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Wiele B, Cook S, Raj EX, Heim S. Long-term evaluation of psychosocial impact and stuttering severity after intensive stuttering therapy. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-15. [PMID: 39219356 DOI: 10.1080/17549507.2024.2371869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
PURPOSE The purpose of this study was to assess the long-term stability of objective and subjective psychosocial improvements and fluency more than 10 years after participation in an intensive stuttering therapy camp. METHOD Ten former participants in intensive stuttering therapy (IST; mean age at time of intervention 14; 2 years) participated in this study. Outcomes of the IST at that time were assessed with the Stuttering Severity Instrument (SSI-3; Riley, 1994) and a questionnaire to measure the psychosocial impact of stuttering. A semi-structured video call and a general questionnaire for the long-term evaluation were used to gauge the participants' perceptions of the IST. These follow-up data were compared to the therapy outcomes reported by Cook (2011, 2013). RESULT Therapy effects on the severity of stuttering and psychosocial impact were stable over the follow-up period of more than 10 years. Moreover, scores for psychosocial impact and severity of stuttering further decreased from the end of the IST to the long-term evaluation. The intensive time and the periodically offered follow-up treatments were described as particularly positive by the participants. CONCLUSION Intensive stuttering therapy in childhood or adolescence can have a long-term positive effect on both internal and external stuttering symptoms.
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Affiliation(s)
- Birte Wiele
- Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Susanne Cook
- Stotterintensivtherapie Cook, Karlsruhe, Germany
| | - Erik X Raj
- Department of Speech-Language Pathology, Monmouth University, West Long Branch, NJ, USA
| | - Stefan Heim
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
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Phillips MC, Myers EB. Auditory Processing of Speech and Nonspeech in People Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2533-2547. [PMID: 39058919 DOI: 10.1044/2024_jslhr-24-00107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
PURPOSE We investigated speech and nonspeech auditory processing of temporal and spectral cues in people who do and do not stutter. We also asked whether self-reported stuttering severity was predicted by performance on the auditory processing measures. METHOD People who stutter (n = 23) and people who do not stutter (n = 28) completed a series of four auditory processing tasks online. These tasks consisted of speech and nonspeech stimuli differing in spectral or temporal cues. We then used independent-samples t-tests to assess differences in phonetic categorization slopes between groups and linear mixed-effects models to test differences in nonspeech auditory processing between stuttering and nonstuttering groups, and stuttering severity as a function of performance on all auditory processing tasks. RESULTS We found statistically significant differences between people who do and do not stutter in phonetic categorization of a continuum differing in a temporal cue and in discrimination of nonspeech stimuli differing in a spectral cue. A significant proportion of variance in self-reported stuttering severity was predicted by performance on the auditory processing measures. CONCLUSIONS Taken together, these results suggest that people who stutter process both speech and nonspeech auditory information differently than people who do not stutter and may point to subtle differences in auditory processing that could contribute to stuttering. We also note that these patterns could be the consequence of listening to one's own speech, rather than the cause of production differences.
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Affiliation(s)
- Matthew C Phillips
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs
| | - Emily B Myers
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs
- Department of Psychological Sciences, University of Connecticut, Storrs
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Winters KL, Byrd CT. Caregiver Predictions of Their 3- to 6-Year-Old Child Who Stutters' Communication Attitude. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2086-2105. [PMID: 38889195 PMCID: PMC11253804 DOI: 10.1044/2024_jslhr-23-00662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/11/2024] [Accepted: 04/24/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE Caregivers share critical insight during their child's stuttering evaluation; yet, there have been no empirical studies evaluating whether caregivers provide similar accounts of their 3- to 6-year-old child's communication attitude compared to their child's self-report. This study examined caregiver- and child-reported communication attitude and assessed potential moderators of more comparable caregiver and child ratings (i.e., caregiver confidence, caregiver-child conflict, observer-rated stuttering severity). METHOD One hundred thirteen children who stutter ages 3 through 6 years and a primary caregiver were recruited from clinical settings across the United States. Children completed the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT) and three speaking samples, which were recorded to assess observer-rated stuttering severity using the Stuttering Severity Instrument-Fourth Edition. Caregivers predicted their child's communication attitude (C-KiddyCAT) and provided a confidence rating for their prediction. Caregivers also rated caregiver-child conflict using the Child-Parent Relationship Scale-Short Form (CPRS-SF). Multiple regression was used to (a) evaluate whether caregiver C-KiddyCAT scores predicted child KiddyCAT scores and (b) assess potential moderators of the relationship between C-KiddyCAT and KiddyCAT scores. RESULTS Caregiver ratings of their child's communication attitude (C-KiddyCAT) predicted child communication attitude ratings (KiddyCAT). A significant interaction between caregiver-child conflict (CPRS-SF) and caregiver ratings of their child's communication attitude (C-KiddyCAT) suggested caregiver-child conflict changed the underlying relationship between C-KiddyCAT and KiddyCAT scores, such that low conflict resulted in more similar C-KiddyCAT and KiddyCAT scores. Neither caregiver confidence nor observer-rated stuttering severity influenced the relationship between C-KiddyCAT and KiddyCAT scores. CONCLUSIONS Although many caregivers predicted communication attitude ratings that closely aligned with their child's report, some caregiver-child dyads provided divergent ratings. Clinicians should interpret caregiver predictions of their child's communication attitude within the context of their full evaluation and the caregiver-child relationship. Assessing both self-reported communication attitude and caregiver predictions of their child's communication attitude provides a meaningful starting point to counseling caregivers about cognitive components of stuttering for preschool- and kindergarten-age children who stutter.
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Affiliation(s)
- Katie L. Winters
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Courtney T. Byrd
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
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Bowers A, Hudock D. Lower nonword syllable sequence repetition accuracy in adults who stutter is related to differences in audio-motor oscillations. Neuropsychologia 2024; 199:108906. [PMID: 38740180 DOI: 10.1016/j.neuropsychologia.2024.108906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 03/05/2024] [Accepted: 05/06/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE The goal of this study was to use independent component analysis (ICA) of high-density electroencephalography (EEG) to investigate whether differences in audio-motor neural oscillations are related to nonword syllable repetition accuracy in a group of adults who stutter compared to typically fluent speakers. METHODS EEG was recorded using 128 channels from 23 typically fluent speakers and 23 adults who stutter matched for age, sex, and handedness. EEG was recorded during delayed, 2 and 4 bilabial nonword syllable repetition conditions. Scalp-topography, dipole source estimates, and power spectral density (PSD) were computed for each independent component (IC) and used to cluster similar ICs across participants. Event-related spectral perturbations (ERSPs) were computed for each IC cluster to examine changes over time in the repetition conditions and to examine how dynamic changes in ERSPs are related to syllable repetition accuracy. RESULTS Findings indicated significantly lower accuracy on a measure of percentage correct trials in the AWS group and for a normalized measure of syllable load performance across conditions. Analysis of ERSPs revealed significantly lower alpha/beta ERD in left and right μ ICs and in left and right posterior temporal lobe α ICs in AWS compared to TFS (CC p < 0.05). Pearson correlations with %CT for frequency across time showed strong relationships with accuracy (FWE<0.05) during maintenance in the TFS group and during execution in the AWS group. CONCLUSIONS Findings implicate lower alpha/beta ERD (8-30 Hz) during syllable encoding over posterior temporal ICs and execution in left temporal/sensorimotor components. Strong correlations with accuracy and interindividual differences in ∼6-8 Hz ERSPs during execution implicate differences in motor and auditory-sensory monitoring during syllable sequence execution in AWS.
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Affiliation(s)
- Andrew Bowers
- University of Arkansas, 275 Epley Center, 606 North Razorback Rd. Fayetteville AR, 72701, United States.
| | - Daniel Hudock
- Idaho State University, 921 S. 8th Ave, Mailstop 8116, Pocatello, ID 83209, United States
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Pasculli G, Busan P, Jackson ES, Alm PA, De Gregorio D, Maguire GA, Goodwin GM, Gobbi G, Erritzoe D, Carhart-Harris RL. Psychedelics in developmental stuttering to modulate brain functioning: a new therapeutic perspective? Front Hum Neurosci 2024; 18:1402549. [PMID: 38962146 PMCID: PMC11221540 DOI: 10.3389/fnhum.2024.1402549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Developmental stuttering (DS) is a neurodevelopmental speech-motor disorder characterized by symptoms such as blocks, repetitions, and prolongations. Persistent DS often has a significant negative impact on quality of life, and interventions for it have limited efficacy. Herein, we briefly review existing research on the neurophysiological underpinnings of DS -specifically, brain metabolic and default mode/social-cognitive networks (DMN/SCN) anomalies- arguing that psychedelic compounds might be considered and investigated (e.g., in randomized clinical trials) for treatment of DS. The neural background of DS is likely to be heterogeneous, and some contribution from genetically determinants of metabolic deficiencies in the basal ganglia and speech-motor cortical regions are thought to play a role in appearance of DS symptoms, which possibly results in a cascade of events contributing to impairments in speech-motor execution. In persistent DS, the difficulties of speech are often linked to a series of associated aspects such as social anxiety and social avoidance. In this context, the SCN and DMN (also influencing a series of fronto-parietal, somato-motor, and attentional networks) may have a role in worsening dysfluencies. Interestingly, brain metabolism and SCN/DMN connectivity can be modified by psychedelics, which have been shown to improve clinical evidence of some psychiatric conditions (e.g., depression, post-traumatic stress disorder, etc.) associated with psychological constructs such as rumination and social anxiety, which also tend to be present in persistent DS. To date, while there have been no controlled trials on the effects of psychedelics in DS, anecdotal evidence suggests that these agents may have beneficial effects on stuttering and its associated characteristics. We suggest that psychedelics warrant investigation in DS.
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Affiliation(s)
- Giuseppe Pasculli
- Department of Computer, Control, and Management Engineering (DIAG), La Sapienza University, Rome, Italy
- Italian Society of Psychedelic Medicine (Società Italiana di Medicina Psichedelica–SIMePsi), Bari, Italy
| | | | - Eric S. Jackson
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
| | - Per A. Alm
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Danilo De Gregorio
- IRCCS, San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Gerald A. Maguire
- School of Medicine, American University of Health Sciences, Signal Hill, CA, United States
- CenExel CIT Research, Riverside, CA, United States
| | - Guy M. Goodwin
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - David Erritzoe
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Robin L. Carhart-Harris
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
- Psychedelics Division, Neuroscape, University of California, San Francisco, CA, United States
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Einarsdóttir JT, Hermannsdóttir B, Crowe K. A prospective 14-year follow-up study of the persistence and recovery of stuttering. JOURNAL OF FLUENCY DISORDERS 2024; 80:106058. [PMID: 38636390 DOI: 10.1016/j.jfludis.2024.106058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 03/17/2024] [Accepted: 04/04/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE To document the trajectory of early childhood stuttering longitudinally for 14. years with a consideration on the features of overt and covert stuttering related to recovery status. METHOD Thirty-eight participants were observed longitudinally at three different time points: early childhood (Occasion 1), middle childhood (Occasion 2), and late adolescence (Occasion 3). Data collection involved speech samples and reports of stuttering experiences. Recovery on Occasion 3 was estimated through analysis of speech samples, parent and expert judgments, and self- judgement. Two categories of persistence were used: persistent-subjective (no observable stuttering) and persistent-objective (observable stuttering). RESULTS The recovery rate was 65.6%. The majority of the participants showed minimal disfluent speech with 88% showing less than 1% syllables stuttered and 97% showing less than 3% syllables stuttered in the collected speech samples. All participants classified as persistent reported covert symptoms of stuttering. No relapses in recovery were observed between Occasion 2 and Occasion 3. Late recovery was only observed for those classified as persistent-subjective on Occasion 2. About 64% of the participants showing observable stuttering (persistent-objective) on Occasion 2 showed no observable stuttering (persistent-subjective) on Occasion 3. CONCLUSIONS Children continue to recover from early childhood stuttering as they age.The inclusion of self-reports adds to the understanding of recovery especially concerning the covert stuttering behaviours. The presence of overt symptoms of stuttering in the speech samples of children aged 7 to 13 years seems to be associated with the likelihood of late recovery of stuttering.
