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Eggers K, Heselmans I. Delay frustration in children who do and do not stutter: A preliminary study. JOURNAL OF COMMUNICATION DISORDERS 2024; 107:106403. [PMID: 38101316 DOI: 10.1016/j.jcomdis.2023.106403] [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: 07/12/2023] [Revised: 10/15/2023] [Accepted: 12/09/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Frustration is an emotion often clinically reported by persons who stutter. So far, mainly questionnaire-based studies have reported findings related to increased frustration or decreased frustration tolerance. The aim of this preliminary study was to determine possible group differences between children who stutter (CWS) and children who do not stutter (CWNS) using a behavioral experimental task, as well as to evaluate possible associations with the frequency, duration, and physical concomitants of stuttering disfluencies. METHOD Participants were 13 CWS (mean age = 6;05 years) and 13 CWNS (mean age = 6;06 years), matched on age (±4 months) and gender. Frustration tolerance was assessed by the Delay Frustration task. This task includes normal delay, short delay, and long delay trials. Responses during long delay trials provide an indication of frustration tolerance and were recorded across time intervals during the response window. RESULTS CWS, compared to CWNS, responded more frequently during the long delay trials, which is indicative of higher delay frustration. The variation in responding across time within intervals was similar for both groups. Decreased frustration tolerance was associated with increased duration of stuttered disfluencies and of physical concomitants. CONCLUSIONS In general, the current findings seem to provide support for earlier theoretical conceptualizations about the role of emotional reactivity in the development of stuttering.
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Affiliation(s)
- Kurt Eggers
- Department of Rehabilitation Sciences, Ghent University, Belgium; Department of Speech-Language Pathology, Thomas More University College, Belgium; Department of Psychology and Speech-Language Pathology, University of Turku, Finland.
| | - Iris Heselmans
- Department of Rehabilitation Sciences, Ghent University, Belgium
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Oh C, Morris R, Wang X, Raskin MS. Analysis of emotional prosody as a tool for differential diagnosis of cognitive impairments: a pilot research. Front Psychol 2023; 14:1129406. [PMID: 37425151 PMCID: PMC10327638 DOI: 10.3389/fpsyg.2023.1129406] [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: 12/21/2022] [Accepted: 05/26/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction This pilot research was designed to investigate if prosodic features from running spontaneous speech could differentiate dementia of the Alzheimer's type (DAT), vascular dementia (VaD), mild cognitive impairment (MCI), and healthy cognition. The study included acoustic measurements of prosodic features (Study 1) and listeners' perception of emotional prosody differences (Study 2). Methods For Study 1, prerecorded speech samples describing the Cookie Theft picture from 10 individuals with DAT, 5 with VaD, 9 with MCI, and 10 neurologically healthy controls (NHC) were obtained from the DementiaBank. The descriptive narratives by each participant were separated into utterances. These utterances were measured on 22 acoustic features via the Praat software and analyzed statistically using the principal component analysis (PCA), regression, and Mahalanobis distance measures. Results The analyses on acoustic data revealed a set of five factors and four salient features (i.e., pitch, amplitude, rate, and syllable) that discriminate the four groups. For Study 2, a group of 28 listeners served as judges of emotions expressed by the speakers. After a set of training and practice sessions, they were instructed to indicate the emotions they heard. Regression measures were used to analyze the perceptual data. The perceptual data indicated that the factor underlying pitch measures had the greatest strength for the listeners to separate the groups. Discussion The present pilot work showed that using acoustic measures of prosodic features may be a functional method for differentiating among DAT, VaD, MCI, and NHC. Future studies with data collected under a controlled environment using better stimuli are warranted.
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Affiliation(s)
- Chorong Oh
- School of Rehabilitation and Communication Sciences, Ohio University, Athens, OH, United States
| | - Richard Morris
- School of Communication Science and Disorders, Florida State University, Tallahassee, FL, United States
| | - Xianhui Wang
- School of Medicine, University of California Irvine, Irvine, CA, United States
| | - Morgan S. Raskin
- School of Communication Science and Disorders, Florida State University, Tallahassee, FL, United States
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Erdemir A, Walden TA, Tilsen S, Mefferd AS, Jones RM. A Preliminary Study of Speech Rhythm Differences as Markers of Stuttering Persistence in Preschool-Age Children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:931-950. [PMID: 36827517 PMCID: PMC10205104 DOI: 10.1044/2022_jslhr-22-00126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 09/15/2022] [Accepted: 12/01/2022] [Indexed: 05/25/2023]
Abstract
PURPOSE The purpose of this study was twofold: (a) to determine whether there are speech rhythm differences between preschool-age children who stutter that were eventually diagnosed as persisting (CWS-Per) or recovered (CWS-Rec) and children who do not stutter (CWNS), using empirical spectral analysis and empirical mode decomposition of the speech amplitude envelope, and (b) to determine whether speech rhythm characteristics close to onset are predictive of later persistence. METHOD Fifty children (3-4 years of age) participated in the study. Approximately 2-2.5 years after the experimental testing took place, children were assigned to the following groups: CWS-Per (nine boys, one girl), CWS-Rec (18 boys, two girls), and CWNS (18 boys, two girls). All children produced a narrative based on a text-free storybook. From the audio recordings of these narratives, fluent utterances were selected for each child from which seven envelope-based measures were extracted. Group-based differences on each measure as well as predictive analyses were conducted to identify measures that discriminate CWS-Per versus CWS-Rec. RESULTS CWS-Per were found to have a relatively higher degree of power in suprasyllabic oscillations and greater variability in the timing of syllabic rhythms especially for longer utterances. A logistic regression model using two speech rhythm measures was able to discriminate the eventual outcome of recovery versus persistence, with 80% sensitivity and 75% specificity. CONCLUSION Findings suggest that envelope-based speech rhythm measures are a promising approach to assess speech rhythm differences in developmental stuttering, and its potential for identification of children at risk of developing persistent stuttering should be investigated further.
