Relationships among linguistic processing speed, phonological working memory, and attention in children who stutter

Complex working memory in adults with and without stuttering disorders: Performance patterns and predictive relationships

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.

T-PALS framework to assess children who stutter with coexisting disorders: A tutorial

The purpose of this paper is to present a tutorial on a diagnostic framework developed to assess children who stutter and exhibit co-existing disorders. While we have guidelines for treating these children, there are no specific guidelines for assessing them. We provide a rationale for the development of T-PALS with support from the literature. The T-PALS framework assesses 5 foundational key elements for the child: Temperament (T), Pragmatics (P), Articulation/phonology (A), Language (L), and Stuttering (S). Both qualitative and quantitative measures are used within each dimension. This framework is discussed with reference to using two clinical case examples. T-PALS observation data are presented as well as treatment suggestions for each case. We conclude that T-PALS may be a useful framework for both clinicians and researchers, working with children who present with stuttering and comorbid conditions. Clinicians are encouraged to reach beyond the traditional focus on solely assessing the stuttering behavior, even when that is the main concern for referral, and to consider a broader view of the child. It is hoped that this more integrative approach to assessment may yield a more holistic diagnostic picture of a dual diagnosis child from which treatment goals can be derived.

Individual differences in attentional control predict working memory capacity in adults who stutter

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.

Impaired Categorical Perception of Speech Sounds Under the Backward Masking Condition in Adults Who Stutter

PURPOSE

Evidence increasingly indicates that people with developmental stuttering have auditory perception deficits. Our previous research has indicated similar but slower performance in categorical perception of the speech sounds under the quiet condition in children who stutter and adults who stutter (AWS) compared with their typically fluent counterparts. We hypothesized that the quiet condition may not be sufficiently sensitive to reveal subtle perceptual deficiencies in people who stutter. This study examined this hypothesis by testing the categorical perception of speech and nonspeech sounds under backward masking condition (i.e., a noise was presented immediately after the target stimuli).

METHOD

Fifteen Cantonese-speaking AWS and 15 adults who do not stutter (AWNS) were tested on the categorical perception of four stimulus continua, namely, consonant varying in voice onset time (VOT), vowel, lexical tone, and nonspeech, under the backward masking condition using identification and discrimination tasks.

RESULTS

AWS demonstrated a broader boundary width than AWNS in the identification task. AWS also exhibited a worse performance than AWNS in the discrimination of between-category stimuli but a comparable performance in the discrimination of within-category stimuli, indicating reduced sensitivity to sounds that belonged to different phonemic categories among AWS. Moreover, AWS showed similar patterns of impaired categorical perception across the four stimulus types, although the boundary location on the VOT continuum occurred at an earlier point in AWS than in AWNS.

CONCLUSIONS

The findings provide robust evidence that AWS exhibit impaired categorical perception of speech and nonspeech sounds under the backward masking condition. Temporal processing (i.e., VOT manipulation), frequency/spectral/formant processing (i.e., lexical tone or vowel manipulations), and nonlinguistic pitch processing were all found to be impaired in AWS. Altogether, the findings support the hypothesis that AWS might be less efficient in accessing the phonemic representations when exposed to a demanding listening condition.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20249718.

Identifying Stuttering in Arabic Speakers Who Stutter: Development of a Non-word Repetition Task and Preliminary Results

Stuttering and other conditions that affect speech fluency need to be identified at an early age in order that effective interventions can be given before the problems becomes chronic. This applies in countries where several languages are spoken including those in which English and Arabic are both widely used which calls for assessment procedures that work across these languages. The 'universal' non-word repetition task (UNWR) has been established as an effective screening tool for discriminating between children who stutter (CWS) and children with word-finding difficulty for a number of languages. However, the UNWR does not apply to languages such as Arabic and Spanish. The present study aimed to: (1) introduce an Arabic English NWR (AEN_NWR); which was developed based on the same phonologically informed approach used with UNWR; (2) present preliminary non-word repetition data from Arabic-speaking CWS and adults who stutter (AWS). The AEN_NWR items comprises twenty-seven non-words that meet lexical phonology constraints across Arabic and English. The set of items includes non-words of two, three and four syllables in length. Preliminary non-word repetition data were collected from ten CWS between the ages of 6;5 and 16;7 (M age = 12:1) and fourteen AWS between the ages of 19;2 and 31;0 (M age = 24). Participants performed the non-word repetition task and provided a sample of spontaneous speech. The spontaneous speech samples were used to estimate %stuttered syllables (%SS). To validate that AEN_NWR performance provides an alternative way of assessing stuttering, a significant correlation was predicted between %SS and AEN_NWR performance. Also, word length should affect repetition accuracy of AEN_NWR. As predicted, there was a significant negative correlation between the AEN_NWR and %SS scores (r (25) = -0.5), p < 0.000). Overall, CWS were less accurate in their repetition than AWS at all syllable lengths. The AEN_NWR provides a new assessment tool for detecting stuttering in speaker of Arabic and English. Future studies would benefit from a larger sample of participants, and by testing a population-based sample. These studies would allow further investigation of the AEN_NWR as a screening measure for stuttering in preschool children.

Nonword Repetition Performance Differentiates Children Who Stutter With and Without Concomitant Speech Sound and Developmental Language Disorders

PURPOSE

The aim of this study was to examine how nonword repetition (NWR) performance may be impacted by the presence of concomitant speech and language disorders in young children who stutter (CWS).

METHOD

One hundred forty-one children (88 CWS and 53 children who do not stutter [CWNS]) participated. CWS were divided into groups based on the presence of speech sound and/or language disorder or typical speech sound production and language abilities. NWR abilities were measured using stimuli composed of one- to four-syllable nonwords.

RESULTS

CWS with typical speech and language and CWNS had higher accuracy scores than CWS with concomitant speech and language disorders. We found no difference in accuracy scores between CWNS and CWS with typical speech and language abilities, nor did we find differences between CWS with speech sound disorder and CWS with both speech sound and language disorders. Accuracy decreased as nonword length increased for all groups.

CONCLUSIONS

We found that the presence of a concomitant speech and language disorder was a driving factor behind poorer NWR performance in CWS. Accuracy scores differentiated CWS with concomitant disorders from CWS with typical speech and language but not CWS with typical speech and language from CWNS. Considering the speech and language abilities of CWS helped clarify poorer NWR performance and enhances generalizability to the population that exists clinically.

