1
|
Wagovich SA, Anderson JD, Hill MS. Visual exogenous and endogenous attention and visual memory in preschool children who stutter. JOURNAL OF FLUENCY DISORDERS 2020; 66:105792. [PMID: 33032169 PMCID: PMC7704769 DOI: 10.1016/j.jfludis.2020.105792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/18/2020] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
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.
Collapse
Affiliation(s)
- Stacy A Wagovich
- Department of Speech, Language and Hearing Sciences, University of Missouri, United States.
| | - Julie D Anderson
- Department of Speech and Hearing Sciences, Indiana University, United States
| | - Margaret S Hill
- Department of Applied Clinical and Educational Sciences, Indiana State University, United States
| |
Collapse
|
2
|
Ntourou K, DeFranco EO, Conture EG, Walden TA, Mushtaq N. A parent-report scale of behavioral inhibition: Validation and application to preschool-age children who do and do not stutter. JOURNAL OF FLUENCY DISORDERS 2020; 63:105748. [PMID: 32065916 PMCID: PMC7061916 DOI: 10.1016/j.jfludis.2020.105748] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 12/02/2019] [Accepted: 01/03/2020] [Indexed: 05/27/2023]
Abstract
PURPOSE This two-part (i.e., Study 1, Study 2) study investigated behavioral inhibition (BI) in preschool-age children who do (CWS) and do not (CWNS) stutter. The purpose of Study 1 was to develop the Short Behavioral Inhibition Scale (SBIS), a parent-report scale of BI. The purpose of Study 2 was to determine, based on the SBIS, differences in BI between CWS and CWNS, and associations between BI and CWS's stuttering frequency, stuttering severity, speech-associated attitudes, and stuttering-related consequences/reactions. METHOD Participants in Study 1 were 225 CWS and 243 CWNS with the majority of them being included in Study 2. In Study 2, a speech sample was obtained for the calculation of stuttering frequency and severity, and the parents of a subset of CWS completed the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (Vanryckeghem & Brutten, 2007), and the Test of Childhood Stuttering Disfluency-Related Consequences Rating Scale (Gillam, Logan, & Pearson, 2009). RESULTS Study 1 analyses indicated that SBIS is a valid and reliable tool whose items assess a single, relatively homogeneous construct. In Study 2, CWS exhibited greater mean and extreme BI tendencies than CWNS. Also CWS with higher, compared to CWS with lower, BI presented with greater stuttering frequency, more severe stuttering, greater stuttering-related consequences, and more negative communication attitudes (for CWS older than 4 years of age). CONCLUSION Findings were taken to suggest that BI is associated with early childhood stuttering and that the SBIS could be included as part of a comprehensive evaluation of stuttering.
Collapse
Affiliation(s)
- Katerina Ntourou
- Department of Speech and Hearing Sciences, Vanderbilt University, United States.
| | - Elizabeth Oyler DeFranco
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, United States
| | - Edward G Conture
- Department of Speech and Hearing Sciences, Vanderbilt University, United States
| | - Tedra A Walden
- Department of Psychology and Human Development, Department of Speech and Hearing Sciences, Vanderbilt University, United States
| | - Nasir Mushtaq
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, United States
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Singer CM, Walden TA, Jones RM. Differences in the relation between temperament and vocabulary based on children's stuttering trajectories. JOURNAL OF COMMUNICATION DISORDERS 2019; 78:57-68. [PMID: 30771599 PMCID: PMC6467523 DOI: 10.1016/j.jcomdis.2019.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 01/04/2019] [Accepted: 01/21/2019] [Indexed: 05/13/2023]
Abstract
PURPOSE The purpose of this study was to assess the relation between temperament and vocabulary development for children who stutter and persist, children who stutter and recover and children who do not stutter. METHODS Participants, aged 3;0-4;11 at the start of the study, were followed for two years. They were classified as persisting (n = 10), recovered (n = 26), and non-stuttering (n = 24) based on multiple assessments of stuttering spaced across study participation. Groups were balanced for age and gender ratios. At each visit, participants completed the Peabody Picture Vocabulary Test, 4th edition, and the Expressive Vocabulary Test, 2nd edition; caregivers completed the Children's Behavior Questionnaire. RESULTS For both persisting and recovered groups, higher negative emotionality was associated with lower receptive vocabulary. These associations were both significantly more negative than the non-stuttering group's association. CONCLUSION These findings suggest that receptive vocabulary development is differentially linked to temperament based on a child's stuttering status. As others have speculated (Conture & Walden, 2012), it appears as though there are salient associations between temperament, speech-language development, and childhood stuttering.