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Affiliation(s)
- Aysu Erdemir
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Tedra A. Walden
- Department of Psychology, Vanderbilt University, Nashville, TN
| | - Sam Tilsen
- Department of Linguistics, Cornell University, Ithaca, NY
| | - Antje S. Mefferd
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Robin M. Jones
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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Pruett DG, Porges SW, Walden TA, Jones RM. A study of respiratory sinus arrhythmia and stuttering persistence. JOURNAL OF COMMUNICATION DISORDERS 2023; 102:106304. [PMID: 36738522 PMCID: PMC10006394 DOI: 10.1016/j.jcomdis.2023.106304] [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: 07/05/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION The present study investigated potential differences in respiratory sinus arrhythmia between preschool-age children with persisting stuttering, children who recovered from stuttering, and children who do not stutter. METHODS Participants were 10 children with persisting stuttering (persisting group), 20 children who recovered from stuttering (recovered group), and 36 children who do not stutter (non-stuttering group). Participants viewed a neutral video clip to establish a pre-arousal baseline and then viewed two emotionally-arousing video clips (positive and negative, counterbalanced). Age-appropriate speaking tasks followed each of the video clips (post-baseline, post-positive, and post-negative). Respiratory sinus arrhythmia (RSA), an index of parasympathetic nervous system activity, was measured during the video clips and subsequent speaking tasks. RESULTS First, the persisting group, recovered group, and non-stuttering group did not significantly differ in baseline RSA. Second, during the emotionally-arousing video clips, there was a significant group x condition interaction, with the recovered group exhibiting significantly lower RSA in the positive than negative condition, and the non-stuttering group exhibiting significantly higher RSA in the positive than negative condition. Third, in the narrative tasks, there was a significant group x condition interaction, with a greater difference in RSA between the post-baseline speaking task and the post-positive and post-negative speaking tasks for the persisting compared to the non-stuttering group. Lastly, a follow-up analysis indicated that the recovered and nonstuttering groups, compared to the persisting group, exhibited significantly greater RSA during the baseline (neutral) condition compared to the post-neutral narrative task. CONCLUSIONS Findings provide a physiological perspective of emotion within children who stutter and persist and children who stutter and recover. Future investigations with larger sample sizes and diverse methodologies are necessary to provide novel insights on the specific emotion-related processes that are potentially involved with persistence of stuttering in young children.
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Affiliation(s)
- Dillon G Pruett
- Department of Hearing and Speech Sciences, Vanderbilt University, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN 37232, USA.
| | - Stephen W Porges
- Traumatic Stress Research Consortium, Kinsey Institute, Indiana University, Bloomington, IN, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tedra A Walden
- Department of Psychology, Vanderbilt University, Peabody #552, 230 Appleton Place, Nashville, TN 37203, USA
| | - Robin M Jones
- Department of Hearing and Speech Sciences, Vanderbilt University, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN 37232, USA
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Salvo HD, Arnold HS. Electrodermal Activity of Preschool-Age Children Who Stutter During a Child-Friendly Stroop Paradigm. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2591-2608. [PMID: 36194770 DOI: 10.1044/2022_ajslp-21-00225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE The aim of the study was to assess whether emotional reactivity, indexed by a distinct physiological measure of sympathetic activation, differs between preschool-age children who stutter (CWS) and preschool-age children who do not stutter (CWNS) during a child-friendly Stroop task (i.e., day-night task). Additionally, researchers aimed to assess whether the Stroop task, compared to a control task, was a significant physiological stressor. METHOD Fifteen preschool-age CWS and 22 preschool-age CWNS were asked to perform a day-night Stroop task in order to elicit psychophysiological reactivity, indexed by electrodermal response (EDR) occurrence frequency and EDR amplitude. Physiological measurements were recorded during pretask baselines, performance of the day-night Stroop task, and performance of a speech-language control task. RESULTS Findings based on EDR measures did not support the hypothesis that the child-friendly day-night Stroop task is an effective stressor as compared to a control task based on measures of physiological arousal in preschool-age children. The CWS and CWNS did not significantly differ in their EDR measures relative to the control task or Stroop task (p > .05). However, CWS, compared to CWNS, exhibited significantly greater EDR amplitudes during the control task baseline (p < .05) and the Stroop task baseline (p < .05). CONCLUSION Overall, these findings may suggest that a predisposition to heightened levels of sympathetic activity prior to tasks in preschool-age CWS is important to consider with regard to the nature of developmental stuttering.