Complex nonverbal response inhibition and stopping impulsivity in childhood stuttering

PURPOSE

The primary purpose of this study was to examine complex nonverbal response inhibition and stopping impulsivity in children who do (CWS) and do not stutter (CWNS).

METHOD

A total of 30 CWS and 30 CWNS between the ages of 3;1 and 6;0 (years; months) performed the Peg-Tapping Task (PTT; Diamond & Taylor, 1996; Luria, 1966), in which children were required to tap a dowel once when an examiner taps twice and vice versa. The main dependent variables were the number of practice trials, response accuracy, response latency for accurate responses, and the number of extra taps (i.e., tapping more than two times).

RESULTS

The CWS were less accurate and slower on the PTT than the CWNS, with no differences in the number of practice trials. Furthermore, the CWS, especially boys, produced more extra taps than the CWNS.

CONCLUSIONS

Findings revealed that preschool CWS have weaknesses in complex response inhibition and stopping impulsivity in the nonverbal domain compared to CWNS. Taken together, these findings along with those of previous studies indicate that CWS may have weaknesses in inhibition and impulsivity in the nonverbal domain as well as the verbal domain, suggesting a domain-general weakness.

Verbal Response Inhibition in Adults Who Stutter

Purpose Adults who stutter (AWS) often attempt, with varying degrees of success, to suppress their stuttered speech. The ability to effectively suppress motoric behavior after initiation relies on executive functions such as nonselective inhibition. Although previous studies found that AWS were slower to inhibit manual, button-press response than adults who do not stutter (AWNS), research has yet to confirm a consistent relationship between manual and verbal inhibition. No study has examined verbal inhibition ability in AWS. The purpose of this study, therefore, is to compare verbal response inhibition between AWS and AWNS, and compare verbal response inhibition to both the overt stuttering and the lived experience of stuttering. Method Thirty-four adults (17 AWNS, 17 AWS) completed one manual and three verbal stop-signal tasks. AWS were assessed for stuttering severity (Stuttering Severity Instrument-Fourth Edition: SSI-4) and experience with stuttering (Overall Assessment of the Speaker's Experience With Stuttering [OASES]). Results Results indicate no correlation between manual and verbal inhibition for either group. Generalized linear mixed-model analyses suggested no significant group differences in manual or verbal inhibition. Manual and verbal inhibition did not predict SSI-4 in AWS. However, verbal inhibition was uniquely associated with OASES scores. Conclusion Although underlying manual and verbal inhibition was comparable between AWS and AWNS, verbal inhibition may be linked to the adverse experience of stuttering rather than the overt symptoms of stuttering severity. Supplemental Material https://doi.org/10.23641/asha.15145185.

Exploring Relationships Among Risk Factors for Persistence in Early Childhood Stuttering

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.

Cognitive Flexibility and Effortful Control in School-Age Children With and Without Stuttering Disorders

Purpose This study compared attention control and flexibility in school-age children who stutter (CWS) and children who do not stutter (CWNS) based on their performance on a behavioral task and parent report. We used a classic attention-shifting paradigm that included manipulations of task goals and timing to test effects of varying demands for flexibility on switching accuracy and speed. We also examined associations between task performance, group, and relevant aspects of temperament. Method Participants included 33 children (15 CWS, 18 CWNS) between 8 and 11 years of age. Children sorted stimuli that differed on two dimensions (color and shape) based on sorting rules that varied from block to block or trial to trial. Timing manipulations included intervals of 200-, 600-, or 1,200-ms durations for critical trial components. Temperament data were obtained via the Children's Behavior Questionnaire. Results All children showed expected performance costs in response to block and trial manipulations; however, CWS were more affected by task conditions that increased demands for cognitive flexibility. Effects of interval durations also differed by group. Factor scores on the Children's Behavior Questionnaire indicated differences in effortful control between groups; however, this aspect of temperament did not mediate between-groups differences in switching performance. Conclusions Findings suggest that stuttering continues to be associated with differences in attention control and flexibility beyond the preschool years. Further research is needed to clarify how these cognitive processes shape the development of stuttering throughout childhood.

A comparison of the performance of Persian speaking children who do and do not stutter on three nonwords repetition tasks

PURPOSE

The purpose of the study was to examine the performance of Persian speaking children who stutter (CWS) and children who do not stutter (CWNS) on three nonword repetition tasks, while also focusing on which task and scoring method best differentiates the two groups of children.

METHOD

Thirty CWS and 30 CWNS between the ages of 5;0 to 6;6 completed three nonword repetition tasks that varied in complexity. Each task was scored using two methods: nonwords correct and phonemes correct. Between-group differences in performance on each task were examined, along with disfluencies for CWS and the task and scoring method that best differentiated the CWS and CWNS.

RESULTS

The findings revealed that, across all three nonword repetition tasks, the CWS consistently produced fewer nonwords correct and phonemes correct than the CWNS group at virtually all syllable lengths. The CWS produced more disfluencies on longer nonwords than shorter nonwords in all three nonword repetition tasks. The nonword repetition task with lower wordlikeness and more phonologically complex items best differentiated the two groups of children. Findings further revealed that discriminative accuracy was highest for scoring based on the number of phonemes produced correctly.

CONCLUSION

Findings provide further evidence to suggest that CWS may have difficulty with phonological working memory and/or phonological processing.

Do dyslexia and stuttering share a processing deficit?

This study assessed the prevalence of childhood stuttering in adults with dyslexia (AWD) and the prevalence of dyslexia in adults who stutter (AWS). In addition, the linguistic profiles of 50 AWD, 30 AWS and 84 neurotypical adults were measured. We found that 17 out of 50 AWD (34 %) reported stuttering during childhood compared to 1 % of the neurotypical population. This was moderated by the severity of dyslexia: People with mild dyslexia showed a lower prevalence rate (15 %) of childhood stuttering than those with severe dyslexia (47 %). In addition, we observed that 50 % of the AWS (n = 30) fulfilled the diagnostic criteria of dyslexia, even though they had never been diagnosed as dyslexic. Compared to neurotypical adults, phonological working memory, awareness, and retrieval were similarly reduced in AWS and AWD. The findings supports the view that stuttering and dyslexia may share a phonological deficit.

College professors' perceptions of students who stutter and the impact on comfort approaching professors

PURPOSE

Previous literature has documented that college professors view hypothetical students who stutter more negatively than their fluent peers. The purpose of the present study was to investigate whether individuals who stutter report they experience more negative perceptions in the college classroom, and the impact of those perceptions on their comfort approaching professors.

