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PubMed2002

Measuring lexical diversity in children who stutter: application of vocd.

UNLABELLED: There is growing but equivocal evidence that the language abilities of young children who stutter (CWS) may be depressed when compared to those of their fluent peers. In particular, the lexical skills of CWS have variously been reported to be weaker or stronger than comparison children in a number of recent studies. One source for such disagreement may be the measures used to compute lexical characteristics of these children's spoken conversations. In this study, we examined the concurrent validity of two measures of lexical diversity in spontaneous language samples, Type-Token Ratio (TTR) and the newly developed utility vocd (Malvern & Richards, 1997), using a standard test of expressive vocabulary as the comparison measure. Findings indicated that vocd values ("D") correlated well with standardized measures of expressive vocabulary, while TTR values did not. In addition, both the standardized measure and vocd revealed significantly poorer expressive lexical skills of CWS, whereas TTR analyses did not evidence this difference. Results are discussed in relation to the relative strength of vocd over TTR as a method for describing lexical characteristics of the spontaneous language samples of this population. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to (1) identify several common measures of conversational vocabulary and the strengths and weaknesses of each, and (2) compare the performance of the young CWS in this study to their normally fluent peers in terms of vocabulary performance on both formal and conversational measures of vocabulary.

Algorithms↗
PubMed2002

Statistical power in stuttering research: a tutorial.

The capacity to make reliable inductive statements about populations is critical for the advancement of scientific knowledge. An important contribution to that advancement of knowledge is determining that effects are either present or not present in populations. Statistical power is an important methodological qualification for any research that presents statistical results, and particularly so for research that presents null results. In this paper we describe the statistical concept of power, outline parameters of research that influence it, and demonstrate how it is calculated. With reference to selected published research, attention is drawn to the problems associated with a body of underpowered research, one being that population effects may go undetected. One way to prevent this problem is to calculate power a priori in planning research and include confidence intervals when presenting the results of research. However, it is difficult, if not impossible in many cases, to obtain high participant numbers for communication disorders of low prevalence such as stuttering. With this in mind, the paper concludes with an attempt to open discussion about ways to redress the problems associated with statistical power.

Humans↗
PubMed2003

Generalizability Theory II: Application to perceptual scaling of speech naturalness in adults who stutter.

Generalizability theory has been recommended as the most comprehensive method for assessing the reliability of observational data. It provides a framework for calculating the various sources of measurement error and allows further design of measurements for a particular purpose. This paper gives a practical illustration of how this method may be used in the analysis of observational data. We use the ratings of 15 unsophisticated raters using the 9-point speech naturalness scale of R. R. Martin, S. K. Haroldson, and K. A. Triden (1984) to evaluate the speech of adults before and after treatment for stuttering. We calculate various sources of measurement error and use these to estimate the minimum number of raters and ratings per rater for a reliable result. For posttreatment data, the average of three independent raters, and for pretreatment data, the average of five independent raters should give a result within one scale point of the hypothetical true score for the speaker in at least 80% of samples. The example illustrates the advantages of using this method of analysis.

Adult↗
PubMed2003

Atypical syntactic processing in individuals who stutter: evidence from event-related brain potentials and behavioral measures.

Syntactic processing was explored in individuals who stutter (IWS). Grammaticality judgments and event-related brain potentials (ERPs) were obtained while participants read sentences, half containing verb-agreement violations. Grammaticality judgments for an offline verb-agreement task did not differ between IWS and normal speakers (NS). However, judgment accuracy of IWS for the online task was lower than that of NS, particularly for verb-agreement violations that occurred in longer and more syntactically complex sentences. Further, while NS exhibited a classic P600 ERP response to verb-agreement violations, the P600s of IWS were reduced in amplitude and distribution. The behavioral and ERP results are consistent with the hypothesis that underlying mechanisms mediating language processing, including those related to postlexical syntactic reanalysis, may operate atypically in IWS even in the absence of speech production demands.

Adult↗
PubMed1975

Onset, prevalence, and recovery from stuttering.

A critical review of research and opinion concerning age of onset, prevalence, and recovery from stuttering indicates some inconsistency among findings: the reported recovery rates may be too high, although all data sources had limitations.

Adolescent↗
PubMed1975

A biofeedback treatment for stuttering.

