1
|
Engelen MM, Franken MCJP, Stipdonk LW, Horton SE, Jackson VE, Reilly S, Morgan AT, Fisher SE, van Dulmen S, Eising E. The Association Between Stuttering Burden and Psychosocial Aspects of Life in Adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1385-1399. [PMID: 38625147 DOI: 10.1044/2024_jslhr-23-00562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
PURPOSE Stuttering is a speech condition that can have a major impact on a person's quality of life. This descriptive study aimed to identify subgroups of people who stutter (PWS) based on stuttering burden and to investigate differences between these subgroups on psychosocial aspects of life. METHOD The study included 618 adult participants who stutter. They completed a detailed survey examining stuttering symptomatology, impact of stuttering on anxiety, education and employment, experience of stuttering, and levels of depression, anxiety, and stress. A two-step cluster analytic procedure was performed to identify subgroups of PWS, based on self-report of stuttering frequency, severity, affect, and anxiety, four measures that together inform about stuttering burden. RESULTS We identified a high- (n = 230) and a low-burden subgroup (n = 372). The high-burden subgroup reported a significantly higher impact of stuttering on education and employment, and higher levels of general depression, anxiety, stress, and overall impact of stuttering. These participants also reported that they trialed more different stuttering therapies than those with lower burden. CONCLUSIONS Our results emphasize the need to be attentive to the diverse experiences and needs of PWS, rather than treating them as a homogeneous group. Our findings also stress the importance of personalized therapeutic strategies for individuals with stuttering, considering all aspects that could influence their stuttering burden. People with high-burden stuttering might, for example, have a higher need for psychological therapy to reduce stuttering-related anxiety. People with less emotional reactions but severe speech distortions may also have a moderate to high burden, but they may have a higher need for speech techniques to communicate with more ease. Future research should give more insights into the therapeutic needs of people highly burdened by their stuttering. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25582980.
Collapse
Affiliation(s)
- Marscha M Engelen
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
| | - Marie-Christine J P Franken
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Lottie W Stipdonk
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Sarah E Horton
- Speech and Language, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Victoria, Australia
| | - Victoria E Jackson
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
| | - Sheena Reilly
- Speech and Language, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
| | - Angela T Morgan
- Speech and Language, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Victoria, Australia
- Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Simon E Fisher
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands
| | - Sandra van Dulmen
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden
| | - Else Eising
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
| |
Collapse
|
2
|
Panzarino R, Vanryckeghem M, Bedwell JS, Wendt O. Relationships Between Psychological Distress and Affective, Behavioral, and Cognitive Experiences of Stuttering. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:262-278. [PMID: 37956694 DOI: 10.1044/2023_ajslp-22-00347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
PURPOSE People who stutter (PWS) are vulnerable to the development of various psychopathological symptoms, although prevalence data are mixed and less clarity exists about factors that potentially influence their occurrence. The current study sought to shed light on the prevalence of self-reported psychopathology in PWS and aimed to identify relationships between affective, behavioral, and cognitive (ABC) experiences of stuttering and psychological distress (PD). METHOD Forty-four PWS were administered the Behavior Assessment Battery (BAB) for Adults who Stutter and the Brief Symptom Inventory-18. The prevalence of clinically significant PD was calculated via BSI-18 global severity index t-score cutoffs. Regression analyses examined relationships between ABC variables of stuttering and PD. RESULTS Participants' BAB scores approximated normative values, while the PD score distribution was similar to that of a nonclinical sample. Nine percent of participants met thresholds for clinically significant PD. All ABC correlates of stuttering significantly and positively correlated with PD scores, capturing considerable amounts of shared variance. CONCLUSIONS Levels of PD in PWS approximate those of the general community, highlighting the existence of psychologically distressed subgroups of PWS. Speech situation-specific anxiety had the strongest relationship to PD, followed closely by one's report of situation-specific speech disruption. To a lesser but still significant extent, PWS' frequency to which they engage in various avoidance/escape behaviors, as well as their communication attitude, predicted levels of psychopathology. These data inform diagnostic and clinical decision making, drawing attention to factors that should be attended to in treatment.
Collapse
Affiliation(s)
| | - Martine Vanryckeghem
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
| | | | - Oliver Wendt
- Department of Inclusive Education, University of Potsdam, Germany
- Center for Families and Department of Educational Studies, Purdue University, West Lafayette, IN
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
| |
Collapse
|
3
|
Croft RL, Byrd CT. Clinical and Psychosocial Predictors of Post-Event Processing in Adults Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4259-4279. [PMID: 37816227 PMCID: PMC10715847 DOI: 10.1044/2023_jslhr-23-00245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/30/2023] [Accepted: 08/02/2023] [Indexed: 10/12/2023]
Abstract
PURPOSE Post-event processing, defined by self-critical rumination following a stressful communication event, is significantly associated with reduced quality of life. However, despite its relevance to the stuttering experience, to date, only a few studies have investigated post-event processing among adults who stutter, and no study has identified clinical and psychosocial predictors of post-event processing. The purpose of this study was to determine the contributions of clinical markers of stuttering and psychosocial variables to post-event processing. METHOD Adults who stutter (N = 96) participated in two virtual sessions. After completing the Trier Social Stress Test, a standardized social stress task in Session 1, participants completed measures of post-event processing, clinical markers of stuttering (i.e., the experience of stuttering, self- and observer-rated stuttering severity), and psychosocial characteristics (i.e., self-perceived performance, self-esteem, social anxiety, trait, and state self-compassion) in Session 2. RESULTS Hierarchical linear regression models indicated that a more negative experience of stuttering, higher self-rated stuttering severity, and greater social anxiety predicted more post-event processing. Greater self-perceived performance and state self-compassion predicted less rumination. Observer-rated severity, self-esteem, and trait self-compassion were not significantly associated with post-event processing behavior. CONCLUSION Findings reveal clinical and psychosocial variables to consider in the assessment and mitigation of post-event processing behavior in adults who stutter, and to bolster resiliency to social stress. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24223213.
