The Role of Executive Function in Developmental Stuttering

Assessment of verbal and nonverbal cognitive abilities in children with stuttering using 5th edition Stanford Binet

Stuttering is a speech disorder disrupting fluency with implications that could affect psychological, educational, social, and occupational aspects of life. Cognitive functions include mental processes that allows for execution of goal-directed responses in different situations. They are usually referred to as executive functions (EF) which consists of three main components, working memory, cognitive flexibility, and inhibitory control. The Stanford Binet 5th edition (SB5) is an intelligence scale designed to assess various cognitive skills by measuring five main domains that require the administration of these executive skills. Recent research has focused on executive functions skills among children with stuttering (CWS), and how it might affect stuttering development and severity.

AIM OF THE STUDY

The aim of this study was to compare the cognitive verbal and nonverbal skills using the Stanford Binet intelligence quotient test 5th edition (SB5) between children with stuttering (CWS) and children with no stuttering (CWNS) and to assess which of these skills affected stuttering severity among CWS.

METHODS

A total of 70 children, 40 CWS and 30 CWNS, were assessed using the SB5 test. Further assessment of the CWS was done using the stuttering severity index (SSI) to determine the degree of stuttering. Statistical analysis and comparison were used to determine results and differences in cognitive skills, and regressive analysis was used to determine the most predicative factor in stuttering development and severity.

RESULTS

Showed that CWS performed lower scores than CWNS in all SB5 domains except in non-verbal domain, where the two groups did not differ significantly in their performance. Working memory was the weakest skill among CWS and stood out as the only significant predicative factor in stuttering. Children with severe stuttering performed higher in their total IQ, nonverbal IQ, knowledge, and fluid reasoning than moderate stutterers, having the strongest performance in non-verbal IQ, still none of these domains turned out to be of a predicative significance in severity.

CONCLUSION

Findings suggest that working memory is the weakest executive skill in CWS as well as other executive functions related to cognitive flexibility compared to fluent controls. Working memory skills are significantly lower in CWS but does not correlate with its severity; whereas the strongest skills, among CWS compared to fluent controls, are in the nonverbal domains.

Factors influencing the efficacy and implementation of teletherapy for stuttering

Purpose: Telepractice is a promising alternative to treat children who stutter. This study aimed to investigate factors influencing telepractice for treating stuttering in a group of school-aged children. Methods: This study involved 20 children aged 7 to 9 years diagnosed with moderate to severe stuttering using the Stuttering Severity Instrument (SSI) - Arabic version. The Stanford-Binet Intelligence Scales (SB-5), Fifth Edition was applied. Speech teletherapy via Zoom application was employed for 9 months by the same speech pathologists. After treatment, SSI was measured to check the improvement and to correlate the results to age, sex, and IQ subtests. Results: The SSI scores decreased significantly after treatment (p < 0.001) with a mean percentage of change of 57.4 ± 27.1% (21.7%-100%). Stuttering severity decreased significantly after teletherapy (p < 0.001); all children with moderate stuttering (n = 12) were converted to slight severity. Three out of eight of those with severe stuttering (37.5%), had slight severity after the end of treatment. The children's attendance and attention during treatment sessions were excellent sessions. The scores on all components of the SB scales and the full-scale IQ were average scores in all children. The treatment outcome was not affected by the children's age, sex, or IQ. Conclusion: Teletherapy for 9 months is successful in reducing stuttering scores and severity in school-age children. The outcome of treatment was not affected by the child's age, sex, and IQ.

Auditory Processing of Speech and Nonspeech in People Who Stutter

PURPOSE

We investigated speech and nonspeech auditory processing of temporal and spectral cues in people who do and do not stutter. We also asked whether self-reported stuttering severity was predicted by performance on the auditory processing measures.

METHOD

People who stutter (n = 23) and people who do not stutter (n = 28) completed a series of four auditory processing tasks online. These tasks consisted of speech and nonspeech stimuli differing in spectral or temporal cues. We then used independent-samples t-tests to assess differences in phonetic categorization slopes between groups and linear mixed-effects models to test differences in nonspeech auditory processing between stuttering and nonstuttering groups, and stuttering severity as a function of performance on all auditory processing tasks.

