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PubMed2006

Anxiety levels in adolescents who stutter.

UNLABELLED: High levels of anxiety can negatively affect the lives of children and adolescents. Thirty-six adolescents who stutter and 36 adolescents who do not stutter were administered standardized scales for anxiety and self-esteem. Significant differences were found for the total T-scores for Revised Children's Manifest Anxiety Scale for the two groups, although both groups mean T-scores were within normal range. Eighty-three percent of adolescents who stutter and 95% of adolescents who do not stutter earned scores in the normal range. No significant differences were found on the self-esteem scale, with 86% of adolescents who stutter and 97% of adolescents who do not stutter earning scores in the normal/positive range. Adolescents who stutter with co-occurring disorders displayed significantly higher levels of anxiety than adolescents who stutter with no co-occurring disorders. No significant differences were found between groups on ethnicity, socioeconomic class, gender and anxiety levels. A positive, significant correlation between anxiety scores and self-esteem scores was found for both groups. LEARNING OUTCOMES: Readers will learn about and understand (a) the role of anxiety and self-esteem in stuttering; (b) the methods used to evaluate anxiety and self-esteem in adolescents; and (c) the similarities between adolescents who stutter and adolescents who do not stutter on anxiety and self-esteem scales.

Adolescent↗
PubMedDate not supplied

Second formant transitions in fluent speech of persistent and recovered preschool children who stutter.

UNLABELLED: This study investigated frequency change and duration of the second formant (F2) transitions in perceptually fluent speech samples recorded close to stuttering onset in preschool age children. Comparisons were made among 10 children known to eventually persist in stuttering, 10 who eventually recovered from stuttering, and 10 normally fluent controls. All were enrolled in the longitudinal Stuttering Research Project at the University of Illinois. Subjects fluently repeated standard experimental sentences. The same 36 perceptually fluent target segments (syllables embedded in words) from each subject's repeated sentences were analyzed. The syllables were divided into three phonetic categories based on their initial consonant: bilabial, alveolar, and velar placement. The frequency change and duration of F2 transitions were analyzed for each of the target CV segments. F2 transition onset and offset frequencies and their interval (duration) were measured for each utterance. Data indicate that near stuttering onset, children whose stuttering eventually persisted demonstrated significantly smaller frequency change than that of the recovered group. It is suggested that the F2 transitions should continue to be investigated as a possible predictor of stuttering pathways. LEARNING OUTCOMES: (1) Readers will learn about studies regarding second formant transition related to stuttering. (2) Readers will learn about differences between children who persist in stuttering and those who recover from stuttering. (3) Readers will learn about research concerned with early identification of risk criteria in persistent stuttering.

Child, Preschool↗
PubMed2004

Brain correlates of stuttering and syllable production: gender comparison and replication.

This article reports a gender replication study of the P. T. Fox et al. (2000) performance correlation analysis of neural systems that distinguish between normal and stuttered speech in adult males. Positron-emission tomographic (PET) images of cerebral blood flow (CBF) were correlated with speech behavior scores obtained during PET imaging for 10 dextral female stuttering speakers and 10 dextral, age- and sex-matched normally fluent controls. Gender comparisons were made between the total number of voxels per region significantly correlated with speech performance (as in P. T. Fox et al., 2000) plus total voxels per region that were significantly correlated with stutter rate and not with syllable rate. Stutter-rate regional correlates were generally right-sided in males, but bilateral in the females. For both sexes the positive regional correlates for stuttering were in right (R) anterior insula and the negative correlates were in R Brodmann area 21/22 and an area within left (L) inferior frontal gyrus. The female stuttering speakers displayed additional positive correlates in L anterior insula and in basal ganglia (L globus pallidus, R caudate), plus extensive right hemisphere negative correlates in the prefrontal area and the limbic and parietal lobes. The male stuttering speakers were distinguished by positive correlates in L medial occipital lobe and R medial cerebellum. Regions that positively correlated with syllable rate (essentially stutter-free speech) in stuttering speakers and controls were very similar for both sexes. The findings strengthen claims that chronic developmental stuttering is functionally related to abnormal speech-motor and auditory region interactions. The gender differences may be related to differences between the genders with respect to susceptibility (males predominate) and recovery from chronic stuttering (females show higher recovery rates during childhood).