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Affiliation(s)
| | | | - Kathryn Crowe
- University of Iceland, Reykjavik, Iceland; Charles Sturt University, Bathurst, Australia
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Lindström E, Lundström C, Sand A, Samson I. FreDESS: a clinical tool for perceptual evaluation of stuttering. LOGOP PHONIATR VOCO 2024:1-8. [PMID: 38644572 DOI: 10.1080/14015439.2024.2338084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 03/28/2024] [Indexed: 04/23/2024]
Abstract
AIM Stuttering is a communication disorder that involves both manifest speech disfluencies and associated symptoms. The purpose of the present study was to introduce an easily administered and ecologically valid assessment tool designed for perceptual evaluation of stuttered speech, FreDESS (frequency of stuttering events, duration of events, effort, secondary behaviours, and severity). More specifically, we wanted to study its reliability and validity. METHOD Video recordings of conversations with 38 people who stutter (PWS), 19 females and 19 males aged 13-25, were assessed by three speech language pathologists (SLP). Inter- and intrajudge reliability was estimated with intraclass correlation, standard error of measurement, and agreement between listeners. Internal consistency for the FreDESS parameters was estimated with Cronbach's alpha (α). To test the validity of FreDESS, the relationships between the average estimated parameters of frequency, duration, secondary behaviours, and severity of FreDESS and the Stuttering Severity Instrument (SSI-3), were analysed using intraclass correlation. RESULTS The interjudge reliability was good, especially for the frequency, duration, and severity parameters (90 per cent + agreement given 1 scale point difference). All parameters of the FreDESS had strong intrajudge reliability (ICC = 0.86-0.94) and the overall internal consistency was high (α = 0.98). The average ratings on the two assessment scales were in line with each other (r = 0.90-0.96), indicating high concurrent validity. CONCLUSION The FreDESS scale for the assessment of stuttered speech may be a valuable tool in clinical and research contexts. It is a valid and more time-efficient assessment instrument than the more commonly used SSI.
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Affiliation(s)
- Elisabeth Lindström
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
- Faculty of Arts, Psychology and Theology, Logopedics, Åbo Akademi University, Turku, Finland
| | - Cecilia Lundström
- Department of Clinical Sciences Section IV, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Anders Sand
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Ineke Samson
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Division of speech and language pathology, Danderyd Hospital, Stockholm, Sweden
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Hart AK, Breen LJ, Hennessey NW, Beilby JM. Evaluation of an Integrated Fluency and Acceptance and Commitment Therapy Intervention for Adolescents and Adults Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1003-1019. [PMID: 38358941 DOI: 10.1044/2023_jslhr-23-00252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE Developmental stuttering is a complex and multifaceted neurodevelopmental disorder that may cause pervasive negative consequences for adults who stutter (AWS). Historically, intervention for AWS has primarily addressed speech fluency, with less focus on the covert psychosocial aspects of the disorder. The purpose of this article is to report on a feasibility trial evaluating a novel integrated intervention that combines traditional stuttering management techniques with Acceptance and Commitment Therapy (ACT) for AWS. METHOD Twenty-nine AWS participated in the feasibility trial. All participants successfully completed a combined fluency and ACT intervention, titled the fluency and Acceptance and Commitment Therapy for Stuttering (fACTS) Program. As this was a feasibility study, no control group was included. Intervention was administered by two certified practicing speech-language pathologists, over eight 60- to 90-min sessions. RESULTS Generalized linear mixed modeling was used to determine change from pre- to post-intervention and follow-up. Significant pre- and post-intervention improvements in self-efficacy, psychosocial functioning, and psychological flexibility were observed, along with significant reductions in observable stuttering behaviors (i.e., stuttered speech frequency). Intervention gains for all variables of interest were maintained 3 and 6 months post-intervention. CONCLUSIONS The fACTS Program was created to be a holistic and flexible intervention to promote self-efficacy beliefs and address stuttering-related psychosocial impacts and speech fluency goals of AWS. Preliminary results indicated positive improvement in all psychosocial outcomes (i.e., self-efficacy, psychosocial impact, and psychological flexibility) and observable speech fluency following completion of the program. Future clinical trials of the fACTS Program with an included control group will further investigate the mechanisms of change for the positive effects observed.
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Affiliation(s)
- Alice K Hart
- Curtin School of Allied Health, Curtin University, Bentley, Western Australia, Australia
| | - Lauren J Breen
- Curtin enAble Institute, Curtin University, Bentley, Western Australia, Australia
- Curtin School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Neville W Hennessey
- Curtin School of Allied Health, Curtin University, Bentley, Western Australia, Australia
| | - Janet M Beilby
- Curtin School of Allied Health, Curtin University, Bentley, Western Australia, Australia
- Curtin enAble Institute, Curtin University, Bentley, Western Australia, Australia
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Neef NE, Chang SE. Knowns and unknowns about the neurobiology of stuttering. PLoS Biol 2024; 22:e3002492. [PMID: 38386639 PMCID: PMC10883586 DOI: 10.1371/journal.pbio.3002492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Stuttering occurs in early childhood during a dynamic phase of brain and behavioral development. The latest studies examining children at ages close to this critical developmental period have identified early brain alterations that are most likely linked to stuttering, while spontaneous recovery appears related to increased inter-area connectivity. By contrast, therapy-driven improvement in adults is associated with a functional reorganization within and beyond the speech network. The etiology of stuttering, however, remains enigmatic. This Unsolved Mystery highlights critical questions and points to neuroimaging findings that could inspire future research to uncover how genetics, interacting neural hierarchies, social context, and reward circuitry contribute to the many facets of stuttering.
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Affiliation(s)
- Nicole E. Neef
- Institute for Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Communication Disorders, Ewha Womans University, Seoul, Korea
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Hokstad S, Næss KAB. Stuttering in individuals with Down syndrome: a systematic review of earlier research. Front Psychol 2023; 14:1176743. [PMID: 38094702 PMCID: PMC10716236 DOI: 10.3389/fpsyg.2023.1176743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 10/09/2023] [Indexed: 07/19/2024] Open
Abstract
The main objective of this systematic review was to synthesize the evidence on the occurrence and characteristics of stuttering in individuals with Down syndrome and thus contribute knowledge about stuttering in this population. Group studies reporting outcome measures of stuttering were included. Studies with participants who were preselected based on their fluency status were excluded. We searched the Eric, PsychInfo, Medline, Scopus, and Web of Science Core Collection databases on 3rd January 2022 and conducted supplementary searches of the reference lists of previous reviews and the studies included in the current review, as well as relevant speech and language journals. The included studies were coded in terms of information concerning sample characteristics, measurement approaches, and stuttering-related outcomes. The appraisal tool for cross-sectional studies (AXIS) was used to evaluate study quality. We identified 14 eligible studies, with a total of 1,833 participants (mean = 131.29, standard deviation = 227.85, median = 45.5) between 3 and 58 years of age. The estimated occurrence of stuttering ranged from 2.38 to 56%, which is substantially higher than the estimated prevalence (1%) of stuttering in the general population. The results also showed that stuttering severity most often was judged to be mild-to-moderate and that individuals with Down syndrome displayed secondary behaviors when these were measured. However, little attention has been paid to investigating the potential adverse effects of stuttering for individuals with Down syndrome. We judged the quality of the evidence to be moderate-to-low. The negative evaluation was mostly due to sampling limitations that decreased the representability and generalizability of the results. Based on the high occurrence of stuttering and the potential negative effects of this condition, individuals with Down syndrome who show signs of stuttering should be referred to a speech and language pathologist for an evaluation of their need for stuttering treatment.
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Affiliation(s)
- Silje Hokstad
- Department of Education, Lillehammer, Inland Norway University of Applied Sciences, Lillehammer, Norway
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Kari-Anne B. Næss
- Department of Education, Lillehammer, Inland Norway University of Applied Sciences, Lillehammer, Norway
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Kohmäscher A, Primaßin A, Heiler S, Avelar PDC, Franken MC, Heim S. Effectiveness of Stuttering Modification Treatment in School-Age Children Who Stutter: A Randomized Clinical Trial. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4191-4205. [PMID: 37801699 DOI: 10.1044/2023_jslhr-23-00224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
PURPOSE This study investigated the effectiveness of the stuttering modification intervention Kinder Dürfen Stottern (KIDS) in school-age children who stutter. METHOD Seventy-three children who stutter were included in this multicenter, two-group parallel, randomized, wait-list controlled trial with a follow-up of 12 months. Children aged 7-11 years were recruited from 34 centers for speech therapy and randomized to either the immediate-treatment group or the 3 months delayed-treatment group. KIDS was provided by 26 clinicians who followed a treatment manual. Although the primary outcome measure was the impact of stuttering (Overall Assessment of the Speaker's Experience of Stuttering-School-Age [OASES-S]), the secondary outcomes included objective and subjective data on stuttering severity. RESULTS At 3 months postrandomization, the mean score changes of the OASES-S differed significantly between the experimental (n = 33) and control group (n = 29; p = .026). Furthermore, treatment outcomes up to 12 months were analyzed (n = 59), indicating large effects of time on the OASES-S score (p < .001, partial η2 = .324). This was paralleled by significant improvements in parental ratings and objective ratings (stuttering severity, frequency, and physical concomitants). CONCLUSIONS The significant short-term treatment effects in the OASES-S are in line with the (initial) focus of KIDS on cognitive and affective aspects of stuttering. Over 12 months, these changes were maintained and accompanied by behavioral improvements. The results suggest that individual treatment with KIDS is an adequate treatment option for this age group. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24207864.
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Affiliation(s)
- Anke Kohmäscher
- Department of Health, FH Münster University of Applied Sciences, Germany
| | - Annika Primaßin
- Department of Health, FH Münster University of Applied Sciences, Germany
| | - Sabrina Heiler
- Department of Health, FH Münster University of Applied Sciences, Germany
| | - Patricia Da Costa Avelar
- Medical Faculty, Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Germany
| | - Marie-Christine Franken
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Stefan Heim
- Medical Faculty, Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University, Germany
- Institute of Neuroscience and Medicine (INM-1), Forschungszentrum Jülich, Germany
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Norman A, Lowe R, Onslow M, O'Brian S, Packman A, Menzies R, Schroeder L. Cost of Illness and Health-Related Quality of Life for Stuttering: Two Systematic Reviews. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4414-4431. [PMID: 37751681 DOI: 10.1044/2023_jslhr-23-00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
PURPOSE For those who stutter, verbal communication is typically compromised in social situations. This may attract negative responses from listeners and stigmatization by society. These have the potential to impair health-related quality of life across a range of domains, including qualitative and quantitative impacts on speech output, mental health issues, and failure to attain educational and occupational potential. These systematic reviews were designed to explore this matter using traditional health economics perspectives of utility measures and cost of illness. METHOD Studies were included if they involved children, adolescents, or adults with stuttering as a primary diagnosis. The quality of life search strategy identified 2,607 reports, of which three were included in the quality of life analysis. The cost of illness search strategy identified 3,778 reports, of which 39 were included in the cost of illness analysis. RESULTS Two of the three studies included in the quality of life analysis had a high risk of bias. When measured using utility scores, quality of life for people who stutter was in the range of those reported for chronic health conditions such as diabetes mellitus, cardiovascular disease, and cancer. However, there is little such evidence of quality of life impairment during the preschool years. Studies included in the cost of illness analysis carried considerable risk of bias overall. CONCLUSIONS For people who stutter, there are substantive direct and indirect costs of illness. These include impairment, challenges, and distress across many domains throughout life, including income, education, employment, and social functioning. Evidence of quality of life impairment using utility measures is extremely limited. If this situation is not remedied, the lifetime impairment, challenges, and distress experienced by those who stutter cannot be documented in a form that can be used to influence health policy and health care spending. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24168201.