RESULTS

We found statistically significant differences between people who do and do not stutter in phonetic categorization of a continuum differing in a temporal cue and in discrimination of nonspeech stimuli differing in a spectral cue. A significant proportion of variance in self-reported stuttering severity was predicted by performance on the auditory processing measures.

CONCLUSIONS

Taken together, these results suggest that people who stutter process both speech and nonspeech auditory information differently than people who do not stutter and may point to subtle differences in auditory processing that could contribute to stuttering. We also note that these patterns could be the consequence of listening to one's own speech, rather than the cause of production differences.

Lower nonword syllable sequence repetition accuracy in adults who stutter is related to differences in audio-motor oscillations

OBJECTIVE

The goal of this study was to use independent component analysis (ICA) of high-density electroencephalography (EEG) to investigate whether differences in audio-motor neural oscillations are related to nonword syllable repetition accuracy in a group of adults who stutter compared to typically fluent speakers.

METHODS

EEG was recorded using 128 channels from 23 typically fluent speakers and 23 adults who stutter matched for age, sex, and handedness. EEG was recorded during delayed, 2 and 4 bilabial nonword syllable repetition conditions. Scalp-topography, dipole source estimates, and power spectral density (PSD) were computed for each independent component (IC) and used to cluster similar ICs across participants. Event-related spectral perturbations (ERSPs) were computed for each IC cluster to examine changes over time in the repetition conditions and to examine how dynamic changes in ERSPs are related to syllable repetition accuracy.

RESULTS

Findings indicated significantly lower accuracy on a measure of percentage correct trials in the AWS group and for a normalized measure of syllable load performance across conditions. Analysis of ERSPs revealed significantly lower alpha/beta ERD in left and right μ ICs and in left and right posterior temporal lobe α ICs in AWS compared to TFS (CC p < 0.05). Pearson correlations with %CT for frequency across time showed strong relationships with accuracy (FWE<0.05) during maintenance in the TFS group and during execution in the AWS group.

CONCLUSIONS

Findings implicate lower alpha/beta ERD (8-30 Hz) during syllable encoding over posterior temporal ICs and execution in left temporal/sensorimotor components. Strong correlations with accuracy and interindividual differences in ∼6-8 Hz ERSPs during execution implicate differences in motor and auditory-sensory monitoring during syllable sequence execution in AWS.

Inhibitory Control, Cognitive Flexibility, and the Production of Disfluencies in Children Who Do and Do Not Stutter

PURPOSE

Differences in inhibitory control and cognitive flexibility between children who stutter (CWS) and children who do not stutter (CWNS) have been previously demonstrated. The aim of the current study was to investigate whether the previously reported inhibitory control- and cognitive flexibility-related performance costs for CWS are associated with the number of speech disfluencies that they produce.

METHOD

Participants were 19 CWS (Mage = 7.58 years, range: 6.08-9.17) and 19 CWNS matched on age and gender (Mage = 7.58 years, range: 6.08-9.33). Gamma regression models were used to investigate possible associations between performance costs in speed and accuracy measured during a computer task evaluating inhibitory control and cognitive flexibility and the number of speech disfluencies during video-recorded speech samples (story retelling and casual conversation).

RESULTS

Two significant interactions were observed. For both inhibitory control and cognitive flexibility, we identified a significant group and inhibitory control/cognitive flexibility performance-cost interaction in stuttering-like disfluencies (SLDs), indicating that the performance-cost effects on SLD production were significantly higher in the CWS group, compared to the CWNS group.

CONCLUSIONS

CWS with reduced inhibitory control or cognitive flexibility produce more SLDs, but not other disfluencies. These results are partly in line with some previous findings in nonstuttering and stuttering populations linking inhibitory control and cognitive flexibility weaknesses to the production of speech disfluencies.