Adult↗
PubMed1990

Verbal behaviors of preschool stutterers and conversational partners: observing reciprocal relationships.

Standard counseling practices with the families of young stutterers include recommendations that listeners' negative verbal behaviors be modified in order to reduce the likelihood of stuttering. This study tested the hypothesis that stuttering and normal disfluencies in preschool stutterers are related to selected verbal behaviors in conversational partners. Twelve 2- to 6-year-old stutterers were video recorded while playing with their mother, father, and a familiar peer. The resulting videotapes were transcribed and two types of social communicative analyses (total number of words and utterances, verbal intent of the speaker) were undertaken. Results suggested that fathers used more words and utterances than mothers and peers. Parents provided more positive interactions with their stutterer offspring than did peers. Parents also asked significantly more negative and routine questions when talking to their stuttering child. Peer playmates were significantly more negative and generally commented more frequently when interacting with stutterers than did the parents. Stutterers were involved in significantly more positive interactions with their fathers. The frequency of fluency failures did not differ significantly when stutterers communicated with their mother, father, or peer partners. Implications regarding verbal styles of partners in relationship to the stuttering of preschool children are discussed.

Adult↗
PubMed1994

Interpreting results of the fluent speech paradigm in stuttering research: difficulties in separating cause from effect.

This paper examines difficulties inherent in interpreting results of studies that compare the fluent speech characteristics of stutterers and nonstutterers. The majority of these studies have reported stutterer/nonstutterer differences in temporal parameters of fluent speech production. Such differences have been interpreted as indicating that stutterers possess temporal-motor deficits that are ever-present in speech and, therefore, causal to stuttering. However, a problem for researchers studying the fluent speech of stutterers is that samples may be contaminated by the influence of stuttering. In this paper, evidence is reviewed which suggests that characteristics of the perceptually fluent speech of stutterers change as a function of a number of variables: (a) context of experimental samples, (b) treatment history of subjects, (c) stuttering severity of subjects, and (d) developmental history of stuttering. In addition, evidence is presented which can be interpreted to show that each of these variables reflect stuttering, either directly or indirectly. It is argued that because these variables are difficult to fully control, or account for, comparison of the characteristics of the perceptually fluent speech of stutters and nonstutterers as a method of studying stuttering causation is problematic. Alternative directions for research activity are discussed.

Age Factors↗
PubMed1997

Altered patterns of cerebral activity during speech and language production in developmental stuttering. An H2(15)O positron emission tomography study.

To assess dynamic brain function in adults who had stuttered since childhood, regional cerebral blood flow (rCBF) was measured with H2O and PET during a series of speech and language tasks designed to evoke or attenuate stuttering. Speech samples were acquired simultaneously and quantitatively compared with the PET images. Both hierarchical task contrasts and correlational analyses (rCBF versus weighted measures of dysfluency) were performed. rCBF patterns in stuttering subjects differed markedly during the formulation and expression of language, failing to demonstrate left hemispheric lateralization typically observed in controls; instead, regional responses were either absent, bilateral or lateralized to the right hemisphere. Significant differences were detected between groups when all subjects were fluent-during both language formulation and non-linguistic oral motor tasks-demonstrating that cerebral function may be fundamentally different in persons who stutter, even in the absence of stuttering. Comparison of scans acquired during fluency versus dysfluency-evoking tasks suggested that during the production of stuttered speech, anterior forebrain regions-which play an a role in the regulation of motor function-are disproportionately active in stuttering subjects, while post-rolandic regions-which play a role in perception and decoding of sensory information-are relatively silent. Comparison of scans acquired during these conditions in control subjects, which provide information about the sensorimotor or cognitive features of the language tasks themselves, suggest a mechanism by which fluency-evoking maneuvers might differentially affect activity in these anterior and posterior brain regions and may thus facilitate fluent speech production in individuals who stutter. Both correlational and contrast analyses suggest that right and left hemispheres play distinct and opposing roles in the generation of stuttering symptoms: activation of left hemispheric regions appears to be related to the production of stuttered speech, while activation of right hemispheric regions may represent compensatory processes associated with attenuation of stuttering symptoms.

