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PubMed1987

Surface EMG recording of the perioral reflexes: preliminary observations on stutterers and nonstutterers.

The capability to record muscle-specific reflexes in the perioral muscles with surface electrodes could have practical significance for the study of speech production disorders. In the present study, surface electrodes were used to describe the perioral reflexes in 7 stutterers and 5 nonstutterers. Electromyographic (EMG) recordings were obtained at electrode sites associated with the orbicularis oris inferior muscle (OOI) and depressor labii inferior muscle (DLI) during lower-lip press and depression gestures. During postural maintenance of these gestures, innocuous mechanical stimuli were applied at the corner of the mouth. Signal averages on the two EMG signals for the two gestures and electrode sites revealed four distinct reflex response components: two excitatory (E1 and E2) and two suppression components (S1 and S2). During lip pressing, the OOI electrode site showed a prominent E1 response in all subjects, and, during lip depression, the DLI site showed an initial S1-E2 response pattern in the nonstutterers. These observations are consistent with previous descriptions of the perioral reflexes involving intramuscular electrodes. Quantitative differences in the perioral reflexes were not seen in the stutterers and nonstutterers. However, a difference was noted in the pattern of reflex response between the two groups during lip depression at the DLI electrode site.

Adult↗
PubMed1988

Clustering of disfluencies in the speech of stuttering and nonstuttering preschool children.

Cluster formation in speech disfluencies of 15 preschool stuttering children and an equal number of nonstuttering control subjects was studied and compared. Clustering was defined as the occurrence of two or more disfluencies on the same or adjacent words. A computer program, based on the Monte Carlo method, was used to generate sets of expected numbers of single disfluencies and disfluencies in various cluster sizes according to simulation models. Results indicate that disfluencies occurred in clusters more often than could have been expected by chance for both groups. The proportions of clustered disfluencies, as well as the size of clusters, in the speech of the stutterers were significantly greater than those of the nonstuttering subjects.

Child, Preschool↗
PubMed1988

Stutterers' and nonstutterers' voice fundamental frequency changes in response to auditory stimuli.

An acoustic analysis of certain aspects of voice fundamental frequency (Fo) in response to auditory clicks may provide a tool for studying short-latency auditory-laryngeal reflexes in humans (Sapir, McClean, & Larson, 1983). The purpose of this investigation was to compare 18 adult male stutterers' and 19 adult male nonstutterers' auditory-laryngeal reflexes. Subjects sustained phonation at constant pitch and intensity levels while receiving bilateral auditory click stimuli. Fo signal averages were generated and measured. Data analyses indicated that there were no differences between stutterers and nonstutterers with respect to the frequency of reflex occurrence. Also, there were no significant group differences with respect to the mean reflex temporal measures or the variability of the reflex temporal measures.

Acoustic Stimulation↗
PubMed1989

A comparative investigation of the laryngeal premotor, adjustment, and reaction times of stutterers and nonstutterers.

The laryngeal premotor, adjustment, and reaction times of 24 stutterers and 24 nonstutterers were assessed by means of a group (2) by stimulus modality (3) by stimulus order (6) factorial investigation. The laryngeal measures were determined from print outs made from electroglottographic recordings taken during the production of [a] that was cued by a visual, auditory, or somato-sensory stimulus. The results revealed that the laryngeal reaction times of stutterers were significantly longer than those of the nonstutterers. Moreover, the reaction times were significantly longer both during the laryngeal premotor and adjustment time periods. The observed between-group difference for each of these laryngeal measures was independent of the stimulus that was employed.

Adolescent↗
PubMed1990

Acoustical durations of speech segments during stuttering adaptation.