METHODS

Two hundred forty-six adults who do and do not stutter, matched for age, participated in this study. Participants were presented with 16 positive and negative personality traits and asked to rate how strongly they believed their professor viewed them along each trait. All participants were asked whether they felt comfortable approaching their professors to discuss their performance. Adults who stutter were asked additional questions to investigate their college experience more comprehensively.

RESULTS

Adults who stutter reported they experienced significantly more negative perceptions from their professors than adults who do not stutter, and were significantly less likely to feel comfortable approaching their professors. These reported negative perceptions, specifically being perceived as less self-assured, predicted comfort approaching professors to receive performance feedback for adults who stutter. Finally, amongst adults who stutter, perception of how they were evaluated compared to their peers was significantly related to comfort approaching professors.

CONCLUSIONS

Results support that the negative perceptions towards hypothetical students who stutter reported in previous literature are experienced by individuals who stutter, and that these perceptions drive comfort approaching professors for performative feedback. Results suggest professors may increase students' comfort by clearly outlining equality in evaluation procedures.

Emotional Reactivity and Regulation in Preschool-Age Children Who Do and Do Not Stutter: Evidence From Autonomic Nervous System Measures

Purpose: This experimental cross-sectional research study examined the emotional reactivity and emotion regulation in preschool-age children who do (CWS) and do not stutter (CWNS) by assessing their psychophysiological response during rest and while viewing pictures from the International Affective Picture System (Lang et al., 2008). Method: Participants were 18 CWS (16 boys and two girls; mean age 4 years, 5 months) and 18 age- and gender-matched CWNS. Participants' psychophysiological responses were measured during two baselines and two picture viewing conditions. Skin conductance level (SCL) and heart rate were measured to assess emotional reactivity. Respiratory sinus arrhythmia (RSA) was measured to assess emotional regulation. Participants' shyness and executive function were assessed via parent report and considered for their effects on participants' psychophysiological responses. Results: First, CWNS and CWS did not differ in their initial baseline SCL, heart rate, or RSA, but all participants had higher SCL and lower RSA in the second baseline, subsequent to the first challenge condition, compared to the first baseline. Second, during the challenge conditions, CWS did not differ from CWNS in their SCL, but showed a significantly higher heart rate than CWNS. Third, CWS exhibited a significantly lower RSA during the challenge conditions compared to CWNS. Lastly, the temperamental quality of shyness was associated with preschool-age children's SCL, such that participants who were rated higher in shyness had a higher SCL during the challenge conditions. Participants' executive function had a marginally significant effect on the RSA, such that the participants who had higher executive function composite scores exhibited lower RSA during the challenge conditions. Conclusions: Our findings suggest that CWS and CWNS did not differ in their emotional reactivity and emotional regulation abilities at rest. During challenge conditions, however, CWS tended to be more emotionally reactive, as indicated by a higher heart rate, and also employed more emotional regulation, indexed by a greater decrease in RSA, compared to CWNS. Preschool-age children's behavior is largely dominated by reactivity, but there is the emergence of regulation, which can help children adjust to various contextual demands. For CWS who are more emotionally reactive, regulatory skills may be particularly critical to their prognosis and treatment.

Visual exogenous and endogenous attention and visual memory in preschool children who stutter

PURPOSE

Attention develops gradually from infancy to the preschool years and beyond. Exogenous attention, consisting of automatic responses to salient stimuli, develops in infancy, whereas endogenous attention, or voluntary attention, begins to develop later, in the preschool years. The purpose of this study was to examine (a) exogenous and endogenous attention in young children who stutter (CWS) and children who do not stutter (CWNS) through two conditions of a visual sustained selective attention task, and (b) visual short-term memory (STM) between groups within the context of this task.

METHOD

42 CWS and 42 CWNS, ages 3;0-5;5 (years;months), were pair-matched in age, gender (31 males, 11 females per group), and socioeconomic status. Children completed a visual tracking task (Track-It Task; Fisher et al., 2013) requiring sustained selective attention and engaging exogenous and endogenous processes. Following each item, children were asked to recall the item they had tracked, as a memory check.

RESULTS

The CWS group demonstrated significantly less accuracy in overall tracking and visual memory for the tracked stimuli, compared to the CWNS group. Across groups, the children performed better in sustained selective attention when the target stimuli were more salient (the condition tapping both exogenous and endogenous attention) than when stimuli were less so (the condition tapping primarily endogenous processes).

CONCLUSIONS

Relative to peers, preschool-age CWS, as a group, display weaknesses in visual sustained selective attention and visual STM.

Associations between stuttering, comorbid conditions and executive function in children: a population-based study

Background

The aim of this study was to investigate the relationship between executive function (EF), stuttering, and comorbidity by examining children who stutter (CWS) and children who do not stutter (CWNS) with and without comorbid conditions. Data from the National Health Interview Survey were used to examine behavioral manifestations of EF, such as inattention and self-regulation, in CWS and CWNS.

Methods

The sample included 2258 CWS (girls = 638, boys = 1620), and 117,725 CWNS (girls = 57,512; boys = 60,213). EF, and the presence of stuttering and comorbid conditions were based on parent report. Descriptive statistics were used to describe the distribution of stuttering and comorbidity across group and sex. Regression analyses were to determine the effects of stuttering and comorbidity on EF, and the relationship between EF and socioemotional competence.

Results

Results point to weaker EF in CWS compared to CWNS. Also, having comorbid conditions was also associated with weaker EF. CWS with comorbidity showed the weakest EF compared to CWNS with and without comorbidity, and CWS without comorbidity. Children with stronger EF showed higher socioemotional competence. A majority (60.32%) of CWS had at least one other comorbid condition in addition to stuttering. Boys who stutter were more likely to have comorbid conditions compared to girls who stutter.

Conclusion

Present findings suggest that comorbidity is a common feature in CWS. Stuttering and comorbid conditions negatively impact EF.