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Emotion and Mood Blending in Embodied Artificial Agents: Expressing Affective States in the Mini Social Robot. Int J Soc Robot 2022. [DOI: 10.1007/s12369-022-00915-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
AbstractRobots that are devised for assisting and interacting with humans are becoming fundamental in many applications, including in healthcare, education, and entertainment. For these robots, the capacity to exhibit affective states plays a crucial role in creating emotional bonding with the user. In this work, we present an affective architecture that grounds biological foundations to shape the affective state of the Mini social robot in terms of mood and emotion blending. The affective state depends upon the perception of stimuli in the environment, which influence how the robot behaves and affectively communicates with other peers. According to research in neuroscience, mood typically rules our affective state in the long run, while emotions do it in the short term, although both processes can overlap. Consequently, the model that is presented in this manuscript deals with emotion and mood blending towards expressing the robot’s internal state to the users. Thus, the primary novelty of our affective model is the expression of: (i) mood, (ii) punctual emotional reactions to stimuli, and (iii) the decay that mood and emotion undergo with time. The system evaluation explored whether users can correctly perceive the mood and emotions that the robot is expressing. In an online survey, users evaluated the robot’s expressions showing different moods and emotions. The results reveal that users could correctly perceive the robot’s mood and emotion. However, emotions were more easily recognized, probably because they are more intense affective states and mainly arise as a stimuli reaction. To conclude the manuscript, a case study shows how our model modulates Mini’s expressiveness depending on its affective state during a human-robot interaction scenario.
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Snyder MC, Arnold HS. Emotion-related regulation strategy use in preschool-age children who stutter. JOURNAL OF COMMUNICATION DISORDERS 2022; 97:106219. [PMID: 35594756 DOI: 10.1016/j.jcomdis.2022.106219] [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: 02/19/2021] [Revised: 04/22/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Past findings indicate the quality and quantity of emotion regulation often differs between preschool-age children who stutter (CWS) and children who do not stutter (CWNS). The purpose of this study was to identify whether specific emotion-related regulatory strategy types differ between preschool-age CWS and CWNS during a temptation task. METHODS Participants were 13 CWS and 13 CWNS between 3;2 and 5;7 (years;months), matched for gender and age (+/- 6 months). Participants completed a Forbidden Toy paradigm, a resistance to temptation task, in which the children were asked to refrain from touching a toy. Types of emotion-related regulation, including (1) verbal regulation, (2) behavioral regulation, and (3) attentional regulation, were behaviorally coded during the temptation task. RESULTS A higher proportion of the CWNS (92%) failed to resist the temptation to touch the toy than CWS (48%). Additionally, a higher proportion of the CWS (23%), compared to CWNS (0%), presented with signs of distress, resulting in their task ending prematurely. Limited differences were detected in the types of emotion-related regulatory strategies used by CWS, or the frequency of those strategies. CWNS, compared to the CWS, used more approach-related behavioral strategies. CONCLUSIONS Interpretations of these findings must be mitigated by the observation that a higher proportion of CWS than CWNS demonstrated distress during the paradigm, suggesting a need for further research into the interplay between emotional reactivity and emotion regulation for preschool-age CWS.
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Affiliation(s)
- Marielle C Snyder
- School of Health and Rehabilitation Sciences, Department of Communication Science and Disorders, Speech-Language Pathology, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA 15260, United States; School of Health Sciences, Speech Pathology and Audiology, Center for Performing Arts, Kent State University, 1325 Theatre Drive, Kent, OH 44242-0001, United States
| | - Hayley S Arnold
- School of Health and Rehabilitation Sciences, Department of Communication Science and Disorders, Speech-Language Pathology, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA 15260, United States; School of Health Sciences, Speech Pathology and Audiology, Center for Performing Arts, Kent State University, 1325 Theatre Drive, Kent, OH 44242-0001, United States.