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Affiliation(s)
- Alicia Norman
- Macquarie University Centre for the Health Economy, Macquarie University Business School, North Ryde, New South Wales, Australia
- Australian Institute for Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Robyn Lowe
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Sue O'Brian
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Ann Packman
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Ross Menzies
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Liz Schroeder
- Macquarie University Centre for the Health Economy, Macquarie University Business School, North Ryde, New South Wales, Australia
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
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Boyle MP, Cheyne MR, Rosen AL. Self-Stigma of Stuttering: Implications for Communicative Participation and Mental Health. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3328-3345. [PMID: 37524109 DOI: 10.1044/2023_jslhr-23-00098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
PURPOSE The purpose of this study was to determine if self-stigma-related variables predicted communicative participation and mental health in adults who stutter. A progressive model of self-stigma was theorized and tested. METHOD Adults who stutter (N = 344) completed a survey that included measures of communicative participation, global mental health, and a variety of self-stigma-related variables including perceived enacted stigma, stigma awareness, anticipated stigma, felt stigma, stereotype agreement, and stigma application, in addition to demographic and speech-related variables. Hierarchical regression was performed to test whether self-stigma-related variables progressively explained significant variance in both communicative participation and global mental health.c Results: After controlling for demographic and speech-related variables, stigma-related variables were found to be significant predictors of both communicative participation and global mental health among adults who stutter. Most self-stigma-related variables entered later in the model predicted additional unique variance in the outcome variables than the self-stigma-related variables entered in previous steps, thus supporting the trickle-down and progressive nature of the self-stigma model theorized. CONCLUSIONS Accounting for self-stigma in the assessment and treatment of individuals who stutter may identify and ultimately reduce environmental and personal barriers to communicative functioning and well-being in people who stutter. The self-stigma terminology and model described in this study will help practitioners, researchers, and the public better understand the process of self-stigma and how it may be associated with adverse outcomes experienced by people who stutter.
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Affiliation(s)
- Michael P Boyle
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
| | - Madeline R Cheyne
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
| | - Amy L Rosen
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
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Irani F, Mock JR, Myers JC, Johnson J, Golob EJ. A novel non-word speech preparation task to increase stuttering frequency in experimental settings for longitudinal research. JOURNAL OF COMMUNICATION DISORDERS 2023; 105:106353. [PMID: 37331327 DOI: 10.1016/j.jcomdis.2023.106353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/20/2023]
Abstract
PURPOSE The variable and intermittent nature of stuttering makes it difficult to consistently elicit a sufficient number of stuttered trials for longitudinal experimental research. This study tests the efficacy of using non-word pairs that phonetically mimic English words with no associated meaning, to reliably elicit balanced numbers of stuttering and fluent trials over multiple sessions. The study also evaluated the effect of non-word length on stuttering frequency, the consistency of stuttering frequency across sessions, and potential carry-over effects of increased stuttering frequency in the experimental task to conversational and reading speech after the task. METHODS Twelve adults who stutter completed multiple sessions (mean of 4.8 sessions) where they were video-recorded during pre-task reading and conversation, followed by an experimental task where they read 400 non-word pairs randomized for each session, and then a post-task reading and conversation sample. RESULTS On average, across sessions and participants, non-word pairs consistently yielded a balanced distribution of fluent (60.7%) and stuttered (39.3%) trials over five sessions. Non-word length had a positive effect on stuttering frequency. No carryover effects from experimental to post-task conversation and reading were found. CONCLUSIONS Non-word pairs effectively and consistently elicited balanced proportions of stuttered and fluent trials. This approach can be used to gather longitudinal data to better understand the neurophysiological and behavioral correlates of stuttering.
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Affiliation(s)
- Farzan Irani
- Department of Communication Disorders, Texas State University, Round Rock Campus.
| | - Jeffrey R Mock
- Department of Psychology, University of Texas, San Antonio
| | - John C Myers
- Department of Psychology, University of Texas, San Antonio; Department of Neurosurgery, Baylor College of Medicine, Houston TX
| | - Jennifer Johnson
- Department of Communication Disorders, Texas State University, Round Rock Campus
| | - Edward J Golob
- Department of Psychology, University of Texas, San Antonio
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15
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Węsierska K, Yaruss JS, Kosacka K, Kowalczyk Ł, Boroń A. The experience of Polish individuals who stutter based on the OASES outcomes. JOURNAL OF FLUENCY DISORDERS 2023; 77:105991. [PMID: 37354736 DOI: 10.1016/j.jfludis.2023.105991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 05/10/2023] [Accepted: 06/12/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Prior research has shown that stuttering is a complex and individualized condition. The Overall Assessment of the Speaker's Experience of Stuttering (OASES; Yaruss & Quesal, 2016) is a well-researched tool that measures the impact of stuttering on an individual's life. This study has used the Polish version of the OASES to examine the experience of stuttering among Polish people who stutter. METHOD The original, English version of the OASES was translated into Polish. Reliability and validity for the Polish version were evaluated. Comparisons were made between samples from Poland and the United States for all of the sections and for the overall results of the OASES-S, OASES-T, and OASES-A. To explore the structure of the stuttering experience, a factor structure of the OASES was conducted. RESULTS Like other versions of the OASES, the OASES-Polish (OASES-PL) demonstrated good reliability and validity. Cross-cultural comparisons have shown that Polish school-age children had significantly lower knowledge and awareness of stuttering than children in the United States (USA). Factor analysis further revealed that the structure of the experience of stuttering is similar across all age groups, but the importance of the particular aspects of stuttering varies at different stages of life. CONCLUSION The OASES-PL is a reliable and valid instrument for measuring the impact of stuttering on Polish people who stutter and can therefore be used as a clinical tool. Polish results were relatively similar to those from the USA, though there were subtle cross-cultural differences that are worthy of further exploration. EDUCATIONAL OBJECTIVES After reading the article, the participant will be able: (1) to describe the diverse experiences of Polish people who stutter at different ages, (2) to explain the importance of quality of life analysis in diagnosis and speech therapy with people who stutter, and (3) to explain the breadth of the stuttering phenomenon among Polish individuals who stutter.
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Eichorn N, Hall J, Marton K. Complex working memory in adults with and without stuttering disorders: Performance patterns and predictive relationships. JOURNAL OF FLUENCY DISORDERS 2023; 77:105993. [PMID: 37406551 DOI: 10.1016/j.jfludis.2023.105993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/13/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE Available studies of working memory (WM) in speakers who stutter tend to rely on parent report, focus on phonological WM, or measure WM in combination with other processes. The present research aimed to: (1) compare complex WM in adults who stutter (AWS) and adults who do not stutter (AWNS); (2) characterize group performance patterns; and (2) determine whether WM predicts stuttering severity. METHODS Eighteen AWS and 20 AWNS completed parallel verbal and spatial span tasks in which to-be-remembered items were interleaved with a distracting task across varying set sizes. Dependent variables included the number of correctly recalled items, accuracy on distraction tasks, and detailed analyses of item-level responses. We further examined whether span scores predicted subjective and objective measures of stuttering severity. RESULTS Relative to AWNS, AWS showed poorer recall, specifically on short set sizes in the spatial task. Groups performed similarly on distraction tasks and showed comparable error patterns. Predictive relationships differed by span task and severity measure. Lower verbal span scores predicted greater stuttering impact and more overt stuttering behaviors; lower spatial span scores predicted lower impact and was unrelated to overt behaviors. CONCLUSIONS Findings suggest that AWS differ subtly from AWNS in WM performance. Group differences became more apparent under certain task conditions but could not be attributed to specific underlying processes. Data further indicated a complex relationship between WM and stuttering severity. Overall, results corroborate previous studies linking stuttering to domain-general weaknesses, but highlight the need for additional research to clarify the nature of this relationship.
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Affiliation(s)
- Naomi Eichorn
- The University of Memphis, 4055 N. Park Loop, Memphis, TN, 38152, USA.
| | - Jessica Hall
- The University of Memphis, 4055 N. Park Loop, Memphis, TN, 38152, USA
| | - Klara Marton
- Graduate Center, City University of New York, 365 Fifth Ave, New York, NY 10016, USA; Brooklyn College, City University of New York, 2900 Bedford Ave, Brooklyn, NY 11210, USA; MTA-ELTE Language-Learning Disorders Research Group, Bárczi Gusztáv College of Special Needs Education, Eötvös Loránd University, Egyetem tér 1-3, Budapest 1053, Hungary
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Goldfarb JH, Orpella J, Jackson ES. Eliciting Stuttering in School-Age and Adolescent Stutterers in Experimental Settings. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1631-1638. [PMID: 37059075 PMCID: PMC10465159 DOI: 10.1044/2023_jslhr-22-00626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/03/2023] [Accepted: 02/07/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE Most neural and physiological research on stuttering focuses on the fluent speech of speakers who stutter due to the difficulty associated with eliciting stuttering reliably in the laboratory. We previously introduced an approach to elicit stuttered speech in the laboratory in adults who stutter. The purpose of this study was to determine whether that approach reliably elicits stuttering in school-age children and teenagers who stutter (CWS/TWS). METHOD Twenty-three CWS/TWS participated. A clinical interview was used to identify participant-specific anticipated and unanticipated words in CWS and TWS. Two tasks were administered: (a) a delayed word reading task in which participants read words and produced them after a 5-s delay and (b) a delayed response question task in which participants responded to examiner questions after a 5-s delay. Two CWS and eight TWS completed the reading task; six CWS and seven TWS completed the question task. Trials were coded as unambiguously fluent, ambiguous, and unambiguously stuttered. RESULTS The method yielded, at a group level, a near-equal distribution of unambiguously stuttered and fluent utterances: 42.5% and 45.1%, respectively, in the reading task and 40.5% and 51.4%, respectively, in the question task. CONCLUSIONS The method presented in this article elicited a comparable amount of unambiguously stuttered and fluent trials in CWS and TWS, at a group level, during two different word production tasks. The inclusion of different tasks supports the generalizability of our approach, which can be used to elicit stuttering in studies that aim to unravel the neural and physiological bases that underlie stuttered speech.
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Affiliation(s)
- Jake H Goldfarb
- Department of Communicative Sciences and Disorders, New York University, NY
| | - Joan Orpella
- Department of Psychology, New York University, NY
| | - Eric S Jackson
- Department of Communicative Sciences and Disorders, New York University, NY
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Maessen B, Zink I, Maes B, Rombouts E. The effect of manual movements on stuttering in individuals with down syndrome. JOURNAL OF FLUENCY DISORDERS 2023; 75:105958. [PMID: 36621164 DOI: 10.1016/j.jfludis.2023.105958] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 01/02/2023] [Accepted: 01/02/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE Stuttering may disrupt the speech of individuals with Down syndrome (DS), but standard stuttering therapies may be less adapted to these clients' needs. This study examined if their strength in gesture use can lead to the development of a new stuttering therapy. METHOD Eighteen individuals with DS who stutter participated in an experimental task. During this task, they produced sentences in three different conditions: once without the ability to use gestures, once while moving the mouth of a hand puppet synchronous with their speech, and once while making beat gestures along their speech. Stuttering frequency was measured and compared between conditions while controlling for the effect of articulation rate. RESULTS The experimental hand puppet and beat condition did not affect the stuttering frequency, but the covariate articulation rate did. An exploratory posthoc analysis showed that the articulation rate decreased during the experimental hand puppet and beat condition. Manual movements in the present task might only induce fluency through articulation rate reduction. However, analyses at individual level show significant interindividual variability. CONCLUSION Individual analyses show that effect on stuttering frequency cannot be attributed entirely to articulation rate reduction and that beat gestures might still play a role. However, at this point, there is not enough direct evidence to implement beat gestures in current stuttering therapy.
