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Horton S, Jackson V, Boyce J, Franken MC, Siemers S, John MS, Hearps S, van Reyk O, Braden R, Parker R, Vogel AP, Eising E, Amor DJ, Irvine J, Fisher SE, Martin NG, Reilly S, Bahlo M, Scheffer I, Morgan A. Self-Reported Stuttering Severity Is Accurate: Informing Methods for Large-Scale Data Collection in Stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-10. [PMID: 38052068 DOI: 10.1044/2023_jslhr-23-00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
PURPOSE To our knowledge, there are no data examining the agreement between self-reported and clinician-rated stuttering severity. In the era of big data, self-reported ratings have great potential utility for large-scale data collection, where cost and time preclude in-depth assessment by a clinician. Equally, there is increasing emphasis on the need to recognize an individual's experience of their own condition. Here, we examined the agreement between self-reported stuttering severity compared to clinician ratings during a speech assessment. As a secondary objective, we determined whether self-reported stuttering severity correlated with an individual's subjective impact of stuttering. METHOD Speech-language pathologists conducted face-to-face speech assessments with 195 participants (137 males) aged 5-84 years, recruited from a cohort of people with self-reported stuttering. Stuttering severity was rated on a 10-point scale by the participant and by two speech-language pathologists. Participants also completed the Overall Assessment of the Subjective Experience of Stuttering (OASES). Clinician and participant ratings were compared. The association between stuttering severity and the OASES scores was examined. RESULTS There was a strong positive correlation between speech-language pathologist and participant-reported ratings of stuttering severity. Participant-reported stuttering severity correlated weakly with the four OASES domains and with the OASES overall impact score. CONCLUSIONS Participants were able to accurately rate their stuttering severity during a speech assessment using a simple one-item question. This finding indicates that self-report stuttering severity is a suitable method for large-scale data collection. Findings also support the collection of self-report subjective experience data using questionnaires, such as the OASES, which add vital information about the participants' experience of stuttering that is not captured by overt speech severity ratings alone.
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Affiliation(s)
- Sarah Horton
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, University of Melbourne, Victoria, Australia
| | - Victoria Jackson
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Victoria, Australia
| | - Jessica Boyce
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, University of Melbourne, Victoria, Australia
| | - Marie-Christine Franken
- Department of Otorhinolaryngology, Speech and Hearing Centre, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Stephanie Siemers
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Miya St John
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, University of Melbourne, Victoria, Australia
| | - Stephen Hearps
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Olivia van Reyk
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Ruth Braden
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, University of Melbourne, Victoria, Australia
| | - Richard Parker
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Adam P Vogel
- Department of Audiology and Speech Pathology, University of Melbourne, Victoria, Australia
- Centre for Neuroscience of Speech, University of Melbourne, Victoria, Australia
- Redenlab Inc. Melbourne, Victoria, Australia
| | - Else Eising
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
| | - David J Amor
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Janelle Irvine
- Stuttering Treatment and Research Trust (START), Auckland, New Zealand
| | - 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
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Sheena Reilly
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
| | - Melanie Bahlo
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Victoria, Australia
| | - Ingrid Scheffer
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- Epilepsy Research Centre, Department of Medicine at Austin Health, University of Melbourne, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Angela Morgan
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Audiology and Speech Pathology, University of Melbourne, Victoria, Australia
- Royal Children's Hospital, Melbourne, Victoria, Australia
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Gahl S. Bilingualism as a risk factor for false reports of stuttering in the Early Childhood Longitudinal Study (ECLS-K:2011). Front Psychol 2023; 14:1155895. [PMID: 37546483 PMCID: PMC10399746 DOI: 10.3389/fpsyg.2023.1155895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/27/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Bilingualism has historically been claimed to be a risk factor for developmental stuttering. The Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K:2011) ostensibly contains evidence to test that claim. Methods We analyze data from monolingual and bilingual children in Kindergarten through fifth grade in the ECLS-K:2011. Results and discussion The prevalence, male/female ratio, and onset and recovery of reported stuttering in the ECLS are inconsistent with widely-accepted clinical reports of stuttering. We argue that the reported figures may be misleading. We discuss some factors that may inflate the reported prevalence, including a lack of awareness of the difference between stuttering vs. normal disfluencies, and the informal usage of the word "stuttering" on the part of teachers and parents to describe typical disfluencies.