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Koenraads SPC, Jansen PW, Baatenburg de Jong RJ, van der Schroeff MP, Franken MC. Bidirectional Associations of Childhood Stuttering With Behavior and Temperament. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4563-4579. [PMID: 34735297 DOI: 10.1044/2021_jslhr-20-00252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Behavior and temperament (e.g., emotional reactivity, self-regulation) have been considered relevant to stuttering and its developmental course, but the direction of this relation is still unknown. Knowledge of behavior difficulties and temperament in childhood stuttering can improve screening and intervention. The current study examined both directions of the relationship between stuttering and behavior difficulties and temperament and between persistent stuttering and behavior difficulties and temperament across childhood. METHOD This study was embedded in the Generation R Study, a population-based cohort from fetal life onward in the Netherlands. We analyzed data from 145 children (4.2%) with a history of stuttering (118 recovered, 27 persistent) and 3,276 children without such a history. Behavior and temperament were repeatedly assessed using parental questionnaires (Child Behavior Checklist) and Infant/Child Behavior Questionnaire between 0.5 and 9 years of age. Multiple logistic and linear regression analyses were performed. RESULTS Six-month-old children who were less able to "recover from distress," indicating poor self-regulation, were more likely to develop persistent stuttering later in childhood (odds ratio = 2.05, 95% confidence interval (CI) [1.03, 4.05], p = .04). In the opposite direction, children with a history of stuttering showed more negative affectivity (β = 0.19, 95% CI [0.02, 0.37], p = .03) at 6 years of age than children without such a history. Stuttering persistence was associated with increased internalizing behaviors (β = 0.38, 95% CI [0.03, 0.74], p = .04) and higher emotional reactivity (β = 0.53, 95% CI [0.09, 0.89], p = .02) at the age of 9 years. CONCLUSIONS Behavior and temperament were associated with stuttering persistency-seemingly as both predictor and consequence-but did not predict a history of stuttering. We suggest that children who persist in stuttering should be carefully monitored, and if behavioral or temperamental problems appear, treatment for these problems should be offered. Supplemental Material https://doi.org/10.23641/asha.16869479.
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Affiliation(s)
- Simone P C Koenraads
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Pauline W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands
| | - Robert Jan Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marc P van der Schroeff
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marie-Christine Franken
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
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Sugathan N, Maruthy S. Predictive factors for persistence and recovery of stuttering in children: A systematic review. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:359-371. [PMID: 32933336 DOI: 10.1080/17549507.2020.1812718] [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] [Indexed: 06/11/2023]
Abstract
PURPOSE The purpose of this study was to systematically review the available literature on various factors that can predict the persistence and recovery of stuttering in children. METHOD An electronic search yielded a total of 35 studies, which considered 44 variables that can be potential factors for predicting persistence and recovery. RESULT Among 44 factors studied, only four factors- phonological abilities, articulatory rate, change in the pattern of disfluencies, and trend in stuttering severity over one-year post-onset were identified to be replicated predictors of recovery of the stuttering. Several factors, such as differences in the second formant transition between fluent and disfluent speech, articulatory rate measured in phones/sec, etc., were observed to predict the future course of stuttering. However, these factors lack replicated evidence as predictors. CONCLUSION There is clear support only for limited factors as reliable predictors. Also, it is observed to be too early to conclude on several replicated factors due to differences in the age group of participants, participant sample size, and the differences in tools used in research that lead to mixed findings as a predictive factor. Hence there is a need for systematic and replicated testing of the factors identified before initiating their use for clinical purposes.
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Affiliation(s)
- Nirmal Sugathan
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, India
| | - Santosh Maruthy
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, India
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Pinto JS, Picoloto LA, Capellini SA, Palharini TA, Oliveira CMCD. Fluency and reading comprehension in students with and without stuttering. Codas 2021; 33:e20200059. [PMID: 34259753 DOI: 10.1590/2317-1782/20202020059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 10/02/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To analyze and to compare fluency parameters in spontaneous speech and reading and reading comprehension of school-age children who stutter and who do not stutter. METHODS Cross-sectional and prospective study approved by the Research Ethics Committee. Sample consisted of 30 scholars aged 8 and 11 years and 11 months divided into two groups: Study Group with 15 school-age children who stutter, Control Group with 15 school-age children who do not stutter. Participants underwent fluency evaluation of spontaneous speech, reading of expository and narrative texts, and reading comprehension evaluation. Inferential statistical analysis was conducted using the Mann-Whitney tests and correlation analysis was conducted using the Spearman's Coefficient test. RESULTS The comparison between the fluency parameters indicated that school-age children who stutter showed a greater amount of stuttering-like disfluencies, while school-age children who do not stutter showed longer flows of syllables and words per minute, in spontaneous speech and reading. Regarding reading comprehension, school-age children who stutter had lower performance than school-age children who do not stutter in both texts. There was no association between the frequency of disfluencies and reading comprehension in school-age children who stutter and who do not stutter. CONCLUSION School-age children who stutter showed impairments in reading comprehension when compared to fluent, since there was no association between the frequencies of disfluencies with reading comprehension for both groups. It is suggested that reading comprehension be evaluated and, if necessary, improved in order to reduce the consequences of stuttering and provide learning of this school-age children.