Collapse
Affiliation(s)
- Robyn L. Croft
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
| | - Courtney T. Byrd
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
| |
Collapse
|
4
|
Tichenor SE, Gerwin KL, Walsh B. Repetitive Negative Thinking in Adolescents Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3290-3306. [PMID: 37494925 PMCID: PMC10558142 DOI: 10.1044/2023_jslhr-23-00147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Repetitive negative thinking (RNT) is the process of engaging in negatively valenced and habitual thought patterns. RNT is strongly associated with mental health conditions and often affects quality of life. This study explored RNT in older school-age children and adolescents who stutter to quantify the relationship between RNT and self-reported anxiety characteristics. An additional aim was to describe how individual differences in an adolescent's goal when speaking influences the frequency they engage in RNT. METHOD Ninety-nine children and adolescents who stutter aged 9-18 years completed a measurement of the frequency/severity of RNT, a screener of anxiety characteristics, and a measure of adverse impact related to stuttering. Children aged 10 years and above also answered questions about their goal when speaking. RESULTS Individual differences in RNT significantly predicted Overall Assessment of the Speaker's Experience of Stuttering (OASES) Total Scores more so than a child or adolescent's age. Higher generalized or social anxiety scores were significantly correlated with more frequent RNT and higher OASES Total Scores. Individual differences in goal when speaking (i.e., whether or not to stutter openly) were found to predict RNT. Finally, 22 children and adolescents (22.2%) also screened positive for generalized anxiety disorder and 32 (32.3%) screened positive for social anxiety disorder. DISCUSSION These data provide strong evidence that (a) many children and adolescents who stutter engage in RNT; (b) children and adolescents who engage more frequently in RNT or who have higher OASES Total Scores may be at increased risk for more characteristics of generalized or social anxiety; and (c) individual differences in goal when speaking can predict the degree to which an adolescent engages in RNT. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23713296.
Collapse
|
5
|
Tichenor SE, Palasik S, Yaruss JS. Understanding the Broader Impact of Stuttering: Suicidal Ideation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2087-2110. [PMID: 37473446 PMCID: PMC10561962 DOI: 10.1044/2023_ajslp-23-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/01/2023] [Accepted: 04/21/2023] [Indexed: 07/22/2023]
Abstract
PURPOSE Suicide and suicidal ideation are topics that have a long but limited history in stuttering research. Clinicians and clinical researchers have discussed personal and therapeutic experiences with clients who have attempted suicide, died by suicide, or struggled with suicidal thoughts. This study sought to (a) explore the occurrence of suicidal ideation in a sample of adults who stutter; (b) evaluate the relationship between adverse impact related to stuttering and suicidal ideation; and (c) document respondents' thoughts related to suicide, stuttering, and their intersection. METHOD One hundred forty adults who stutter completed the Suicide Behavior Questionnaire-Revised (SBQ-R). Of these, 70 participants completed the Perseverative Thinking Questionnaire (PTQ), and 67 completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES). Participants who indicated at least some tendency for suicidal thoughts on the SBQ-R (n = 95) were then asked a set of follow-up questions to explore their experiences of suicidal ideation related to stuttering. RESULTS Quantitative data indicated that the majority of adults who reported experiencing suicidal ideation associated these experiences with stuttering (61.2%, n = 59). Individuals with higher Total Scores on the PTQ and OASES were predicted to experience significantly higher rates of suicidal ideation and, in particular, a higher likelihood of having more frequent suicidal ideation in the past year. Qualitative analyses revealed that suicidal ideation intersects meaningfully with the experience of stuttering. CONCLUSIONS Data from this study highlight the importance of considering broader life consequences of stuttering that some adults may experience, including suicidal ideation. By being cognizant that clients may develop such thoughts, speech-language pathologists can play a valuable role in identifying and providing necessary support for at-risk individuals. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23699688.
Collapse
Affiliation(s)
- Seth E. Tichenor
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Scott Palasik
- School of Speech-Language Pathology and Audiology, University of Akron, OH
| | - J. Scott Yaruss
- Department of Communicative Science and Disorders, Michigan State University, East Lansing
| |
Collapse
|
6
|
Croft RL, Byrd CT. A pilot study of an online self-compassion intervention for adults who stutter. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-14. [PMID: 37572047 DOI: 10.1080/17549507.2023.2236813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/14/2023]
Abstract
PURPOSE The primary aim of this pilot study was to determine the preliminary effectiveness of an online self-compassion intervention for improving self-compassion and quality of life in adults who stutter. A secondary aim was to determine intervention acceptability and participant satisfaction. METHOD Participants included adults who stutter who completed an online self-compassion module once a week for six consecutive weeks. Pre- and post-intervention measures included the Self-Compassion Scale-Trait and the Overall Assessment of the Speaker's Experience of Stuttering. Participants also completed acceptability questionnaires weekly and post-intervention via quantitative and qualitative reports. RESULT Ten participants completed all six intervention modules, as well as pre- and post-intervention measures. Participants reported increased self-compassion and improved quality of life at post-intervention, as well as high intervention acceptability with regard to delivery format, content, duration, and relevance to stuttering and daily life. Individual variation was also observed across acceptability domains. CONCLUSION The present study provides pilot data supporting the use of online modules to increase self-compassion and decrease the negative impact of stuttering on the quality of life among adults who stutter. Future studies should employ larger sample sizes, compare outcomes to a control group, and determine if gains are maintained over time.