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Aldukair L, Ward D. Telepractice application for the overt stuttering assessment of children aged 6-15 years old. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:1050-1070. [PMID: 35703426 DOI: 10.1111/1460-6984.12739] [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: 09/22/2020] [Accepted: 05/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite the importance of delivering speech and language therapy services to children who stutter (CWS), there are barriers to accessing speech and language therapy. One way to improve access for those who may otherwise be deprived of speech and language therapy services, including CWS, is through telepractice (TP). However, there is currently no evidence as to the viability of TP stuttering assessments for CWS. AIM To investigate the validity and reliability, and acceptability of using a TP application to assess overt stuttering behaviour children aged 6-15 years. METHODS & PROCEDURE A total of 30 CWS, aged between 6 and 15 years, were recruited from a speech therapy clinic in King Abdulaziz University Hospital in Riyadh, Saudi Arabia. Children were divided into two testing conditions, either face-to-face (f2f)-led or TP-led testing, and the Stuttering Severity Instrument (SSI-IV) was administered, percentage of syllables stuttered (%SS) was calculated, and severity ratings (SR) assigned, either via f2f or via TP using two laptops with webcams, video conference software and a broadband internet connection. Agreement and reliability of scoring in the two testing conditions were reported in addition to findings from questionnaires exploring children's and their caregivers' perceptions both before and immediately after the TP assessment was carried out. OUTCOME & RESULTS A total of 30 sessions were successfully carried out, with results revealing unsatisfactory levels of agreement when applying the Bland and Altman method. However, when discrepancies were found, these were comparable with those from traditional f2f studies. Generally, parents and children exhibited high levels of satisfaction and held a positive view regarding TP pre- and post-assessment. CONCLUSIONS & IMPLICATIONS The results of the study suggest that conducting an overt stuttering assessment via TP for 6-15-year-olds CWS is reliable and valid. Although the TP model posed some (mainly technical) challenges for executing the assessment, high levels of satisfaction were recorded by parents and children alike. The TP system and equipment chosen in this study has provided a basis for the delivery of TP overt stuttering assessment in a clinical setting, thus addressing the barriers to access that are present for CWS. These results are preliminary, but they can be seen as a building block for future research in TP assessment studies for CWS. WHAT THIS PAPER ADDS What is already known on the subject Stuttering treatment via TP has been proven to be feasible and successful across a variety of treatment programs (e.g., Lidcombe, Camperdown). However, the viability of assessing stuttering via videoconferencing has never been explored in children. What this paper adds to existing knowledge Preliminary support for the assessment of overt stuttering in CWS aged 6-15 years via video conferencing. The results justify larger scale studies of this service delivery method. What are the potential or actual clinical implications of this work? The TP system and equipment chosen in this study has provided a basis for the delivery of TP overt stuttering assessment in a clinical setting, thus addressing the barriers to access that are present for CWS aged 6-15 years.
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Affiliation(s)
- Lamya Aldukair
- Health Rehabilitation Sciences Department, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - David Ward
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Differences in implicit motor learning between adults who do and do not stutter. Neuropsychologia 2022; 174:108342. [PMID: 35931135 DOI: 10.1016/j.neuropsychologia.2022.108342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 11/20/2022]
Abstract
Implicit learning allows us to acquire complex motor skills through repeated exposure to sensory cues and repetition of motor behaviours, without awareness or effort. Implicit learning is also critical to the incremental fine-tuning of the perceptual-motor system. To understand how implicit learning and associated domain-general learning processes may contribute to motor learning differences in people who stutter, we investigated implicit finger-sequencing skills in adults who do (AWS) and do not stutter (ANS) on an Alternating Serial Reaction Time task. Our results demonstrated that, while all participants showed evidence of significant sequence-specific learning in their speed of performance, male AWS were slower and made fewer sequence-specific learning gains than their ANS counterparts. Although there were no learning gains evident in accuracy of performance, AWS performed the implicit learning task more accurately than ANS, overall. These findings may have implications for sex-based differences in the experience of developmental stuttering, for the successful acquisition of complex motor skills during development by individuals who stutter, and for the updating and automatization of speech motor plans during the therapeutic process.