Adult↗
PubMed1978

Prevalence of stuttering.

The prevalence of stuttering in a university population was 2.1%; 3.4% were former stutterers. More men than women stuttered. Right handed female stutterers were less likely to have "lost" their stutter than were right handed males. Stutterers, past stutterers, and questionable stutterers all had a family history of stuttering. The significant prevalence of stuttering, the increased prevalence among males, the lack of a decline of this disorder over the past few decades despite the increased number of speech clinicians and data concerning handedness, emphasise the need to investigate organic causes of stuttering.

Adult↗
PubMedDate not supplied

The perception of speech naturalness of post-therapeutic and altered auditory feedback speech of adults with mild and severe stuttering.

The effect of therapy and altered auditory feedback (AAF) on the perception of speech naturalness of people who stutter was examined. Thirty-five naive young adult listeners rated speech samples from fluent speakers and individuals who stutter. Samples came from normal adults who spoke Standard American English; adults with mild or severe stuttering who spoke under conditions of non-altered feedback (NAF), delayed auditory feedback (DAF), and frequency-altered feedback (FAF); and adults with mild or severe stuttering prior to and following successful completion of a Precision Fluency Shaping Program. Speech produced under AAF was rated as significantly more natural sounding than speech from the same individuals under NAF (p < 0.0001). Speech produced during FAF was judged to be more natural sounding than that produced during DAF for those with mild (p = 0.003) and severe (p < 0.0001) stuttering. Mild stuttered speech was judged to have more natural-sounding speech than severe stuttered speech during AAF (p < 0.0001). Speech from individuals following therapy was rated significantly less natural sounding than that from individuals during AAF for both mild and severe stuttering (p < 0.0001). The speech of individuals prior to therapy was rated significantly more natural than their speech produced after therapy (p < 0.0001). Speech from normal fluent speakers was rated as significantly more natural sounding than all samples produced from the individuals who stutter (p < 0.0001). These findings support the contention that AAF benefits those who stutter through a reduction of stuttering with a gain in perceived speech naturalness.

Adult↗
PubMed2001

Speech-motor control and interhemispheric relations in recovered and persistent stuttering.

The neurological basis of stuttering is associated with anomalies of interhemispheric relations and of the neural mechanisms of speech-motor control, specifically those involving the supplementary motor area (SMA). Stuttering typically develops through childhood and adolescence but many children will recover without formal treatment or intervention. The hypothesis that such spontaneous recovery is related to a maturation of the SMA is explored. Four experimental tasks were performed by adults whose stuttering has persisted, adults who reported having stuttered as children, and a control group of adults who reported never having stuttered. A Sequence Reproduction Finger Tapping task (Webster, 1986) and a Bimanual Crank Turning task (Preilowski, 1972) examined the functioning of the SMA, and 2 Divided Visual Field tasks examined asymmetries of hemispheric activation. The overall pattern of results for persistent stutterers compared to nonstutterers was consistent with motor-perceptual anomalies previously reported in the literature. The Bimanual Crank Turning task revealed additionally that the bimanual coordination deficits reported in adults who stutter are kinesthetically based and mediated through anterior callosal systems, including the SMA. Ex-stutterers were similar to nonstutterers in their performance of the motor control tasks, but similar to persistent stutterers in perceptual asymmetries associated with Divided Visual Field tasks. Taken together, the results from the four experimental tasks support the general hypothesis that an anomaly in interhemispheric relations and a deficit in the mechanisms of speech-motor control are each a necessary but not sufficient condition for stuttering and that recovery from childhood stuttering reflects a maturation of the mechanisms of speech-motor control.

