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[Applies phoniatry. III. Stuttering and Cluttering (author's transl)].

Stuttering is caused by many factors, and consequential verbal communication may be abolished partially or even totally. Medical management should not concern itself solely with the speech problem, and the individual problem and behaviour of each patient should be considered. Unlike stuttering, cluttering does not mean poor communication, but again in its treatment, individuality must be considered. Treatment is based on frequent tuition of a slower speech and of control of the impulsive personality traits.

Adolescent↗

[Effect of psycholeptics on several physiologic indices of stutterers].

The report is concerned with the action of single doses of aminazine, seduxen and benzctyzine on the EMG of the orbicular muscle of the mouth, pulse frequency, GSR and EEG during rest and in the process of speech in individuals with stuttering and neurotic disturbances (25 cases) and in early organic lesions (20 cases). The conclusion is made that there is a selective effect of these preparations on the different structures of the functional brain systems in stutterers.

Adolescent↗

[Comparative electroencephalographic studies of stutterers on the basis of neurotic disorders and on the basis of organic lesions of the central nervous system].

The paper contains information regarding EEG registration in stuttering patients from 20-35 years of age. In 55 cases stuttering was found against the background of neurotic disorders, in 39--accompanied by residual signs of organic brain lesions. In the first group there was a tendency towards an acceleration of the rhythms and desynchronization of the EEG activity which reached normal levels during the treatment period. The patients of the second group demonstrated a stable tendency towards a synchronization of activity, slower rhythms with pathological activity of a bilateral--synchronous character and theta-rhythm in the central parietal areas.

Brain↗

[My child stutters! Which speech disorders are to be treated by a specialist?].

The etiology of stuttering is multifactorial. Developmental disturbances in "speech flow" usually clear up within six months. However, inappropriate reactions on the part of the child's surroundings (parents, unqualified physicians), but also psychosocial problems, may consolidate the disorder. Chronic stuttering may, under certain circumstances have far-reaching consequences for communication and social behavior, and even impact negatively on the victim's subsequent occupational life. A qualified diagnostic work-up leading to appropriate early pedaudiological and logopedic therapeutic measures can prevent this negative development.

Child↗

[Acquired stuttering as an early symptom in a patient with progressive supranuclear palsy].

We report a 57-year-old man with progressive supranuclear palsy (PSP) showing acquired stuttering (AS) as an early symptom. He had noticed micrographia at age 48, and thereafter he began to suffer from progressive speech disturbance at age 49. Neurological examination at age 57 revealed prominent acquired stuttering, supranuclear vertical gaze palsy, axial rigidity, disturbance of postural reflex, motor perseveration, and catalepsy, but no aphasia. A brain MRI study demonstrated atrophy of the midbrain tegmentum and dilatation of the third ventricle with a few lacunar infarcts in the basal ganglia. Anti-parkinsonian drugs were ineffective. We diagnosed his illness as PSP. His speech was characterized by repetition of sounds and syllables. It was more dominant at repetition of sentences than at that of words, and was improved with rhythmic stimulation. Although pathophysiology underlying AS remains unknown, the AS in this patient seems to be closely related to his motor perseveration and catalepsy. These symptoms may be caused by the disturbance of dopaminergic system from midbrain to limbic system and frontal cortex as reported in PSP. In conclusion, As can be an early and prominent symptom which may be related to characteristic impairment of the dopaminergic system.

Catalepsy↗

[Echo reading and stuttering].

Echo-reading is a practical therapeutic tool which has been proposed for use in stuttering, most especially when the functions of rhythm and association are disrupted in stuttered speech. After a period of preparation in which the mechanical work involved in speech is integrated, it is proposed that there should follow a period of listening and association, which serves to re-establish the spoken word with its meaning and expressivity. The subject undergoes rehabilitation in a living language which is correlated with the imagination, and with that Other quality which always forms a part of speech.

Association Learning↗

[The formation of interhemispheric asymmetry in human ontogeny during the perception of emotions in normal speech and in stuttering].

Age peculiarities of functional brain asymmetry in perception of emotional information of speech have been revealed. It was shown that the age of 4-7 years is most important for formation of this asymmetry in emotional perception. It is in this age that functional reorganization of perception in stuttering children is observed. These data indicate that correction of emotional activity in stutterers should be made at early periods of their life.

Aging↗

[Plan of therapy and rehabilitation in stuttering patients].

The aim of the paper is to present the program of therapy and rehabilitation in stuttering patients based of the digital speech aid. The device has been applied to 130 patients aged 6-47 y.o. 85% of the patients had statistically significant instant improvement of speech fluency after application of digital speech aid. After completing diagnostic process, the patients were enrolled for the rehabilitation program which comprised of training with the use of speech aid, speech therapy, psychotherapy, audio-psycho-linguistic stimulation with the use of the Tomatis Method, physiotherapy, relaxation exercises, phoniatric rehabilitation and medical therapy. After 6 months of therapy and rehabilitation a statistically significant improvement of speech fluency was found in 124 patients, i.e. in 96%. The therapeutic programme based on the use of digital speech aid proves effective for majority of stuttering patients.

Adolescent↗

[THe age-related characteristics of interhemispheric asymmetry during the perception of verbal information by stuttering children].

Age peculiarities of functional brain asymmetry in perception of emotional information of the speech have been revealed. It was shown that the age of 4-7 years is the most important period in ontogenesis for the age dynamics of functional brain asymmetry in perception of emotions. It is in this particular age that functional reorganization of perception in stuttering children is observed. The revealed disturbances in functional brain asymmetry indicate that correction of emotional activity in stutterers should be made during early periods of ontogenesis.