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Næss KAB, Nygaard E, Hofslundsengen H, Yaruss JS. The Association between Difficulties with Speech Fluency and Language Skills in a National Age Cohort of Children with Down Syndrome. Brain Sci 2021; 11:704. [PMID: 34073641 PMCID: PMC8226845 DOI: 10.3390/brainsci11060704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 12/05/2022] Open
Abstract
The present study (a) addressed difficulties in speech fluency in children with Down syndrome and typically developing children at a similar non-verbal level and (b) examined the association between difficulties with speech fluency and language skills in children with Down syndrome. Data from a cross-sectional parent survey that included questions about children's difficulties with speech fluency, as well as clinical tests from a national age cohort of 43 six-year-olds with Down syndrome and 57 young typically developing children, were collected. Fisher's exact test, Student's t-test, linear regression, and density ellipse scatter plots were used for analysis. There was a significantly higher occurrence of parent-reported difficulties with speech fluency in the children with Down syndrome. Higher language scores were significantly associated with a lower degree of difficulties; this association was strongest for vocabulary and phonological skills. Although difficulties with speech fluency were not reported for all children with Down syndrome, a substantially higher occurrence of such difficulties was reported compared to that for typically developing children. The significant association between difficulties with speech fluency and the level of language functioning suggests that speech fluency and language skills should be taken into consideration when planning treatment for children with Down syndrome.
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Affiliation(s)
- Kari-Anne B. Næss
- Department of Special Needs Education, University of Oslo, 0318 Oslo, Norway
| | - Egil Nygaard
- Department of Psychology, University of Oslo, 0373 Oslo, Norway;
| | - Hilde Hofslundsengen
- Faculty of Teacher Education, Arts and Sports, Western Norway University of Applied Sciences, 6851 Sogndal, Norway;
| | - J. Scott Yaruss
- Communicative Sciences and Disorders, Michigan State University, East Lansing, MI 48824, USA;
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The effects of sex on prevalence and mechanisms underlying neurodevelopmental disorders. HANDBOOK OF CLINICAL NEUROLOGY 2020. [PMID: 32958183 DOI: 10.1016/b978-0-444-64150-2.00025-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Neurodevelopmental disorders occur more frequently in boys than in girls and often differ in presentation between the sexes. The sex differences in prevalence and presentation of autism spectrum disorder, intellectual disability, communication disorders, specific learning disabilities, attention deficit/hyperactivity disorder, Tourette's syndrome, and epilepsy are discussed, as well as sex differences in the patterns of comorbidities between these disorders. Prominent theories have been proposed to explain sex biases. These include genetic factors, sex hormones, sociological factors, cognitive differences between the sexes, and environmental insult. Despite the large body of research reviewed in this chapter, many aspects of sex-related effects in neurodevelopmental disorders remain poorly understood.
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Nang C, Reynolds V, Hersh D, Andrews C, Humphries O. The experiences of migrants to Australia who stutter. JOURNAL OF FLUENCY DISORDERS 2019; 62:105723. [PMID: 31711011 DOI: 10.1016/j.jfludis.2019.105723] [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: 05/26/2019] [Revised: 09/17/2019] [Accepted: 09/23/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE Migration is a contemporary, global matter. With the number of international migrants doubling over the past four decades, speech-language pathologists will likely work with migrants who have childhood-onset stuttering. However, combined migration and stuttering experiences have never been investigated specifically. This study is the first to investigate the experiences of migrants to Australia who stutter. METHODS Three women and six men, aged 23 to 66 years old, participated. Data from individual interviews were analysed using Interpretative Phenomenological Analysis to examine the 'lived experience' of participants, as well as with NVivo 12 software for the management of coding. Participants also completed The Overall Assessment of the Speaker's Experience of Stuttering (OASES™). RESULTS The stress experienced from migration interacted and compounded the existing stress of stuttering. Central themes emerged pertaining to the impact of increased stress on self-identity, the interactions of the stresses, as well as the coping strategies/facilitators. Stuttering and other personal factors, such as language(s) spoken and accent, had a negative impact on communication skills. CONCLUSION Migration cannot be experienced independently of a stutter, as both are intrinsically linked to self-identity. The combined stress of migration with stuttering amplified the perception of feeling abnormal and resulted in difficulties with establishing a stable self-identity and a sense of belonging in the new context. Participants found strength in the company of others and considered Australia to be accepting of stuttering.