Auditory feedback of laryngeal muscle tension was found to reduce stuttering dramatically in an exploratory study of a single patient. Amplitude of EMG signals was similarly reduced. Apparently, the therapeutic effect of biofeedback cannot be attributed to masking, distraction, or suggestion.

Adult↗
PubMed1982

Stuttering: the results of 5 days treatment with an airflow technique.

Brief treatments for stuttering would be available if they could produce long term benefits. Six clients were given training in a variant of an airflow technique. Treatment required eight hours of clinician time per client. Significant improvement occurred after four days of treatment, but relapse was considerable and by the end of the year speech was unimproved in respect to pretreatment scores. Presently, proven effective treatments require 30 hours of clinician time per client and shorter treatments do not appear to produce comparable results.

Adult↗
PubMed1983

Assessment of oral-motor reflexes in stutterers and normal speakers: preliminary observations.

Reflex responses of nine stutterers and nine normal speakers to low-level tactile and auditory stimuli were measured as changes in isometric molar biting force and masseter muscle activity. Tactile stimuli (mechanical displacement of the tissue) were applied to five intraoral and perioral sites. The acoustic stimulus was noise gated on for 12 msec. These low-level stimuli significantly modulated jaw-closing force and muscle activity in most of the subjects tested. In general, the initial effect of both auditory and tactile stimuli was suppression, although the initial response was excitation in some subjects with some forms of tactile stimulation. Within both groups of subjects, the amplitude and direction of reflex responses, particularly to mechanical stimuli, were highly variable between subjects, but these measures were stable within an individual over repeated tests.

Adult↗
PubMed1988

Response contingent stimuli and stuttering: issues and implications.

The first papers concerning effects of response contingent stimuli (RCS) on stuttering and speech disfluency were published approximately 30 years ago. Research in this area fluorished until about 1980 after which relatively few studies have been reported. Reasons for the decline in interest are not altogether clear because crucial issues remain unresolved. This paper highlights and evaluates these issues and considers their implications for future research.

Behavior Therapy↗
PubMed1991

Thalamic-induced stuttering (surgical observations).

Repetitive dysfluencies of speech were elicited by mechanical perturbation of the thalamus in a patient, preparatory to therapeutic lesion placement for chronic pain. Perturbation consisted of a 2 mm advancement of a 1 mm diameter electrode in the posteroventromedial thalamus. A thalamogram revealed electropathologic discharges at the site of perturbation. These findings are of special interest anatomically because in other patients, electrical stimulation at the same site was found to alleviate stuttering (Andy, 1987; Andy, 1989; Andy & Jurko, 1985; Bhatnagar & Andy, 1989). It is suggested that dysfluencies in this patient may have resulted from an electrophysiologic disturbance of the mesothalamic component of a speech-regulating corticomesothalamic feedback circuit.

Adult↗
PubMed1992

Measurable outcomes of instructions to modify normal parent-child verbal interactions: implications for indirect stuttering therapy.

This study was a preliminary analysis of the differential effects of instructions to slow maternal speech rate, or to slow and simplify maternal speech when conversing with normally fluent children. Twenty mothers and their normally fluent children participated. Instructions to slow maternal rate resulted in maternal speech simplification as a by-product. No significant differences were found between the effects of the two sets of instructions. Furthermore, children's speech rate and language complexity did not parallel maternal adjustments. These last findings are problematic for some of the premises that underlie the use of parental counseling as a component of indirect therapy for stuttering.

Child, Preschool↗
PubMed1992

Reliability of speech naturalness ratings of stuttered speech during treatment.

This study evaluated the reliability with which relatively sophisticated and unsophisticated judges used a 9-point scale to rate the speech naturalness of speech samples from 10 clients in a treatment program for stuttering that employed prolonged speech. Judges rated repeated speech samples from different speakers during various phases of the program. Different groups of sophisticated and unsophisticated judges made ratings at either 15 sec, 30 sec, or 60 sec intervals while listening to the samples. Of the reliability indices, intraclass correlations were significantly higher for sophisticated judges although the consistency and agreement of unsophisticated judges were generally equivalent to that of sophisticated judges. Both agreement scores and intraclass correlations were higher when ratings were made at 60 sec rather than 30 sec intervals. The predominant variable that influenced judgement reliability appeared to be differences among the subjects. The methodology partially replicated Martin, Haroldson, and Triden's (1984) initial investigation on the use of this scale. However, the levels of intra- or interjudge reliability in this study were lower than the levels achieved by Martin et al.'s judges. There were important differences between the Martin et al. study and this one that may account for the findings, and these are discussed.