Streptococcal Serology in Children With Stuttering

Introduction: Stuttering is a pronunciation disorder represented by repetitive perpetuations, duplications, or freezes of spoken words or syllables, as well as nervousness and cognitive shunning. Group A beta-hemolytic Streptococcus (GABHS) can lead to pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS). Many case reports have proposed that stuttering is the result of a PANDAS, and that it can be identified together with Tourette syndrome, which shares many clinical characteristics with stuttering. Aim: The purpose of this study was to examine the association between streptococcal serology and stuttering in children. Method: The participants in this study are 26 children who stutter (CWS; mean age = 8.3 + 3.1 years) and 25 children who do not stutter (CWNS; mean age = 9.2 + 2.9 years). Participants were matched in terms of age (±3 months) and gender. We analyzed serum antistreptococcal antibodies [antistreptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and antistreptokinase] in both groups. Results: In the CWS group, ASO, anti-DNase B, and antistreptokinase were significantly higher than in the CWNS group (P < .0001, P < .0001, P < .0001). Conclusion: The higher serum antistreptococcal antibody amounts in CWS suggest that an increased autoimmune response against GAHBS may be the etiology of childhood stuttering. It has been suggested that CWS should be examined for autoimmune reactions, especially to GAHBS.

Differences in auditory verbal working memory between adults who do and do not stutter on an N-back task

PURPOSE

The purpose of this study was to investigate auditory verbal working memory in adults who do (AWS) and do not (AWNS) stutter using a highly demanding linguistic N-back task.

METHODS

Fifteen AWS and 15 AWNS matched in age, gender and educational level were asked to hear series of words and respond by pressing a "yes" button if the word they just heard was the same as the word one, two, or three trials back. Words were either phonologically similar (i.e., Phonological Linguistic Condition) or phonologically dissimilar (i.e., Neutral Linguistic Condition). Accuracy and false alarms rates as well as reaction time on correct target trials, missed target trials and false alarms were collected and analyzed.

RESULTS

Differences were not found between AWS and AWNS in accuracy. Both groups were more accurate and significantly faster in 1- followed by 2- followed by 3-back trials. However, AWS were significantly slower than AWNS in the 2-back level, regardless of linguistic condition. Furthermore, AWS demonstrated more false alarms compared to AWNS.

CONCLUSION

Results revealed differences in auditory verbal working memory and interference control between AWS and AWNS when processing highly linguistically demanding stimuli.

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

PURPOSE

Available studies of working memory (WM) in speakers who stutter tend to rely on parent report, focus on phonological WM, or measure WM in combination with other processes. The present research aimed to: (1) compare complex WM in adults who stutter (AWS) and adults who do not stutter (AWNS); (2) characterize group performance patterns; and (2) determine whether WM predicts stuttering severity.

METHODS

Eighteen AWS and 20 AWNS completed parallel verbal and spatial span tasks in which to-be-remembered items were interleaved with a distracting task across varying set sizes. Dependent variables included the number of correctly recalled items, accuracy on distraction tasks, and detailed analyses of item-level responses. We further examined whether span scores predicted subjective and objective measures of stuttering severity.

RESULTS

Relative to AWNS, AWS showed poorer recall, specifically on short set sizes in the spatial task. Groups performed similarly on distraction tasks and showed comparable error patterns. Predictive relationships differed by span task and severity measure. Lower verbal span scores predicted greater stuttering impact and more overt stuttering behaviors; lower spatial span scores predicted lower impact and was unrelated to overt behaviors.

CONCLUSIONS

Findings suggest that AWS differ subtly from AWNS in WM performance. Group differences became more apparent under certain task conditions but could not be attributed to specific underlying processes. Data further indicated a complex relationship between WM and stuttering severity. Overall, results corroborate previous studies linking stuttering to domain-general weaknesses, but highlight the need for additional research to clarify the nature of this relationship.

Norwegian speech-language pathologists treatment practices for preschool children who stutter: An explorative study

PURPOSE

This study investigated the treatment practices of speech-language pathologists (SLPs) with preschool children who stutter to explore variations in service delivery and, consequently to better inform and support evidence-based practice.

METHOD

121 Norwegian SLPs completed an online survey about stuttering treatment for preschool children aged up to six years. They reported on treatment training, choices, setting, dosage, and outcomes. Data was analysed descriptively. Correlation analyses between years of clinical experience and clinician perceived outcomes were conducted.