Adult↗
PubMed2004

Aberrant auditory processing and atypical planum temporale in developmental stuttering.

OBJECTIVE: To learn if people with persistent developmental stuttering and atypical anatomy of their auditory temporal cortex have, when compared to control subjects, changes in fluency induced with delayed auditory feedback (DAF). BACKGROUND: DAF improves fluency in many individuals who stutter, and induces dysfluency in some normal people. The planum temporale (PT), a portion of auditory temporal cortex, is anatomically atypical in some adults who stutter and atypical anatomy might induce aberrant function. Thus, the people who demonstrate the paradoxical response to DAF might be those who have atypical anatomy. METHODS: Experimental subjects were adults with developmental stuttering (n = 14) and control subjects (n = 14) matched for age, sex, education, and handedness. Volumetric MRI scans of all subjects were obtained and the PT was measured in the right and left hemispheres. Based on these scans, subjects were classified as typical (leftward PT asymmetry) or atypical (rightward PT asymmetry). Prose passages were read at baseline, with non-altered feedback (NAF), and with DAF, and fluency was measured in these three conditions. RESULTS: At baseline the adults with developmental stuttering were significantly more dysfluent than controls (p < 0.0005). Controls' fluency did not significantly change with DAF, but DAF improved fluency in adults with developmental stuttering (p < 0.0005). In the stutter group enhanced fluency was associated with atypical (rightward) PT asymmetry, and the presence of typical (leftward) PT asymmetry was not associated with any significant change in fluency. The individuals with atypical PT asymmetry also had more severe stuttering at baseline compared to the experimental subjects with typical PT anatomy. CONCLUSIONS: In adults with persistent developmental stuttering and atypical PT anatomy, fluency is improved with DAF. These experimental subjects who showed improvement had more severe stuttering at baseline. Anomalous PT anatomy may be a neural risk for developmental stuttering in some individuals. Although a number of explanations are tenable, it may be that atypical rightward PT asymmetry may alter speech feedback, and treatment with DAF might allow these people to compensate.

Adult↗
PubMed1999

Stroke-associated stuttering.

OBJECTIVE: To present patients with stuttering speech in association with stroke. DESIGN: Case series with follow-up for 5 years, or until the stuttering resolved. SETTING: University and community hospital neurology wards, and ambulatory neurology clinics. PATIENTS: Four patients who developed stuttering speech in association with an acute ischemic stroke. A 68-year-old man acutely developed stuttering with a large left middle cerebral artery distribution stroke. A 59-year-old man who had stuttered as a child began to stutter 2 months after a left temporal lobe infarction, as nonfluent aphasia was improving. Another childhood stutterer, a 59-year-old originally left-handed man developed severe but transient stuttering with a right parietal infarction. A 55-year-old man with a left occipital infarction had a right hemianopia and an acquired stutter, for which he was anosognosic. CONCLUSION: The clinical presentation of stroke-associated stuttering is variable, as are the locations of the implicated infarctions.

Aged↗
PubMed2004

Using independent component analysis to remove artifact from electroencephalographic measured during stuttered speech.

The electro-encephalographic (EEG) activity of people who stutter could provide invaluable information about the association of neural processing and stuttering. However, the EEG has never been adequately studied during speech in which stuttering naturally occurs. This is owing, in part, to the masking of the EEG signal by artifact from sources such as the speech musculature and from ocular activity. The aim of this paper was to demonstrate the ability of independent component analysis (ICA) to remove artifact from the EEG of stuttering children recorded while they are speaking and stuttering. The EEG of 16 male children who stuttered and 16 who did not stutter was recorded during a reading task. The recorded EEG that contained artifact was then subjected to ICA. The results demonstrated that the EEG assessed during stuttered speech had substantially more noise than the EEG of speech that did not contain stuttering (p < 0.01). Furthermore, it was shown that ICA could effectively remove this artifact in all 16 children (p < 0.01). The results from one child highlight the findings that ICA can be used to remove dominant artifact that has prevented the study of EEG activity during stuttered speech in children.