Disfluencies and Strategies Used by People Who Stutter During a Working Memory Task

Purpose Working memory (WM) deficits are implicated in various communication disorders, including stuttering. The reading span test (RST) measures WM capacity with the dual task of reading sentences aloud and remembering target words. This study demonstrates a difference in strategy between people who stutter (PWS) and people who do not stutter (PWNS) in performing the RST. The impact of the effective strategy and the stuttering-like disfluencies during the RST were investigated. Method Twenty-six PWS and 24 people who do not stutter performed the RST and a simple reading aloud task. After the RST, they were asked which strategy ("imagery" or "rehearsal") they had used in order to remember the target words during the task. Results The proportion of those who used an "imagery" strategy during the RST was significantly smaller in the PWS group. However, the RST scores of those who used an "imagery" strategy were significantly higher than the RST scores of those who used a "rehearsal" strategy in both groups. The "rehearsal" users were asked to undertake one more RST with an "imagery" strategy, which resulted in an increased score for both groups. The disfluency frequency of the PWS group was significantly reduced during the RST than during the oral reading task, irrespective of the employed strategy. Conclusions PWS tended to use the less effective verbal "rehearsal" strategy during the RST. The differential effects of switching strategies on the measured WM capacity and on the disfluency rate suggest that the enhanced fluency during the RST would be mostly attributable to the reduced attention to speech motor control. Therefore, the use of the "imagery" strategy and focusing on the contents of communication, away from speech motor control, should help PWS communicate better in daily conversation.

Nonword repetition and identification skills in Kannada speaking school-aged children who do and do not stutter

PURPOSE

The present study employed nonword repetition and nonword identification tasks to explore the phonological working memory (PWM) abilities and its interaction with speech motor control in school-aged children who do and do not stutter.

METHOD

Participants were 17 children who stutter (CWS) (Age range = 7-12) and 17 age and gender-matched children who do not stutter (CWNS). For the nonword repetition task, the participants repeated sets of 2-, 3-, and 4-syllable nonwords (n = 12 per set). The participants silently identified a target nonword from a subsequent set of three nonwords (n = 12 per 2-, 3- and 4-syllable length) for the nonword identification task. The performance of CWS on the nonword repetition task was compared with the CWNS for the mean number of accurate repetitions, number of trials taken, number of accurate repetitions on initial trial, and number of fluent repetitions across the three-syllable conditions for the tasks. For the nonword identification task, the number of nonwords identified accurately by the two groups were subjected to analysis.

RESULTS

CWS were significantly less accurate on the initial production of nonwords and required significantly more number of attempts to repeat the nonword accurately. Further for the nonword identification task, CWS were significantly less accurate than CWNS in correctly identifying the target nonword.

CONCLUSIONS

The present findings suggest that, in addition to limitations in PWM capacity, an unstable speech motor control system in CWS may lead to dysfluent speech.

Temperament, Executive Functioning, and Anxiety in School-Age Children Who Stutter

The purpose of this study was to examine temperament dimensions, executive functioning ability, and anxiety levels in school-age children who stutter and their non-stuttering peers. Participants were 100 Portuguese children aged 7 to 12 years (M = 9.13; SD = 1.70), including 50 children who stutter and 50 children who do not stutter. Analyses, which were performed separately for younger and older participants, sought to identify correlations between key variables. Temperament was evaluated through a parent questionnaire, executive functioning was evaluated through children’s responses on a performance test, and anxiety level was assessed through a self-perception scale. On the temperament measure, comparisons between children who stutter and their non-stuttering peers revealed that older children who stutter exhibited significantly higher scores on the Anger/Frustration, Impulsivity, and Sadness subscales, and lower averages on the Attention/Focusing, Perceptual sensitivity, and Soothability/Falling Reactivity subscales. On the executive functioning task, comparisons revealed that the group of younger children who stutter exhibited significantly higher average execution times than their non-stuttering peers. There were no statistically significant differences in anxiety between children who stutter and children who do not stutter, and there were no statistically significant correlations between temperament factors and measures of executive functioning. Children who stutter experienced lower ability to orient attention and greater emotional reactivity compared with their non-stuttering peers. Significant correlations were found between executive functioning and age and among the temperament factors themselves. These results, which support the need for a multidimensional view of stuttering, were interpreted in the context of the Dual Diathesis – Stressor model. Findings indicate that temperament and executive functioning abilities may contribute to the development of stuttering.

Effect of phonological and morphological factors on speech disfluencies of Kannada speaking preschool children who stutter

PURPOSE

Empirical investigations have revealed a strong association between linguistic factors and stuttering, specifically phonological and morphological factors. However, the effect of these factors is suggested to vary across languages owing to the differences in their linguistic structure. Further, the trend is found to vary between AWS and CWS. Literature in this regard is scarce in the Kannada language, particularly in children. Hence, the study was driven by the need to understand the effect of phonological and morphological factors on stuttering in Kannada speaking CWS.

METHOD

Spontaneous speech samples were obtained from twenty Kannada speaking preschool CWS with a confirmed diagnosis of stuttering by an experienced speech-language pathologist. The recorded samples were transcribed, and disfluencies were marked. Further, the stuttered words were analysed for phonological and morphological features. The phonological factors included were phoneme position in a word, phoneme type and word length. Morphological factors consisted of word class and word end inflectional morphology. The percentage of stuttering was calculated with respect to each of the factors mentioned above.

RESULTS

Phoneme in the initial position of a word and words beginning with consonants had a higher rate of stuttering. Word length, word class and word end inflections were found to have no significant effect on the rate of stuttering in CWS.

CONCLUSION

Overall, current findings revealed that stuttering might manifest differently across languages varying in their linguistic structures.

The Role of Executive Function in Developmental Stuttering

Developmental stuttering is a complex disorder and children who stutter form a heterogeneous group. Most contemporary researchers would agree that multiple factors, including those associated with linguistic, motor, sensory, and emotional processes, are likely involved in its development and/or maintenance. There is growing evidence, however, that cognitive processes also play a role. In this article, we briefly review behavioral and parent-report studies of executive function in children who stutter, the findings of which have generally suggested that these skills may be challenging for at least some children who stutter. We then consider how deficits in executive function could provide an explanatory account for not only the multifactorial nature of developmental stuttering but also the considerable amount of variability that exists among individuals who stutter.

Impaired processing speed in categorical perception: Speech perception of children who stutter

There have been controversial debates across multiple disciplines regarding the underlying mechanism of developmental stuttering. Stuttering is often related to issues in the speech production system; however, the presence and extent of a speech perception deficit is less clear. This study aimed to investigate the speech perception of children who stutter (CWS) using the categorical perception paradigm to examine their ability to categorize different acoustic variations of speech sounds into the same or different phonemic categories. In this study, 15 CWS and 16 children who do not stutter (CWNS) completed identification and discrimination tasks involving acoustic variations of Cantonese speech sounds in three stimulus contexts: consonants (voice onset times, VOTs), lexical tones, and vowels. The results showed similar categorical perception performance in boundary position and width in the identification task and similar d' scores in the discrimination task between the CWS and CWNS groups. However, the reaction times (RTs) were slower in the CWS group compared with the CWNS group in both tasks. Moreover, the CWS group had slower RTs in identifying stimuli located across categorical boundaries compared with stimuli located away from categorical boundaries. Overall, the data implied that the phoneme representation evaluated in speech perception might be intact in CWS as revealed by similar patterns in categorical perception as those in CWNS. However, the CWS group had slower processing speeds during categorical perception, which may indicate an insufficiency in accessing the phonemic representations in a timely manner, especially when the acoustic stimuli were ambiguous.

