Speech disfluencies of preschool-age children who do and do not stutter

Self-perceived competence and social acceptance of young children who stutter: Initial findings

PURPOSE

The goals of this study were to determine whether young children who stutter (CWS) perceive their own competence and social acceptance differently than young children who do not stutter (CWNS), and to identify the predictors of perceived competence and social acceptance in young speakers.

METHOD

We administered the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children (PSPCSA; Harter & Pike, 1984) to 13 CWS and 14 CWNS and examined group differences. We also collected information on the children's genders, temperaments, stuttering frequencies, language abilities, and phonological skills to identify which of these factors predicted PSPCSA scores.

RESULTS

CWS, as a group, did not differ from CWNS in their perceived general competence or social acceptance. Gender predicted scores of perceived general competence, and stuttering frequency predicted perceived social acceptance. Temperament, language abilities, and phonological skills were not significant predictors of perceived competence or social acceptance in our sample.

CONCLUSIONS

While CWS did not significantly differ from CWNS in terms of perceived competence and social acceptance, when both talker groups were considered together, girls self-reported greater perceived competence than boys. Further, lower stuttering frequency was associated with greater perceived social acceptance. These preliminary findings provide motivation for further empirical study of the psychosocial components of childhood stuttering.

LEARNING OUTCOMES

Readers will be able to describe the constructs of perceived competence and social acceptance in young children, and whether early stuttering plays a role in the development of these constructs.

Prolongamentos na fala de adultos com e sem gagueira

RESUMO Objetivo: realizar uma análise quantitativa e qualitativa dos prolongamentos de adultos com e sem gagueira. Métodos: os participantes foram divididos em: Grupo de Pesquisa (GP, 15 adultos com gagueira) e Grupo Controle (GC, 15 fluentes). Os procedimentos utilizados foram: avaliação da fluência, Instrumento de Gravidade da Gagueira e análises quantitativa e qualitativa dos prolongamentos. Resultados: GP mostrou maior número de prolongamentos não hesitativos, enquanto que GC mostrou maior ocorrência de prolongamentos hesitativos em relação ao total das disfluências. Prolongamentos não hesitativos ocorreram com maior frequência na palavra inicial e monossilábica, bem como na posição medial da frase para GP. Em relação à tensão muscular e duração, observou-se diferença apenas para a tensão muscular nos prolongamentos não hesitativos com maior média de ocorrência para GP. Conclusão: os prolongamentos não hesitativos ocorreram com maior frequência no GP, nas palavras iniciais, monossílabos e na posição medial da frase. Qualitativamente a tensão muscular foi uma característica típica dos prolongamentos não hesitativos no GP. Com relação aos prolongamentos hesitativos houve semelhança entre os adultos dos dois grupos quanto à frequência em relação ao total da fala, a posição dos prolongamentos nas palavras e nas frases e nos aspectos qualitativos, relacionados a tensão muscular e duração.

Emotional Diathesis, Emotional Stress, and Childhood Stuttering

PURPOSE

The purpose of this study was to determine (a) whether emotional reactivity and emotional stress of children who stutter (CWS) are associated with their stuttering frequency, (b) when the relationship between emotional reactivity and stuttering frequency is more likely to exist, and (c) how these associations are mediated by a 3rd variable (e.g., sympathetic arousal).

METHOD

Participants were 47 young CWS (M age = 50.69 months, SD = 10.34). Measurement of participants' emotional reactivity was based on parental report, and emotional stress was engendered by viewing baseline, positive, and negative emotion-inducing video clips, with stuttered disfluencies and sympathetic arousal (indexed by tonic skin conductance level) measured during a narrative after viewing each of the various video clips.

RESULTS

CWS's positive emotional reactivity was positively associated with percentage of their stuttered disfluencies regardless of emotional stress condition. CWS's negative emotional reactivity was more positively correlated with percentage of stuttered disfluencies during a narrative after a positive, compared with baseline, emotional stress condition. CWS's sympathetic arousal did not appear to mediate the effect of emotional reactivity, emotional stress condition, and their interaction on percentage of stuttered disfluencies, at least during this experimental narrative task following emotion-inducing video clips.

CONCLUSIONS

Results were taken to suggest an association between young CWS's positive emotional reactivity and stuttering, with negative reactivity seemingly more associated with these children's stuttering during positive emotional stress (a stress condition possibly associated with lesser degrees of emotion regulation). Such findings seem to support the notion that emotional processes warrant inclusion in any truly comprehensive account of childhood stuttering.