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Affiliation(s)
- Juliana Sandoval Pinto
- Programa de Pós-graduação em Fonoaudiologia, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP - Marília (SP), Brasil
| | - Luana Altran Picoloto
- Programa de Pós-graduação em Fonoaudiologia, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP - Marília (SP), Brasil
| | - Simone Aparecida Capellini
- Departamento de Fonoaudiologia, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP - Marília (SP), Brasil
| | - Talissa Almeida Palharini
- Programa de Pós-graduação em Fonoaudiologia, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP - Marília (SP), Brasil
| | - Cristiane Moço Canhetti de Oliveira
- Programa de Pós-graduação em Fonoaudiologia, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP - Marília (SP), Brasil.,Departamento de Fonoaudiologia, Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP - Marília (SP), Brasil
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Fiorin M, Marconato E, Palharini TA, Picoloto LA, Frizzo ACF, Cardoso ACV, Oliveira CMCD. Impact of auditory feedback alterations in individuals with stuttering. Braz J Otorhinolaryngol 2021; 87:247-254. [PMID: 31648949 PMCID: PMC9422389 DOI: 10.1016/j.bjorl.2019.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/26/2019] [Accepted: 08/16/2019] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Electrophysiological evidence has reinforced the hypothesis that stuttering is associated with a deficit in modulation of the cortical auditory system during speech planning, contributing to an inefficient auditory feedback monitoring and, consequently, resulting in disfluencies. OBJECTIVE To verify the impact of auditory feedback modifications on the spontaneous speech of individuals with stuttering. METHODS Sixteen individuals, of both genders, aged 8-17 years and 11 months, with a diagnosis of persistent neurodevelopmental stuttering, were divided into two groups: Moderate Stuttering Group and Severe Stuttering Group. The testing procedures consisted of three stages: collection of identification data, audiological assessment and fluency evaluation of spontaneous speech in four auditory feedback conditions (non-altered, delayed, masked and amplified). The speech sample obtained in the non-altered feedback was considered the control; the others were considered as modified listening conditions. RESULTS Regarding the stuttering-like disfluencies, a statistically significant difference was observed in the intragroup analysis of the Moderate Stuttering Group between non-altered and masked auditory feedback (p = 0.042), as well as between non-altered and amplified (p = 0.042). There was a statistically significant difference in the Severe Stuttering Group for all auditory feedback modifications in relation to the non-altered (delayed p = 0.012, masked p = 0.025 and amplified p = 0.042). There was also a reduction in flows of syllables and words-per-minute in the Moderate Stuttering Group for the delayed auditory feedback, as compared to non-altered (p = 0.017 and p = 0.025, respectively). CONCLUSION The effect of delayed auditory feedback was favorable for the Severe Stuttering Group, promoting speech fluency. The conditions of masked and amplified auditory feedback resulted in speech benefits in both groups, decreasing the number of stuttering-like disfluencies. The speech rate was not impaired by any listening condition analyzed.
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Affiliation(s)
- Michele Fiorin
- Universidade Estadual Paulista Júlio de Mesquita Filho (Unesp), Faculdade de Filosofia e Ciências, Programa de Pós-Graduação em Fonoaudiologia, Marília, SP, Brazil
| | - Eduarda Marconato
- Universidade Estadual Paulista Júlio de Mesquita Filho (Unesp), Faculdade de Filosofia e Ciências, Programa de Pós-Graduação em Fonoaudiologia, Marília, SP, Brazil
| | - Talissa Almeida Palharini
- Universidade Estadual Paulista Júlio de Mesquita Filho (Unesp), Faculdade de Filosofia e Ciências, Programa de Pós-Graduação em Fonoaudiologia, Marília, SP, Brazil
| | - Luana Altran Picoloto
- Universidade Estadual Paulista Júlio de Mesquita Filho (Unesp), Faculdade de Filosofia e Ciências, Programa de Pós-Graduação em Fonoaudiologia, Marília, SP, Brazil
| | - Ana Cláudia Figueiredo Frizzo
- Universidade Estadual Paulista Júlio de Mesquita Filho (Unesp), Faculdade de Filosofia e Ciências, Programa de Pós-Graduação em Fonoaudiologia, Marília, SP, Brazil
| | - Ana Claudia Vieira Cardoso
- Universidade Estadual Paulista Júlio de Mesquita Filho (Unesp), Faculdade de Filosofia e Ciências, Programa de Pós-Graduação em Fonoaudiologia, Marília, SP, Brazil
| | - Cristiane Moço Canhetti de Oliveira
- Universidade Estadual Paulista Júlio de Mesquita Filho (Unesp), Faculdade de Filosofia e Ciências, Programa de Pós-Graduação em Fonoaudiologia, Marília, SP, Brazil.
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Tumanova V, Woods C, Wang Q. Effects of Physiological Arousal on Speech Motor Control and Speech Motor Practice in Preschool-Age Children Who Do and Do Not Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3364-3379. [PMID: 32931716 DOI: 10.1044/2020_jslhr-20-00092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose We examined the effects of physiological arousal on speech motor control and speech motor practice effects in preschool-age children who do (CWS) and do not stutter (CWNS). Method Participants included 18 CWS (M age = 4 years 5 months) and 18 age- and gender-matched CWNS. The participants repeated a phrase "buy bobby a puppy" interspersed with viewing pictures from the International Affective Picture System under two experimental conditions speaking after viewing pictures with (a) negative and (b) neutral valence. Participants' lip movements were tracked using Optotrak system. The spatiotemporal index and mean utterance duration were calculated to examine speech motor control and speech motor practice effects. Skin conductance level was measured during the experimental conditions to assess participants' physiological level of arousal. Results Preschool-age CWS demonstrated greater speech movement variability across all conditions and trials than CWNS. Furthermore, the younger participants produced more variable articulatory movements than the older participants. Participants' speech movement variability did not significantly differ between the negative and neutral experimental conditions, and the level of physiological arousal did not have a significant effect on it. There was a nonsignificant trend of decrease in speech movement variability across the repeated trials in both groups. Last, CWS and CWNS did not differ in their mean utterance duration, suggesting that their articulation rate was similar across all conditions and trials. Conclusions Our findings indicate that, compared to preschool-age CWNS, CWS demonstrate less mature speech motor control. However, present findings do not support the hypothesis that CWS benefit less from motor practice relative to CWNS. Given that our conditions elicited similar levels of arousal in the participants, future research is needed to examine whether physiological arousal disrupts speech motor control in preschool-age children potentially contributing to disruptions of speech fluency and the development of stuttering.