Abnormal neural response to phonological working memory demands in persistent developmental stuttering

Persistent developmental stuttering is a neurological disorder that commonly manifests as a motor problem. Cognitive theories, however, hold that poorly developed cognitive skills are the origins of stuttering. Working memory (WM), a multicomponent cognitive system that mediates information maintenance and manipulation, is known to play an important role in speech production, leading us to postulate that the neurophysiological mechanisms underlying stuttering may be associated with a WM deficit. Using functional magnetic resonance imaging, we aimed to elucidate brain mechanisms in a phonological WM task in adults who stutter and controls. A right-lateralized compensatory mechanism for a deficit in the rehearsal process and neural disconnections associated with the central executive dysfunction were found. Furthermore, the neural abnormalities underlying the phonological WM were independent of memory load. This study demonstrates for the first time the atypical neural responses to phonological WM in PWS, shedding new light on the underlying cause of stuttering.

The Efficacy of Phonological Processing Treatment on Stuttering Severity in Persian Pre-School Children

OBJECTIVES

Correct phonological encoding is crucial to fluent speech production. Phonological working memory and phonological awareness are important phonological processes that affect phonological encoding. The purpose of this study was to investigate the effect of phonological processing on stuttering severity of Persian pre-school children.

MATERIALS & METHODS

Six children were targeted in this study in Ahvaz City, southern Iran in 2018, with Quasi-experimental design (Before and after clinical trial). These children participated in a treatment protocol, scheduled in 13-sessions. The treatment protocol of the phonological processing included nonword repetition in the phonological working memory and phonological awareness therapy. Overall, 30 nonwords were taken to examine the phonological working memory. The Persian test of language development was taken to examine phonological awareness. Stuttering severity measurements were performed with pre- and post-treatment. The severity rating was instructed to the parents based on Guitar protocol. They were asked to keep score every day until the end of the treatment sessions, and they reported the score to the therapist.

RESULTS

The stuttering severity score in pre and post-treatment was significant (P=0.027), and in the follow-up, phase was not significant (P=0.236); stuttering severity was reduced in children who stutter. Moreover, the severity rating score reported by parents during treatment was significant (P= 0.0001). This showed a reduction in stuttering severity.

CONCLUSION

The poor performance of phonological awareness and phonological working memory in phonological processing affect stuttering severity. Treatment of sub-systems of phonological processing can have an important role in reducing stuttering severity and increasing speech fluency.

Phonological working memory in developmental stuttering: Potential insights from the neurobiology of language and cognition

The current review examines how neurobiological models of language and cognition could shed light on the role of phonological working memory (PWM) in developmental stuttering (DS). Toward that aim, we review Baddeley's influential multicomponent model of PWM and evidence for load-dependent differences between children and adults who stutter and typically fluent speakers in nonword repetition and dual-task paradigms. We suggest that, while nonword repetition and dual-task findings implicate processes related to PWM, it is unclear from behavioral studies alone what mechanisms are involved. To address how PWM could be related to speech output in DS, a third section reviews neurobiological models of language proposing that PWM is an emergent property of cyclic sensory and motor buffers in the dorsal stream critical for speech production. We propose that anomalous sensorimotor timing could potentially interrupt both fluent speech in DS and the emergent properties of PWM. To further address the role of attention and executive function in PWM and DS, we also review neurobiological models proposing that prefrontal cortex (PFC) and basal ganglia (BG) function to facilitate working memory under distracting conditions and neuroimaging evidence implicating the PFC and BG in stuttering. Finally, we argue that cognitive-behavioral differences in nonword repetition and dual-tasks are consistent with the involvement of neurocognitive networks related to executive function and sensorimotor integration in PWM. We suggest progress in understanding the relationship between stuttering and PWM may be accomplished using high-temporal resolution electromagnetic experimental approaches.

Segmental and metrical complexity during non-word repetition in adults who stutter

Non-word repetition is weaker for adults who stutter (AWS) compared to adults who do not stutter (AWNS) as phonological demands increase. However, non-word stimuli used in previous studies varied by length, but did not vary with regard to segmental or metrical complexity. The purpose of the present study was to examine the unique influence of these two distinct types of complexity on non-word repetition in AWS and AWNS via administration of the Test of Phonological Structure (TOPhS). Twenty-four adults (12 AWNS, 12 AWS) repeated 96 non-words within a soundproof booth immediately after auditory presentation. All 96 non-word targets included on the TOPhS were one to four syllables in length and ranked based on segmental complexity (simple, moderate and complex) and metrical complexity (simple, moderate and complex). No main effect of metrical complexity was detected between groups, and no differences in accuracy were observed for non-words with simple or moderate segmental complexity. However, AWS were significantly more likely to produce a phonemic error when repeating words with complex segmental structure than AWNS, irrespective of metrical complexity. Segmental complexity may contribute to the differences in phonological working memory in AWS when controlling for metrical complexity and length.

Short-Term Memory, Inhibition, and Attention in Developmental Stuttering: A Meta-Analysis

Purpose

This study presents a meta-analytic review of differences in verbal short-term memory, inhibition, and attention between children who stutter (CWS) and children who do not stutter (CWNS).

Method

Electronic databases and reference sections of articles were searched for candidate studies that examined verbal short-term memory, inhibition, and attention using behavioral and/or parent report measures. Twenty-nine studies met the eligibility criteria, which included, among other things, children between the ages of 3 and 18 years and the availability of quantitative data for effect size calculations. Data were extracted, coded, and analyzed, with the magnitude of the difference between the 2 groups of children being estimated using Hedge's g (Hedges & Olkin, 1985).

Results

Based on the random-effects model (Hunter & Schmidt, 2004), findings revealed that CWS scored lower than CWNS on measures of nonword repetition (Hedges' g = -0.62), particularly at lengths of 2 and 3 syllables (Hedges' g = -0.62 and - 0.50, respectively), and forward span (Hedges' g = -0.40). Analyses further revealed that the parents of CWS rated their children as having weaker inhibition (Hedges' g = -0.44) and attentional focus/persistence (Hedges' g = -0.36) skills than the parents of CWNS, but there were no significant differences between CWS and CWNS in behavioral measures of inhibition and attention.