Adolescent↗
PubMed2006

Some empirical observations about early stuttering: a possible link to language development.

UNLABELLED: This article suggests a possible link between incipient stuttering and early difficulty in language formulation. The hypothesis offers a unifying explanation of an array of empirical observations. Among these observations are the following: early stuttering occurs only on the first word of a syntactic structure; stuttering does not appear to be influenced by word-related factors; early stuttering seldom occurs on one-word utterances; the earliest age at which stuttering is reported is 18 months, with the beginning of grammatical development; the age at which most onset of stuttering is reported, 2-5 years, coincides with the period during which children acquire syntax; considerable spontaneous recovery takes place at the time most children have mastered syntax; incipient stuttering is influenced by the length and grammatical complexity of utterances; young children who stutter may be somewhat deficient in language skills; boys who stutter outnumber girls. LEARNING OUTCOMES: The reader will learn about a number of empirical observations about incipient stuttering and how they may be explained by a syntax-based hypothesis about its etiology.

Age of Onset↗
PubMed2004

Measuring role entrapment of people who stutter.

UNLABELLED: The purpose of this study was to explore whether people who stutter experience role entrapment in the form of vocational stereotyping. To accomplish this, 385 university students reported their perceptions of appropriate career choices for people who stutter. Direct survey procedures, utilizing the newly developed Vocational Advice Scale (VAS), were used in this study. Comparisons for the main effect of speaker status (person who stutters and person who does not stutter) were conducted using a one-way analysis of variance (ANOVA). Results of this analysis suggested that the university students reported an overall perception that stuttering affected career opportunities and that 20 careers were judged to be inappropriate choices for people who stutter. Conversely, 23 careers were judged to be appropriate choices for people who stutter. Findings of this study provide initial data that supports that people who stutter may suffer from role entrapment related to career choices. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) provide the definitions of stereotyping, role entrapment, and how these relate to people who stutter; (2) discuss the career choices that college students perceive as appropriate and inappropriate for people who stutter; and (3) summarize the needs for future research in this area.

Adult↗
PubMed2005

Unassisted recovery from stuttering: self-perceptions of current speech behavior, attitudes, and feelings.

UNLABELLED: The purpose of this study was to investigate the nature of recovery from stuttering based on the experiences of adults who recovered without treatment. Using a semi-structured, open-ended interview format, 15 speakers verified as persons who recovered without treatment were asked to describe their status as everyday speakers. Seven speakers reported that they no longer stuttered and eight reported that they still stuttered on occasion. Interview material was coded and analyzed by the investigators and checked by independent judges. Results suggested that complete recovery was possible for speakers who reported that they no longer stuttered; whereas, those who still stuttered occasionally appeared to no longer be handicapped by stuttering, but required some vigilance to maintain their relatively fluent speech. EDUCATIONAL OBJECTIVES: After completing this activity, the learner will be able to: (1) describe the relevance of self-report data for evaluating the nature of recovery from stuttering without treatment; (2) describe the differences in self-perception concerning the nature of recovery for those who no longer have any tendency to stutter compared to those who still have an occasional tendency to stutter; and (3) suggest the possible implications for understanding the nature of recovery from persistent stuttering based on investigations of late recovery without treatment.

Adult↗
PubMed2006

The relationship between pre-treatment clinical profile and treatment outcome in an integrated stuttering program.