Does Working Memory Enhance or Interfere With Speech Fluency in Adults Who Do and Do Not Stutter? Evidence From a Dual-Task Paradigm

PURPOSE

The present study examined whether engaging working memory in a secondary task benefits speech fluency. Effects of dual-task conditions on speech fluency, rate, and errors were examined with respect to predictions derived from three related theoretical accounts of disfluencies.

METHOD

Nineteen adults who stutter and twenty adults who do not stutter participated in the study. All participants completed 2 baseline tasks: a continuous-speaking task and a working-memory (WM) task involving manipulations of domain, load, and interstimulus interval. In the dual-task portion of the experiment, participants simultaneously performed the speaking task with each unique combination of WM conditions.

RESULTS

All speakers showed similar fluency benefits and decrements in WM accuracy as a result of dual-task conditions. Fluency effects were specific to atypical forms of disfluency and were comparable across WM-task manipulations. Changes in fluency were accompanied by reductions in speaking rate but not by corresponding changes in overt errors.

CONCLUSIONS

Findings suggest that WM contributes to disfluencies regardless of stuttering status and that engaging WM resources while speaking enhances fluency. Further research is needed to verify the cognitive mechanism involved in this effect and to determine how these findings can best inform clinical intervention.

The function of repeating: The relation between word class and repetition type in developmental stuttering

BACKGROUND

It is already known that preschool-age children who stutter (CWS) tend to stutter on function words at the beginning of sentences. It is also known that phonological errors potentially resulting in part-word repetitions tend to occur on content words. However, the precise relation between word class and repetition type in preschool-age stuttering is unknown.

AIMS

To investigate repetitions associated with monosyllabic words in preschool-age CWS. Specifically, it was hypothesized that repetition type should vary according to word class in preschool-age CWS and children who do not stutter (CWNS).

METHODS & PROCEDURES

Thirteen preschool-age CWS and 15 preschool-age CWNS produced age-appropriate narratives, which were transcribed and coded for part-word repetitions (PWR) and whole-word repetitions (WWR) occurring on monosyllabic words. Each repetition type was also coded for word class (i.e., function versus content).

OUTCOMES & RESULTS

Results indicated that although CWS and CWNS were significantly more likely to produce PWR on content words, this tendency did not differ between the two talker groups. Further, CWS and CWNS did not differ in their tendencies to produce PWR versus WWR overall, but the tendency to produce repetitions on function words was significantly greater for CWS versus CWNS.

CONCLUSIONS & IMPLICATIONS

Findings are taken to suggest that repetitions of monosyllabic words in young children are not easily explained from the perspective of phonological errors, but may instead be considered from an incremental planning of speech perspective.

Sympathetic arousal of young children who stutter during a stressful picture naming task

PURPOSE

The purpose of the current study was to investigate sympathetic arousal of young children who do and do not stutter during a stressful picture-naming task under instructions to name pictures as rapidly as possible.

METHOD

Thirty-seven young children who stutter (CWS) and 39 young children who do not stutter (CWNS) served as participants. Dependent measures consisted of tonic skin conductance during a pretask baseline, a stress-inducing rapid picture-naming task, and post-picture-naming task condition.

RESULTS

Findings indicated that, when chronological age was not taken into account, there was no between-group difference in tonic skin conductance level. When age was taken into account, however, there was a significant talker group×age group interaction, with follow-up analyses indicating that 3-year-old CWS exhibited significantly higher sympathetic arousal than their CWNS peers, and their 4-year-old CWNS peers.

CONCLUSIONS

Findings were taken to be consistent with non-physiological results indicating an association between emotional processes and childhood stuttering. This association, at least for this cross-sectional study of tonic skin conductance level (SCL) during a picture-naming task, was moderated by children's chronological age. Such developmental differences may be associated with various processes, for example, attention, cognition, or physiology, or some combination of two or more of these processes. Future empirical study of these processes in young CWS and CWNS may profit from longitudinal measurement of converging lines of evidence from behavioral, parent and psychophysiological indexes of emotional reactivity and regulation.

EDUCATIONAL OBJECTIVES

After reading this article, the reader will be able to: (a) discuss salient findings in the literature regarding the association between emotional processes and childhood stuttering; (b) discuss sympathetic arousal, and how skin conductance is used to measure it; and (c) discuss the role of chronological age in the association between emotion and stuttering in young children.