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Affiliation(s)
- Charn Nang
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia.
| | - Victoria Reynolds
- Communication Sciences and Disorders, State University of New York at Plattsburgh, New York, United States of America
| | - Deborah Hersh
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Clare Andrews
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Oswell Humphries
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
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Neumann K, Euler HA, Zens R, Piskernik B, Packman A, St Louis KO, Kell CA, Amir O, Blomgren M, Boucand VA, Eggers K, Fibiger S, Fourches A, Franken MCJP, Finn P. "Spontaneous" late recovery from stuttering: Dimensions of reported techniques and causal attributions. JOURNAL OF COMMUNICATION DISORDERS 2019; 81:105915. [PMID: 31301534 DOI: 10.1016/j.jcomdis.2019.105915] [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: 04/10/2018] [Revised: 06/01/2019] [Accepted: 06/09/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE (1) To survey the employed techniques and the reasons/occasions which adults who had recovered from stuttering after age 11 without previous treatment reported as causal to overcome stuttering, (2) to investigate whether the techniques and causal attributions can be reduced to coherent (inherently consistent) dimensions, and (3) whether these dimensions reflect common therapy components. METHODS 124 recovered persons from 8 countries responded by SurveyMonkey or paper-and-pencil to rating scale questions about 49 possible techniques and 15 causal attributions. RESULTS A Principal Component Analysis of 110 questionnaires identified 6 components (dimensions) for self-assisted techniques (Speech Restructuring; Relaxed/Monitored Speech; Elocution; Stage Performance; Sought Speech Demands; Reassurance; 63.7% variance explained), and 3 components of perceived causal attributions of recovery (Life Change, Attitude Change, Social Support; 58.0% variance explained). DISCUSSION Two components for self-assisted techniques (Speech Restructuring; Elocution) reflect treatment methods. Another component (Relaxed/Monitored Speech) consists mainly of items that reflect a common, non-professional understanding of effective management of stuttering. The components of the various perceived reasons for recovery reflect differing implicit theories of causes for recovery from stuttering. These theories are considered susceptible to various biases. This identification of components of reported techniques and of causal attributions is novel compared to previous studies who just list techniques and attributions. CONCLUSION The identified dimensions of self-assisted techniques and causal attributions to reduce stuttering as extracted from self-reports of a large, international sample of recovered formerly stuttering adults may guide the application of behavioral stuttering therapies.
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Affiliation(s)
- Katrin Neumann
- Department of Phoniatrics and Pediatric Audiology, Clinic for Otorhinolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr University Bochum, Germany.
| | - Harald A Euler
- Department of Phoniatrics and Pediatric Audiology, Clinic for Otorhinolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr University Bochum, Germany
| | - Rebekka Zens
- Department of Phoniatrics and Pediatric Audiology, ENT Clinic, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Bernhard Piskernik
- Institute of Applied Psychology: Health, Development, Enhancement, and Intervention, Faculty of Psychology, University of Vienna, Austria
| | - Ann Packman
- Australian Stuttering Research Centre, University of Technology Sydney, Australia
| | - Kenneth O St Louis
- Department of Speech Pathology and Audiology, West Virginia University, Morgantown, WV, USA
| | - Christian A Kell
- Department of Neurology and Brain Imaging Center, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Ofer Amir
- Department of Communication Disorders, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Blomgren
- Department of Communication Sciences & Disorders, The University of Utah, Salt Lake City, UT, USA
| | | | - Kurt Eggers
- Department of Speech-Language Therapy and Audiology, Thomas More University College, Antwerp, Belgium; Department of Psychology and Speech-Language Pathology, University of Turku, Finland
| | - Steen Fibiger
- University Library of Southern Denmark, Odense, Denmark
| | | | - Marie-Christine J P Franken
- Erasmus Medical University Centre, Sophia Children's Hospital, KNO/Gehoor- en Spraakcentrum, Rotterdam, Netherlands
| | - Patrick Finn
- Communication Sciences and Special Education, University of Georgia, Athens, GA, USA