Acoustical durations of stutter- and disfluency-free speech segments from Readings #1 and #5 in an adaptation series were measured in 4 adapting, 4 nonadapting, and 4 nonstuttering subjects. The segment durations measured were intervocalic interval, stop-gap, voice onset time, and vowel duration. No clear trends in the change of acoustical durations from Reading #1 to Reading #5 distinguished the adapting, nonadapting, or nonstuttering subjects. Moreover, on the basis of speech naturalness judgements, listeners did not differentiate the Reading #1 and #5 phrase segments of subjects with high adaptation versus those with low adaptation scores. From these findings and related literature, adaptation of stuttering, as well as other fluency-inducing conditions, are viewed as circumstances that reduce demands upon central motor-linguistic processes.

Adaptation, Physiological↗
PubMed1991

Magnitude estimation and cross-modal matching of auditory and lingual vibrotactile sensation by normal speakers and stutterers.

The present experiment was a preliminary attempt to employ the psychophysical scaling methods of magnitude estimation and cross-modal matching to investigate suprathreshold auditory and lingual vibrotactile sensation magnitude responses for normal-speaking young adults (N = 20) and young adult stutterers (N = 7). A 1000-Hz binaural auditory stimulus and a 250-Hz lingual vibrotactile stimulus were employed for both procedures. Results indicated that the stutterers tended to use more restricted response ranges than the normal speakers for auditory magnitude scaling, and lower response ranges than the normal speakers for lingual vibrotactile magnitude scaling.

Adolescent↗
PubMed1991

The structure of disfluency behaviors in the speech of adult stutterers.

Throughout the stuttering literature numerous references to a twofold classification of disfluency types are found. However, no rigorous empirical test of that dichotomous classification has been reported in the literature. This investigation was designed to conduct such a test in order to provide an empirical foundation for that distinction. The hypotheses stated that the relationships among disfluency behaviors were consistent with an underlying two-dimensional structure and specified the group of variables (disfluency behaviors) having primary association with each dimension. Instrumentation and procedures permitting reliable identification and coding of nine disfluency behaviors were developed. This observational system was applied to baseline monologues obtained from 180 adult stutterers. Results of factor analyses supported the hypotheses on the two-factor structure and on the disposition of the disfluency variables.

Adult↗
PubMed1992

Psychogenic stuttering of adult onset.

The characteristic features of psychogenic stuttering of adult onset are reviewed and four cases of this disorder are presented. Psychogenic stuttering of adult onset is best classified as a conversion reaction, and tentative criteria for this diagnosis are proposed.

Adult↗
PubMed1992

Disfluencies in the conversations of young children who stutter: some answers about questions.

Parents of children who stutter are often advised to reduce the number of questions they ask their children. Implicit in this advice is the assumption that children who stutter will be more disfluent when answering questions. This study assessed parent-child conversational speech for 8 parent-child pairs to determine the relative amounts of disfluency in the child's responses to questions versus making assertions. Length and complexity of the children's utterances and the frequency of the parents' requests by level of demand were also evaluated. Results suggested that the responses made by the children to their parents' requests were significantly less likely to contain disfluencies than were their assertions. Also, longer and more complex utterances were more likely to contain disfluencies, regardless of their designation as assertions or responses. Parents were shown to favor request types of lower levels of demand in conversations. Requests posed with greater levels of demand were somewhat more likely to yield disfluent responses than were those at a lower demand level.

Child↗
PubMed1994

Evaluating differences between stuttering and nonstuttering speakers: the group difference design.

This paper focuses on some suggested analytical indices to be used in group difference studies, specifically in research comparing stuttering with nonstuttering speakers. The introductory material places the group difference design in an historical context and shows its relationship to underlying conceptualizations of the nature of stuttering. The major portion of the paper addresses the development, interpretation, and application of these analytical indices. Finally, limitations of the group difference design are described.

Acoustic Stimulation↗
PubMed1994

Long-term results of an intensive treatment program for adults and adolescents who stutter.