Conclusion

The present findings were taken to suggest that cognitive processes are important variables associated with developmental stuttering.

Longitudinal Predictors of the Overlap between Reading and Math Skills

The predictors of developing reading skill are well known, and there is increasing coherence around predictors of developing math as well. These achievement skills share strong relations. Less knowledge is available regarding the extent to which predictors overlap and predict one another, particularly longitudinally, and across different types of reading and math. We followed kindergarten students (n = 193) for one year, evaluating a range of relevant predictor skills in kindergarten, and a range of relevant achievement outcomes (core, fluency, complex) of reading and math in grade 1. Few predictors differentially predicted math versus reading with some exception (phonological awareness and rapid naming for reading; counting knowledge for math). The pattern was more similar for core and fluency outcomes relative to complex ones. A small set of predictors accounted for much of the overlap among math and reading outcomes, regardless of type (core, fluency, or complex). Results have the potential to inform the development of early screening tools to consider both achievement domains simultaneously, and support the importance of following students identified as at-risk in one domain for their performance in both domains.

Exogenously triggered response inhibition in developmental stuttering

PURPOSE

The purpose of the present study was to examine relations between children's exogenously triggered response inhibition and stuttering.

METHOD

Participants were 18 children who stutter (CWS; mean age = 9;01 years) and 18 children who not stutter (CWNS; mean age = 9;01 years). Participants were matched on age (±3 months) and gender. Response inhibition was assessed by a stop signal task (Verbruggen, Logan, & Stevens, 2008).

RESULTS

Results suggest that CWS, compared to CWNS, perform comparable to CWNS in a task where response control is externally triggered.

CONCLUSIONS

Our findings seem to indicate that previous questionnaire-based findings (Eggers, De Nil, & Van den Bergh, 2010) of a decreased efficiency of response inhibition cannot be generalized to all types of response inhibition.

Evidence for a Resting State Network Abnormality in Adults Who Stutter

Neural network-based investigations of stuttering have begun to provide a possible integrative account for the large number of brain-based anomalies associated with stuttering. Here we used resting-state EEG to investigate functional brain networks in adults who stutter (AWS). Participants were 19 AWS and 52 age-, and gender-matched normally fluent speakers. EEGs were recorded and connectivity matrices were generated by LORETA in the theta (4-8 Hz), alpha (8-12 Hz), beta1 (12-20 Hz), and beta2 (20-30 Hz) bands. Small-world propensity (SWP), shortest path, and clustering coefficients were computed for weighted graphs. Minimum spanning tree analysis was also performed and measures were compared by non-parametric permutation test. The results show that small-world topology was evident in the functional networks of all participants. Three graph indices (diameter, clustering coefficient, and shortest path) exhibited significant differences between groups in the theta band and one [maximum betweenness centrality (BC)] measure was significantly different between groups in the beta2 band. AWS show higher BC than control in right temporal and inferior frontal areas and lower BC in the right primary motor cortex. Abnormal functional networks during rest state suggest an anomaly of DMN activity in AWS. Furthermore, functional segregation/integration deficits in the theta network are evident in AWS. These deficits reinforce the hypothesis that there is a neural basis for abnormal executive function in AWS. Increased beta2 BC in the right speech-motor related areas confirms previous evidence that right audio-speech areas are over-activated in AWS. Decreased beta2 BC in the right primary motor cortex is discussed in relation to abnormal neural mechanisms associated with time perception in AWS.

Nonword repetition in adults who stutter: The effects of stimuli stress and auditory-orthographic cues

Purpose

Adults who stutter (AWS) are less accurate in their immediate repetition of novel phonological sequences compared to adults who do not stutter (AWNS). The present study examined whether manipulation of the following two aspects of traditional nonword repetition tasks unmask distinct weaknesses in phonological working memory in AWS: (1) presentation of stimuli with less-frequent stress patterns, and (2) removal of auditory-orthographic cues immediately prior to response.

Method

Fifty-two participants (26 AWS, 26 AWNS) produced 12 bisyllabic nonwords in the presence of corresponding auditory-orthographic cues (i.e., immediate repetition task), and the absence of auditory-orthographic cues (i.e., short-term recall task). Half of each cohort (13 AWS, 13 AWNS) were exposed to the stimuli with high-frequency trochaic stress, and half (13 AWS, 13 AWNS) were exposed to identical stimuli with lower-frequency iambic stress.

Results

No differences in immediate repetition accuracy for trochaic or iambic nonwords were observed for either group. However, AWS were less accurate when recalling iambic nonwords than trochaic nonwords in the absence of auditory-orthographic cues.

Conclusions

Manipulation of two factors which may minimize phonological demand during standard nonword repetition tasks increased the number of errors in AWS compared to AWNS. These findings suggest greater vulnerability in phonological working memory in AWS, even when producing nonwords as short as two syllables.

Auditory Attentional Set-Shifting and Inhibition in Children Who Stutter

PURPOSE

The purpose of this study was to investigate whether previously reported parental questionnaire-based differences in attentional shifting and inhibitory control (AS and IC; Eggers, De Nil, & Van den Bergh, 2010) would be supported by direct measurement of AS and IC using a computer task.

METHOD

Participants were 16 Finnish children who stutter (CWS; mean age = 7.06 years) and 16 Finnish children who do not stutter (mean age = 7.05 years). Participants were matched on age (±8 months) and gender. AS and IC were assessed by the auditory set-shifting task of the Amsterdam Neuropsychological Tasks (De Sonneville, 2009).

RESULTS

No group differences were found for the speed of auditory AS or IC. However, CWS, as a group, scored significantly lower on the accuracy (error percentage) of auditory AS. In addition, CWS, compared with the children who do not stutter, showed a higher increase in error percentages under AS and IC conditions.

CONCLUSIONS

The findings on error percentages partly corroborate earlier questionnaire-based findings showing difficulties in CWS on AS and IC. Moreover, it also seems to imply that CWS are less able to slow down their responses to achieve higher accuracy rates.

The Influence of Executive Functions on Phonemic Processing in Children Who Do and Do Not Stutter

PURPOSE

The aim of the present study was to investigate dual-task performance in children who stutter (CWS) and those who do not to investigate if the groups differed in the ability to attend and allocate cognitive resources effectively during task performance.

METHOD

Participants were 24 children (12 CWS) in both groups matched for age and sex. For the primary task, participants performed a phoneme monitoring in a picture-written word interference task. For the secondary task, participants made pitch judgments on tones presented at varying (short, long) stimulus onset asynchrony (SOA) from the onset of the picture.