Collapse
Affiliation(s)
- Cara M Singer
- Department of Hearing and Speech Sciences, Vanderbilt University, 1215 21st Avenue South, Suite 8310 MCE South Tower, Nashville, TN 37232-8242, United States.
| | - Tedra A Walden
- 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
| |
Collapse
|
5
|
Kraft SJ, Lowther E, Beilby J. The Role of Effortful Control in Stuttering Severity in Children: Replication Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:14-28. [PMID: 30517950 PMCID: PMC6503866 DOI: 10.1044/2018_ajslp-17-0097] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 01/08/2018] [Accepted: 05/16/2018] [Indexed: 05/17/2023]
Abstract
Background In 2014, Kraft et al. assessed the temperament, home environment, and significant life events of 69 North American children who stutter to examine the combined and compounded effects of these individualized factors on mediating overt stuttering severity. The temperament domain of effortful control was singularly found to be significantly predictive of stuttering severity. Purpose Because of the clinical significance of the initial study's findings, a replication study with a different, larger cohort of children who stutter was warranted to validate the reported outcomes. Method The current study assesses 98 children who stutter, ages 2;4 to 12;6 (years; months, M = 6;7), recruited from Perth, Australia. Results The results support the previous findings of Kraft, Ambrose, and Chon (2014) , with effortful control remaining the sole significant contributor to variability in stuttering severity, as rated by both parents and clinicians. Conclusion These cumulative and consistent outcomes support the need to develop targeted intervention strategies that specifically strengthen aspects of effortful control as a means to support positive therapeutic change in children who stutter.
Collapse
Affiliation(s)
- Shelly Jo Kraft
- Behavioral Speech & Genetics Lab, Department of Communication Sciences and Disorders, Wayne State University, Detroit, MI
| | - Emily Lowther
- Behavioral Speech & Genetics Lab, Department of Communication Sciences and Disorders, Wayne State University, Detroit, MI
| | - Janet Beilby
- Social Work and Speech Pathology, School of Occupational Therapy, Curtin University, Perth, Australia
| |
Collapse
|
6
|
Ofoe LC, Anderson JD, Ntourou K. Short-Term Memory, Inhibition, and Attention in Developmental Stuttering: A Meta-Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1626-1648. [PMID: 29984373 PMCID: PMC6195058 DOI: 10.1044/2018_jslhr-s-17-0372] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 03/26/2018] [Indexed: 05/05/2023]
Abstract
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.
Collapse
Affiliation(s)
- Levi C. Ofoe
- Department of Speech and Hearing Sciences, Indiana University, Bloomington
| | - Julie D. Anderson
- Department of Speech and Hearing Sciences, Indiana University, Bloomington
| | - Katerina Ntourou
- Department of Speech and Hearing Sciences, Indiana University, Bloomington
| |
Collapse
|
7
|
Erdemir A, Walden TA, Jefferson CM, Choi D, Jones RM. The effect of emotion on articulation rate in persistence and recovery of childhood stuttering. JOURNAL OF FLUENCY DISORDERS 2018; 56:1-17. [PMID: 29443691 PMCID: PMC5963974 DOI: 10.1016/j.jfludis.2017.11.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/27/2017] [Accepted: 11/16/2017] [Indexed: 05/13/2023]
Abstract
PURPOSE This study investigated the possible association of emotional processes and articulation rate in pre-school age children who stutter and persist (persisting), children who stutter and recover (recovered) and children who do not stutter (nonstuttering). METHODS The participants were ten persisting, ten recovered, and ten nonstuttering children between the ages of 3-5 years; who were classified as persisting, recovered, or nonstuttering approximately 2-2.5 years after the experimental testing took place. The children were exposed to three emotionally-arousing video clips (baseline, positive and negative) and produced a narrative based on a text-free storybook following each video clip. From the audio-recordings of these narratives, individual utterances were transcribed and articulation rates were calculated. RESULTS Results indicated that persisting children exhibited significantly slower articulation rates following the negative emotion condition, unlike recovered and nonstuttering children whose articulation rates were not affected by either of the two emotion-inducing conditions. Moreover, all stuttering children displayed faster rates during fluent compared to stuttered speech; however, the recovered children were significantly faster than the persisting children during fluent speech. CONCLUSION Negative emotion plays a detrimental role on the speech-motor control processes of children who persist, whereas children who eventually recover seem to exhibit a relatively more stable and mature speech-motor system. This suggests that complex interactions between speech-motor and emotional processes are at play in stuttering recovery and persistency; and articulation rates following negative emotion or during stuttered versus fluent speech might be considered as potential factors to prospectively predict persistence and recovery from stuttering.