RESULT

Sixty-eight percent of SLPs were trained in one or more stuttering treatment programs. The majority of SLPs (83 %) provided treatment in person in preschool centers; 59 % reported providing treatment once a week. Thirty-four percent of SLPs reported that they often or always delivered the whole treatment program. Treatment practice addressed various elements, including advising parents about language and communication strategies, supporting the child's self-image, and perceived outcomes. The SLPs reported their clinician perceived outcomes as 'always' or 'often' reduction of audible stuttering (70 %), reduced cognitive and emotional reactions (55 %), and improved communication skills (58 %). Factors influencing treatment choices were identified at the systemic level (e.g., work place regulations) and individual level (e.g., SLPs competency, child's best).

CONCLUSION

Stuttering treatment services in Norway differ from those reported in existing literature as treatment is given in preschool settings, only 34 % of SLPs deliver programs as intended whilst the majority use treatment elements only, and still experience positive changes. Provision is variable, and seems influenced by SLP training and competence.

Exogenous verbal response inhibition in adults who do and do not stutter

INTRODUCTION

Behavioral and questionnaire-based studies suggest that children who stutter (CWS) exhibit poorer response inhibition than children who do not stutter (CWNS). However, the behavioral findings in adults who stutter (AWS) are less unequivocal and mainly based on manual response inhibition. Further study is therefore needed, especially given the lack of studies on verbal response inhibition among these groups.

METHODS

Thirteen AWS and 14 adults who do not stutter (AWNS) participated in a verbal stop signal task (SST) in which they were asked to read aloud six Chinese characters as fast as possible during the go-signal and ignore-signal trials and refrain from naming them during the stop-signal trials.

RESULTS

The two groups showed a comparable response reaction time in the go-signal and ignore-signal trial conditions. Furthermore, there were no significant differences in terms of the stop-signal reaction time (SSRT) and accuracy. However, a significant positive correlation was found between SSRT and the frequency of stuttering in conversation but not in reading.

CONCLUSION

Current findings seem to provide additional support that exogenously triggered response inhibition among AWS does not differ from AWNS. The association between stuttering frequency and SSRT seems to suggest that individuals with more severe stuttering in conversational speech have reduced exogenous response inhibition. However, this finding needs to be further explored in future studies using different measures of stuttering severity.

Bibliometric analysis study on cognitive function in developmental coordination disorder from 2010 to 2022

Objective

To identify the research hotspots on cognitive function in developmental coordination disorder (DCD) in recent years, predict the research frontier and development trend, and provide more perspectives for the study of the DCD population.

Methods

Using CiteSpace and VOSviewer software to draw charts, 1,082 pieces of literature about DCD and cognitive function in the Web of Science core collection database from 2010 to 2022 were visually analyzed.

Results and conclusion

Interest in the cognitive function of DCD has been on the rise in the past 10 years. Over 40 countries and regions, 117 institutions and 200 researchers have participated in the corresponding research, mainly in the United States, and their institutions have published more highly influential results. The hot keywords are DCD, children, attention, working memory, performance, and attention-deficit/hyperactivity disorder (ADHD), and the main research hot topics include functional performance, population, cognitive psychology. The research directions include "DCD," "Asperger syndrome," "memory," "infant," "clumsiness," "neurodevelopmental disorder," "occupational therapy," "preschool children," "motor competence," "model," and "online control." Future research should focus on motor imagery and intrinsic models and use more neurophysiological techniques to reveal the cognitive characteristics of children with DCD and develop intervention programs.

Complex response inhibition and cognitive flexibility in school-aged Cypriot-Greek-speaking children who stutter

PURPOSE

Over the last few years, research findings have suggested limitations in executive function (EF) of children who stutter (CWS) with the evidence being more consistent in studies with preschoolers (3-6  years old) than in studies with school-aged children (6-12  years old). The purpose of the current study was to assess complex response inhibition and cognitive flexibility in school-aged CWS and their non-stuttering peers.