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Affiliation(s)
- Babette Maessen
- Department of Neurosciences, Experimental Otorinolaryngology, KU Leuven, Belgium.
| | - Inge Zink
- Department of Neurosciences, Experimental Otorinolaryngology, KU Leuven, Belgium
| | - Bea Maes
- Parenting and Special Education Research Group, KU Leuven, Belgium
| | - Ellen Rombouts
- Department of Neurosciences, Experimental Otorinolaryngology, KU Leuven, Belgium
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Frankford SA, Cai S, Nieto-Castañón A, Guenther FH. Auditory feedback control in adults who stutter during metronome-paced speech I. Timing Perturbation. JOURNAL OF FLUENCY DISORDERS 2023; 75:105943. [PMID: 36423506 PMCID: PMC9974758 DOI: 10.1016/j.jfludis.2022.105943] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 10/26/2022] [Accepted: 11/14/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE This study determined whether adults who stutter (AWS) exhibit deficits in responding to an auditory feedback timing perturbation, and whether external timing cues, which increase fluency, attenuate any disruptions due to altered temporal auditory feedback. METHODS Fifteen AWS and sixteen adults who do not stutter (ANS) read aloud a multisyllabic sentence either with normal pacing or with each syllable paced at the rate of a metronome. On random trials, an auditory feedback timing perturbation was applied, and timing responses were compared between groups and pacing conditions. RESULTS Both groups responded to the timing perturbation by delaying subsequent syllable boundaries, and there were no significant differences between groups in either pacing condition. Furthermore, no response differences were found between normally paced and metronome-paced conditions. CONCLUSION These findings are interpreted as showing that 1) AWS respond normally to pure timing perturbations, and 2) metronome-paced speech has no effect on online speech timing control as assessed in the present experiment.
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Affiliation(s)
- Saul A Frankford
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Shanqing Cai
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Alfonso Nieto-Castañón
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Frank H Guenther
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA; Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA.
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20
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Singer CM, Kelly EM, White AZ, Zengin-Bolatkale H, Jones RM. Validation of the Vanderbilt Responses to Your Child's Speech Rating Scale for Parents of Young Children Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4652-4666. [PMID: 36455149 PMCID: PMC9934910 DOI: 10.1044/2022_jslhr-22-00182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/04/2022] [Accepted: 08/25/2022] [Indexed: 06/03/2023]
Abstract
PURPOSE This study reports the development, refinement, and exploration of the psychometric properties of the Vanderbilt Responses to Your Child's Speech (VRYCS) rating scale, a novel measure designed to assess parents' self-perceived responses to the speech of their children who stutter (CWS). METHOD Parents of 214 young (ages 2;4[years;months]-5;11) CWS completed the original 40-item version of the VRYCS. Content analyses and an exploratory factor analysis determined the scale's factors and identified specific items corresponding to each. Items that did not load onto the factors were removed and internal consistency was assessed. RESULTS The final 18-item VRYCS rating scale includes five factors relating to parents' responses to the speech of their CWS including (a) Requesting Change, (b) Speaking for the Child, (c) Supporting Communication, (d) Slowing and Simplifying, and (e) Responding Emotionally. Reliability was demonstrated, responses by parents of CWS were described, and a revised scoring form developed. CONCLUSIONS The VRYCS is a valid and reliable tool for assessing and exploring parents' perceptions of their own responses to the speech of their CWS for clinical and research purposes. Clinical applications of the VRYCS for assessment and treatment of childhood stuttering are discussed.
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Affiliation(s)
- Cara M. Singer
- Department of Communication Sciences and Disorders, Grand Valley State University, Grand Rapids, MI
| | - Ellen M. Kelly
- Arthur M. Blank Center for Stuttering Education and Research, The University of Texas at Austin
| | - A. Zebedee White
- Arthur M. Blank Center for Stuttering Education and Research, The University of Texas at Austin
| | - Hatun Zengin-Bolatkale
- Department of Communicative Sciences and Deaf Studies, California State University, Fresno
| | - Robin M. Jones
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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Samson I, Schalling E, Herlitz A, Lindström E, Sand A. A Cross-Sectional Investigation of the Impact of Stuttering on Swedish Females and Males in Childhood, Adolescence, and Young Adulthood. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4608-4622. [PMID: 36399792 DOI: 10.1044/2022_jslhr-22-00043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE We aimed to cross-sectionally describe the impact of stuttering on persons who stutter (PWS): children, adolescents, and young adults. Based on previous research on PWS and psychosocial health in the general population, we hypothesized that (a) the adverse impact of stuttering in PWS would be larger among adolescents than children and young adults and that (b) females, especially adolescent females, would report being more adversely impacted by their stuttering than males. METHOD We pooled samples of Swedish PWS, obtaining 162 individuals (75 females and 87 males), aged 7-30 years. We measured the impact of stuttering using age-relevant versions of the Overall Assessment of the Speaker's Experience of Stuttering (OASES). The relationship between OASES score, age, and sex was described using a polynomial model with an interaction term between age and sex to allow for potential differences between females and males' age-related curves. RESULTS The average trends were that (a) the impact of stuttering was greater for the adolescents than for the children and young adults, and (b) females, especially adolescent females, were on average more impacted by their stuttering than males. Taking self-reported speech fluency into account did not change this pattern. CONCLUSIONS In line with findings on psychosocial health, communication attitude, and self-esteem in the general population, the impact of stuttering seems to be particularly adverse among adolescents, especially female adolescents. Thus, clinicians need to be aware of the risk that young girls who stutter may develop a negative attitude to speech and communication, and this should also be communicated to caregivers and teachers. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21554877.
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Affiliation(s)
- Ineke Samson
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Division of Speech and Language Pathology, Danderyd Hospital, Stockholm, Sweden
| | - Ellika Schalling
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and Caring Sciences/Speech-Language Pathology, Uppsala University, Sweden
| | - Agneta Herlitz
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Elisabeth Lindström
- Logopedics, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Anders Sand
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
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Frankford SA, Cai S, Nieto-Castañón A, Guenther FH. Auditory feedback control in adults who stutter during metronome-paced speech II. Formant Perturbation. JOURNAL OF FLUENCY DISORDERS 2022; 74:105928. [PMID: 36063640 PMCID: PMC9930613 DOI: 10.1016/j.jfludis.2022.105928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 07/11/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Prior work has shown that Adults who stutter (AWS) have reduced and delayed responses to auditory feedback perturbations. This study aimed to determine whether external timing cues, which increase fluency, resolve auditory feedback processing disruptions. METHODS Fifteen AWS and sixteen adults who do not stutter (ANS) read aloud a multisyllabic sentence either with natural stress and timing or with each syllable paced at the rate of a metronome. On random trials, an auditory feedback formant perturbation was applied, and formant responses were compared between groups and pacing conditions. RESULTS During normally paced speech, ANS showed a significant compensatory response to the perturbation by the end of the perturbed vowel, while AWS did not. In the metronome-paced condition, which significantly reduced the disfluency rate, the opposite was true: AWS showed a significant response by the end of the vowel, while ANS did not. CONCLUSION These findings indicate a potential link between the reduction in stuttering found during metronome-paced speech and changes in auditory motor integration in AWS.
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Affiliation(s)
- Saul A Frankford
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Shanqing Cai
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Alfonso Nieto-Castañón
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Frank H Guenther
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA; Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA.
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Tichenor SE, Wray AH, Ravizza SM, Yaruss JS. Individual differences in attentional control predict working memory capacity in adults who stutter. JOURNAL OF COMMUNICATION DISORDERS 2022; 100:106273. [PMID: 36274445 DOI: 10.1016/j.jcomdis.2022.106273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 10/03/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Prior research has suggested that people who stutter exhibit differences in some working memory tasks, particularly when more phonologically complex stimuli are used. This study aimed to further specify working memory differences in adults who stutter by not only accounting for linguistic demands of the stimuli but also individual differences in attentional control and experimental influences, such as concomitant processing requirements. METHOD This study included 40 adults who stutter and 42 adults who do not stutter who completed the Attention Network Test (ANT; Fan et al., 2002) and three complex span working memory tasks: the Operation Span (OSPAN), Rotation Span, and Symmetry Span (Draheim et al., 2018; Foster et al., 2015; Unsworth et al., 2005, 2009). All complex span tasks were dual-tasks and varied in linguistic content in task stimuli. RESULTS Working memory capacities demonstrated by adults who stutter paralleled the hierarchy of linguistic content across the three complex span tasks, with statistically significant between-group differences in working memory capacity apparent in the task with the highest linguistic demand (i.e., OSPAN). Individual differences in attentional control in adults who stutter also significantly predicted working memory capacity on the OSPAN. DISCUSSION Findings from this study extend existing working memory research in stuttering by showing that: (1) significant working memory differences are present between adults who stutter and adults who do not stutter even using relatively simple linguistic stimuli in dual-task working memory conditions; (2) adults who stutter with stronger executive control of attention demonstrate working memory capacity more comparable to adults who do not stutter on the OSPAN compared to adults who stutter with lower executive control of attention.
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Aldukair L, Ward D. Telepractice application for the overt stuttering assessment of children aged 6-15 years old. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:1050-1070. [PMID: 35703426 DOI: 10.1111/1460-6984.12739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 05/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite the importance of delivering speech and language therapy services to children who stutter (CWS), there are barriers to accessing speech and language therapy. One way to improve access for those who may otherwise be deprived of speech and language therapy services, including CWS, is through telepractice (TP). However, there is currently no evidence as to the viability of TP stuttering assessments for CWS. AIM To investigate the validity and reliability, and acceptability of using a TP application to assess overt stuttering behaviour children aged 6-15 years. METHODS & PROCEDURE A total of 30 CWS, aged between 6 and 15 years, were recruited from a speech therapy clinic in King Abdulaziz University Hospital in Riyadh, Saudi Arabia. Children were divided into two testing conditions, either face-to-face (f2f)-led or TP-led testing, and the Stuttering Severity Instrument (SSI-IV) was administered, percentage of syllables stuttered (%SS) was calculated, and severity ratings (SR) assigned, either via f2f or via TP using two laptops with webcams, video conference software and a broadband internet connection. Agreement and reliability of scoring in the two testing conditions were reported in addition to findings from questionnaires exploring children's and their caregivers' perceptions both before and immediately after the TP assessment was carried out. OUTCOME & RESULTS A total of 30 sessions were successfully carried out, with results revealing unsatisfactory levels of agreement when applying the Bland and Altman method. However, when discrepancies were found, these were comparable with those from traditional f2f studies. Generally, parents and children exhibited high levels of satisfaction and held a positive view regarding TP pre- and post-assessment. CONCLUSIONS & IMPLICATIONS The results of the study suggest that conducting an overt stuttering assessment via TP for 6-15-year-olds CWS is reliable and valid. Although the TP model posed some (mainly technical) challenges for executing the assessment, high levels of satisfaction were recorded by parents and children alike. The TP system and equipment chosen in this study has provided a basis for the delivery of TP overt stuttering assessment in a clinical setting, thus addressing the barriers to access that are present for CWS. These results are preliminary, but they can be seen as a building block for future research in TP assessment studies for CWS. WHAT THIS PAPER ADDS What is already known on the subject Stuttering treatment via TP has been proven to be feasible and successful across a variety of treatment programs (e.g., Lidcombe, Camperdown). However, the viability of assessing stuttering via videoconferencing has never been explored in children. What this paper adds to existing knowledge Preliminary support for the assessment of overt stuttering in CWS aged 6-15 years via video conferencing. The results justify larger scale studies of this service delivery method. What are the potential or actual clinical implications of this work? The TP system and equipment chosen in this study has provided a basis for the delivery of TP overt stuttering assessment in a clinical setting, thus addressing the barriers to access that are present for CWS aged 6-15 years.