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Affiliation(s)
- Victoria Tumanova
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | - Carly Woods
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | - Qiu Wang
- Department of Higher Education, Syracuse University, NY
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Singer CM, Hessling A, Kelly EM, Singer L, Jones RM. Clinical Characteristics Associated With Stuttering Persistence: A Meta-Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2995-3018. [PMID: 32772868 PMCID: PMC7890223 DOI: 10.1044/2020_jslhr-20-00096] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/01/2020] [Accepted: 06/03/2020] [Indexed: 05/07/2023]
Abstract
Purpose The purpose of this meta-analytic study was to identify clinical characteristics, defined as child factors that can be assessed by a speech-language pathologist as part of a routine speech-language evaluation that may differentiate children who persist in stuttering from children who eventually recover from stuttering. Clinical characteristics explored included sex, age at onset, family history of stuttering, stuttering frequency and severity, speech-language skills, and temperament. Method Studies were identified through electronic databases, journals, and reference lists of relevant reports (e.g., research articles). Eligible studies followed young children who stutter (i.e., under 6 years old) for at least 24 months, assessed a potential clinical marker at study entry, and determined talker group classification (i.e., persistent or recovered) at study completion. Sex and family history differences were estimated using risk ratios; all other differences were estimated using Hedges's g. Heterogeneity and methodological differences among studies were evaluated. Results Eleven studies (41 reports) met eligibility criteria. Persistent children were older at stuttering onset and exhibited higher frequencies of stuttering-like disfluencies, lower speech sound accuracy, and lower expressive and receptive language skills than recovered children. Males and children with a family history of stuttering were also more likely to persist. Conclusions Clinical characteristics were identified that are associated with increased risk for stuttering persistence. Future studies have the potential to translate these clinical characteristics into prognostic markers for stuttering persistence risk.
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Affiliation(s)
- Cara M. Singer
- Department of Communication Sciences and Disorders, Grand Valley State University, Grand Rapids, MI
| | - Alison Hessling
- Department of Communication Sciences and Disorders, Baylor University, Waco, TX
| | - Ellen M. Kelly
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Lisa Singer
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA
| | - Robin M. Jones
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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Tichenor SE, Yaruss JS. Recovery and Relapse: Perspectives From Adults Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2162-2176. [PMID: 32598208 DOI: 10.1044/2020_jslhr-20-00010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Recovery and relapse relating to stuttering are often defined in terms of the presence or absence of certain types of speech disfluencies as observed by clinicians and researchers. However, it is well documented that the experience of the overall stuttering condition involves more than just the production of stuttered speech disfluencies. This study sought to identify what recovery and relapse mean to people who stutter based on their own unique experiences to account for both the stuttering behaviors and the broader adverse impact of the condition. Method In this study, 228 adults who stutter participated in a mixed-methods exploration of the terms "recovery" and "relapse." Participants categorized themselves on whether they considered themselves to have recovered or experienced relapse. Data were analyzed thematically through the lens of the speaker self-categorizations to determine how adults who stutter define recovery and relapse regarding stuttering. Results Results indicate that, to adults who stutter, recovery from stuttering is associated with increases in positive affective/emotional, behavioral, and cognitive reactions to the condition and simultaneous decreases in associated negative constructs. These group-level definitions did not change as a function of whether respondents reported that they had experienced recovery or relapse themselves. Discussion Recovery or relapse from stuttering behaviors can occur independently from recovery or relapse from the broader adverse impact related to the condition, suggesting that researchers and clinicians should consider recovery and relapse as involving more than just a reduction or an increase in observable behaviors. These findings support recent research evidence further specifying the many individual phenotypes of stuttering, in that pathways to recovery and relapse can be experienced in different ways for people with different stuttering phenotype profiles.