Collapse
Affiliation(s)
| | | | | | - Dahye Choi
- University of South Alabama, United States
| | | |
Collapse
|
8
|
Zengin-Bolatkale H, Conture EG, Walden TA, Jones RM. Sympathetic arousal as a marker of chronicity in childhood stuttering. Dev Neuropsychol 2018; 43:135-151. [PMID: 29412003 DOI: 10.1080/87565641.2018.1432621] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE This study investigated whether sympathetic activity during a stressful speaking task was an early marker for stuttering chronicity. METHOD Participants were 9 children with persisting stuttering, 23 children who recovered, and 17 children who do not stutter. Participants performed a stress-inducing picture-naming task and skin conductance was measured across three time points. RESULTS Findings indicated that at the initial time point, children with persisting stuttering exhibited higher sympathetic arousal during the stressful speaking task than children whose stuttering recovered. CONCLUSIONS Findings are taken to suggest that sympathetic activity may be an early marker of heightened risk for chronic stuttering.
Collapse
Affiliation(s)
- Hatun Zengin-Bolatkale
- a Department of Hearing and Speech Sciences , Vanderbilt University , Nashville , TN , USA
| | - Edward G Conture
- a Department of Hearing and Speech Sciences , Vanderbilt University , Nashville , TN , USA
| | - Tedra A Walden
- a Department of Hearing and Speech Sciences , Vanderbilt University , Nashville , TN , USA.,b Department of Psychology and Human Development, Peabody College , Vanderbilt University , Nashville , TN , USA
| | - Robin M Jones
- a Department of Hearing and Speech Sciences , Vanderbilt University , Nashville , TN , USA
| |
Collapse
|
9
|
Choi D, Conture EG, Tumanova V, Clark CE, Walden TA, Jones RM. Young children's family history of stuttering and their articulation, language and attentional abilities: An exploratory study. JOURNAL OF COMMUNICATION DISORDERS 2018; 71:22-36. [PMID: 29223492 PMCID: PMC6309324 DOI: 10.1016/j.jcomdis.2017.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 10/16/2017] [Accepted: 11/22/2017] [Indexed: 06/01/2023]
Abstract
PURPOSE The purpose of this study was to determine whether young children who do (CWS) and do not stutter (CWNS) with a positive versus negative family history of stuttering differ in articulation, language and attentional abilities and family histories of articulation, language and attention related disorders. METHOD Participants were 25 young CWS and 50 young CWNS. All 75 participants' caregivers consistently reported a positive or negative family history of stuttering across three consecutive time points that were about 8 months apart for a total of approximately 16 months. Each participant's family history focused on the same, relatively limited number of generations (i.e., participants' parents & siblings). Children's family history of stuttering as well as articulation, language, and attention related disorders was obtained from one or two caregivers during an extensive interview. Children's speech and language abilities were measured using four standardized articulation and language tests and their attentional abilities were measured using caregiver reports of temperament. RESULTS Findings indicated that (1) most caregivers (81.5% or 75 out 92) were consistent in their reporting of positive or negative history of stuttering; (2) CWNS with a positive family history of stuttering, compared to those with a negative family history of stuttering, were more likely to have reported a positive family history of attention deficit/hyperactivity disorder (ADHD), and (3) CWNS with a positive family history of stuttering had lower language scores than those with a negative family history of stuttering. However, there were no such significant differences in family histories of ADHD and language scores for CWS with a positive versus negative family history of stuttering. In addition, although 24% of CWS versus 12% of CWNS's caregivers reported a positive family history of stuttering, inferential analyses indicated no significant differences between CWS and CWNS in relative proportions of family histories of stuttering. CONCLUSION Finding that a relatively high proportion (i.e., 81.5%) of caregivers consistently reported a positive or negative family history of stuttering across three consecutive time points should provide some degree of assurance to those who collect such caregiver reports. Based on such consistent caregiver reports, linguistic as well as attentional vulnerabilities appear associated with a positive family history of stuttering, a finding that must await further empirical study for confirmation or refutation.