Adult↗
PubMed1994

Psychophysical analysis of audiovisual judgments of speech naturalness of nonstutterers and stutterers.

The purpose of this study was to determine through psychophysical comparison of scaling data whether speech naturalness judgments of stutterers and nonstutterers from audiovisual recordings form a prothetic or a metathetic continuum. Comparison of direct magnitude estimation and equal-appearing interval scale data indicated that speech naturalness forms a metathetic continuum when observers judge audiovisual recordings, suggesting that either scaling procedure is valid for the quantification of this dimension. Ease of use, an existing body of comparative data from different clinics, and somewhat better reliability favor the interval scaling procedure.

Humans↗
PubMed1994

Intersyllabic movement timing in the fluent speech of stutterers with different disfluency levels.

The goal of this study was to identify possible differences in movement timing in the fluent speech of adult stutterers who show varying levels of speech disfluency. Strain gauge recordings of lip and jaw movements and electroglottographic recordings of laryngeal vibration were obtained in 31 subjects as they repeated simple speech utterances. Measures of the duration and variability of intersyllablic articulatory events were analyzed in relation to speech disfluency level and history of speech treatment. As expected, movement durations were longer in subjects who had been through speech treatment. No significant associations were observed between timing durations and disfluency level. However, more disfluent subjects tended to show reduced variability in timing durations, an effect that was independent of speech treatment. This finding is interpreted in relation to previous observations on control systems that show instability and disfunction in association with reduced output variability. When disfluency level was measured during physiologic testing, duration interacted with speech treatment, with more disfluent subjects in the treatment group showing increased durations in their fluent speech. This effect is attributed to volitional control intended to facilitate speech fluency.

Adult↗
PubMed1998

Guidelines for documentation of treatment efficacy for young children who stutter.

The pressing need to document treatment efficacy for young children who stutter is discussed. Guidelines for such documentation are suggested and illustrated. Measures for verifying treatment effects in four realms are delineated: (a) conditions of documentation, (b) dependent variables to be measured, (c) establishment of treatment integrity, and (d) verification of the relationship between treatment and outcome. Illustrations of the application of the suggested guidelines are presented for 2 children.

Child, Preschool↗
PubMed2002

A common element in the immediate inducement of effortless, natural-sounding, fluent speech in people who stutter: 'the second speech signal'.

Recent attempts to find a common element in the inducement of fluent speech have focused on Wingate's notion that fluency can be induced via an altered manner of speaking by placing an emphasis on phonation. The problem with this notion of fluency enhancement is that it appears to be too expansive a scheme of fluency. The schemata allows for any forward flowing speech or speech-like act to be considered fluent despite the increased cognitive mediation, the extra effort involved in implementing the procedure, the unnaturalness of the resultant end product, and a lack of stability over time. It is proposed that the only significant characteristics of 'true fluency' are that it is indistinguishable from the typical fluent speech of people who do not stutter, and that it is effortless in nature. This is achieved via the use of a second speech signal which is not cognitive in nature, is operationally delineated, and is easy to manipulate.

Humans↗
PubMed2002

Speech modification approaches to stuttering treatment in schools.

The treatment procedures referred to here as "speech modification" are those that use a known fluency-inducing condition and that have as an explicit goal teaching the client to speak in a manner that will not include stuttering. This paper briefly reviews four subcategories of speech modification approaches for children in the schools: variations on prolonged speech, extended length of utterance approaches, response-contingent approaches, and mixed approaches. Special challenges to be faced by clinicians who would like to use speech modification procedures in the schools are also addressed.

Child↗
PubMed2003

Finding good resources for treating school-age children who stutter.

One of the challenges facing school-based speech-language pathologists is finding appropriate resources for use in treating children who stutter. This article highlights several excellent resources and provides illustrations of how some of these resources may be used. The need to adapt resources for use with specific clients to maximize treatment effectiveness is emphasized.

Child↗