UNLABELLED: A procedure for subtyping individuals who stutter and its relationship to treatment outcome is explored. Twenty-five adult participants of the Comprehensive Stuttering Program (CSP) were classified according to: (1) stuttering severity and (2) severity of negative emotions and cognitions associated with their speech problem. Speech characteristics (percentage of stuttered syllables, distorted speech score, and the number of correctly produced syllables on a diadochokinesis task) and emotional/cognitive states (emotional reaction, speech satisfaction, and attitudes toward speaking) were assessed before and after treatment, and at a 1- and 2-year follow-up. The results showed that: (a) there was no relationship between stuttering severity and the severity of negative emotions and cognitions, (b) the severe stuttering group had the largest treatment gains but also the highest level of regression, and (c) at post-treatment and both follow-up assessments the differences on measures of emotions between the mild and severe emotional group had disappeared, chiefly due to a large decrease in the latter group's negative emotions and cognitions. Our findings show that, based on treatment gains, specific subgroups can be identified, each requiring different treatment approaches. This underlines the necessity of developing a better understanding of how various dimensions of stuttering relate to treatment outcome. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) describe why stuttering severity and negative emotions and cognitions that are related to stuttering should be investigated separately and (2) describe how treatment outcome relates to subtypes of persons who stutter.

Adolescent↗
PubMed2006

Comparing judgments of stuttering made by students, clinicians, and highly experienced judges.

PURPOSE: The purpose of this study was to compare judgments of stuttering made by students and clinicians with previously available judgments made by highly experienced judges in stuttering. METHOD: On two occasions, 41 university students and 31 speech-language pathologists judged the presence or absence of stuttering in each of 216 audiovisually recorded 5-s intervals of the speech of adults who stutter. Intrajudge and interjudge agreement were calculated, and comparisons were made to judgments previously made about the same recordings by 10 highly experienced judges of stuttering. RESULTS: Students and clinicians showed similar and relatively high levels of intrajudge and interjudge agreement, but both students and clinicians identified less than half as much stuttering as the highly experienced judges had identified. CONCLUSIONS: These results replicate previous findings of high agreement coexisting with low accuracy in students' judgments of stuttering, extending those findings to show that similar problems are evident in judgments made by practicing clinicians. Implications include the need for explicit stuttering judgment training programs for both students and practicing clinicians. EDUCATIONAL OBJECTIVES: After reading this article, the reader will be able to: (1) describe different methods for identifying stuttering and possible problems associated with each method; (2) describe two different methods for reporting interjudge reliability; (3) describe how the identification of stuttering differs for student, clinician, and highly experienced judges.

Adult↗
PubMed2003

Childhood stuttering and speech disfluencies in relation to children's mean length of utterance: a preliminary study.

UNLABELLED: The purpose of this study was to examine the influence of utterance length and complexity relative to the children's mean length of utterance (MLU) on stuttering-like disfluencies (SLDs) for children who stutter (CWS) and nonstuttering-like disfluencies (nonSLDs) for children who do not stutter (CWNS). Participants were 12 (3;1-5;11, years;months) children: 6 CWS and 6 age-matched (+/-5 months) CWNS, with equal numbers in each talker group (CWS and CWNS) exhibiting MLU from the lower to the upper end of normal limits. Data were based on audio-video recordings of each child in two separate settings (i.e., home and laboratory) during loosely structured, 30-min parent-child conversational interactions and analyzed in terms of each participant's utterance length, MLU, frequency and type of speech disfluency. Results indicate that utterances above children's MLU are more apt to be stuttered or disfluent and that both stuttering-like as well as nonstuttering-like disfluencies are most apt to occur on utterances that are both long and complex. Findings were taken to support the hypothesis that the relative "match" or "mismatch" between linguistic components of an utterance (i.e., utterance length and complexity) and a child's language proficiency (i.e., MLU) influences the frequency of the child's stuttering/speech disfluency. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to: (1) compare different procedures for assessing the relationship among stuttering, length and complexity of utterance, (2) describe the difference between relative and absolute measures of utterance length, (3) discuss the measurement and value of mean length of utterance and its possible contributions to childhood stuttering, and (4) describe how length and complexity influence nonstuttering-like disfluencies of children who stutter as well as the stuttering-like disfluencies of children who do not stutter.

Child, Preschool↗