RESULTS

The CWS were comparable to the children who do not stutter in performing the monitoring task although the SOA-based performance differences in this task were more variable in the CWS. The CWS were also significantly slower in making tone decisions at the short SOA and showed a trend for making more errors in this task.

CONCLUSIONS

The findings are interpreted to suggest higher dual-task cost effects in CWS. A potential explanation for this finding requiring further testing and confirmation is that the CWS show reduced efficiency in attending to the tone stimuli while simultaneously prioritizing attention to the phoneme-monitoring task.

Identification of fluency and word-finding difficulty in samples of children with diverse language backgrounds

BACKGROUND

Stuttering and word-finding difficulty (WFD) are two types of communication difficulty that occur frequently in children who learn English as an additional language (EAL), as well as those who only speak English. The two disorders require different, specific forms of intervention. Prior research has described the symptoms of each type of difficulty. This paper describes the development of a non-word repetition test (UNWR), applicable across languages, that was validated by comparing groups of children identified by their speech and language symptoms as having either stuttering or WFD.

AIMS

To evaluate whether non-word repetition scores using the UNWR test distinguished between children who stutter and those who have a WFD, irrespective of the children's first language.

METHODS & PROCEDURES

UNWR was administered to ninety-six 4-5-year-old children attending UK schools (20.83% of whom had EAL). The children's speech samples in English were assessed for symptoms of stuttering and WFD. UNWR scores were calculated.

OUTCOMES & RESULTS

Regression models were fitted to establish whether language group (English only/EAL) and symptoms of (1) stuttering and (2) WFD predicted UNWR scores. Stuttering symptoms predicted UNWR, whereas WFD did not. These two findings suggest that UNWR scores dissociate stuttering from WFD. There were no differences between monolingual English-speakers and children who had EAL.

CONCLUSIONS & IMPLICATIONS

UNWR scores distinguish between stuttering and WFD irrespective of language(s) spoken, allowing future evaluation of a range of languages in clinics or schools.

Explicit and Implicit Verbal Response Inhibition in Preschool-Age Children Who Stutter

PURPOSE

The purpose of this study was to examine (a) explicit and implicit verbal response inhibition in preschool children who do stutter (CWS) and do not stutter (CWNS) and (b) the relationship between response inhibition and language skills.

METHOD

Participants were 41 CWS and 41 CWNS between the ages of 3;1 and 6;1 (years;months). Explicit verbal response inhibition was measured using a computerized version of the grass-snow task (Carlson & Moses, 2001), and implicit verbal response inhibition was measured using the baa-meow task. Main dependent variables were reaction time and accuracy.

RESULTS

The CWS were significantly less accurate than the CWNS on the implicit task, but not the explicit task. The CWS also exhibited slower reaction times than the CWNS on both tasks. Between-group differences in performance could not be attributed to working memory demands. Overall, children's performance on the inhibition tasks corresponded with parents' perceptions of their children's inhibition skills in daily life.

CONCLUSIONS

CWS are less effective and efficient than CWNS in suppressing a dominant response while executing a conflicting response in the verbal domain.

Disfluency characteristics of children with attention-deficit/hyperactivity disorder symptoms

The purpose of the current study was to investigate the characteristics of speech disfluency in 15 children with attention-deficit/hyperactivity disorder (ADHD) symptoms and 15 age-matched control children. Reading, story retelling, and picture description tasks were used to elicit utterances from the participants. The findings indicated that children with ADHD symptoms produced significantly more stuttering-like disfluencies (SLD) and other disfluencies (OD) when compared to the control group during all three tasks. Further statistical analysis showed that children with ADHD symptoms produced more OD during the story retelling task than the other two tasks, whereas no significant differences in OD were observed among the three tasks in the control children. Finally, children with ADHD symptoms exhibited a higher proportion of SLD in total disfluencies (TD) than the control children. These results are consistent with previous studies that children with ADHD are disfluent in their verbal production. Furthermore, children with ADHD symptoms seem to be more vulnerable to a speaking task that places greater demands on their attentional resources for language production, resulting in increased speech disfluencies.

Evidence-Based Multifactorial Assessment of Preschool-Age Children Who Stutter

This review summarizes extant findings supporting multifactorial models of stuttering within the context of preschool-age stuttering assessment. Evidence is given for a number of speech-language and associated factors/domains to consider when evaluating young children who stutter. Selected factors are presented in two parts: (1) Caregiver Interview and (2) Direct Child Assessment. Factors addressed during caregiver interviews include: gender, time since and age at stuttering onset, family history of stuttering, caregivers' perception/concerns about stuttering, and temperament. Factors addressed during direct child assessments include: stuttering behaviors, speech-associated attitudes/awareness, and speech rate, as well as speech sound and language development. Interactions/relations among factors are noted, showing their combined effects and contributions to childhood stuttering. Additionally, suggested clinical applications are provided wherever appropriate. Such evidence and practical applications bridge the gap between theory and clinical practice, thus advancing the abilities of speech-language pathologists to conduct well-informed, comprehensive stuttering evaluations.

Phonological memory in young children who stutter

This study investigated phonological memory in 5- and 6-year old children who stutter. Participants were 11 children who stutter matched on general language abilities, maternal education level, and sex to 11 typically fluent children. Participants completed norm-referenced nonword repetition and digit span tasks, as well as measures of expressive and receptive vocabulary and articulation. The nonword repetition task included stimuli that ranged from 1 to 7 syllables, while the digit naming task contained number strings containing 2-10 digits. Standardized tests of vocabulary and articulation abilities were tested as well. Groups were comparable on measures expressive vocabulary, receptive vocabulary, and articulation. Despite the fact that the majority of participants scored within typical limits, young children who stutter still performed significantly less well than children who do not stutter on the nonword repetition task. No between-group differences were revealed in the digit naming task. Typically fluent children demonstrated strong correlations between phonological memory tasks and language measures, while children who stutter did not. These findings indicate that young children who stutter may have sub-clinical differences in nonword repetition.

Delayed N2 response in Go condition in a visual Go/Nogo ERP study in children who stutter

PURPOSE OF THE STUDY

The main aim of the study was to investigate the attentional and inhibitory abilities and their underlying processes of children who stutter by using behavioural measurement and event-related potentials (ERP) in a visual Go/Nogo paradigm.