Collapse
Affiliation(s)
- Dahye Choi
- Department of Speech Pathology and Audiology, University of South Alabama, Mobile, AL, United States.
| | - Edward G Conture
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States
| | - Victoria Tumanova
- Department of Communications Sciences and Disorders, Syracuse University, Nashville, TN, United States
| | | | - Tedra A Walden
- Department of Psychology & Human Development, Vanderbilt University, Nashville, TN, United States
| | - Robin M Jones
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States
| |
Collapse
|
10
|
Leech KA, Bernstein Ratner N, Brown B, Weber CM. Preliminary Evidence That Growth in Productive Language Differentiates Childhood Stuttering Persistence and Recovery. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:3097-3109. [PMID: 29049493 PMCID: PMC5945073 DOI: 10.1044/2017_jslhr-s-16-0371] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 03/06/2017] [Accepted: 05/27/2017] [Indexed: 05/13/2023]
Abstract
Purpose Childhood stuttering is common but is often outgrown. Children whose stuttering persists experience significant life impacts, calling for a better understanding of what factors may underlie eventual recovery. In previous research, language ability has been shown to differentiate children who stutter (CWS) from children who do not stutter, yet there is an active debate in the field regarding what, if any, language measures may mark eventual recovery versus persistence. In this study, we examined whether growth in productive language performance may better predict the probability of recovery compared to static profiles taken from a single time point. Method Productive syntax and vocabulary diversity growth rates were calculated for 50 CWS using random coefficient models. Logistic regression models were then used to determine whether growth rates uniquely predict likelihood of recovery, as well as if these rates were predictive over and above currently identified correlates of stuttering onset and recovery. Results Different linguistic profiles emerged between children who went on to recover versus those who persisted. Children who had steeper productive syntactic growth, but not vocabulary diversity growth, were more likely to recover by study end. Moreover, this effect held after controlling for initial language ability at study onset as well as demographic covariates. Conclusions Results are discussed in terms of how growth estimates can be incorporated in recommendations for fostering productive language skills among CWS. The need for additional research on language in early stuttering and recovery is suggested.
Collapse
Affiliation(s)
- Kathryn A. Leech
- University of Maryland, College Park
- Harvard Graduate School of Education, Cambridge, MA
| | | | | | | |
Collapse
|
11
|
Arenas RM, Walker EA, Oleson JJ. Developmental Stuttering in Children Who Are Hard of Hearing. Lang Speech Hear Serv Sch 2017; 48:234-248. [PMID: 28915514 PMCID: PMC5944374 DOI: 10.1044/2017_lshss-17-0028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/24/2017] [Accepted: 06/23/2017] [Indexed: 02/03/2023] Open
Abstract
Purpose A number of studies with large sample sizes have reported lower prevalence of stuttering in children with significant hearing loss compared to children without hearing loss. This study used a parent questionnaire to investigate the characteristics of stuttering (e.g., incidence, prevalence, and age of onset) in children who are hard of hearing (CHH). Method Three hundred three parents of CHH who participated in the Outcomes of Children With Hearing Loss study (Moeller & Tomblin, 2015) were sent questionnaires asking about their child's history of stuttering. Results One hundred ninety-four parents of CHH responded to the survey. Thirty-three CHH were reported to have stuttered at one point in time (an incidence of 17.01%), and 10 children were still stuttering at the time of survey submission (a prevalence of 5.15%). Compared to estimates in the general population, this sample displayed a significantly higher incidence and prevalence. The age of onset, recovery rate, and other characteristics were similar to hearing children. Conclusions Based on this sample, mild to moderately severe hearing loss does not appear to be a protective factor for stuttering in the preschool years. In fact, the incidence and prevalence of stuttering may be higher in this population compared to the general population. Despite the significant speech and language needs that children with mild to moderately severe hearing loss may have, speech-language pathologists should appropriately prioritize stuttering treatment as they would in the hearing population. Supplemental Material https://doi.org/10.23641/asha.5397154.