Gagueira desenvolvimental persistente familial: disfluências e prevalência

Resumo: OBJETIVO: caracterizar e comparar a frequência das disfluências da fala de adultos com gagueira desenvolvimental persistente familial do sexo masculino e feminino, a severidade do distúrbio e determinar a prevalência familial e a razão entre gêneros da gagueira nos familiares dos probandos. MÉTODOS: participaram 30 adultos com gagueira (18 a 53 anos), divididos em dois grupos, sendo 20 do sexo masculino e 10 do sexo feminino. Os procedimentos realizados foram: história clínica e familial, avaliação da fluência e Instrumento de Severidade da Gagueira. RESULTADOS: as porcentagens de disfluências típicas da gagueira (p=0,352), de outras disfluências (p=0,947) e do total das disfluências (p=0,522) foram semelhantes entre os grupos masculino e feminino. A média de disfluências típicas da gagueira foi 5,23% e de outras disfluências 5,50%. O subtipo leve foi manifestado pela maioria dos participantes (83,3%). Os familiares do gênero masculino apresentaram maior risco de apresentar gagueira (p<0,001). Do total de 1002 familiares, 85 apresentaram gagueira. No total de familiares afetados (n=85), 53 eram do sexo masculino e 32 do feminino. CONCLUSÃO: não houve diferenças entre os grupos masculino e feminino nas medidas analisadas. Quanto à frequência das disfluências, aproximadamente metade do total das disfluências foi caracterizada como disfluências típicas da gagueira. O subtipo de gagueira desenvolvimental persistente familial foi caracterizado principalmente por um distúrbio classificado quanto à severidade como leve. O risco dos familiares dos probandos afetados foi de 8,5%. A gagueira afetou mais pessoas do gênero masculino em relação ao feminino, numa proporção de 3,72:1.

Speech-Language Dissociations, Distractibility, and Childhood Stuttering

PURPOSE

This study investigated the relation among speech-language dissociations, attentional distractibility, and childhood stuttering.

METHOD

Participants were 82 preschool-age children who stutter (CWS) and 120 who do not stutter (CWNS). Correlation-based statistics (Bates, Appelbaum, Salcedo, Saygin, & Pizzamiglio, 2003) identified dissociations across 5 norm-based speech-language subtests. The Behavioral Style Questionnaire Distractibility subscale measured attentional distractibility. Analyses addressed (a) between-groups differences in the number of children exhibiting speech-language dissociations; (b) between-groups distractibility differences; (c) the relation between distractibility and speech-language dissociations; and (d) whether interactions between distractibility and dissociations predicted the frequency of total, stuttered, and nonstuttered disfluencies.

RESULTS

More preschool-age CWS exhibited speech-language dissociations compared with CWNS, and more boys exhibited dissociations compared with girls. In addition, male CWS were less distractible than female CWS and female CWNS. For CWS, but not CWNS, less distractibility (i.e., greater attention) was associated with more speech-language dissociations. Last, interactions between distractibility and dissociations did not predict speech disfluencies in CWS or CWNS.

CONCLUSIONS

The present findings suggest that for preschool-age CWS, attentional processes are associated with speech-language dissociations. Future investigations are warranted to better understand the directionality of effect of this association (e.g., inefficient attentional processes → speech-language dissociations vs. inefficient attentional processes ← speech-language dissociations).

Autonomic nervous system activity of preschool-age children who stutter

PURPOSE

The purpose of this study was to investigate potential differences in autonomic nervous system (ANS) activity to emotional stimuli between preschool-age children who do (CWS) and do not stutter (CWNS).

METHODS

Participants were 20 preschool-age CWS (15 male) and 21 preschool-age CWNS (11 male). Participants were exposed to two emotion-inducing video clips (negative and positive) with neutral clips used to establish pre-and post-arousal baselines, and followed by age-appropriate speaking tasks. Respiratory sinus arrhythmia (RSA)-often used as an index of parasympathetic activity-and skin conductance level (SCL)-often used as an index of sympathetic activity-were measured while participants listened to/watched the audio-video clip presentation and performed a speaking task.

RESULTS

CWS, compared to CWNS, displayed lower amplitude RSA at baseline and higher SCL during a speaking task following the positive, compared to the negative, condition. During speaking, only CWS had a significant positive relation between RSA and SCL.

CONCLUSION

Present findings suggest that preschool-age CWS, when compared to their normally fluent peers, have a physiological state that is characterized by a greater vulnerability to emotional reactivity (i.e., lower RSA indexing less parasympathetic tone) and a greater mobilization of resources in support of emotional reactivity (i.e., higher SCL indexing more sympathetic activity) during positive conditions. Thus, while reducing stuttering to a pure physiological process is unwarranted, the present findings suggest that the autonomic nervous system is involved.

EDUCATIONAL OBJECTIVES

The reader will be able to: (a) summarize current empirical evidence on the role of emotion in childhood stuttering; (b) describe physiological indexes of sympathetic and parasympathetic activity; (c) summarize how preschool-age children who stutter differ from preschool-age children who do not stutter in autonomic activity; (d) discuss possible implications of current findings in relation to the development of childhood stuttering.