as service providers; and (4) the desire to advance theoretical knowledge. This article addresses the first three of these issues from a practical point of view, illustrating how data collection for stuttering treatment outcome research in a clinical setting is intimately blended with that required for clinical purposes and providing an example of a process of evaluating data for clinical and research purposes. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to (1) differentiate between treatment outcome and treatment efficacy research, (2) describe models for integrating data collection for treatment outcome and clinical purposes, and (3) utilize guidelines for treatment efficacy that are applicable to outcome research to evaluate data for use in treatment outcome studies and to design outcome studies.

Data Collection↗
PubMed2003

Evidence-based treatment of stuttering: IV. Empowerment through evidence-based treatment practices.

UNLABELLED: Assertion-based treatments for stuttering have historically been more popular than evidence-based treatments. In this paper it is argued that the use of evidence-based treatments for stuttering is professionally empowering for clinicians, but that the use of assertion-based treatments is a circular process that inhibits professional development. The arguments in favor of evidence-based treatment are elaborated under headings of "professional investment," "professional development and diversity," and "optimizing treatment efficacy." EDUCATIONAL OBJECTIVES: The reader will understand and be able (1) to describe the distinction between assertion-based and evidence-based treatment practices (2) to present a series of arguments that evidence-based treatment practices are professionally empowering.

Evidence-Based Medicine↗
PubMed2001

Stuttering in history and culture.

The phenomenon of stuttering from Biblical times is covered from a historical and cultural point of view. Theories of its origin and the methods by which it was treated in former times including the surgical procedures of the 18th and 19th century are examined. Since the Renaissance, examples of stutterers in the performing arts have been found.

Attitude to Health↗
PubMed1999

[Management of stuttering in children].

This paper presents definition and characteristics of appearance, psychological consequences, risk factors, differential diagnosis, and management of stuttering in children. Stuttering requires early recognition and management in order to prevent the consequences of secondary psychological disturbances. Management associating speech and behavioral therapies must be entrusted to expert specialists.

Child↗