Collapse
Affiliation(s)
- Richard M Arenas
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque
| | | | | |
Collapse
|
12
|
Parish-Morris J, Liberman MY, Cieri C, Herrington JD, Yerys BE, Bateman L, Donaher J, Ferguson E, Pandey J, Schultz RT. Linguistic camouflage in girls with autism spectrum disorder. Mol Autism 2017; 8:48. [PMID: 29021889 PMCID: PMC5622482 DOI: 10.1186/s13229-017-0164-6] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/08/2017] [Indexed: 11/29/2022] Open
Abstract
Background Autism spectrum disorder (ASD) is diagnosed more frequently in boys than girls, even when girls are equally symptomatic. Cutting-edge behavioral imaging has detected “camouflaging” in girls with ASD, wherein social behaviors appear superficially typical, complicating diagnosis. The present study explores a new kind of camouflage based on language differences. Pauses during conversation can be filled with words like UM or UH, but research suggests that these two words are pragmatically distinct (e.g., UM is used to signal longer pauses, and may correlate with greater social communicative sophistication than UH). Large-scale research suggests that women and younger people produce higher rates of UM during conversational pauses than do men and older people, who produce relatively more UH. Although it has been argued that children and adolescents with ASD use UM less often than typical peers, prior research has not included sufficient numbers of girls to examine whether sex explains this effect. Here, we explore UM vs. UH in school-aged boys and girls with ASD, and ask whether filled pauses relate to dimensional measures of autism symptom severity. Methods Sixty-five verbal school-aged participants with ASD (49 boys, 16 girls, IQ estimates in the average range) participated, along with a small comparison group of typically developing children (8 boys, 9 girls). Speech samples from the Autism Diagnostic Observation Schedule were orthographically transcribed and time-aligned, with filled pauses marked. Parents completed the Social Communication Questionnaire and the Vineland Adaptive Behavior Scales. Results Girls used UH less often than boys across both diagnostic groups. UH suppression resulted in higher UM ratios for girls than boys, and overall filled pause rates were higher for typical children than for children with ASD. Higher UM ratios correlated with better socialization in boys with ASD, but this effect was driven by increased use of UH by boys with greater symptoms. Conclusions Pragmatic language markers distinguish girls and boys with ASD, mirroring sex differences in the general population. One implication of this finding is that typical-sounding disfluency patterns (i.e., reduced relative UH production leading to higher UM ratios) may normalize the way girls with ASD sound relative to other children, serving as “linguistic camouflage” for a naïve listener and distinguishing them from boys with ASD. This first-of-its-kind study highlights the importance of continued commitment to understanding how sex and gender change the way that ASD manifests, and illustrates the potential of natural language to contribute to objective “behavioral imaging” diagnostics for ASD.
Collapse
Affiliation(s)
- Julia Parish-Morris
- Center for Autism Research, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146 USA.,Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Mark Y Liberman
- Linguistic Data Consortium, University of Pennsylvania, 3600 Market St #810, Philadelphia, PA 19104 USA
| | - Christopher Cieri
- Linguistic Data Consortium, University of Pennsylvania, 3600 Market St #810, Philadelphia, PA 19104 USA
| | - John D Herrington
- Center for Autism Research, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146 USA.,Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Benjamin E Yerys
- Center for Autism Research, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146 USA.,Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Leila Bateman
- Center for Autism Research, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146 USA
| | - Joseph Donaher
- Center for Childhood Communication, Buerger Center for Advanced Pediatric Care, Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Philadelphia, PA 19104 USA
| | - Emily Ferguson
- Center for Autism Research, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146 USA
| | - Juhi Pandey
- Center for Autism Research, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146 USA
| | - Robert T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146 USA.,Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 USA
| |
Collapse
|
13
|
Jones RM, Walden TA, Conture EG, Erdemir A, Lambert WE, Porges SW. Executive Functions Impact the Relation Between Respiratory Sinus Arrhythmia and Frequency of Stuttering in Young Children Who Do and Do Not Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:2133-2150. [PMID: 28763803 PMCID: PMC5829798 DOI: 10.1044/2017_jslhr-s-16-0113] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/03/2016] [Accepted: 02/08/2017] [Indexed: 05/26/2023]
Abstract
Purpose This study sought to determine whether respiratory sinus arrhythmia (RSA) and executive functions are associated with stuttered speech disfluencies of young children who do (CWS) and do not stutter (CWNS). Method Thirty-six young CWS and 36 CWNS were exposed to neutral, negative, and positive emotion-inducing video clips, followed by their participation in speaking tasks. During the neutral video, we measured baseline RSA, a physiological index of emotion regulation, and during video viewing and speaking, we measured RSA change from baseline, a physiological index of regulatory responses during challenge. Participants' caregivers completed the Children's Behavior Questionnaire from which a composite score of the inhibitory control and attentional focusing subscales served to index executive functioning. Results For both CWS and CWNS, greater decrease of RSA during both video viewing and speaking was associated with more stuttering. During speaking, CWS with lower executive functioning exhibited a negative association between RSA change and stuttering; conversely, CWNS with higher executive functioning exhibited a negative association between RSA change and stuttering. Conclusion Findings suggest that decreased RSA during video viewing and speaking is associated with increased stuttering and young CWS differ from CWNS in terms of how their executive functions moderate the relation between RSA change and stuttered disfluencies.