Collapse
Affiliation(s)
- Robyn L Croft
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Courtney T Byrd
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, TX, USA
| |
Collapse
|
7
|
Walsh BM, Grobbel H, Christ SL, Tichenor SE, Gerwin KL. Exploring the Relationship Between Resilience and the Adverse Impact of Stuttering in Children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:2278-2295. [PMID: 37390495 PMCID: PMC10468119 DOI: 10.1044/2023_jslhr-23-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 03/22/2023] [Accepted: 04/05/2023] [Indexed: 07/02/2023]
Abstract
PURPOSE People who stutter often experience significant adverse impact related to stuttering. However, it is unclear how adverse impact develops in children who stutter (CWS) and whether there are protective factors that may mitigate its development. This study examined the relationship between resilience, a potentially protective factor, and stuttering's adverse impact in CWS. Resilience comprises external factors, such as family support and access to resources as well as personal attributes, making it a comprehensive protective factor to explore. METHOD One hundred forty-eight CWS aged 5-18 years completed the age-appropriate version of the Child and Youth Resilience Measure (CYRM) and the Overall Assessment of the Speaker's Experience of Stuttering. Parents completed a caregiver version of the CYRM and a behavioral checklist for their child. The adverse impact of stuttering was modeled as a function of resilience (external, personal, and total), controlling for child age and behavioral checklist score. We also estimated correlations between child-report and parent-report CYRM measures to assess rater agreement. RESULTS Children reporting greater external, personal, or total resilience were more likely to experience lower degrees of adverse impact related to their stuttering. We documented stronger correlations between younger child and parent ratings of resilience and weaker correlations between older child and parent ratings. CONCLUSIONS These results yield valuable insight into the variability of adverse impact experienced by CWS and offer empirical support for strength-based speech therapy approaches. We discuss the factors that contribute to a child's resilience and provide practical suggestions for how clinicians can incorporate resilience-building strategies into intervention for children experiencing significant adverse impact from their stuttering. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23582172.
Collapse
|
8
|
Israel S, Reuveni O, Glick I, Levit-Binnun N. Accepting Things as They Are: Dispositional Mindfulness, Decentering, Self-Compassion, and the Impact of Stuttering on Adults Who Stutter. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-17. [PMID: 37256701 DOI: 10.1044/2023_ajslp-22-00388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Mindfulness is defined as intentional, present-moment, nonjudgmental awareness. Previous studies have proposed that mindfulness practice may benefit people who stutter. This study aimed to test the relationship between levels of dispositional mindfulness in people who stutter and the impact of stuttering and whether self-compassion and the metacognitive ability of shifting to an objective perspective (decentering) mediate this relationship. It is hypothesized that greater dispositional mindfulness is associated with attenuated negative impact of stuttering on a person's life through a higher capability to shift into an objective and compassionate perspective. METHOD A total of 150 Israeli adults who stutter completed a full online survey in Hebrew to assess their levels of dispositional mindfulness, self-compassion, decentering capability, and impact of stuttering on their lives. The relationships between constructs were assessed using Pearson's correlation and mediation analysis. RESULTS The adverse impact of stuttering was negatively and moderately associated with dispositional mindfulness, such that individuals with greater self-reported dispositional mindfulness reported fewer reactions to stuttering, difficulty in communication, and higher quality of life. This relationship was fully and sequentially mediated via decentering and self-compassion, which were also negatively and moderately associated with the impact of stuttering. CONCLUSIONS People who stutter with greater dispositional mindfulness have an increased ability to view their experiences in a more objective and compassionate manner, which is associated with an attenuated impact of stuttering on their lives. As these capabilities can be cultivated through practice, this study proposes mindfulness practice as an additional beneficial tool for people who stutter.
Collapse
Affiliation(s)
- Shiran Israel
- Sagol Center for Brain and Mind, Reichman University, Herzliya, Israel
| | - Omer Reuveni
- Sagol Center for Brain and Mind, Reichman University, Herzliya, Israel
- School of Psychological Sciences, University of Haifa, Israel
| | | | - Nava Levit-Binnun
- Sagol Center for Brain and Mind, Reichman University, Herzliya, Israel
| |
Collapse
|
9
|
Mahesh S, Pushpavathi M, Seth D, Saravanan S, Yaruss JS. Adaptation and Validation of Overall Assessment of the Speaker's Experience of Stuttering for Adults in Kannada (OASES-A-K). Folia Phoniatr Logop 2023; 76:30-38. [PMID: 37231963 DOI: 10.1159/000531048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Psychosocial aspects of stuttering may affect the quality of life of a person who stutters (PWS). Further, the social stigma and experiences of PWS may vary globally. The WHO-ICF guidelines recommend quality of life as an essential component in the assessment of individuals who stutter. However, the availability of linguistically and culturally appropriate tools is often a challenge. Thus, the current study adapted and validated the OASES-A for Kannada-speaking adults who stutter. METHOD The original English version of OASES-A was adapted to Kannada using a standard reverse translation process. The adapted version was administered on 51 Kannada-speaking adults with very mild to very severe stuttering. The data were analyzed for item characteristics, reliability, and validity assessment. RESULTS The results revealed floor and ceiling effects for six and two items, respectively. The mean overall impact score indicated a moderate impact of stuttering. Further, the impact score for section II was relatively higher when compared to the data from other countries. The reliability and validity analyses showed good internal consistency and test-retest reliability for OASES-A-K. CONCLUSION The findings of the current research suggest that OASES-A-K is a sensitive and reliable tool to assess the impact of stuttering in Kannada-speaking PWS. The findings also highlight cross-cultural differences and the need for research in this direction.
Collapse
Affiliation(s)
- Sangeetha Mahesh
- Department of Clinical Services, All India Institute of Speech and Hearing, Mysore, India
| | - Mariswamy Pushpavathi
- Department of Speech-Language Pathology, All India Institute of Speech and Hearing, Mysore, India
| | - Divya Seth
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sivaranjani Saravanan
- Department of Clinical Services, All India Institute of Speech and Hearing, Mysore, India
| | - J Scott Yaruss
- Department of Communicative Sciences and Disorders, College of Communication Arts and Sciences, Michigan State University, East Lansing, Michigan, USA
| |
Collapse
|
10
|
Uysal HT, Incebay Ö, Köse A. Speech-language therapists' approach towards adults who stutter in Turkey: which components are important for therapeutic alliance and comprehensive assessment? REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2023. [DOI: 10.5209/rlog.81706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Speech-Language Therapists (SLT) may have negative approaches toward Adults Who Stutter (AWS). There is no consensus about the SLT perspectives on AWS. This study aimed to investigate the SLT approach to AWS and assessment-therapy components in their practices. SLT (N=209) were included in the study. The survey consisted of four sections: demographic information, assessment-therapy components, and attitudes. The results are reported through boxplot graphics. The majority of the SLT were female (86.6%) and aged in the young group (20-29 years) (81.2%). SLT noted that they frequently used non-standard tools in the assessments and traditional or contemporary methods are preferred in the therapy components. The participants mentioned that important to AWS's quality of life, resilience, and psychosocial characteristics. SLT are more likely to utilize non-standard approaches while evaluating AWS. Traditional methods, as well as current approaches, are preferred by the SLT. SLT cares about AWS's resilience and temperament differences.