METHODS

Participants, 19 CWS (mean age = 7.58  years, range 6.08-9.17) and 19 age-and gender-matched children who do not stutter (CWNS; mean age = 7.58  years, range 6.08-9.33), completed a visual task consisting of three task blocks. Analyses were based on response times and error percentages during the different task blocks.

RESULTS

All participants showed expected performance-costs in task block comparisons targeting complex response inhibition and cognitive flexibility. Significant group differences were found in measures of cognitive flexibility with CWS performing slower compared to CWNS (p = 0.02). Additionally, significant block × group interactions demonstrated that CWS, compared to CWNS, slowed down more (i.e., higher performance-cost) under both complex response inhibition (p = 0.049) and cognitive flexibility task conditions (p = 0.04 for no-set-shifting and p = 0.02 for set-shifting).

CONCLUSION

These results are in line with some of the previous findings in school-aged CWS and suggest that CWS present lower performance in complex response inhibition and cognitive flexibility task conditions when compared to their non-stuttering peers.

Cognitive flexibility in younger and older children who stutter

Purpose

Recent research findings suggest possible weaknesses in cognitive flexibility (CF) in children who stutter (CWS) when compared to children who do not stutter (CWNS). Studies so far, have been conducted with either younger (3-6 years old) or older children (6-12 years old) with a variety of measures. The purpose of the present study was to investigate CF with the use of a single behavioral measure across a broader age range (4-10 years old).

Methods

Participants were 37 CWS (mean age = 6.90 years) and 37 age-and gender-matched CWNS (mean age = 6.88 years), divided in a younger (below 7 years) and older (above 7 years) age group. All participants undertook a computerized visual set-shifting task consisting of three blocks. CF was evaluated through across-and within-block comparisons of the actual response speed and accuracy values. In addition, mixing-and set-shifting-costs were evaluated based on the mean response speed and accuracy.

Results

All participants showed expected mixing-and set-shifting-costs. Only the within-block analyses yielded significant between (sub)group differences. Investigation of the block × classification group × age group interactions showed that older CWS had larger set-shifting-costs (slowed down more and made more errors) compared to older CWNS.

Conclusion

While all participants required more time during set-shifting trials, only the older CWS (7-10 years old), and not younger CWS, were slower and made more errors. This finding corroborates previous findings in CWS of a similar age and could possibly point to a role of CF in stuttering persistence.

Activation in Right Dorsolateral Prefrontal Cortex Underlies Stuttering Anticipation

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.

Linguistic aspects of stuttering: research updates on the language-fluency interface

PURPOSE

Although commonly defined as a speech disorder, stuttering interacts with the language production system in important ways. Our purpose is to summarize research findings on linguistic variables that influence stuttering assessment and treatment.

METHOD AND RESULTS

Numerous topics are summarized. First, we review research that has examined linguistic features that increase stuttering frequency and influence where it occurs. Second, we tackle the question of whether or not persons who stutter exhibit subtle language differences or deficits. Next, we explore language factors that appear to influence recovery from early stuttering in children. The final topic discusses the unique challenges inherent in differentially diagnosing stuttering in bilingual children. Clinical implications for each topic are discussed.

DISCUSSION

The article concludes with a discussion of the unique differences in the integration of language and speech demands by people who stutter, when compared to people who are typically fluent, and their clinical ramifications.

Complex nonverbal response inhibition and stopping impulsivity in childhood stuttering

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

How children with neurodevelopmental disorders can benefit from the neurocognitive effects of exercise

Exercise is an integral part of children's lives, and research in educational settings has found that regular engagement promises improvements in executive function (i.e. top-down control of goal-directed behavior). Based on recent advances in understanding the moderators and the neurocognitive mechanisms of these effects, we highlight a potential application of exercise in the treatment of executive dysfunction. Even though different neurodevelopmental disorders are characterized by a heterogeneity in core symptoms, children affected by these disorders often face common executive function deficits. So far, exercise has not been recognized as an alternative or additional treatment for this specific cognitive impairment. The limited experimental evidence in children with neurodevelopmental disorders provides a first indication that regular exercise engagement benefits executive function. However, we identified key research questions that need to be answered before a prescription of exercise to children with executive dysfunction can be encouraged in clinical practice.