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Affiliation(s)
- Lamya Aldukair
- Health Rehabilitation Sciences Department, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - David Ward
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Bayat M, Boostani R, Sabeti M, Yadegari F, Taghavi M, Pirmoradi M, Chakrabarti P, Nami M. Speech Related Anxiety in Adults Who Stutter. J PSYCHOPHYSIOL 2022. [DOI: 10.1027/0269-8803/a000305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The relationship between anxiety and stuttering has always been a topic of debate with a great emphasis on research focused on examining whether speech-related anxiety can exacerbate stuttering. This investigation compares some speech-related anticipatory anxiety indices in fluent and dysfluent utterances in adults who stutter (AWS). We scored the level of cognitive speech-related anxiety (anticipatory anxiety) using a self-reporting method and also evaluated the autonomic aspects of anxiety (state anxiety) through recording changes in Galvanic Skin Response (GSR) signals. Explaining the link between stuttering and anxiety is expected to assist practitioners in stuttering assessment and subsequent treatment strategies. Phasic GSR values of six events related to answering the verbal stimuli through fluent and dysfluent responses were registered to measure sympathetic arousal as an index of state anxiety in 20 AWS ( Mage = 35 ± 4 years, range: 21–42). To quantitatively examine the cognitive aspects of speech-related anticipatory anxiety, two questionnaires were rated by participants addressing the stuttering anticipation and semantic difficulty of verbal stimuli. GSR measures of fluent events were significantly higher than dysfluent counterparts within time windows before and during answering aloud the verbal stimuli ( p < .001). Later in the experiment, GSR values of dysfluent events were found to be higher than their fluent counterparts ( p < .001). Stuttering anticipation yielded a weak negative meaningful correlation with the scores of fluency ( r = −0.283, p = .046) and a positive yet nonsignificant correlation with the stuttering scores. The semantic difficulty had a moderately significant correlation with stuttering anticipation ( r = 0.354, p = .012) but not a meaningful correlation with fluency state. Autonomic and cognitive indices of speech-related anticipatory anxiety are not robust predictors of fluency. Anxiety seems to be more of a consequence of stuttering than a cause.
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Affiliation(s)
- Masoumeh Bayat
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Boostani
- Head of Biomedical Engineering Group, Faculty of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran
| | - Malihe Sabeti
- Department of Computer Engineering, Islamic Azad University, North-Tehran Branch, Tehran, Iran
| | - Fariba Yadegari
- Department of Speech and Language Pathology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahsa Taghavi
- Psychiatry group, medical school, Islamic Azad University, Kazeroon Branch, Kazeroon, Iran
| | - Mohammadreza Pirmoradi
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- ITM SLS, Baroda University, Vadodara, Gujarat, India
- Dana Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran
- Society for Brain Mapping and Therapeutics, Brain Mapping Foundation, Los Angeles, CA, USA
- Harvard Alumni for Mental Health, Harvard University, Boston, MA, USA
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Boyle MP, Chagachbanian NJ. Uncertainty and Perceived Control as Predictors of Communicative Participation and Mental Health in Adults Who Stutter. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:757-769. [PMID: 35007427 DOI: 10.1044/2021_ajslp-21-00230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE This study examined the role of uncertainty and perceived control in predicting the communicative participation and mental health of adults who stutter. METHOD Two hundred sixty-nine adults who stutter completed measures of uncertainty about stuttering, perceived control of stuttering, communicative participation, and global mental health. In addition, participants self-reported on a variety of demographic and speech-related measures. Correlational analyses and hierarchical regression were performed to determine associations between variables of interest. RESULTS Uncertainty accounted for significant variance in communicative participation and global mental health after statistically controlling for the effects of demographic and speech-related variables. Perceived control accounted for significant variance in communicative participation over and above what was accounted for by demographic variables, speech-related variables, and uncertainty. CONCLUSIONS The findings suggest that uncertainty about stuttering and perceived control of stuttering should be accounted for during assessment and intervention with adults who stutter. Interventions that specifically target uncertainty and perceived control may be useful in improving therapeutic outcomes for individuals who stutter.
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Affiliation(s)
- Michael P Boyle
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
| | - Nicole J Chagachbanian
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
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Lescht E, Dickey MW, Stockbridge MD, Ratner NB. Adults Who Stutter Show Diminished Word Fluency, Regardless of Mode. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:906-922. [PMID: 35133869 PMCID: PMC9150734 DOI: 10.1044/2021_jslhr-21-00344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/03/2021] [Accepted: 11/07/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE Language abilities have long been thought to be weaker in adults who stutter (AWS) compared to adults who do not stutter (AWNS). However, it is unknown whether modality affects language performance by AWS in time pressure situations. This study aimed to examine lexical access and retrieval abilities of AWS in oral and typed modes. METHOD Fifteen AWS and 15 well-matched AWNS completed computer-administered letter fluency tasks. Adults were asked to orally produce words that began with one of two letter targets and type words that began with one of two alternate letters. Conditions were counterbalanced across participants. RESULTS Generalized linear mixed-effects models were evaluated to determine the effects of group (AWS/AWNS), mode (oral/typed), and expressive vocabulary on letter fluency performance. Group predicted letter fluency such that AWS generated fewer items on both the oral and typed letter fluency tasks. Mode did not impact letter fluency results. Expressive Vocabulary Test scores predicted letter fluency similarly in both AWS and AWNS. CONCLUSIONS AWS were not penalized by oral task demands. AWS generated fewer items on the letter fluency tasks regardless of response mode, suggesting that they have weaker lexical access abilities. Furthermore, better expressive vocabulary skills were associated with better letter fluency performance in both groups.
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Affiliation(s)
- Erica Lescht
- Department of Communication Science and Disorders, University of Pittsburgh, PA
| | - Michael Walsh Dickey
- Department of Communication Science and Disorders, University of Pittsburgh, PA
- Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, PA
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Constantino C, Campbell P, Simpson S. Stuttering and the social model. JOURNAL OF COMMUNICATION DISORDERS 2022; 96:106200. [PMID: 35248920 DOI: 10.1016/j.jcomdis.2022.106200] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 02/02/2022] [Accepted: 02/22/2022] [Indexed: 06/14/2023]
Abstract
Stuttering has traditionally been thought of as a defect located within an individual. As such, stuttering is caused by pathology, leading to impaired communication and reduced quality of life. Research from this medical tradition has looked to understand the etiology of stuttering to develop curative therapeutic approaches. From this frame, professionals and academics are experts and holders of knowledge; people who stutter the recipients of this expertise. The social model emerged from within the disability rights movement and offers a counter narrative. It sees the way society is structured as disabling rather than physical impairment itself. Disability is experienced when a person is unable to participate fully in society through a mismatch between their body and the environment around them; thus, disability becomes a dynamic process, not an inherent characteristic. The social model highlights society's norms and values, and, in the case of stuttering, demonstrates how society is designed for, and expects, fluent speakers. From this frame, people who stutter are the experts of their experience and holders of knowledge; professionals and academics are their allies, collaborators, and advocates for social change. This theoretical framework poses challenging questions of the foundational theories upon which stuttering therapy is historically rooted. They call into question the hierarchical structures, power dynamics and even purpose of stuttering therapy and research. In this discussion paper, we will explore the social model of disability and its implications for stuttering therapy and research. We discuss the benefits of a social model approach as well as its limitations.
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Tichenor SE, Constantino C, Yaruss JS. A Point of View About Fluency. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:645-652. [PMID: 34982943 PMCID: PMC9135003 DOI: 10.1044/2021_jslhr-21-00342] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/15/2021] [Accepted: 09/28/2021] [Indexed: 05/14/2023]
Abstract
PURPOSE This article presents several potential concerns with the common usage of the term fluency in the study of stuttering and people who stutter (or, as many speakers now prefer, stutterers). Our goal is to bridge gaps between clinicians, researchers, and stutterers to foster a greater sense of collaboration and understanding regarding the words that are used and meanings that are intended. METHOD We begin by reviewing the history of the term fluency. We then explore its usage and current connotations to examine whether the term meaningfully describes constructs that are relevant to the study of the stuttering condition. RESULTS By highlighting current research and perspectives of stutterers, we conclude that the term fluency (a) is not fully inclusive, (b) encourages the use of misleading measurement procedures, (c) constrains the subjective experience of stuttering within a false binary categorization, and (d) perpetuates a cycle of stigma that is detrimental to stutterers and to the stuttering community as a whole. CONCLUSIONS We recommend that researchers and clinicians cease referring to stuttering as a fluency disorder and simply refer to it as stuttering. Furthermore, we recommend that researchers and clinicians distinguish between moments of stuttering (i.e., what stutterers experience when they lose control of their speech or feel stuck) and the overall lived experience of the stuttering condition.
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Tichenor SE, Herring C, Yaruss JS. Understanding the Speaker's Experience of Stuttering Can Improve Stuttering Therapy. TOPICS IN LANGUAGE DISORDERS 2022; 42:57-75. [PMID: 35757374 PMCID: PMC9231935 DOI: 10.1097/tld.0000000000000272] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The purpose of this paper is to highlight the value for speech-language pathologists of considering the overall stuttering condition-including speakers' experiences during and around moments of stuttering-in treatment with individuals who stutter. We first highlight a framework for conceptualizing the entirety of the stuttering condition. We then present recent research and clinical perspectives about stuttering to support the claim that speech-language pathologists who account for individual differences in how their clients experience stuttering are better positioned to treat stuttering more effectively. Ultimately, this will yield better treatment outcomes and help clinicians achieve greater gains in quality of life for their clients who stutter.
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Affiliation(s)
| | - Caryn Herring
- Communicative Sciences and Disorders, Michigan State University
| | - J Scott Yaruss
- Communicative Sciences and Disorders, Michigan State University
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Alm PA. The Dopamine System and Automatization of Movement Sequences: A Review With Relevance for Speech and Stuttering. Front Hum Neurosci 2021; 15:661880. [PMID: 34924974 PMCID: PMC8675130 DOI: 10.3389/fnhum.2021.661880] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 10/12/2021] [Indexed: 12/28/2022] Open
Abstract
The last decades of research have gradually elucidated the complex functions of the dopamine system in the vertebrate brain. The multiple roles of dopamine in motor function, learning, attention, motivation, and the emotions have been difficult to reconcile. A broad and detailed understanding of the physiology of cerebral dopamine is of importance in understanding a range of human disorders. One of the core functions of dopamine involves the basal ganglia and the learning and execution of automatized sequences of movements. Speech is one of the most complex and highly automatized sequential motor behaviors, though the exact roles that the basal ganglia and dopamine play in speech have been difficult to determine. Stuttering is a speech disorder that has been hypothesized to be related to the functions of the basal ganglia and dopamine. The aim of this review was to provide an overview of the current understanding of the cerebral dopamine system, in particular the mechanisms related to motor learning and the execution of movement sequences. The primary aim was not to review research on speech and stuttering, but to provide a platform of neurophysiological mechanisms, which may be utilized for further research and theoretical development on speech, speech disorders, and other behavioral disorders. Stuttering and speech are discussed here only briefly. The review indicates that a primary mechanism for the automatization of movement sequences is the merging of isolated movements into chunks that can be executed as units. In turn, chunks can be utilized hierarchically, as building blocks of longer chunks. It is likely that these mechanisms apply also to speech, so that frequent syllables and words are produced as motor chunks. It is further indicated that the main learning principle for sequence learning is reinforcement learning, with the phasic release of dopamine as the primary teaching signal indicating successful sequences. It is proposed that the dynamics of the dopamine system constitute the main neural basis underlying the situational variability of stuttering.