Collapse
|
11
|
Kikuchi Y, Kenjo M, Yoshida E, Takahashi S, Murakami D, Yamaguchi Y, Adachi K, Sawatsubashi M, Taura M, Nakagawa T, Umezaki T. Social anxiety disorder in adolescents who stutter: A risk for school refusal. Pediatr Int 2023; 65:e15622. [PMID: 37690080 DOI: 10.1111/ped.15622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/05/2023] [Accepted: 07/10/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Stuttering is a childhood-onset fluency disorder. Part of the counseling for middle and high school students with persistent stuttering is related to school refusal. Anxiety disorders are known to contribute to school refusal. However, it is not known whether social anxiety disorder (SAD) is a factor in school refusal among adolescents who stutter. METHODS In our first study, we examined the relationship between school refusal and SAD in 84 middle and high school students who stutter; 26% of the 84 students were in the school refusal group and the remaining 74% were in the school attendance group. The second study examined whether SAD was associated with 10 factors related to speech and stuttering frequency using the Japanese version of the Liebowitz Social Anxiety Scale for Children and Adolescents to determine the presence of SAD. Of the 84 students in the first study, 40 participated in the second study. RESULTS The school refusal group of adolescents who stutter had significantly higher rates of SAD than the school attendance group. Fifty percent of adolescents who stutter met the criteria for SAD. Moreover, adolescents who stutter with SAD had significantly higher scores on the items "When speaking in public, do you experience tremors in your limbs?" and "After you stutter, do you have negative thoughts about yourself?" than the adolescents who stutter without SAD. CONCLUSIONS When examining adolescents who stutter, checking for comorbid SAD may lead to better support. Moreover, noticing their repetitive negative thinking, nervousness, and trembling during speech may help to resolve SAD.
Collapse
Affiliation(s)
- Yoshikazu Kikuchi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masamutsu Kenjo
- Department of Special Needs Education, University of Teacher Education Fukuoka, Fukuoka, Japan
| | - Eriko Yoshida
- Faculty of Nursing and Nutrition, University of Nagasaki, Nagasaki, Japan
| | | | - Daisuke Murakami
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yumi Yamaguchi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuo Adachi
- Voice and Swallowing Center, Fukuoka Sanno Hospital, Fukuoka, Japan
- Adachi Otorhinolaryngology Clinic, Fukuoka, Japan
| | | | - Masahiko Taura
- Department of Otorhinolaryngology, Fukuoka University Hospital, Fukuoka, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiro Umezaki
- Voice and Swallowing Center, Fukuoka Sanno Hospital, Fukuoka, Japan
- International University of Health and Welfare, Fukuoka, Japan
| |
Collapse
|
12
|
Samson I, Schalling E, Herlitz A, Lindström E, Sand A. A Cross-Sectional Investigation of the Impact of Stuttering on Swedish Females and Males in Childhood, Adolescence, and Young Adulthood. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4608-4622. [PMID: 36399792 DOI: 10.1044/2022_jslhr-22-00043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE We aimed to cross-sectionally describe the impact of stuttering on persons who stutter (PWS): children, adolescents, and young adults. Based on previous research on PWS and psychosocial health in the general population, we hypothesized that (a) the adverse impact of stuttering in PWS would be larger among adolescents than children and young adults and that (b) females, especially adolescent females, would report being more adversely impacted by their stuttering than males. METHOD We pooled samples of Swedish PWS, obtaining 162 individuals (75 females and 87 males), aged 7-30 years. We measured the impact of stuttering using age-relevant versions of the Overall Assessment of the Speaker's Experience of Stuttering (OASES). The relationship between OASES score, age, and sex was described using a polynomial model with an interaction term between age and sex to allow for potential differences between females and males' age-related curves. RESULTS The average trends were that (a) the impact of stuttering was greater for the adolescents than for the children and young adults, and (b) females, especially adolescent females, were on average more impacted by their stuttering than males. Taking self-reported speech fluency into account did not change this pattern. CONCLUSIONS In line with findings on psychosocial health, communication attitude, and self-esteem in the general population, the impact of stuttering seems to be particularly adverse among adolescents, especially female adolescents. Thus, clinicians need to be aware of the risk that young girls who stutter may develop a negative attitude to speech and communication, and this should also be communicated to caregivers and teachers. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21554877.
Collapse
Affiliation(s)
- Ineke Samson
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Neurology, Division of Speech and Language Pathology, Danderyd Hospital, Stockholm, Sweden
| | - Ellika Schalling
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and Caring Sciences/Speech-Language Pathology, Uppsala University, Sweden
| | - Agneta Herlitz
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Elisabeth Lindström
- Logopedics, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Anders Sand
- Department of Clinical Science, Intervention and Technology, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
13
|
Tichenor SE, Wray AH, Ravizza SM, Yaruss JS. Individual differences in attentional control predict working memory capacity in adults who stutter. JOURNAL OF COMMUNICATION DISORDERS 2022; 100:106273. [PMID: 36274445 DOI: 10.1016/j.jcomdis.2022.106273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 10/03/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Prior research has suggested that people who stutter exhibit differences in some working memory tasks, particularly when more phonologically complex stimuli are used. This study aimed to further specify working memory differences in adults who stutter by not only accounting for linguistic demands of the stimuli but also individual differences in attentional control and experimental influences, such as concomitant processing requirements. METHOD This study included 40 adults who stutter and 42 adults who do not stutter who completed the Attention Network Test (ANT; Fan et al., 2002) and three complex span working memory tasks: the Operation Span (OSPAN), Rotation Span, and Symmetry Span (Draheim et al., 2018; Foster et al., 2015; Unsworth et al., 2005, 2009). All complex span tasks were dual-tasks and varied in linguistic content in task stimuli. RESULTS Working memory capacities demonstrated by adults who stutter paralleled the hierarchy of linguistic content across the three complex span tasks, with statistically significant between-group differences in working memory capacity apparent in the task with the highest linguistic demand (i.e., OSPAN). Individual differences in attentional control in adults who stutter also significantly predicted working memory capacity on the OSPAN. DISCUSSION Findings from this study extend existing working memory research in stuttering by showing that: (1) significant working memory differences are present between adults who stutter and adults who do not stutter even using relatively simple linguistic stimuli in dual-task working memory conditions; (2) adults who stutter with stronger executive control of attention demonstrate working memory capacity more comparable to adults who do not stutter on the OSPAN compared to adults who stutter with lower executive control of attention.