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Neumann K. Redeflussstörungen im Kindes- und Jugendalter. HNO 2019; 67:547-560. [DOI: 10.1007/s00106-019-0694-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Redeflussstörungen im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2019. [DOI: 10.1007/s00112-019-0674-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Neumann K, A. Euler H, Bosshardt HG, Cook S, Sandrieser P, Sommer M. The Pathogenesis, Assessment and Treatment of Speech Fluency Disorders. DEUTSCHES ARZTEBLATT INTERNATIONAL 2017; 114:383-390. [PMID: 28655373 PMCID: PMC5504509 DOI: 10.3238/arztebl.2017.0383] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 03/18/2017] [Accepted: 03/24/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Approximately 1% of children and adolescents, 0.2% of women, and 0.8% of men suffer from stuttering, and lesser numbers from cluttering. Persistent speech fluency disorders often cause lifelong problems in communication and social participation. METHODS In an interdisciplinary, evidence and consensus based clinical practice guideline, the current understanding of the nature, identification, diagnosis, and treatment of stuttering and cluttering was summarized. A systematic review of the literature was carried out to assess the efficacy and effectiveness of treatments for stuttering. Evidence is lacking on the etiology, pathogenesis, evaluation, and treatment of cluttering. RESULTS In view of the fact that common (developmental, idiopathic) stuttering is associated with structural and functional changes of the brain, the guideline recommends that it should be called "originary neurogenic non-syndromic stuttering." Heritability estimates for this disorder range from 70% to over 80%. For preschool children, the Lidcombe therapy has the best evidence of efficacy (Cohen's d = 0.72-1.00). There is also strong evidence for an indirect treatment approach. For children aged 6 to 12, there is no solid evidence for the efficacy of any treatment. For adolescents and adults, there is good evidence with high effect sizes (Cohen's d = 0.75-1.63) for speech restructuring methods such as fluency shaping; weak evidence with intermediate effect sizes for stuttering modification (Cohen's d = 0.56-0.65); and weak evidence for combined speech restructuring and stuttering modification. The evidence does not support the efficacy of pharmacotherapy, rhythmic speaking, or breathing regulation as the sole or main form of treatment, or that of hypnosis or eclectic, unspecified stuttering therapies. CONCLUSION Stuttering is often treated in Germany with therapies for which there is inadequate evidence, and the initiation of treatment is often unnecessarily delayed. The guideline presents treatment methods whose efficacy is supported by the current evidence.
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Affiliation(s)
- Katrin Neumann
- Department of Phoniatrics and Pediatric Audiology, Clinic of Otorhinolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr University Bochum
| | - Harald A. Euler
- Department of Phoniatrics and Pediatric Audiology, Clinic of Otorhinolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr University Bochum
| | | | | | | | - Martin Sommer
- Department of Clinical Neurophysiology, University of Göttingen
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Lu C, Zheng L, Long Y, Yan Q, Ding G, Liu L, Peng D, Howell P. Reorganization of brain function after a short-term behavioral intervention for stuttering. BRAIN AND LANGUAGE 2017; 168:12-22. [PMID: 28113105 DOI: 10.1016/j.bandl.2017.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 12/14/2016] [Accepted: 01/08/2017] [Indexed: 06/06/2023]
Abstract
This study investigated changes in brain function that occurred over a 7-day behavioral intervention for adults who stutter (AWS). Thirteen AWS received the intervention (AWS+), and 13 AWS did not receive the intervention (AWS-). There were 13 fluent controls (FC-). All participants were scanned before and after the intervention. Whole-brain analysis pre-intervention showed significant differences in task-related brain activation between AWS and FC- in the right inferior frontal cortex (IFC) and left middle temporal cortex, but there were no differences between the two AWS groups. Across the 7-day period of the intervention, AWS+ alone showed a significant increase of brain activation in the left ventral IFC/insula. There were no changes in brain function for the other two groups. Further analysis revealed that the change did not correlate with resting-state functional connectivity (RSFC) that AWS showed in the cerebellum (Lu et al., 2012). However, both changes in task-related brain function and RSFC correlated with changes in speech fluency level. Together, these findings suggest that functional reorganization in a brain region close to the left IFC that shows anomalous function in AWS, occurs after a short-term behavioral intervention for stuttering.