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Affiliation(s)
- Seth E Tichenor
- Department of Communicative Sciences & Disorders, Michigan State University, East Lansing
| | - J Scott Yaruss
- Department of Communicative Sciences & Disorders, Michigan State University, East Lansing
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Alencar PBAD, Palharini TA, Silva LMD, Oliveira CMCD, Berti LC. Indicators of speech fluency in stuttering and in phonological disorder. Codas 2020; 32:e20190002. [PMID: 32267336 DOI: 10.1590/2317-1782/20192019002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 06/12/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To identify the indicators of speech fluency that differs subjects with stuttering, with phonological disorder, and with the two disorders in comorbidity. METHODS Thirty subjects aged 4-11 years old were divided into 3 groups, each one with 10 subjects: groups with developmental stuttering (SG), phonological disorder (PDG), and with two diagnoses in comorbidity (SPDG) participated in this study. The procedures were speech fluency and phonology evaluation. The data were submitted to statistical analysis. RESULTS Subjects from SG and SPDG showed a greater occurrence of stuttering-like disfluencies and total of disfluencies in relation to the subjects with PDG. Regarding to the other disfluencies, the three groups were similar. Subjects with PDG showed fewer monosyllabic word repetitions, part of word repetition and prolongations in relation to subjects from SG and SPDG. Blocks occurred more frequently in the two groups with stuttering (SG and SPDG) than in the group with PDG. Interjection occurred more frequently in subjects from SG than in PDG. CONCLUSION The PDG was the most differentiated in quantitative and qualitative terms in the three groups analyzed. The similarities and differences between the groups will assist the differential diagnosis and, consequently, will enable improved therapy. The presence of blocks represents an important marker for the diagnosis of stuttering.
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Affiliation(s)
| | - Talissa Almeida Palharini
- Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Marília (SP), Brasil
| | - Lídia Maurício da Silva
- Instituto de Biociências, Letras e Ciências Exatas, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, São José do Rio Preto (SP), Brasil
| | | | - Larissa Cristina Berti
- Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Marília (SP), Brasil
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Singer CM, Walden TA, Jones RM. Attention, Speech-Language Dissociations, and Stuttering Chronicity. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:157-167. [PMID: 31841358 PMCID: PMC7231910 DOI: 10.1044/2019_ajslp-19-00039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/29/2019] [Accepted: 08/14/2019] [Indexed: 05/13/2023]
Abstract
The purpose of this study was to investigate the singular and joint contributions of speech-language dissociations and attention (i.e., distractibility and attention span) to stuttering chronicity. Method Participants, aged 3;0-4;11 (years;months) at an initial visit, were classified as persisting (n = 10; 9 boys), recovered (n = 32; 23 boys), and nonstuttering (n = 28; 19 boys) based on multiple speech and language evaluations spread across 2 years. The evaluations included assessments of articulation, receptive and expressive vocabulary, and omnibus receptive and expressive language. These measures were used to identify speech-language dissociations using a correlation-based statistical approach. Attentional characteristics, which included measures of distractibility and attention span, were based on parent report. Analyses investigated between-group differences related to dissociations and attentional characteristics as well as the relation between these indices. Results There were no significant between-group differences for the persisting and recovered groups on measures of speech-language dissociations; however, the recovered group was found to exhibit less optimal attention span than the persisting group. In addition, children with dissociations exhibited less optimal distractibility and attention spans at the final time point than children without dissociations. Conclusions Present results indicate that attention is related to both stuttering chronicity and the presence of speech-language dissociations; however, they do not support the notion that dissociations are associated with stuttering persistence. These results provide novel insights into the complex nature of the association between developmental stuttering, speech-language dissociations, and attention.
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Affiliation(s)
- Cara M. Singer
- Department of Communication Sciences and Disorders, Grand Valley State University, Grand Rapids, MI
| | - Tedra A. Walden
- Department of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN
| | - Robin M. Jones
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN
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Bauerly KR, Jones RM, Miller C. Effects of Social Stress on Autonomic, Behavioral, and Acoustic Parameters in Adults Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:2185-2202. [PMID: 31265363 DOI: 10.1044/2019_jslhr-s-18-0241] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose The purpose of this study was to assess changes in autonomic, behavioral, and acoustic measures in response to social stress in adults who stutter (AWS) compared to adults who do not stutter (ANS). Method Participants completed the State-Trait Anxiety Inventory ( Speilberger, Gorsuch, Luschene, Vagg, & Jacobs, 1983 ). In order to provoke social stress, participants were required to complete a modified version of the Trier Social Stress Test (TSST-M, Kirschbaum, Pirke, & Hellhammer, 1993 ), which included completing a nonword reading task and then preparing and delivering a speech to what was perceived as a group of professionals trained in public speaking. Autonomic nervous system changes were assessed by measuring skin conductance levels, heart rate, and respiratory sinus arrhythmia (RSA). Behavioral changes during speech production were measured in errors, percentage of syllable stuttered, percentage of other disfluencies, and speaking rate. Acoustic changes were measured using 2nd formant frequency fluctuations. In order to make comparisons of speech with and without social-cognitive stress, measurements were collected while participants completed a speaking task before and during TSST-M conditions. Results AWS showed significantly higher levels of self-reported state and trait anxiety compared to ANS. Autonomic nervous system changes revealed similar skin conductance level and heart rate across pre-TSST-M and TSST-M conditions; however, RSA levels were significantly higher in AWS compared to ANS across conditions. There were no differences found between groups for speaking rate, fundamental frequency, and percentage of other disfluencies when speaking with or without social stress. However, acoustic analysis revealed higher levels of 2nd formant frequency fluctuations in the AWS compared to the controls under pre-TSST-M conditions, followed by a decline to a level that resembled controls when speaking under the TSST-M condition. Discussion Results suggest that AWS, compared to ANS, engage higher levels of parasympathetic control (i.e., RSA) during speaking, regardless of stress level. Higher levels of self-reported state and trait anxiety support this view point and suggest that anxiety may have an indirect role on articulatory variability in AWS.