Collapse
|
14
|
Jackson ES, Dravida S, Zhang X, Noah JA, Gracco V, Hirsch J. Activation in Right Dorsolateral Prefrontal Cortex Underlies Stuttering Anticipation. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2022; 3:469-494. [PMID: 37216062 PMCID: PMC10158639 DOI: 10.1162/nol_a_00073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 05/16/2022] [Indexed: 05/24/2023]
Abstract
People who stutter learn to anticipate many of their overt stuttering events. Despite the critical role of anticipation, particularly how responses to anticipation shape stuttering behaviors, the neural bases associated with anticipation are unknown. We used a novel approach to identify anticipated and unanticipated words, which were produced by 22 adult stutterers in a delayed-response task while hemodynamic activity was measured using functional near infrared spectroscopy (fNIRS). Twenty-two control participants were included such that each individualized set of anticipated and unanticipated words was produced by one stutterer and one control participant. We conducted an analysis on the right dorsolateral prefrontal cortex (R-DLPFC) based on converging lines of evidence from the stuttering and cognitive control literatures. We also assessed connectivity between the R-DLPFC and right supramarginal gyrus (R-SMG), two key nodes of the frontoparietal network (FPN), to assess the role of cognitive control, and particularly error-likelihood monitoring, in stuttering anticipation. All analyses focused on the five-second anticipation phase preceding the go signal to produce speech. The results indicate that anticipated words are associated with elevated activation in the R-DLPFC, and that compared to non-stutterers, stutterers exhibit greater activity in the R-DLPFC, irrespective of anticipation. Further, anticipated words are associated with reduced connectivity between the R-DLPFC and R-SMG. These findings highlight the potential roles of the R-DLPFC and the greater FPN as a neural substrate of stuttering anticipation. The results also support previous accounts of error-likelihood monitoring and action-stopping in stuttering anticipation. Overall, this work offers numerous directions for future research with clinical implications for targeted neuromodulation.
Collapse
Affiliation(s)
- Eric S. Jackson
- Department of Communicative Sciences and Disorders, New York University, New York, USA
| | - Swethasri Dravida
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Xian Zhang
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - J. Adam Noah
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Vincent Gracco
- Haskins Laboratories, New Haven, CT, USA
- McGill University, Montreal, Canada
| | - Joy Hirsch
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Department of Neuroscience, Department of Comparative Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| |
Collapse
|
15
|
Tichenor SE, Walsh BM, Gerwin KL, Yaruss JS. Emotional Regulation and Its Influence on the Experience of Stuttering Across the Life Span. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2412-2430. [PMID: 35738025 PMCID: PMC9584136 DOI: 10.1044/2022_jslhr-21-00467] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/21/2021] [Accepted: 03/21/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE This study evaluated the relationship between emotional regulation (ER) and adverse impact related to stuttering across the developmental spectrum, in preschool and school-age children, adolescents, and adults who stutter. An additional aim examined how these variables relate to the ways that individuals approach speaking (i.e., their agreement on whether their goal is to speak fluently). METHOD Participants were the parents of 60 preschoolers and younger school-age children (ages 3-9 years), 95 school-age children and adolescents who stutter (ages 7-18 years), and 180 adults who stutter (ages 18-81 years). All participants completed surveys with age-appropriate measures examining ER and the adverse impact of stuttering. Older children and adults who stutter also answered questions regarding their goals when speaking. Multiple regression and ordinal logistic regression were used to examine relationships among ER, adverse impact related to stuttering, and goal when speaking. RESULTS In preschool children, adverse impact was significantly predicted by a parent-reported measure of ER skills; in school-age children and adults, adverse impact was significantly predicted by measures of the ER strategies cognitive reappraisal (CR) and expressive suppression. Less frequent use of CR by adults was significantly associated with an increased likelihood of having "not stuttering" as a goal when speaking. Differences in the significance and magnitude of these relationships were found across the life span. DISCUSSION For both children and adults who stutter, ER is a significant factor related to the adverse impact of stuttering; the relationship between ER and adverse impact may change over development. Accounting for individual differences in ER can improve understanding of why a person copes with stuttering in the ways they do, and this has notable implications for individualizing intervention for both children and adults who stutter. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20044469.
Collapse
|
16
|
Tichenor SE, Herring C, Yaruss JS. Understanding the Speaker's Experience of Stuttering Can Improve Stuttering Therapy. TOPICS IN LANGUAGE DISORDERS 2022; 42:57-75. [PMID: 35757374 PMCID: PMC9231935 DOI: 10.1097/tld.0000000000000272] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The purpose of this paper is to highlight the value for speech-language pathologists of considering the overall stuttering condition-including speakers' experiences during and around moments of stuttering-in treatment with individuals who stutter. We first highlight a framework for conceptualizing the entirety of the stuttering condition. We then present recent research and clinical perspectives about stuttering to support the claim that speech-language pathologists who account for individual differences in how their clients experience stuttering are better positioned to treat stuttering more effectively. Ultimately, this will yield better treatment outcomes and help clinicians achieve greater gains in quality of life for their clients who stutter.