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Affiliation(s)
- Chunming Lu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
| | - Lifen Zheng
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Yuhang Long
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Qian Yan
- Stuttering Therapy Center, Beijing, China
| | - Guosheng Ding
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Li Liu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Danling Peng
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Peter Howell
- Division of Psychology and Language Sciences, University College London, UK
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Iverach L, Lowe R, Jones M, O'Brian S, Menzies RG, Packman A, Onslow M. A speech and psychological profile of treatment-seeking adolescents who stutter. JOURNAL OF FLUENCY DISORDERS 2017; 51:24-38. [PMID: 28212718 DOI: 10.1016/j.jfludis.2016.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/30/2016] [Accepted: 11/06/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the relationship between stuttering severity, psychological functioning, and overall impact of stuttering, in a large sample of adolescents who stutter. METHOD Participants were 102 adolescents (11-17 years) seeking speech treatment for stuttering, including 86 boys and 16 girls, classified into younger (11-14 years, n=57) and older (15-17 years, n=45) adolescents. Linear regression models were used to evaluate the relationship between speech and psychological variables and overall impact of stuttering. RESULTS The impact of stuttering during adolescence is influenced by a complex interplay of speech and psychological variables. Anxiety and depression scores fell within normal limits. However, higher self-reported stuttering severity predicted higher anxiety and internalizing problems. Boys reported externalizing problems-aggression, rule-breaking-in the clinical range, and girls reported total problems in the borderline-clinical range. Overall, higher scores on measures of anxiety, stuttering severity, and speech dissatisfaction predicted a more negative overall impact of stuttering. CONCLUSION To our knowledge, this is the largest cohort study of adolescents who stutter. Higher stuttering severity, speech dissatisfaction, and anxiety predicted a more negative overall impact of stuttering, indicating the importance of carefully managing the speech and psychological needs of adolescents who stutter. Further research is needed to understand the relationship between stuttering and externalizing problems for adolescent boys who stutter.
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Affiliation(s)
- Lisa Iverach
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
| | - Robyn Lowe
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
| | - Mark Jones
- School of Public Health, University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD 4006, Australia.
| | - Susan O'Brian
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
| | - Ross G Menzies
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
| | - Ann Packman
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
| | - Mark Onslow
- Australian Stuttering Research Centre, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia.
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Lustyk T, Bergl P, Cmejla R. Evaluation of disfluent speech by means of automatic acoustic measurements. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2014; 135:1457-1468. [PMID: 24606282 DOI: 10.1121/1.4863646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
An experiment was carried out to determine whether the level of the speech fluency disorder can be estimated by means of automatic acoustic measurements. These measures analyze, for example, the amount of silence in a recording or the number of abrupt spectral changes in a speech signal. All the measures were designed to take into account symptoms of stuttering. In the experiment, 118 audio recordings of read speech by Czech native speakers were employed. The results indicate that the human-made rating of the speech fluency disorder in read speech can be predicted on the basis of automatic measurements. The number of abrupt spectral changes in the speech segments turns out to be the most appropriate measure to describe the overall speech performance. The results also imply that there are measures with good results describing partial symptoms (especially fixed postures without audible airflow).