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Affiliation(s)
- Per A Alm
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
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Werle D, Winters KL, Byrd CT. Preliminary study of self-perceived communication competence amongst adults who do and do not stutter. JOURNAL OF FLUENCY DISORDERS 2021; 70:105848. [PMID: 33895686 DOI: 10.1016/j.jfludis.2021.105848] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/20/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Adults who stutter report a significant impact of stuttering on their quality of life, including negative thoughts and attitudes toward communication. In addition to this impact, adolescents who stutter also report lower levels of self-perceived communication competence (SPCC) compared to fluent peers. The purpose of this study was to extend the investigation of SPCC to adults who do and do not stutter. Additional aims investigated included if 1) SPCC predicted overall impact of stuttering, and, 2) stuttering frequency predicted SPCC among adults who stutter. METHODS Twenty-four adults who stutter and twenty-seven adults who do not stutter matched for age, gender, and education completed the Self-Perceived Communication Competence Scale (Richmond & McCroskey, 1997). All participants who stutter completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES [ages 18+]; Yaruss & Quesal, 2006) and speaking samples to measure stuttering frequency. RESULTS Adults who stutter reported significantly lower SPCC scale total scores than adults who do not stutter. For adults who stutter, lower SPCC scale scores significantly predicted more severe overall impact of stuttering as measured by the OASES. Stuttering frequency did not predict SPCC scale scores. DISCUSSION This is the first study to report differences in self-perceived communication competence between adults who do and do not stutter. Results suggest adults who stutter report lower self-perceived communication competence compared to adults who do not stutter. Adults who perceive themselves to have greater communication competence reported less severe overall impact of stuttering, and stuttering frequency did not influence SPCC. Clinical implications for intervention are discussed.
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Affiliation(s)
- Danielle Werle
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, University Station A1100, Austin, TX, 78759, United States.
| | - Katherine L Winters
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, University Station A1100, Austin, TX, 78759, United States
| | - Courtney T Byrd
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, University Station A1100, Austin, TX, 78759, United States
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Zebrowski PM, Rodgers NH, Gerlach H, Paiva AL, Robbins ML. Applying the Transtheoretical Model to Stuttering Management Among Adolescents: Part I. Scale Development. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2492-2509. [PMID: 34525312 DOI: 10.1044/2021_ajslp-20-00186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose This article is the first in a two-part series on the application of the Transtheoretical Model to stuttering management among adolescents. In this article, we describe the process of developing measures to assess stage of change (SOC) by defining behaviors of stuttering management, as well as the two primary cognitive constructs that underlie one's readiness to make behavioral change: decisional balance (DB) and situational self-efficacy (SSE). This work hinges on the ability to develop an operational definition of what it means to successfully manage or do something positive about one's stuttering. Method We used an iterative process to develop the three scales. Through qualitative analysis of key informant interview and focus group transcripts with 24 adolescents who stutter and 26 clinicians specializing in stuttering, we developed stuttering-specific SOC, DB, and SSE scales. The drafted scales were cognitively tested with nine adolescents who stutter. Results Thematic analysis yielded a three-part definition of successful stuttering management that formed the basis for the SOC scale: (a) learning and using strategies to modify speech or stuttering, (b) changing negative thoughts and attitudes regarding stuttering, and (c) talking without avoiding sounds, words, or situations. Results from this analysis support a broader view of successful stuttering management; that is, it is likely that doing so requires more than just behavior change, which has long been considered the main objective of stuttering treatment. Additional analyses yielded pros and cons of managing stuttering (62 items for the DB scale) and situations in which it is difficult to manage stuttering (39 items for the SSE scale). Conclusions Qualitative analyses provided a three-part definition of "stuttering management" and a comprehensive pool of items that would allow measurement of DB and SSE that underlie readiness to manage stuttering among adolescents. In the companion article in this two-part series, we describe the next step in scale development: exploratory scale validation of the drafted SOC, DB, and SSE scales.
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Affiliation(s)
- Patricia M Zebrowski
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City
| | - Naomi H Rodgers
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln
| | - Hope Gerlach
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo
| | - Andrea L Paiva
- Department of Psychology, University of Rhode Island, Kingston
| | - Mark L Robbins
- Department of Psychology, University of Rhode Island, Kingston
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Brundage SB, Ratner NB, Boyle MP, Eggers K, Everard R, Franken MC, Kefalianos E, Marcotte AK, Millard S, Packman A, Vanryckeghem M, Yaruss JS. Consensus Guidelines for the Assessments of Individuals Who Stutter Across the Lifespan. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2379-2393. [PMID: 34516299 PMCID: PMC9132036 DOI: 10.1044/2021_ajslp-21-00107] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 05/24/2023]
Abstract
Purpose This project sought to develop consensus guidelines for clinically meaningful, comprehensive assessment procedures for people who stutter across the lifespan. Method Twelve expert clinicians and researchers who have written extensively about stuttering provided detailed descriptions of the type of data that they routinely collect during diagnostic evaluations of preschool children, school-age children, adolescents, and adults who stutter. Iterative content analysis, with repeated input from the respondents, was used to identify core areas that reflect common domains that these experts judge to be important for evaluating stuttering for varying age groups. Results Six core areas were identified as common components of a comprehensive evaluation of stuttering and people who stutter. These areas should be included to varying degrees depending upon the age and needs of the client or family. The core areas include the following: (a) stuttering-related background information; (b) speech, language, and temperament development (especially for younger clients); (c) speech fluency and stuttering behaviors; (d) reactions to stuttering by the speaker; (e) reactions to stuttering by people in the speaker's environment; and (f) adverse impact caused by stuttering. Discussion These consensus recommendations can help speech-language pathologists who are uncertain about appropriate stuttering assessment procedures to design and conduct more thorough evaluations, so that they will be better prepared to provide individualized and comprehensive treatment for people who stutter across the lifespan.
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Affiliation(s)
- Shelley B. Brundage
- Department of Speech, Language & Hearing Sciences, George Washington University, Washington, DC
| | | | - Michael P. Boyle
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
| | - Kurt Eggers
- Speech-Language Pathology & Audiology, Thomas More University, Antwerp, Belgium
- Speech-Language Pathology, University of Turku, Finland
| | | | - Marie-Christine Franken
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Elaina Kefalianos
- Department of Audiology and Speech Pathology, The University of Melbourne, Parkville, Victoria, Australia
- Speech & Language Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Anne K. Marcotte
- Department of Communication Sciences and Special Education, University of Georgia, Athens
| | - Sharon Millard
- The Michael Palin Centre for Stammering Children, London, United Kingdom
| | - Ann Packman
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Martine Vanryckeghem
- Department of Communication Sciences and Disorders, University of Central Florida, Orlando
| | - J. Scott Yaruss
- Department of Communicative Sciences & Disorders, Michigan State University, East Lansing
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Seitz SR, Choo AL. Stuttering: Stigma and perspectives of (dis)ability in organizational communication. HUMAN RESOURCE MANAGEMENT REVIEW 2021. [DOI: 10.1016/j.hrmr.2021.100875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Irani F, Rojas R. Intensive Stuttering Therapy with Telepractice Follow-Up: Longitudinal Outcomes. Folia Phoniatr Logop 2021; 74:254-270. [PMID: 34583350 DOI: 10.1159/000519866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 09/19/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE This study estimated the treatment outcomes of a behavioral stuttering therapy program that blended a combination of intensive face-to-face therapy with telepractice-based follow-up therapy. METHOD A total of 17 participants (mean age = 22 years) who stutter participated in the program, preceded by an extended baseline period. The participants completed a series of assessments conducted over multiple time points, spanning a total of 42 weeks. Growth curve modeling was used to analyze the changes participants experienced in the frequency of stuttering, stuttering severity, communication attitudes, and quality of life. RESULTS The participants demonstrated stability throughout the extended baseline period, and experienced positive outcomes from the intensive program and the gains in communication attitudes and quality of life were largely maintained with weekly follow-up telepractice sessions. However, stuttering frequency and severity increased when the telepractice follow-up session frequency transitioned to a biweekly basis. Neither gender nor age group predicted the treatment outcomes for frequency or severity of stuttering. Gender-based differences were found for the treatment outcomes of specific self-report measures, with male participants having demonstrated a greater proportional decline on their standard scores, relative to female participants. Outcomes were similar for both adolescents and adults. CONCLUSIONS Participants attending the intensive stuttering therapy program experienced positive and significant changes in their speech, attitudes toward communication, and overall quality of life, which were maintained over time with structured, weekly telepractice follow-up sessions.
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Affiliation(s)
- Farzan Irani
- Department of Communication Disorders, Texas State University, Round Rock, Texas, USA
| | - Raúl Rojas
- Department of Speech, Language and Hearing, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, Texas, USA
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Walsh B, Christ S, Weber C. Exploring Relationships Among Risk Factors for Persistence in Early Childhood Stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2909-2927. [PMID: 34260279 PMCID: PMC8740747 DOI: 10.1044/2021_jslhr-21-00034] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/13/2021] [Accepted: 04/07/2021] [Indexed: 05/31/2023]
Abstract
Purpose The purpose of this study is to investigate how epidemiological and clinical factors collectively predict whether a preschooler who is stuttering will persist or recover and to provide guidance on how clinicians can use these factors to evaluate a child's risk for stuttering persistence. Method We collected epidemiological and clinical measures from 52 preschoolers (M = 54.4 months, SD = 6.7 months; 38 boys and 14 girls) diagnosed as stuttering. We then followed these children longitudinally to document whether they eventually recovered or persisted in stuttering. Risk factors found to be significantly associated with stuttering persistence were used to build single and multiple variable predictive statistical models. Finally, we assessed each model's prediction capabilities by recording how accurate a model was in predicting a child's stuttering outcome-persisting or recovered. Results We found that a positive family history of stuttering, poorer performance on a standardized articulation/phonological assessment, higher frequency of stuttering-like disfluencies during spontaneous speech, and lower accuracy on a nonword repetition task were all significantly associated with an increased probability of persistence. The interaction between family history of stuttering and nonword repetition performance was also significant. The full multiple regression model incorporating all these risk factors resulted in the best fitting model with the highest predictive accuracy and lowest error rate. Conclusions For the first time, we show how multiple risk factors collectively predict the probability of stuttering persistence in 3- to 5-year-old preschool children who stutter. Using the full combination of risk factors to assess preschoolers who stutter yielded more accurate predictions of persistence compared to sparser models. A better understanding of the factors that underlie stuttering persistence will yield insight into the underpinnings of chronic stuttering and will help identify etiological targets for novel treatment approaches.
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Affiliation(s)
- Bridget Walsh
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Sharon Christ
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN
| | - Christine Weber
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
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Mancinelli JM. A Framework for a Sociological Description of the Communicative Interaction in Adults Who Stutter. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1660-1672. [PMID: 34138670 DOI: 10.1044/2021_ajslp-20-00279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The author presents a descriptive sociological framework for the communicative interaction between an adult who stutters (AWS) and other communication partners. The author shows that the communicative interaction between an AWS and another interactant is a sociological object that can be evaluated by both parties in real-time, and is impacted by settings, participants, identity, stigmatization, and the type of talk. These elements are consistent with Hymes' SPEAKING model, which was developed to describe speech communication in a social context and can lay the foundation for the development of an ethnography of stuttering. The clinical applications and implications of a sociological framework are discussed and future directions for research are suggested. Method This work is a refinement and enhancement of Mancinelli (2018) and Mancinelli (2019) and the research associated with that work. This is a tutorial with a clinical focus designed to introduce the readership to a sociological perspective on communicative interactions in AWS. Conclusions Stuttering is an emergent phenomenon embedded within a social interaction, necessitating a deeper understanding of the processes at work during those interactions. A sociological framework can provide a more comprehensive description of the communicative interactions as well as the sociocommunicative lives of people who stutter. The information obtained can inform the formulation of realistic, functional goals based on the daily life of the client. Implications for the development of an ethnography of stuttering are discussed.