Collapse
Affiliation(s)
| | - Caryn Herring
- Communicative Sciences and Disorders, Michigan State University
| | - J Scott Yaruss
- Communicative Sciences and Disorders, Michigan State University
| |
Collapse
|
17
|
Brundage SB, Winters KL, Armendariz K, Sabat R, Beilby JM. Comparing evaluations of social situations for adults who do and do not stutter. JOURNAL OF COMMUNICATION DISORDERS 2022; 95:106161. [PMID: 34872018 DOI: 10.1016/j.jcomdis.2021.106161] [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: 04/29/2021] [Revised: 10/02/2021] [Accepted: 10/30/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE Numerous research studies indicate that stuttering is associated with increased risk for social anxiety disorder (SAD). Interpretation bias is one of four cognitive biases thought to maintain symptoms associated with SAD. Interpretation bias occurs when one evaluates social situations as more negative than they actually are. The purpose of this study was to investigate if adults who do and do not stutter interpret positive, ambiguous, mildly negative, and profoundly negative social situations similarly, or-if like individuals with SAD-adults who stutter exhibit negative interpretation biases. METHOD Forty-eight adults who stutter and 42 age-and gender-matched adults who do not stutter participated. Participants completed the Fear of Negative Evaluation (FNE) and were assigned to one of four groups: adults who stutter with high FNE (AWS-High), adults who stutter with low FNE (AWS-Low), adults who do not stutter with high FNE (AWNS-High), and adults who do not stutter with low FNE (AWNS-Low). All participants completed the trait scale of the State Trait Anxiety Inventory (STAI) and the Interpretation and Judgmental Questionnaire (IJQ). The IJQ contains descriptions of four types of social situations: positive, mildly negative, profoundly negative, and ambiguous. Within each situation type there are five different scenarios, for a total of 20 scenarios across the four situation types. Participants provided written responses to these 20 social scenarios. Qualitative analyses were used to understand how members of each group interpreted the different social scenarios. RESULTS Thematic analysis revealed that each group responded in similar ways to each of the social scenarios, regardless of the type of situation. Adults who do and do not stutter with low and high FNE agreed on many themes related to the 20 social scenarios, and they agreed across all four types of social situations. Somewhat surprisingly, the theme "stuttering" was mentioned infrequently by the adults who stutter. CONCLUSIONS Results suggested that adults who do and do not stutter with low and high FNE interpret social situations similarly, and that no group demonstrated a negative interpretation bias consistent with what is observed in adults with SAD. The interpretations provided by each group were appropriate to the specific scenarios being evaluated.
Collapse
Affiliation(s)
- Shelley B Brundage
- Department of Speech, Language, and Hearing Sciences, George Washington University, 2115G Street NW, Suite 226, Washington DC 20052, 202-994-5008, United States.
| | - Katherine L Winters
- Department of Speech, Language, and Hearing Sciences, George Washington University, 2115G Street NW, Suite 226, Washington DC 20052, 202-994-5008, United States; Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, 2405A Whitis Ave, Stop A1100, Austin, TX, 78712, United States
| | - Karla Armendariz
- Department of Speech, Language, and Hearing Sciences, George Washington University, 2115G Street NW, Suite 226, Washington DC 20052, 202-994-5008, United States
| | - Ruchi Sabat
- Department of Speech, Language, and Hearing Sciences, George Washington University, 2115G Street NW, Suite 226, Washington DC 20052, 202-994-5008, United States; KIPP NorCal Public Schools, 1000 Broadway #460, Oakland, CA, 94607, United States
| | - Janet M Beilby
- Curtin School of Allied Health, Curtin University, Kent Street, Bentley, Perth, 6102, Western Australia
| |
Collapse
|
18
|
Werle D, Winters KL, Byrd CT. Preliminary study of self-perceived communication competence amongst adults who do and do not stutter. JOURNAL OF FLUENCY DISORDERS 2021; 70:105848. [PMID: 33895686 DOI: 10.1016/j.jfludis.2021.105848] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/20/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Adults who stutter report a significant impact of stuttering on their quality of life, including negative thoughts and attitudes toward communication. In addition to this impact, adolescents who stutter also report lower levels of self-perceived communication competence (SPCC) compared to fluent peers. The purpose of this study was to extend the investigation of SPCC to adults who do and do not stutter. Additional aims investigated included if 1) SPCC predicted overall impact of stuttering, and, 2) stuttering frequency predicted SPCC among adults who stutter. METHODS Twenty-four adults who stutter and twenty-seven adults who do not stutter matched for age, gender, and education completed the Self-Perceived Communication Competence Scale (Richmond & McCroskey, 1997). All participants who stutter completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES [ages 18+]; Yaruss & Quesal, 2006) and speaking samples to measure stuttering frequency. RESULTS Adults who stutter reported significantly lower SPCC scale total scores than adults who do not stutter. For adults who stutter, lower SPCC scale scores significantly predicted more severe overall impact of stuttering as measured by the OASES. Stuttering frequency did not predict SPCC scale scores. DISCUSSION This is the first study to report differences in self-perceived communication competence between adults who do and do not stutter. Results suggest adults who stutter report lower self-perceived communication competence compared to adults who do not stutter. Adults who perceive themselves to have greater communication competence reported less severe overall impact of stuttering, and stuttering frequency did not influence SPCC. Clinical implications for intervention are discussed.
Collapse
Affiliation(s)
- Danielle Werle
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, University Station A1100, Austin, TX, 78759, United States.
| | - Katherine L Winters
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, University Station A1100, Austin, TX, 78759, United States
| | - Courtney T Byrd
- Department of Speech, Language, and Hearing Sciences, University of Texas at Austin, University Station A1100, Austin, TX, 78759, United States
| |
Collapse
|
19
|
Rodgers NH, Jackson ES. Temperament is Linked to Avoidant Responses to Stuttering Anticipation. JOURNAL OF COMMUNICATION DISORDERS 2021; 93:106139. [PMID: 34175560 DOI: 10.1016/j.jcomdis.2021.106139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 05/14/2021] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE The purpose of the present study was to examine the degree to which certain temperament constructs predict individual differences in three types of behavioral responses to anticipation among children and adults who stutter (CWS and AWS, respectively): avoidance, physical change, and approach. METHODS Participants included 64 CWS (9- to 17-years-old) and 54 AWS (18- to 50-years-old) who completed an online survey package including a temperament questionnaire (Early Adolescent Temperament Questionnaire-Revised for the CWS; Adult Temperament Questionnaire for the AWS) and the Stuttering Anticipation Scale. The data were analyzed separately for CWS and AWS using multivariate multiple regressions to assess how each temperament construct predicted avoidance, physical change, and approach responses to anticipation. RESULTS CWS who reported higher levels of shyness were more likely to engage in avoidant behavioral responses when they anticipate an upcoming moment of stuttering. AWS who reported higher levels of orienting sensitivity were more likely to engage in avoidant behavioral responses when they anticipate an upcoming moment of stuttering. No temperament constructs predicted physical change or approach responses to anticipation among either age group. CONCLUSION Specific aspects of temperament appear to be linked to the degree that CWS and AWS engage in avoidant behavioral responses to stuttering anticipation. These findings support the continued study of how individual differences impact the internal experience and outward manifestation of stuttering behaviors.