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Affiliation(s)
- Tomas Lustyk
- Czech Technical University in Prague, Faculty of Electrical Engineering, Department of Circuit Theory, Technicka 2, 166 27, Prague, Czech Republic
| | - Petr Bergl
- Czech Technical University in Prague, Faculty of Electrical Engineering, Department of Circuit Theory, Technicka 2, 166 27, Prague, Czech Republic
| | - Roman Cmejla
- Czech Technical University in Prague, Faculty of Electrical Engineering, Department of Circuit Theory, Technicka 2, 166 27, Prague, Czech Republic
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Law J, Reilly S, Snow PC. Child speech, language and communication need re-examined in a public health context: a new direction for the speech and language therapy profession. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2013; 48:486-496. [PMID: 24033648 DOI: 10.1111/1460-6984.12027] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Historically speech and language therapy services for children have been framed within a rehabilitative framework with explicit assumptions made about providing therapy to individuals. While this is clearly important in many cases, we argue that this model needs revisiting for a number of reasons. First, our understanding of the nature of disability, and therefore communication disabilities, has changed over the past century. Second, there is an increasing understanding of the impact that the social gradient has on early communication difficulties. Finally, understanding how these factors interact with one other and have an impact across the life course remains poorly understood. AIMS To describe the public health paradigm and explore its implications for speech and language therapy with children. METHODS & PROCEDURES We test the application of public health methodologies to speech and language therapy services by looking at four dimensions of service delivery: (1) the uptake of services and whether those children who need services receive them; (2) the development of universal prevention services in relation to social disadvantage; (3) the risk of over-interpreting co-morbidity from clinical samples; and (4) the overlap between communicative competence and mental health. OUTCOMES & CONCLUSIONS It is concluded that there is a strong case for speech and language therapy services to be reconceptualized to respond to the needs of the whole population and according to socially determined needs, focusing on primary prevention. This is not to disregard individual need, but to highlight the needs of the population as a whole. Although the socio-political context is different between countries, we maintain that this is relevant wherever speech and language therapists have a responsibility for covering whole populations. Finally, we recommend that speech and language therapy services be conceptualized within the framework laid down in The Ottawa Charter for Health Promotion.
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Affiliation(s)
- James Law
- Speech and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
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Oliveira CMCD, Cunha D, Santos ACD. Fatores de risco para gagueira em crianças disfluentes com recorrência familial. AUDIOLOGY: COMMUNICATION RESEARCH 2013. [DOI: 10.1590/s2317-64312013000100009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
OBJETIVO: Caracterizar os fatores gênero, idade, tempo de duração e tipologia das disfluências, fatores estressantes físicos e emocionais em crianças com alto risco para a gagueira e com recorrência familial do distúrbio. MÉTODOS: Participaram 65 crianças com alto risco para a gagueira desenvolvimental familial, de ambos os gêneros, na faixa etária de três a 11anos. A coleta de dados foi realizada por meio do Protocolo de Risco para a Gagueira do Desenvolvimento (PRGD). RESULTADOS: A razão masculino/feminino de crianças disfluentes encontrada foi de 2,8:1, com predominância do grupo na faixa etária de três anos. Os resultados revelaram diferença significativa quanto ao tempo de duração: mais crianças apresentaram um período maior de 12 meses de duração das disfluências em relação às crianças que apresentaram de seis a 12 meses de duração. A maioria apresentou algum fator estressante emocional e não apresentou fator estressante físico. CONCLUSÃO: Os resultados sugerem que crianças com recorrência familial da gagueira no gênero masculino, na faixa etária de três anos, com presença de disfluências gagas por mais de 12 meses e com ocorrência de fatores estressantes emocionais são as que apresentam maior risco para o desenvolvimento da gagueira persistente.
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Affiliation(s)
| | - Denise Cunha
- Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil
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Iverach L, Menzies RG, O'Brian S, Packman A, Onslow M. Anxiety and stuttering: continuing to explore a complex relationship. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2011; 20:221-232. [PMID: 21478283 DOI: 10.1044/1058-0360(2011/10-0091)] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE The relationship between anxiety and stuttering has been widely studied. However, a review conducted more than 10 years ago (Menzies, Onslow, & Packman, 1999) identified 5 methodological issues thought to preclude consistent research findings regarding the nature of this relationship. The purpose of the present review was to determine whether methodological improvements have occurred since the Menzies et al. (1999) review. METHOD Literature published since the Menzies et al. review was evaluated with regard to the 5 methodological issues identified in that review: (a) the construct of anxiety, (b) trait anxiety measures, (c) participant numbers, (d) treatment status of participants, and (e) speaking tasks. RESULTS Despite some remaining ambiguous findings, research published since the Menzies et al. review has provided far stronger evidence of a relationship between stuttering and anxiety, and has focused more on social anxiety, expectancies of social harm, and fear of negative evaluation. CONCLUSION The aims of future research should be to improve research design, increase statistical power, employ multidimensional measures of anxiety, and further develop anxiolytic treatment options for people who stutter.
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Affiliation(s)
- Lisa Iverach
- Australian Stuttering Research Centre, The University of Sydney.