Collapse
|
14
|
Hollister J, Van Horne AO, Zebrowski P. The Relationship Between Grammatical Development and Disfluencies in Preschool Children Who Stutter and Those Who Recover. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:44-56. [PMID: 27936278 PMCID: PMC5533550 DOI: 10.1044/2016_ajslp-15-0022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 07/02/2016] [Indexed: 05/13/2023]
Abstract
PURPOSE The dual diathesis stressor model indicates that a mismatch between a child's endogenous linguistic abilities and exogenous linguistic contexts is one factor that contributes to stuttering behavior. In the present study, we used a developmental framework to investigate if reducing the gap between endogenous and exogenous linguistics factors would result in less disfluency for typical children, children who recover from stuttering (CWS-R), and children who persist. METHOD Children between 28 and 43 months of age participated in this study: 8 typical children, 5 CWS-R, and 8 children who persist. The children were followed for 18 months with language samples collected every 6 months. The Index of Productive Syntax (Scarborough, 1990) served as a measure of endogenous grammatical ability. Length and complexity of active declarative sentences served as a measure of exogenous linguistic demand. A hierarchical linear model analysis was conducted using a mixed-model approach. RESULTS The results partially corroborate the dual diathesis stressor model. Disfluencies significantly decreased in CWS-R as grammatical abilities (not age) increased. Language development may serve as a protective factor or catalyst for recovery for CWS-R. As grammatical ability grew and the gap between linguistic ability and demand decreased; however, none of the three groups was more likely to produce disfluencies in longer and more complex utterances.
Collapse
Affiliation(s)
- Julia Hollister
- Department of Communication Sciences and Disorders, Loma Linda University, CA
| | | | - Patricia Zebrowski
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City
| |
Collapse
|
15
|
Children who stutter show reduced action-related activity in the rostral cingulate zone. Neuropsychologia 2017; 96:213-221. [DOI: 10.1016/j.neuropsychologia.2017.01.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 11/18/2022]
|
16
|
Clark CE, Tumanova V, Choi D. Evidence-Based Multifactorial Assessment of Preschool-Age Children Who Stutter. ACTA ACUST UNITED AC 2017. [DOI: 10.1044/persp2.sig4.4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
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.
Collapse
Affiliation(s)
| | - Victoria Tumanova
- Department of Communications Sciences and Disorders, Syracuse University Syracuse, NY
| | - Dahye Choi
- Department of Speech Pathology and Audiology, University of South Alabama Mobile, AL
| |
Collapse
|
17
|
Choi D, Conture EG, Walden TA, Jones RM, Kim H. Emotional Diathesis, Emotional Stress, and Childhood Stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2016; 59:616-30. [PMID: 27327187 PMCID: PMC5280059 DOI: 10.1044/2015_jslhr-s-14-0357] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 07/17/2015] [Accepted: 10/13/2015] [Indexed: 05/08/2023]
Abstract
PURPOSE The purpose of this study was to determine (a) whether emotional reactivity and emotional stress of children who stutter (CWS) are associated with their stuttering frequency, (b) when the relationship between emotional reactivity and stuttering frequency is more likely to exist, and (c) how these associations are mediated by a 3rd variable (e.g., sympathetic arousal). METHOD Participants were 47 young CWS (M age = 50.69 months, SD = 10.34). Measurement of participants' emotional reactivity was based on parental report, and emotional stress was engendered by viewing baseline, positive, and negative emotion-inducing video clips, with stuttered disfluencies and sympathetic arousal (indexed by tonic skin conductance level) measured during a narrative after viewing each of the various video clips. RESULTS CWS's positive emotional reactivity was positively associated with percentage of their stuttered disfluencies regardless of emotional stress condition. CWS's negative emotional reactivity was more positively correlated with percentage of stuttered disfluencies during a narrative after a positive, compared with baseline, emotional stress condition. CWS's sympathetic arousal did not appear to mediate the effect of emotional reactivity, emotional stress condition, and their interaction on percentage of stuttered disfluencies, at least during this experimental narrative task following emotion-inducing video clips. CONCLUSIONS Results were taken to suggest an association between young CWS's positive emotional reactivity and stuttering, with negative reactivity seemingly more associated with these children's stuttering during positive emotional stress (a stress condition possibly associated with lesser degrees of emotion regulation). Such findings seem to support the notion that emotional processes warrant inclusion in any truly comprehensive account of childhood stuttering.
Collapse
|