Collapse
Affiliation(s)
- Naomi H Rodgers
- Department of Special Education & Communication Disorders, University of Nebraska-Lincoln.
| | - Eric S Jackson
- Department of Communicative Sciences and Disorders, New York University
| |
Collapse
|
20
|
Winters KL, Byrd CT. Predictors of communication attitude in preschool-age children who stutter. JOURNAL OF COMMUNICATION DISORDERS 2021; 91:106100. [PMID: 33862497 DOI: 10.1016/j.jcomdis.2021.106100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/22/2021] [Accepted: 03/26/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Although preschool-age children who stutter report more negative attitudes toward communication than their typically fluent peers, few investigations have explored factors that may contribute to the differences observed in communication attitude. The purpose of the present study was to explore whether behavioral characteristics of stuttering severity (frequency, duration, physical concomitants) and time since onset of stuttering predict communication attitude in preschool-age children. METHOD Fifty-nine preschool-aged children who stutter completed two speaking samples and the KiddyCAT, a self-report assessment of communication attitude. Speech samples were analyzed for stuttering frequency (measured by percentage of stuttered syllables), duration, and presence of physical concomitants. Linear regression models were used to assess if these behavioral measures of stuttering and time since onset of stuttering predicted self-reported communication attitude. RESULTS Results indicate stuttering behavioral measures and time since onset do not predict KiddyCAT scores of preschool-age children who stutter. CONCLUSIONS Preliminary data suggest children who have presented with stuttering for a longer period of time are no more likely to report a negative communication attitude than children who have a shorter time since onset. Additionally, in contrast to school-age children who stutter, but similar to adults and adolescents who stutter, communication attitude is not linearly related to stuttering severity in preschool-age children.
Collapse
Affiliation(s)
- Katherine L Winters
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, 2405A Whitis Ave, Stop A1100, Austin, TX, 78712, United States.
| | - Courtney T Byrd
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, 2405A Whitis Ave, Stop A1100, Austin, TX, 78712, United States
| |
Collapse
|
21
|
Eichorn N, Pirutinsky S. Cognitive Flexibility and Effortful Control in School-Age Children With and Without Stuttering Disorders. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:823-838. [PMID: 33630654 DOI: 10.1044/2020_jslhr-20-00440] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose This study compared attention control and flexibility in school-age children who stutter (CWS) and children who do not stutter (CWNS) based on their performance on a behavioral task and parent report. We used a classic attention-shifting paradigm that included manipulations of task goals and timing to test effects of varying demands for flexibility on switching accuracy and speed. We also examined associations between task performance, group, and relevant aspects of temperament. Method Participants included 33 children (15 CWS, 18 CWNS) between 8 and 11 years of age. Children sorted stimuli that differed on two dimensions (color and shape) based on sorting rules that varied from block to block or trial to trial. Timing manipulations included intervals of 200-, 600-, or 1,200-ms durations for critical trial components. Temperament data were obtained via the Children's Behavior Questionnaire. Results All children showed expected performance costs in response to block and trial manipulations; however, CWS were more affected by task conditions that increased demands for cognitive flexibility. Effects of interval durations also differed by group. Factor scores on the Children's Behavior Questionnaire indicated differences in effortful control between groups; however, this aspect of temperament did not mediate between-groups differences in switching performance. Conclusions Findings suggest that stuttering continues to be associated with differences in attention control and flexibility beyond the preschool years. Further research is needed to clarify how these cognitive processes shape the development of stuttering throughout childhood.
Collapse
Affiliation(s)
- Naomi Eichorn
- School of Communication Sciences and Disorders, The University of Memphis, TN
| | | |
Collapse
|
22
|
Tichenor SE, Johnson CA, Yaruss JS. A Preliminary Investigation of Attention-Deficit/Hyperactivity Disorder Characteristics in Adults Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:839-853. [PMID: 33647218 DOI: 10.1044/2020_jslhr-20-00237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose Recent studies have shown that many children who stutter may have elevated characteristics of attention-deficit/hyperactivity disorder (ADHD). Although childhood ADHD commonly persists into adulthood, it is unclear how many adults who stutter experience aspects of ADHD (e.g., inattention or hyperactivity/impulsivity). This study sought to increase understanding of how ADHD characteristics might affect individuals who stutter by evaluating (a) whether elevated ADHD characteristics are common in adults who stutter, (b) whether elevated ADHD characteristics in adults who stutter were significantly associated with greater adverse impact related to stuttering, and (c) whether individual differences in Repetitive Negative Thinking (RNT) and Effortful Control influenced this relationship. Method Two hundred fifty-four adults who stutter completed the Adult ADHD Self-Report Scale, the Perseverative Thinking Questionnaire, the Adult Temperament Questionnaire short form, and the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed via multiple linear regression to determine whether the number of inattention or hyperactivity/impulsivity characteristics was significantly associated with RNT, Effortful Control, or Adverse Impact related to stuttering. Results Almost one quarter of participants (23.2%; 60/254) self-reported experiencing six or more inattention characteristics, while fewer participants (8.3%; 21/254) self-reported experiencing six or more hyperactivity/impulsivity characteristics. Participants with lower Effortful Control and higher levels of both RNT and Adverse Impact were significantly more likely to self-report experiencing more inattention characteristics. Discussion Many adults who stutter may exhibit previously unaccounted for characteristics of ADHD, especially inattention. Results highlight the value of continued research on the intersectionality of stuttering, ADHD, and attention, and the importance of individualizing therapy to the needs of each unique person who stutters.