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Affiliation(s)
- Kim R Bauerly
- Department of Communication Sciences and Disorders, University of Vermont, Burlington
| | - Robin M Jones
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Charlotte Miller
- Department of Communication Sciences and Disorders, University of Vermont, Burlington
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Walsh B, Usler E, Bostian A, Mohan R, Gerwin KL, Brown B, Weber C, Smith A. What Are Predictors for Persistence in Childhood Stuttering? Semin Speech Lang 2018; 39:299-312. [PMID: 30142641 PMCID: PMC6154780 DOI: 10.1055/s-0038-1667159] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Over the past 10 years, we (the Purdue Stuttering Project) have implemented longitudinal studies to examine factors related to persistence and recovery in early childhood stuttering. Stuttering develops essentially as an impairment in speech sensorimotor processes that is strongly influenced by dynamic interactions among motor, language, and emotional domains. Our work has assessed physiological, behavioral, and clinical features of stuttering within the motor, linguistic, and emotional domains. We describe the results of studies in which measures collected when the child was 4 to 5 years old are related to eventual stuttering status. We provide supplemental evidence of the role of known predictive factors (e.g., sex and family history of persistent stuttering). In addition, we present new evidence that early delays in basic speech motor processes (especially in boys), poor performance on a nonword repetition test, stuttering severity at the age of 4 to 5 years, and delayed or atypical functioning in central nervous system language processing networks are predictive of persistent stuttering.
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Affiliation(s)
- Bridget Walsh
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan
| | - Evan Usler
- Department of Speech, Language, and Hearing Sciences, Speech and Feeding Disorders Laboratory, Boston Univer-sity, MGH Institute of Health Professions, Boston, Massachusetts
| | - Anna Bostian
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana
| | - Ranjini Mohan
- Department of Communication Disorders, Texas State University, San Marcos, Texas
| | - Katelyn Lippitt Gerwin
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana
| | - Barbara Brown
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana
| | - Christine Weber
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana
| | - Anne Smith
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana
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Zengin-Bolatkale H, Conture EG, Key AP, Walden TA, Jones RM. Cortical associates of emotional reactivity and regulation in childhood stuttering. JOURNAL OF FLUENCY DISORDERS 2018; 56:81-99. [PMID: 29723729 PMCID: PMC5970082 DOI: 10.1016/j.jfludis.2018.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 01/05/2018] [Accepted: 04/12/2018] [Indexed: 05/24/2023]
Abstract
PURPOSE This study sought to determine the cortical associates of emotional reactivity and emotion regulation (as indexed by the amplitude of evoked response potentials [ERP]) in young children who do and do not stutter during passive viewing of pleasant, unpleasant and neutral pictures. METHOD Participants were 17 young children who stutter and 22 young children who do not stutter (between 4 years 0 months to 6 years 11 months). The dependent measures were (1) mean amplitude of late positive potential (LPP, an ERP sensitive to emotional stimuli) during passive (i.e., no response required) picture viewing and directed reappraisal tasks and (2) emotional reactivity and regulation related scores on caregiver reports of young children's temperament (Children's Behavior Questionnaire, CBQ). RESULTS Young CWS, when compared to CWNS, exhibited significantly greater LPP amplitudes when viewing unpleasant pictures, but no significant between-group difference when viewing pleasant pictures and during the emotion regulation condition. There were, however, for CWS, but not CWNS, significant correlations between temperament-related measures of emotion and cortical measures of emotional reactivity and regulation. CONCLUSIONS Findings provide further empirical support for the notion that emotional processes are associated with childhood stuttering, and that CWS's inherent temperamental proclivities need to be taken into account when empirically studying or theorizing about this association.
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Affiliation(s)
- Hatun Zengin-Bolatkale
- Department of Hearing and Speech Sciences, Vanderbilt University, 1215 21st Avenue South, Suite 8310 MCE South Tower, Nashville, TN 37232-8242, United States.
| | - Edward G Conture
- Department of Hearing and Speech Sciences, Vanderbilt University, 1215 21st Avenue South, Suite 8310 MCE South Tower, Nashville, TN 37232-8242, United States.
| | - Alexandra P Key
- Department of Hearing and Speech Sciences, Vanderbilt University, 1215 21st Avenue South, Suite 8310 MCE South Tower, Nashville, TN 37232-8242, United States; Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University Medical Center, 230 Appleton Place, Nashville, TN 37203, United States.
| | - Tedra A Walden
- Department of Hearing and Speech Sciences, Vanderbilt University, 1215 21st Avenue South, Suite 8310 MCE South Tower, Nashville, TN 37232-8242, United States; Department of Psychology and Human Development, Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203-5721, United States.
| | - Robin M Jones
- Department of Hearing and Speech Sciences, Vanderbilt University, 1215 21st Avenue South, Suite 8310 MCE South Tower, Nashville, TN 37232-8242, United States.
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