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Affiliation(s)
- James M Mancinelli
- Department of Communication Sciences and Disorders, School of Nursing and Health Sciences, La Salle University, Philadelphia, PA
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Jacobs MM, Merlo S, Briley PM. Sleep duration, insomnia, and stuttering: The relationship in adolescents and young adults. JOURNAL OF COMMUNICATION DISORDERS 2021; 91:106106. [PMID: 34015644 DOI: 10.1016/j.jcomdis.2021.106106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/31/2021] [Accepted: 04/27/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Evidence of a linkage between neurodevelopmental stuttering and sleep difficulties has been suggested in studies involving children and adolescents. To further examine the relationship between stuttering and sleep, the current study explored both hours of sleep and insomnia in a longitudinal sample of adolescents and young adults living with stuttering. METHOD The data for this study came from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a nationally representative survey study following 13,564 US respondents over the course of 20 years. In each of the five survey waves, respondents noted their average hours of sleep. In addition, Wave IV, respondents indicated whether they suffered from insomnia (i.e., difficulty falling or staying asleep). Respondents who indicated stuttering at ages 18-26 (Wave III) and 24-32 (Wave IV) are considered as those with persistent stuttering-the focus of this analysis. Regression analysis assessed the association between stuttering, hours of sleep and insomnia controlling for sex, age, race, education and other demographic characteristics. RESULTS The sample included 261 participants (1.7% of total respondents) who identified themselves as people who stutter, comprised of 169 males and 92 females. Compared to their fluent counterparts, individuals who stutter reported to sleep, on average, 20 min less per night. Additionally, 15% of those who stutter reported difficulties falling or staying asleep almost every day or every day, which is twice as likely as controls. Results were robust to demographic characteristics and co-occurring conditions. CONCLUSIONS Speech-language pathologists should be aware of the association between stuttering and insomnia, as well as the lower average hours of sleep among adolescents and young adults who stutter. The possibility that lower sleep duration and insomnia may affect stuttering daily variability and impair improvement from stuttering are discussed.
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Affiliation(s)
- Molly M Jacobs
- Department of Health Services & Information Management, East Carolina University, 4340E Health Sciences Building, MS 668, Greenville, NC, United States.
| | | | - Patrick M Briley
- Department of Communication Sciences & Disorders, East Carolina University, Greenville, NC, United States
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Winters KL, Byrd CT. Predictors of communication attitude in preschool-age children who stutter. JOURNAL OF COMMUNICATION DISORDERS 2021; 91:106100. [PMID: 33862497 DOI: 10.1016/j.jcomdis.2021.106100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/22/2021] [Accepted: 03/26/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Although preschool-age children who stutter report more negative attitudes toward communication than their typically fluent peers, few investigations have explored factors that may contribute to the differences observed in communication attitude. The purpose of the present study was to explore whether behavioral characteristics of stuttering severity (frequency, duration, physical concomitants) and time since onset of stuttering predict communication attitude in preschool-age children. METHOD Fifty-nine preschool-aged children who stutter completed two speaking samples and the KiddyCAT, a self-report assessment of communication attitude. Speech samples were analyzed for stuttering frequency (measured by percentage of stuttered syllables), duration, and presence of physical concomitants. Linear regression models were used to assess if these behavioral measures of stuttering and time since onset of stuttering predicted self-reported communication attitude. RESULTS Results indicate stuttering behavioral measures and time since onset do not predict KiddyCAT scores of preschool-age children who stutter. CONCLUSIONS Preliminary data suggest children who have presented with stuttering for a longer period of time are no more likely to report a negative communication attitude than children who have a shorter time since onset. Additionally, in contrast to school-age children who stutter, but similar to adults and adolescents who stutter, communication attitude is not linearly related to stuttering severity in preschool-age children.
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Affiliation(s)
- Katherine L Winters
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, 2405A Whitis Ave, Stop A1100, Austin, TX, 78712, United States.
| | - Courtney T Byrd
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, 2405A Whitis Ave, Stop A1100, Austin, TX, 78712, United States
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Tichenor SE, Johnson CA, Yaruss JS. A Preliminary Investigation of Attention-Deficit/Hyperactivity Disorder Characteristics in Adults Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:839-853. [PMID: 33647218 DOI: 10.1044/2020_jslhr-20-00237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose Recent studies have shown that many children who stutter may have elevated characteristics of attention-deficit/hyperactivity disorder (ADHD). Although childhood ADHD commonly persists into adulthood, it is unclear how many adults who stutter experience aspects of ADHD (e.g., inattention or hyperactivity/impulsivity). This study sought to increase understanding of how ADHD characteristics might affect individuals who stutter by evaluating (a) whether elevated ADHD characteristics are common in adults who stutter, (b) whether elevated ADHD characteristics in adults who stutter were significantly associated with greater adverse impact related to stuttering, and (c) whether individual differences in Repetitive Negative Thinking (RNT) and Effortful Control influenced this relationship. Method Two hundred fifty-four adults who stutter completed the Adult ADHD Self-Report Scale, the Perseverative Thinking Questionnaire, the Adult Temperament Questionnaire short form, and the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed via multiple linear regression to determine whether the number of inattention or hyperactivity/impulsivity characteristics was significantly associated with RNT, Effortful Control, or Adverse Impact related to stuttering. Results Almost one quarter of participants (23.2%; 60/254) self-reported experiencing six or more inattention characteristics, while fewer participants (8.3%; 21/254) self-reported experiencing six or more hyperactivity/impulsivity characteristics. Participants with lower Effortful Control and higher levels of both RNT and Adverse Impact were significantly more likely to self-report experiencing more inattention characteristics. Discussion Many adults who stutter may exhibit previously unaccounted for characteristics of ADHD, especially inattention. Results highlight the value of continued research on the intersectionality of stuttering, ADHD, and attention, and the importance of individualizing therapy to the needs of each unique person who stutters.
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Byrd CT, Winters KL, Young M, Werle D, Croft RL, Hampton E, Coalson G, White A, Gkalitsiou Z. The Communication Benefits of Participation in Camp Dream. Speak. Live.: An Extension and Replication. Semin Speech Lang 2021; 42:117-135. [PMID: 33725730 DOI: 10.1055/s-0041-1723843] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
School-based guidelines often require that treatment focuses on minimizing or eliminating stuttered speech. The purpose of this study was to examine the benefits of explicit training in communication competencies to children who stutter without targeting stuttered speech. Thirty-seven children (ages 4-16) completed Camp Dream. Speak. Live., an intensive group treatment program which targets the psychosocial needs and communication of children who stutter. Outcome measures included the Overall Assessment of the Speaker's Experience of Stuttering (OASES), the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT), and the Patient Reported Measurement Information System (PROMIS) Pediatric Peer Relationships Short Form (PROMIS Peer Relationships) and Parent Proxy Peer Relationships Short Form (PROMIS Parent Proxy). Pre- and posttreatment public presentations were rated on nine core verbal and nonverbal communication competencies by a neutral observer. Similar to previous studies, participants demonstrated significant improvements in communication attitudes (OASES) and perceived ability to establish peer relationships (PROMIS Peer Relationships), particularly school-aged participants (ages 7-16). Participants also demonstrated significant improvement in eight of the nine communication competencies. Findings suggest that, in addition to the psychosocial gains of programs such as Camp Dream. Speak. Live., children who stutter benefit from explicit training in communication skills, and these gains are not dependent on the presence of stuttered speech.
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Affiliation(s)
- Courtney T Byrd
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, Texas
| | - Katherine L Winters
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, Texas
| | - Megan Young
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, Texas
| | - Danielle Werle
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, Texas
| | - Robyn L Croft
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, Texas
| | - Elizabeth Hampton
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, Texas
| | - Geoffrey Coalson
- Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, Louisiana
| | - Andrew White
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, Texas
| | - Zoi Gkalitsiou
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, Texas
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Svenning A, Panzarino R, Vanryckeghem M, Vestner T. Life partners' perceptions of the emotional, speech disruptive, and attitudinal correlates of stuttering. JOURNAL OF FLUENCY DISORDERS 2021; 67:105821. [PMID: 33290956 DOI: 10.1016/j.jfludis.2020.105821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 08/29/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE The purpose of the current investigation was to explore the extent to which the life partners (LPs) of people who stutter (PWS) perceive their loved ones' speech-situation specific emotional reaction, expectancy of speech disruption, and speech-related communication attitude. METHODS Three subtests of the Behavior Assessment Battery (BAB): the Speech Situation Checklist - Emotional Reaction (SSC-ER), the Speech Situation Checklist - Speech Disruption (SSC-SD) and the Communication Attitude Test for Adults Who Stutter (BigCAT) were administered to 33 PWS and modified versions were administered to their LPs via Qualtrics Survey Software. Effect of relationship duration on subtest scores was considered. Perceived stuttering severity by the participant and their LP was also queried as part of a demographic questionnaire. RESULTS PWS and their LPs rated BigCAT items in a similar way, while they rated certain SSC-ER and SSC-SD items differently. Importantly, between-group agreement was not affected by relationship duration. Among the PWS and LP, perceived stuttering severity influenced all BAB subtest scores. CONCLUSION LPs of PWS appear to be in tune with the cognitive aspects of their partner's experience of stuttering. This has important clinical implications as it relates to active involvement of the family in speech intervention targeting fluency.
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Affiliation(s)
- A Svenning
- University of Central Florida, United States.
| | - R Panzarino
- University of Central Florida, United States
| | | | - T Vestner
- Birkbeck, University of London, United Kingdom
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Samson I, Lindström E, Sand A, Herlitz A, Schalling E. Larger reported impact of stuttering in teenage females, compared to males - A comparison of teenagers' result on Overall Assessment of the Speaker's Experience of Stuttering (OASES). JOURNAL OF FLUENCY DISORDERS 2021; 67:105822. [PMID: 33348210 DOI: 10.1016/j.jfludis.2020.105822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 10/11/2020] [Accepted: 12/02/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE The aim of this cross-sectional study was to explore the impact and experience of stuttering, and attitude to communication for female and male teenagers who stutter (TWS) in comparison with teenagers with no stutter (TWNS). METHODS The Swedish version of the Overall Assessment of the Speaker's Experience of Stuttering (OASES-T-S), was administered to 56 TWS, 13-17 years old (26 females, 30 males). An adapted version of OASES, Attitude to Speech and Communication (ASC), was administered to 233 TWNS. The impact scores were analyzed in relation to sex in TWS and TWNS. RESULTS Female TWS reported that stuttering had a greater impact on their life than it did on male TWS (on average 0.5 higher impact scores; Hedges' g = 0.87). The differences did not seem to be caused by differences in severity of overt stuttering symptoms. Female and male TWS particularly differed on items related to difficulties in day-to-day communication and affective/behavioral reactions to stuttering. Such sex differences were not as pronounced among TWNS, suggesting that teenage women may be more vulnerable to the negative impact of stuttering than men the same age. CONCLUSION Female teenagers report more negative experiences and a greater tendency to use avoidance strategies than male teenagers.
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Affiliation(s)
- Ineke Samson
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Speech and Language Pathology, Danderyd Hospital, Stockholm, Sweden.
| | - Elisabeth Lindström
- Logopedics, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turkku, Finland
| | - Anders Sand
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Herlitz
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Ellika Schalling
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden; Medical Unit Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
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Tichenor SE, Yaruss JS. Variability of Stuttering: Behavior and Impact. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:75-88. [PMID: 33197323 PMCID: PMC8740569 DOI: 10.1044/2020_ajslp-20-00112] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Purpose It has long been known that stuttering behaviors vary across time and situation. Preliminary evidence suggests that this variability negatively affects people who stutter and that stuttering behaviors are more variable than adverse impact associated with stuttering. More information is needed to determine how variability affects people who stutter and what the clinical and research implications of variability may be. Method Two hundred and four adults who stutter participated in a mixed-methods study exploring (a) how variability of stuttering affects people who stutter in comparison to other aspects of the condition and (b) which aspects of the overall experience of stuttering are variable. Results Analyses indicated that variability is very commonly experienced by people who stutter and that it is among the most frustrating aspects of the condition. Qualitative analyses revealed that variability is experienced in all aspects of the stuttering condition, including the observable behavior other affective, behavioral, and cognitive reactions; and the adverse impact of stuttering. Notable individual differences were found in terms of which specific aspects of the condition were more variable for different respondents. Overall, analyses revealed that the variability of different aspects of stuttering can be viewed in a hierarchy from most variable to least variable: more external aspects (e.g., frequency, duration), more internal aspects (e.g., covert behaviors, physical tension), and cognitive-affective experiences (e.g., negative thoughts, feelings, and self-image). Discussion These findings suggest that variability is a common and burdensome aspect of the experience of stuttering and underscore the importance of considering variability in stuttering behavior, reactions, and impact in research, assessment, and treatment for adults who stutter.