Collapse
|
23
|
Tichenor SE, Yaruss JS. Variability of Stuttering: Behavior and Impact. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:75-88. [PMID: 33197323 PMCID: PMC8740569 DOI: 10.1044/2020_ajslp-20-00112] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Purpose It has long been known that stuttering behaviors vary across time and situation. Preliminary evidence suggests that this variability negatively affects people who stutter and that stuttering behaviors are more variable than adverse impact associated with stuttering. More information is needed to determine how variability affects people who stutter and what the clinical and research implications of variability may be. Method Two hundred and four adults who stutter participated in a mixed-methods study exploring (a) how variability of stuttering affects people who stutter in comparison to other aspects of the condition and (b) which aspects of the overall experience of stuttering are variable. Results Analyses indicated that variability is very commonly experienced by people who stutter and that it is among the most frustrating aspects of the condition. Qualitative analyses revealed that variability is experienced in all aspects of the stuttering condition, including the observable behavior other affective, behavioral, and cognitive reactions; and the adverse impact of stuttering. Notable individual differences were found in terms of which specific aspects of the condition were more variable for different respondents. Overall, analyses revealed that the variability of different aspects of stuttering can be viewed in a hierarchy from most variable to least variable: more external aspects (e.g., frequency, duration), more internal aspects (e.g., covert behaviors, physical tension), and cognitive-affective experiences (e.g., negative thoughts, feelings, and self-image). Discussion These findings suggest that variability is a common and burdensome aspect of the experience of stuttering and underscore the importance of considering variability in stuttering behavior, reactions, and impact in research, assessment, and treatment for adults who stutter.
Collapse
Affiliation(s)
- Seth E. Tichenor
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - J. Scott Yaruss
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| |
Collapse
|
24
|
Treleaven SB, Coalson GA. Manual response inhibition and quality of life in adults who stutter. JOURNAL OF COMMUNICATION DISORDERS 2020; 88:106053. [PMID: 33065458 PMCID: PMC7736488 DOI: 10.1016/j.jcomdis.2020.106053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 06/23/2020] [Accepted: 08/24/2020] [Indexed: 06/01/2023]
Abstract
BACKGROUND A considerable amount of research has identified inhibition differences, including slower inhibition of manual responses, in people who stutter. Recent investigations have failed to link slowed motor inhibition with overt stuttering severity. This study investigated the potential relationship between slowed manual response inhibition and the negative impact of stuttering upon individual lives of adults who stutter (AWS). METHODS Thirty-four adults (AWS, n = 17; AWNS, n = 17) matched by nonverbal IQ completed a manual stop-signal task and provided a conversational speech sample. Motor inhibition latency for AWS and AWNS were compared. For AWS, motor inhibition latency was compared to the four subsections of the Overall Assessment of the Speaker's Experience with Stuttering (OASES; Yaruss & Quesal, 2006; General Information, Reactions to Stuttering, Communication in Daily Situations, Quality of Life). RESULTS Similar to previous studies, AWS were significantly slower to inhibit inaccurate manual responses than AWNS. Quality of Life subtest of the OASES was found to significantly predict inhibition latency. CONCLUSION These data replicate findings that indicate that AWS exhibit slower manual inhibition latency, and suggest that these inhibition differences may be associated with an individual's negative experience with stuttering rather than stuttering severity.
Collapse
Affiliation(s)
- Shanley B Treleaven
- Louisiana State University, Department of Communication Sciences and Disorders, 68 Hatcher Hall, Field House Drive, Baton Rouge, LA 70803, United States.
| | - Geoffrey A Coalson
- Louisiana State University, Department of Communication Sciences and Disorders, 68 Hatcher Hall, Field House Drive, Baton Rouge, LA 70803, United States
| |
Collapse
|
25
|
Hedinger T, Eskridge K, Porter E, Hudock D, Saltuklaroglu T. The perceived impact of fluency on personalities of adults who stutter: implicit evidence of self-stigma. LOGOP PHONIATR VOCO 2020; 46:180-185. [PMID: 33106060 DOI: 10.1080/14015439.2020.1833982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The NEO-FFI is an extensively used instrument that has been used to identify personality differences between those who stutter and matched controls or group norms. The goal of this study was to use the NEO-FFI to implicitly capture and quantify self-stigma related to personality in persons who stutter (PWS). METHODS Thirty PWS completed the NEO-FFI twice; once as themselves and once while mentalizing (using theory of mind) to respond as though they did not stutter and had never stuttered, thus comparing their true personality to their perceived personality if they were fluent speakers. Compared to their true personalities, PWS perceived their fluent counterparts to be significantly less neurotic and more extroverted. RESULTS The differences observed are somewhat analogous, though considerably larger in magnitude than personality differences that have previously been reported when comparing PWS to fluent controls or norms. Differences were interpreted to be due to "contrast effects" influencing the comparison. That is, PWS cognitively separated themselves from their fluent counterparts, seeing their true selves in a negative light compared to their fluent counterparts. This "us" vs. "them" separation is considered evidence of self-stigma related to personality in PWS. CONCLUSIONS The finding that the perceived differences were in the domains of Neuroticism and Extraversion is consistent with prevailing stereotypes about PWS and exemplifies how public stigma can become internalized. Clinical implications are discussed with respect to how similar theory of mind/social comparison exercises can be used in cognitive behavioral therapy to help identify and restructure negative thoughts and beliefs about stuttering.
Collapse
Affiliation(s)
- Tricia Hedinger
- Department of Audiology and Speech-Language Pathology, University of Tennessee Health Sciences Center, Knoxville, TN, USA
| | - Kristen Eskridge
- Department of Audiology and Speech-Language Pathology, University of Tennessee Health Sciences Center, Knoxville, TN, USA
| | - Ellie Porter
- Department of Audiology and Speech-Language Pathology, University of Tennessee Health Sciences Center, Knoxville, TN, USA
| | - Daniel Hudock
- Department of Communication Sciences and Disorders, Idaho State University, Pocatello, ID, USA
| | - Tim Saltuklaroglu
- Department of Audiology and Speech-Language Pathology, University of Tennessee Health Sciences Center, Knoxville, TN, USA
| |
Collapse
|
26
|
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.
Collapse
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
| |
Collapse
|