METHODS

Participants were 11 children who stutter (CWS; mean age 8.1, age range 6.3-9.5 years) and 19 typically developed children (TDC; mean age 8.1, age range 5.8-9.6 years). They performed a visual Go/Nogo task with simultaneous EEG recording to obtain ERP responses.

RESULTS

Results showed that CWS had longer N2 and P3 latencies in the Go condition compared to the TDC. In contrast, the groups did not differ significantly in the Nogo condition or behavioural measures.

CONCLUSIONS

Our findings did not confirm less efficient inhibitory control in CWS but suggest atypical attentional processing such as stimulus evaluation and response selection.

EDUCATIONAL OBJECTIVES

The reader will be able to (a) describe recent findings on attention and inhibitory control in children who stutter, (b) describe the measurement of attentional processing, including inhibitory control, and (c) describe the findings on attentional processing in children who stutter as indexed by the event-related potentials in a visual Go/Nogo paradigm.

Speech-Language Dissociations, Distractibility, and Childhood Stuttering

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Nonword repetition and phoneme elision in adults who do and do not stutter: Vocal versus nonvocal performance differences

PURPOSE

The purpose of the present study was to enhance our understanding of phonological working memory in adults who stutter through the comparison of nonvocal versus vocal nonword repetition and phoneme elision task performance differences.

METHOD

For the vocal nonword repetition condition, participants repeated sets of 4- and 7-syllable nonwords (n=12 per set). For the nonvocal nonword repetition condition, participants silently identified each target nonword from a subsequent set of three nonwords. For the vocal phoneme elision condition, participants repeated nonwords with a target phoneme eliminated. For the nonvocal phoneme elision condition, participants silently identified the nonword with the designated target phoneme eliminated from a subsequent set of three nonwords.

RESULTS

Adults who stutter produced significantly fewer accurate initial productions of 7-syllable nonwords compared to adults who do not stutter. There were no talker group differences for the silent identification of nonwords, but both talker groups required significantly more mean number of attempts to accurately silently identify 7-syllable as compared to 4-syllable nonwords. For the vocal phoneme elision condition, adults who stutter were significantly less accurate than adults who do not stutter in their initial production and required a significantly higher mean number of attempts to accurately produce 7-syllable nonwords with a phoneme eliminated. This talker group difference was also significant for the nonvocal phoneme elision condition for both 4- and 7-syllable nonwords.

CONCLUSION

Present findings suggest phonological working memory may contribute to the difficulties persons who stutter have establishing and/or maintaining fluent speech.

EDUCATIONAL OBJECTIVES

(a) Readers can describe the role of phonological working memory in planning for and execution of speech; (b) readers can describe two experimental tasks for exploring the phonological working memory: nonword repetition and phoneme elision; (c) readers can describe how the nonword repetition and phoneme elision skills of adults who stutter differ from their typically fluent peers.

Veridical and false recall in adults who stutter

PURPOSE

This study used a false memory paradigm to explore the veridical and false recall of adults who stutter.

METHOD

Twelve adults who stutter and 12 age-matched typically fluent peers listened to and then verbally recalled lists of words that consisted of either semantic or phonological associates or an equal number of semantic and phonological associates (i.e., hybrid condition) of a single, unpresented critical "lure" word. Three parameters of recall performance were measured across these 3 conditions: (a) number of accurately recalled words, (b) order of recall (primacy vs. recency effect), and (c) number of critical lures produced (i.e., false memories).

RESULTS

Significant group differences were noted in recall accuracy specific to list type and also list position as well as relative to critical lure productions.

CONCLUSIONS

Results suggest that certain basic memory processes (i.e., recency effect) and the processing of gist semantic information are largely intact in adults who stutter, but recall of verbatim phonological information and subvocal rehearsal may be deficient.

Habilidades fonológicas em crianças com gagueira

Objetivo : estudar as características de desenvolvimento fonológico de crianças gagas e não-gagas, e investigar possível associação entre a presença de gagueira e a de processos fonológicos.Métodos : foram selecionadas 20 crianças (10 gagas), do sexo feminino e masculino, entre 04 a 08 anos de idade, pareadas por sexo e idade. As crianças do grupo de estudo tiveram diagnóstico de Gagueira e foram classificadas quanto a gravidade da patologia por meio do Stuttering Severity Instrument-3. Foram excluídas aquelas que apresentaram evidência de surdez, doenças neurológicas e/ou psiquiátricas. As crianças de ambos os grupos foram submetidas à avaliação fonoaudiológica e à aplicação das provas de Fonologia do Teste de Linguagem Infantil- ABFW.Resultados : no grupo de estudo foram observados 60% de processos fonológicos não esperados para a idade, enquanto que no grupo controle foram apenas 10%. As diferenças entre os grupos não foram estatisticamente significantes quanto à incidência de processos fonológicos. Há indícios de que o grupo de crianças gagas esteja mais predisposto à presença de pelo menos um processo fonológico.Conclusão : conclui-se que a metodologia utilizada na investigação dos processos fonológicos foi eficaz, mas devido à amostra reduzida não foi possível o aprofundamento da questão, ou seja, verificar se há uma diferenciação no desempenho de crianças gagas quanto aos processos fonológicos quando comparadas com as não-gagas.

Nonword repetition and phoneme elision skills in school-age children who do and do not stutter

Nonword repetition and phoneme elision represent the combined influence of several speech and language processes. In the present study we investigated nonword repetition and phoneme elision performance in school-age children who stutter (CWS) and children who do not stutter (CNS). Participants were 14 CWS (mean = 11.7 years, SD = 2.1 years) and age- and sex-matched CNS (mean = 11.8 years, SD = 2.0 years). Each talker group was further subdivided into two age groups: younger (N = 7; 8-11.5 years) and older (N = 7; 11.6-15 years). Repeated-measures analyses were conducted on the accuracy and response time (in seconds) data. In nonword repetition, the CWS showed a trend for lower per cent of correct phonemes at the two-syllable level compared with the CNS. In phoneme elision, the younger CWS showed a significantly lower accuracy rate than the older CWS at the two- and three-syllable nonword lengths, while similar differences were not evident between the younger versus older CNS at any of the nonword lengths. No accuracy difference in phoneme elision was noted between the two talker groups. Group differences in speech initiation times were also not evident in either of the tasks. Findings from nonword repetition offer tentative support for difficulties experienced by school-age CWS in phonemic encoding/working memory abilities. Findings from the phoneme elision task suggest a complex pattern of age-dependent performance by the CWS. Comparison of response accuracy and speech initiation times in both the tasks failed to show speed-accuracy trade-off strategies in either of the groups.