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Oliveira CMCD, Souza HAD, Santos ACD, Cunha DDS. Análise dos fatores de risco para gagueira em crianças disfluentes sem recorrência familial. REVISTA CEFAC 2011. [DOI: 10.1590/s1516-18462011005000062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: analisar os fatores gênero, idade, tipo de surgimento da gagueira, tempo de duração e tipologia das disfluências, fatores estressantes físicos e emocionais, e fatores comunicativos e qualitativos associados em crianças disfluentes sem recorrência familial do distúrbio. MÉTODO: participaram 43 crianças com alto risco para a gagueira de ambos os gêneros. A coleta de dados foi realizada por meio do Protocolo de Risco para a Gagueira do Desenvolvimento - PRGD. RESULTADOS: a razão masculino/feminino foi de 3,3:1. A única diferença estatisticamente significante dos fatores de risco analisados nos gêneros masculino e feminino foi a maior ocorrência de fatores comunicativos associados no gênero masculino (p=0,003). Houve uma semelhança dos achados entre os meninos e as meninas: quanto ao tempo de duração das disfluências a maioria apresentou mais de 12 meses de duração, a tipologia gaga foi a mais freqüente, a presença de fatores estressantes emocionais ocorreu na maior parte das crianças, e finalmente os fatores qualitativos associados, como taxa de elocução aumentada, tensão visível e incoordenação pneumo-fono-articulatória estiveram presentes em grande parte da amostra. CONCLUSÃO: os resultados desta investigação permitiram concluir que nos casos de crianças com alto risco para a gagueira isolada ocorreu a interação de inúmeros fatores, sugerindo que o distúrbio é multifatorial. Também foi possível concluir que a interação de alguns fatores como gênero masculino, tipologia gaga manifestada por mais de 12 meses, com início persistente, na presença de fatores qualitativos e comunicativos associados pode representar risco maior para o desenvolvimento da gagueira persistente.
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Bleek B, Montag C, Faber J, Reuter M. Investigating personality in stuttering: results of a case control study using the NEO-FFI. JOURNAL OF COMMUNICATION DISORDERS 2011; 44:218-222. [PMID: 21163491 DOI: 10.1016/j.jcomdis.2010.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 07/27/2010] [Accepted: 11/01/2010] [Indexed: 05/30/2023]
Abstract
UNLABELLED A recent study by Iverach et al. (Journal of Communication Disorders, 2010) compared persons who stutter with two normative samples in the context of the five-factor model of personality measured by the NEO Five-Factor Inventory (NEO-FFI). Persons who stutter were characterized by higher Neuroticism, lower Conscientiousness and lower Agreeableness scores in contrast to the normative data from an Australian and a United States sample. Moreover, the authors report that the scores on all five personality dimensions in the stuttering group were within those of the normative samples. A shortcoming of the Iverach et al. study is the lack of a matched control group. In the present study we compared persons who stutter with a control group matched to age and gender. Furthermore, none of the controls had a history of personal and family stuttering. The findings with respect to Neuroticism could be replicated in our sample. But in contrast to Iverach et al. we found higher Conscientiousness and Agreeableness scores in persons who stutter compared to the control group. LEARNING OUTCOMES The reader of the present study will learn that elevated Neuroticism scores can be observed in persons who stutter across cultures such as Germany or Australia. With respect to other personality dimensions such as Conscientiousness or Agreeableness the picture is much more difficult.
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Affiliation(s)
- Benjamin Bleek
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring, D-53117 Bonn, Germany
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Lu C, Peng D, Chen C, Ning N, Ding G, Li K, Yang Y, Lin C. Altered effective connectivity and anomalous anatomy in the basal ganglia-thalamocortical circuit of stuttering speakers. Cortex 2010; 46:49-67. [PMID: 19375076 DOI: 10.1016/j.cortex.2009.02.017] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Revised: 12/24/2008] [Accepted: 02/21/2009] [Indexed: 10/21/2022]
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Bricker-Katz G, Lincoln M, McCabe P. A life-time of stuttering: How emotional reactions to stuttering impact activities and participation in older people. Disabil Rehabil 2009; 31:1742-52. [DOI: 10.1080/09638280902738672] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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