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

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

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

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

Inhibitory Control of Lexical Selection in Adults who Stutter

PURPOSE

Based on previous evidence that lexical selection may operate differently in adults who stutter (AWS) versus typically-fluent adults (TFA), and that atypical attentional processing may be a contributing factor, the purpose of this study was to investigate inhibitory control of lexical selection in AWS.

METHOD

12 AWS and 12 TFA completed two tasks. One was a picture naming task featuring High and Low Agreement object naming. Naming accuracy and reaction times (RT), and event-related potentials (ERPs) time-locked to picture onset, were recorded. Second was a flanker task featuring Congruent and Incongruent arrow arrays. Push-button accuracy and RTs, and ERPs time-locked to arrow array onset, were recorded.

RESULTS

Low Agreement pictures were named less accurately and slower than High Agreement pictures in both Groups. The magnitude of the Agreement effect on naming RTs was larger in AWS versus TFA. Delta-plot analysis revealed that the Agreement effect was positively correlated with individual differences in inhibition in TFA but not in AWS. Moreover, Low Agreement pictures elicited negative-going ERP activity relative to High Agreement pictures in both Groups. However, the scalp topography of this effect was markedly reduced in AWS versus TFA. For the Flanker task, Congruency affected push-button accuracy and RTs, and N2 amplitudes, similarly between groups.

CONCLUSIONS

Results point to a selective deficit in inhibitory control of lexical selection in AWS. Potential pathways between diminished inhibitory control of lexical selection, speech motor control and stuttering are discussed.

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

PURPOSE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Cognitive Flexibility for Semantic and Perceptual Information in Developmental Stuttering

Purpose The purpose of this study was to examine cognitive flexibility for semantic and perceptual information in preschool children who stutter (CWS) and who do not stutter (CWNS). Method Participants were 44 CWS and 44 CWNS between the ages of 3;0 and 5;11 (years;months). Cognitive flexibility was measured using semantic and perceptual categorization tasks. In each task, children were required to match a target object with two different semantic or perceptual associates. Main dependent variables were reaction time and accuracy. Results The accuracy with which CWS and CWNS shifted between one semantic and perceptual representation to another was similar, but the CWS did so significantly more slowly. Both groups of children had more difficulty switching between perceptual representations than semantic ones. Conclusion CWS are less efficient (slower), though not less accurate, than CWNS in their ability to switch between different representations in both the verbal and nonverbal domains.

The contribution of cognition to the rehabilitation of language and communication deficits

Background/Aims

There is growing evidence to suggest that cognitive processes, in particular working memory and executive functions, are related to language functions such as syntactic processing, reading comprehension, narration and conversational discourse. This article offers rehabilitation considerations for speech-language pathologists to include cognitive assessment and treatment in their clinical practice. The information presented will also be useful in promoting multidisciplinary rehabilitation.

Methods

A critical review of the literature on the interaction between cognitive processes and linguistic functions in communication disorders was undertaken. Specific key terms including but not limited to executive functioning, working memory, language, assessment, intervention and communication disorders were searched on the Google Scholar database. Relevant literature from the last three decades pertaining to cognitive behavior, assessment and intervention in communication disorders of all age groups and severities is included in the review.

Results

The review presents analyses of the multidimensional and dynamic interaction of language and cognition in children (specific language impairment, attention deficit hyperactivity disorder, stuttering) and adults (traumatic brain injury, stroke, dementia) with communication disorders. The article elaborates on the speech-language pathologist's scope of practice in cognitive assessment and intervention that are consistent with the World Health Organization's International Classification of Functioning, Disability and Health framework.

Conclusions

By documenting cognitive-communication behaviour, speech-language pathologists are able to effectively contribute to the clinical assessment and management of cognitive deficits. However, future research efforts are required to develop clinically reliable tests of cognitive functioning in communication disorders and promote evidence-based cognitive treatment practices.

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

Background

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

Methods

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

Results

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

Conclusion

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