Adolescent↗

Neurogenic stuttering as a manifestation of stroke and a mask of dysphonia.

R. L. was a 52-year-old man who was referred for an SLP consultation to determine the nature of his fluency disorder, whether or not treatment would be beneficial, and finally whether resumption of pre-trauma vocational status was feasible. The patient was involved in a motor vehicle accident with no resulting detectable trauma. However, shortly after the accident, R. L. developed a severe dysfluency that was later described as cortical stuttering. We reviewed the medical and rehabilitation work-up that attempted to determine whether the communication disorder was functional or organic in origin. Once the fluency disorder was determined to be caused by a suspected small, focal, hemispheric lesion, a five-month treatment program was undertaken that used a noval prosthetic approach to restore fluency. Once fluency was restored with the use of an artificial larynx, a residual anomia was detected and treated. The case of R. L. illustrates a stuttering that appeared to be caused by a combined neurogenic dyspraxic (vocal control), dysarthric (motor control), and dysnomic (word-finding) dysfluency. The literature on this issue was reviewed and the underlying mechanism of recovery was discussed.

Anomia↗

[A study of simple reaction time to acoustic stimuli in children who stutter].

The authors presented the investigations of the simple reaction time on acoustic stimulation in 50 stuttering and 50 healthy children. The reaction time in stutterers was significantly longer than in normals. The longest time in both groups was in 6, 7, and 8 years old children. In all instances the differences were statistically significant.

Acoustic Stimulation↗

Adult onset stuttering and seizures.

A case is presented in which adult onset stuttering and focal seizures appear to be linked. The EEG showed left anterior and mid-temporal sharp waves. The patient responded well to combined therapy with phenytoin, fluency exercises, and stress reduction. The association between stuttering and seizures in adults and children, as well as treatment with anticonvulsants, are discussed.

Adult↗

The young stuttering child: a problem in management and research.

While many workers believe that parent-child relationships are critical at the time of onset and during the development of stuttering, a review of the literature indicates there is no substantial evidence concerning the attitudes or types of behaviour that are critical. Research is needed to guide the development of more adequate means of managing the young stutterer.

Canada↗

Stuttering: a disorder of movement.

Based on the data and discussion in the two preceding papers a preliminary model for disfluency is proposed. Stuttering is identified as movement patterns associated with perceptually judged disfluencies. It is suggested that the speech structures operate within certain ranges of variability in terms of their movement parameters and interarticulator temporal and spatial relations. This variability may be influenced by emotional, perceptual and/or physiological events. When the "normal" ranges are exceeded, the afferent nerve impulses generated alter the gains of associated brainstem reflexes. Altering of the reflex gains throws the articulatory system out of balance and a breakdown in behavior occurs, often manifested as oscillations or static positioning. The influence of physiological and environmental variables on neuromotor processes leading to these patterns is emphasized. The model suggested has been developed from inferences from movement patterns of the upper articulators. Thus, the patterns discussed involve these structures. It is suggested, however, that an understanding of the many behaviors associated with stuttering will be understood only by analyzing the behavioral and neurophysiological interactions among the respiratory, laryngeal, and supraglottal structures.

Animals↗

An adaptive algorithm for the automatic segmentation of continuous stuttered speech.

This paper presents an adaptive algorithm for the automatic segmentation of continuous speech into voiced, unvoiced, and silence regions (V/U/S). The procedure presented is based on the use of a digital filter bank with control parameters established using formant frequencies of voiced segments of speech. This procedure makes it possible to separate continuous speech into syllable like structures. The use of these speech segments makes possible the determination of stuttered speech. Special care is given to the handling of prolongations and repetitions (audible and silent) to insure they are properly handled by the segmenting algorithm. Segmentation experiments have been conducted on male and female subjects to test the reliability of the system at segmenting fluent and stuttered continuous speech.

Algorithms↗

Neurogenic stuttering: further corroboration of site of lesion.

Cases of neurogenic stuttering have been reported in the literature throughout the past century. Site(s) of lesion(s) have been documented usually by association of symptoms, EEG studies and occasionally by computed tomography (CT). The authors present three cases in which the site(s) of lesion(s) are documented by CT, magnetic resonance imaging (MRI) and SPECT. This study supports previous findings of neurogenic stuttering following either bilateral diffuse lesions or a unilateral lesion. In at least one case, the actual site of the lesion would have been missed without the use of SPECT testing. EEG studies were not helpful in identifying the site of the lesion.

Adult↗

[Clinical characteristics of the initial period of stuttering in childhood].

The author studied 34 stuttering children from 2,5-3,5 years, where 2 groups were distinguished: with neurotic and pseudoneurotic stuttering. It was established that in these 2 groups there were differences in the psychopathological and speech disorders. There are such forms of the disease where there may be a combination of neurotic as well as pseudoneurotic states. It is being stressed that treatment in the initial period is most effective.

Child, Preschool↗

[Dynamics of neurotic stuttering in preschool age].

The report deals with the clinical picture and dynamics of neurotical stuttering in children of preschool age. The authors studied 65 such patients aged from 3-6 years. Two forms of the disease development were distinguished: benign and unfavourable or protracted. It was possible to detect a connection between speech and neurotic disorders. Factors influencing the unfavourable development of neurotic stuttering were the following: hereditary loading of speech pathology, unfavourable microsocial environment, somatic weakness, expressiveness and stability of neurotic symptoms.

Child↗