In order to determine the long-term effects of an intensive treatment program, 17 adult and 25 adolescent stutterers were tested 2 or 3 times during a 12- to 24-month post-intensive treatment phase. The results of this study are intended to augment and supplement the growing body of evidence about the effects of intensive treatment programs on adult and adolescent stutterers. Follow-up measures included surprise phone calls to clients at home/work and a self-administered Speech Performance Questionnaire. Careful training of speech raters was undertaken to ensure high reliability of speech measures. Results from the phone call samples indicated that about 69% of the subjects maintained a satisfactory level of post-treatment fluency, with an additional 7% maintaining a level that was judged to be marginally satisfactory. On the self-administered Questionnaire, 80% of the subjects rated their speech fluency as good or fair 12 to 24 months after treatment.

Adolescent↗
PubMed1995

Programmed stuttering treatment for children: comparison of two establishment programs through transfer, maintenance, and follow-up.

Two different Establishment programs, Delayed Auditory Feedback (DAF) and Gradual increase in Length and Complexity of Utterance (GILCU), for improving the fluency of school-age children who stutter, were compared. The programs were carried out by 12 clinicians under supervision with 24 clients (12 elementary and 12 junior/senior high school) in the schools. Both programs produced important improvement in fluency in 23/24 (96%) of the children in a reasonable time period (7.9 hours). Generally, the two programs were similar in performance. The only difference (between GILCU and DAF) was that the GILCU program provided initially for better generalization of fluency. Transfer and Maintenance programs (10.4 hours) demonstrated that the children from the two Establishment programs performed in a similar manner and that the Transfer and Maintenance Programs were helpful. In a total of 18.3 hours of establishment, transfer, and maintenance treatment, 11 subjects, who completed the programs, reduced their stuttering from 7.9 SW/M to .8 SW/M at a 14-month follow-up showing that the children had maintained their fluency. Clinicians' performances contributed to the effectiveness and efficiency of the programs.

Adolescent↗
PubMed1995

Perceptual rating instrument for speech evaluation of stuttering treatment.

A rating instrument is described that can be used to assess the results of stuttering treatments. The instrument is designed for use with naive listeners. It yields a comprehensive and detailed description of the speech quality in terms of articulation, phonation, pitch, and loudness; in addition, it includes a naturalness scale. Analysis of ratings obtained with the instrument show that naturalness is a multidimensional characteristic. Moreover, the speech characteristics that determine the naturalness ratings appear to be different pretreatment, posttreatment, and at follow-up treatment. The psychometric characteristics of the instrument are analyzed in detail. It is concluded that mixing of samples of stutterers and nonstutterers in one rating experiment may artificially inflate the reliability of the ratings. Also, ratings on equal-appearing interval scales cannot be interpreted in an absolute sense. Solutions for this methodological problem are suggested.

Adolescent↗
PubMed1995

Fluency changes in persons who stutter following a double blind trial of clomipramine and desipramine.

This study compared fluency changes in adult developmental stuttering speakers treated with two tricyclic antidepressants, clomipramine and desipramine. Clomipramine is primarily a serotonergic reuptake inhibitor, and desipramine, primarily a noradrenergic reuptake inhibitor. Sixteen subjects who stuttered participated in a single-blind placebo, double-blind active drug crossover study lasting 12 weeks. Speech rate and percent fluency did not significantly improve in placebo compared to baseline. Speech rate significantly increased while repeating, reading or constructing sentences, and during a telephone conversation, but no significant changes in percent fluency were found under clomipramine compared to placebo. Speech rate during a telephone conversation and percent fluency while speaking in front of an audience of four to seven listeners significantly increased under clomipramine compared to desipramine. No significant improvements in percent fluency or speech rate were found for any speaking task under desipramine compared to placebo. Twelve of 16 subjects reported improved fluency compared to baseline using clomipramine, whereas 6 reported improvement using desipramine. Because more evidence of improvement was found under clomipramine compared to desipramine, fluency improvement may be related to clomipramine's greater selectivity for serotonergic reuptake inhibition.

Adolescent↗
PubMed1996

Pre- and posttreatment comparison of the kinematics of the fluent speech of persons who stutter.