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Affiliation(s)
- Seth E. Tichenor
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - J. Scott Yaruss
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
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Tezel-Bayraktaroglu O, Bayraktaroglu Z, Demirtas-Tatlidede A, Demiralp T, Oge AE. Neuronavigated rTMS inhibition of right pars triangularis anterior in stuttering: Differential effects on reading and speaking. BRAIN AND LANGUAGE 2020; 210:104862. [PMID: 32979643 DOI: 10.1016/j.bandl.2020.104862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 06/11/2023]
Abstract
Functional neuroimaging studies show an overactivation of speech and language related homologous areas of the right hemisphere in persons who stutter. In this study, we inhibited Broca's homologues using 1 Hz repetitive transcranial magnetic stimulation (rTMS) and assessed its effects on stuttering severity. The investigated cortical areas included pars opercularis (BA44), anterior and posterior pars triangularis (BA45), mouth area on the primary motor cortex (BA4). We collected reading and speaking samples before and after rTMS sessions and calculated the percentage of syllables stuttered. Only right anterior pars triangularis stimulation induced significant changes in speech fluency. Notably, the effects were differential for reading and speaking conditions. Overall, our results provide supportive evidence that right anterior BA45 may be a critical region for stuttering. The observed differential effects following the inhibition of right anterior BA45 merits further study of contributions of this region on different language domains in persons who stutter.
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Affiliation(s)
| | - Zubeyir Bayraktaroglu
- Istanbul Medipol University, International School of Medicine, Department of Physiology, 34815 Beykoz, Istanbul, Turkey; Istanbul Medipol University, Research Institute for Health Sciences and Technologies (SABITA), Restorative and Regenerative Medicine Research Center (REMER), functional Imaging and Cognitive Affective Neuroscience Laboratory (fINCAN), 34810 Beykoz, Istanbul, Turkey
| | - Asli Demirtas-Tatlidede
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 34093 Capa, Istanbul, Turkey; Bahcesehir University, School of Medicine, Department of Neurology, 34734 Kadikoy, Istanbul, Turkey
| | - Tamer Demiralp
- Istanbul University, Hulusi Behcet Life Sciences Research Laboratory-Neuroimaging Unit, 34093 Capa, Istanbul, Turkey; Istanbul University, Istanbul Faculty of Medicine, Department of Physiology, 34093 Capa, Istanbul, Turkey
| | - A Emre Oge
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, 34093 Capa, Istanbul, Turkey
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Treleaven SB, Coalson GA. Manual response inhibition and quality of life in adults who stutter. JOURNAL OF COMMUNICATION DISORDERS 2020; 88:106053. [PMID: 33065458 PMCID: PMC7736488 DOI: 10.1016/j.jcomdis.2020.106053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 06/23/2020] [Accepted: 08/24/2020] [Indexed: 06/01/2023]
Abstract
BACKGROUND A considerable amount of research has identified inhibition differences, including slower inhibition of manual responses, in people who stutter. Recent investigations have failed to link slowed motor inhibition with overt stuttering severity. This study investigated the potential relationship between slowed manual response inhibition and the negative impact of stuttering upon individual lives of adults who stutter (AWS). METHODS Thirty-four adults (AWS, n = 17; AWNS, n = 17) matched by nonverbal IQ completed a manual stop-signal task and provided a conversational speech sample. Motor inhibition latency for AWS and AWNS were compared. For AWS, motor inhibition latency was compared to the four subsections of the Overall Assessment of the Speaker's Experience with Stuttering (OASES; Yaruss & Quesal, 2006; General Information, Reactions to Stuttering, Communication in Daily Situations, Quality of Life). RESULTS Similar to previous studies, AWS were significantly slower to inhibit inaccurate manual responses than AWNS. Quality of Life subtest of the OASES was found to significantly predict inhibition latency. CONCLUSION These data replicate findings that indicate that AWS exhibit slower manual inhibition latency, and suggest that these inhibition differences may be associated with an individual's negative experience with stuttering rather than stuttering severity.
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Affiliation(s)
- Shanley B Treleaven
- Louisiana State University, Department of Communication Sciences and Disorders, 68 Hatcher Hall, Field House Drive, Baton Rouge, LA 70803, United States.
| | - Geoffrey A Coalson
- Louisiana State University, Department of Communication Sciences and Disorders, 68 Hatcher Hall, Field House Drive, Baton Rouge, LA 70803, United States
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Briley PM, Wright HH, O'Brien K, Ellis C. Relative contributions to overall impact of stuttering in adults using the overall assessment of the Speaker's Experience of Stuttering (OASES). JOURNAL OF FLUENCY DISORDERS 2020; 65:105775. [PMID: 32569881 DOI: 10.1016/j.jfludis.2020.105775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE Comprehensive assessment of stuttering requires consideration of a wide range of behaviors that impact outcomes, and the Overall Assessment of the Speaker's Experience of Stuttering (OASES) is an assessment tool that accomplishes such. The purpose of this study was to determine how the individual components of the test contribute to the OASES' impact score. METHOD Data collected at a university speech-language and hearing clinic from 29 adults were used for a relative weight analysis (RWA). RWA was utilized to determine the relative contributions of the OASES' subtests to the OASES' impact score. Confidence intervals for the individual relative weights were calculated for each OASES subtest and significance tests based on bootstrapping with 10,000 replications. RESULTS Differences were present in contributions of the OASES' subtests to the OASES' overall impact score, where the following explained a significant amount of variance in the OASES' impact score: Speaker's Reactions; Daily Communication; and Quality of Life. However, contribution of the subtest, "General Information", was not significant. CONCLUSION Through examination of relative contributions to the impact of stuttering using the OASES, this project has identified differences in contributors to the overall impact of the disorder of stuttering. This information is beneficial to researchers and clinicians alike in that it gives specific guidance into what determines increased impact in adults who stutter (AWS). Future works should pursue clarification of these differences with an end goal of identifying and overcoming barriers to positive outcomes while also identifying and nurturing facilitators to optimal management.
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Affiliation(s)
- Patrick M Briley
- Department of Communication Sciences & Disorders, East Carolina University, Greenville, NC, USA.
| | - Heather Harris Wright
- Department of Communication Sciences & Disorders, East Carolina University, Greenville, NC, USA
| | - Kevin O'Brien
- Department of Biostatistics, East Carolina University, Greenville, NC, USA
| | - Charles Ellis
- Department of Communication Sciences & Disorders, East Carolina University, Greenville, NC, USA; Communication Equity and Outcomes Laboratory, East Carolina University, Greenville, NC, USA
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Walsh B, Bostian A, Tichenor SE, Brown B, Weber C. Disfluency Characteristics of 4- and 5-Year-Old Children Who Stutter and Their Relationship to Stuttering Persistence and Recovery. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2555-2566. [PMID: 32692634 PMCID: PMC7872730 DOI: 10.1044/2020_jslhr-19-00395] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Purpose The purpose of this study is to document disfluency behaviors expressed by 4- and 5-year-old children who stutter and to identify whether stuttering characteristics at this age are predictive of later stuttering recovery or persistence. Method We analyzed spontaneous speech samples from 47 children diagnosed with developmental stuttering when they were 4-5 years old. Based on their eventual diagnosis made the final year of participation in the longitudinal study when the children were 6-9 years old, the children were divided into two groups: children who eventually recovered from stuttering (n = 29) and children who were persisting (n = 18). We calculated a composite weighted stuttering-like disfluency (SLD) index of overall severity that considers the frequency, type, and number of repetition units of SLDs. The frequency and type of typical disfluencies were also examined. Results Higher weighted SLD scores at ages 4-5 years were associated with a higher probability of persistent stuttering. The weighted SLD also significantly discriminated between children who would eventually be diagnosed as persisting or recovered from stuttering. The frequency and type of typical disfluency did not distinguish the two groups of children; however, children who were persisting had significantly higher frequencies of part-word repetitions and dysrhythmic phonations (i.e., blocks, prolongations, and broken words) and maximum number of part-word repetitions compared to children who eventually recovered from stuttering. Conclusions Previous findings in younger, 2- to 3-year-old children who stutter did not suggest a relationship between the severity and type of children's SLDs and their eventual stuttering outcome. Yet, by the age of 4-5 years, we found that the weighted SLD, a clinically applicable tool, may be used to help identify children at greater risk for stuttering persistence. We propose that the weighted SLD be considered, along with other predictive factors, when assessing risk of stuttering persistence in 4- and 5-year-old children who are stuttering.
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Affiliation(s)
- Bridget Walsh
- Department of Communicative Sciences & Disorders, Michigan State University, East Lansing
| | - Anna Bostian
- Department of Speech, Language, & Hearing Sciences, Purdue University, West Lafayette, IN
| | - Seth E. Tichenor
- Department of Communicative Sciences & Disorders, Michigan State University, East Lansing
| | - Barbara Brown
- Department of Speech, Language, & Hearing Sciences, Purdue University, West Lafayette, IN
| | - Christine Weber
- Department of Speech, Language, & Hearing Sciences, Purdue University, West Lafayette, IN
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Karani TF, Mupawose A. A descriptive analysis of assessment measures on the effectiveness of a comprehensive stuttering intervention approach: A single case study. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2020; 67:e1-e9. [PMID: 32370524 PMCID: PMC7203267 DOI: 10.4102/sajcd.v67i1.648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/10/2019] [Accepted: 02/23/2020] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND For effective client outcomes, stuttering assessment and intervention approaches need to be aligned. This encompasses using assessment and intervention approaches that address the three multidimensional constructs of stuttering, namely core behaviours, secondary behaviours and negative feelings and attitudes. OBJECTIVE The study aimed to explore whether multiple assessment measures could be used to describe the effectiveness of a comprehensive stuttering intervention approach, undergirded by the International Classification of Functioning, Disability and Health (ICF) framework. METHOD A single-subject case design was employed with one male adult who stutters. Data was collected by administering the Stuttering Severity Instrument-Fourth Edition (SSI-4) and Overall Assessment of the Speaker's Experience of Stuttering-Adults (OASES-A) at three testing periods (pre-intervention, immediately post-intervention and 7 months post-intervention), and a semi-structured interview schedule immediately post-intervention. Descriptive statistics was used to analyse the SSI-4 and OASES-A, and thematic analysis was conducted to evaluate the participant's interview schedule responses. RESULTS The participant's total scores, impact scores and severity ratings of both the SSI-4 and OASES decreased across the three testing periods. The main theme of effectiveness of the comprehensive stuttering intervention to reduce aspects of disability emerged from the participant's responses. CONCLUSION Evaluation of the results from the assessment measures revealed that the comprehensive stuttering intervention approach was effective in reducing the participant's core behaviours, secondary behaviours and negative feelings and attitudes. Assessment and management of fluency disorders should promote a client-specific multidimensional approach that extends beyond the core behaviours and secondary behaviours, by addressing the underlying social and emotional facets of fluency disorders.
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Affiliation(s)
- Tasneem F Karani
- Department of Speech Pathology and Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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