This study reports changes in acoustic, respiratory, laryngeal, and articulatory kinematics of 3 males who stutter, following participation in a version of the Hollins Precision Fluency Shaping Program. Two nonstuttering controls received no treatment. Subjects repeated phrases of the form "He see CVC again" at self-selected slow, normal, and fast speaking rates. For experimental subjects, acoustic duration of the phrases increased significantly in 7 out of 9 comparisons of before- and after-treatment conditions, whereas controls decreased the duration of the phrases in 4 out of 6 comparisons of measurements made over approximately the time interval during which the experimental group received treatment. The experimental group increased inspiratory volume for 7 out of 9 conditions and average expiratory flow significantly for all conditions, whereas the controls decreased both. The experimental group prolonged laryngeal opening in 6 of 7 comparisons, but only 3 of the increases were significant. Lip and jaw movements for consonants were significantly reduced in amplitude for the experimental group for 30 of 36 measures. The direction of change for laryngeal and upper articulator measures was mixed for controls. These results show that behavioral treatment can produce significant changes in the fluent speech of persons who stutter with respect to respiration, laryngeal valving, and articulation. Possible relationships between the observed changes in speech production and the increased fluency of the subjects are discussed.

Adult↗
PubMed1996

Functional-lesion investigation of developmental stuttering with positron emission tomography.

Positron emission tomographic (PET) H2(15)O measurements of resting-state regional cerebral blood flow (CBF) were obtained in 29 right-handed men, 10 of whom stuttered and 19 of whom did not. PET images were analyzed by sampling 74 regions of interest (ROIs), 37 per hemisphere. ROI placement was guided both physiologically and anatomically. Physiological ROI placement was based on speech motor activations. Anatomical ROIs were positioned by reference to a stereotactic, neurosurgical atlas with positions confirmed and finely adjusted by co-registered magnetic-resonance images (MRIs). For all subjects, PET and MR images were normal to visual inspection. Highly significant (p < 0.0001) between-region and between-hemisphere effects were found for both groups, as have been previously reported for normal subjects, but no significant between-group differences were found for any regional CBF values. Analysis by a laterality index found a weakly significant between-groups effect (p = 0.04) that was isolated to five regions, four of which are implicated in speech or hearing. However, these regional laterality effects showed no consistent directionality, nor did these regions have absolute differences in regional blood flow between groups. Present findings do not support recent suggestions that developmental stuttering is associated with abnormalities of brain blood flow at rest. Rather, our findings indicate an essentially normal functional brain terrain with a small number of minor differences in hemispheric symmetry.

Adult↗
PubMed1997

Development of a two-stage procedure for the automatic recognition of dysfluencies in the speech of children who stutter: I. Psychometric procedures appropriate for selection of training material for lexical dysfluency classifiers.

This program of work is intended to develop automatic recognition procedures to locate and assess stuttered dysfluencies. This and the following article together, develop and test recognizers for repetitions and prolongations. The automatic recognizers classify the speech in two stages: In the first, the speech is segmented, and, in the second, the segments are categorized. The units that are segmented are words. Here assessments by human judges on the speech of 12 children who stutter are described using a corresponding procedure. The accuracy of word boundary placement across judges, categorization of the words as fluent, repetition or prolongation, and duration of the different fluency categories are reported. These measures allow reliable instances of repetitions and prolongations to be selected for training and assessing the recognizers in the subsequent paper.

Adolescent↗
PubMed1997

P300 event-related potentials in stutterers and nonstutterers.

This study investigated possible differences between adult stutterers and nonstutterers in the P300 event-related potential. Responses to tonal stimuli were recorded from electrodes placed over the left (C3) and righ (C4) hemispheres. The two groups exhibited different patterns of interhemispheric activity. Although all 8 participants in the fluent group exhibited P300s that were higher in amplitude over the right hemisphere, 5 of the 8 disfluent participants had higher amplitude activity over the left hemisphere. These results provide evidence that stutterers and nonstutterers may exhibit differences between hemispheres in the processing of some types of nonlinguistic (tonal) stimuli.

Adolescent↗