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L Edwards B, Jackson ES, Kefalianos E, Sheedy S, Onslow M. Contemporary clinical conversations about stuttering: Can intervention stop early stuttering development? INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-8. [PMID: 39218003 DOI: 10.1080/17549507.2024.2371870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
PURPOSE To discuss whether early intervention can stop stuttering development. To inform junior clinicians and students of speech-language pathology about contemporary views on this issue. METHOD The issue was discussed by two university researchers and two speech-language pathologists who provide public clinical services. Written conversational turns in an exchange were limited to 100 words each. When that written dialogue was concluded, each participant provided 200 words of final reflection about the issue. RESULT Most differences that emerged centred on the clinical evidence base for early intervention, which emphasises stuttering reduction, and how it should be interpreted. CONCLUSION The evidence base for early intervention has limitations and it should be interpreted cautiously. One interpretation is that reducing stuttering severity is a justifiable core of early management. Another interpretation focuses on ease of communication, anticipation of stuttering, and covert stuttering.
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Affiliation(s)
- Brooke L Edwards
- SAY: The Stuttering Association for the Young, New York, NY, USA
| | - Eric S Jackson
- Communicative Sciences and Disorders, New York University, New York, NY, USA
| | - Elaina Kefalianos
- Department of Audiology and Speech Pathology, University of Melbourne, Parkville, VIC, Australia
| | - Stacey Sheedy
- South Western Sydney Local Health District, Bankstown, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, NSW, Australia
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Pasculli G, Busan P, Jackson ES, Alm PA, De Gregorio D, Maguire GA, Goodwin GM, Gobbi G, Erritzoe D, Carhart-Harris RL. Psychedelics in developmental stuttering to modulate brain functioning: a new therapeutic perspective? Front Hum Neurosci 2024; 18:1402549. [PMID: 38962146 PMCID: PMC11221540 DOI: 10.3389/fnhum.2024.1402549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Developmental stuttering (DS) is a neurodevelopmental speech-motor disorder characterized by symptoms such as blocks, repetitions, and prolongations. Persistent DS often has a significant negative impact on quality of life, and interventions for it have limited efficacy. Herein, we briefly review existing research on the neurophysiological underpinnings of DS -specifically, brain metabolic and default mode/social-cognitive networks (DMN/SCN) anomalies- arguing that psychedelic compounds might be considered and investigated (e.g., in randomized clinical trials) for treatment of DS. The neural background of DS is likely to be heterogeneous, and some contribution from genetically determinants of metabolic deficiencies in the basal ganglia and speech-motor cortical regions are thought to play a role in appearance of DS symptoms, which possibly results in a cascade of events contributing to impairments in speech-motor execution. In persistent DS, the difficulties of speech are often linked to a series of associated aspects such as social anxiety and social avoidance. In this context, the SCN and DMN (also influencing a series of fronto-parietal, somato-motor, and attentional networks) may have a role in worsening dysfluencies. Interestingly, brain metabolism and SCN/DMN connectivity can be modified by psychedelics, which have been shown to improve clinical evidence of some psychiatric conditions (e.g., depression, post-traumatic stress disorder, etc.) associated with psychological constructs such as rumination and social anxiety, which also tend to be present in persistent DS. To date, while there have been no controlled trials on the effects of psychedelics in DS, anecdotal evidence suggests that these agents may have beneficial effects on stuttering and its associated characteristics. We suggest that psychedelics warrant investigation in DS.
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Affiliation(s)
- Giuseppe Pasculli
- Department of Computer, Control, and Management Engineering (DIAG), La Sapienza University, Rome, Italy
- Italian Society of Psychedelic Medicine (Società Italiana di Medicina Psichedelica–SIMePsi), Bari, Italy
| | | | - Eric S. Jackson
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
| | - Per A. Alm
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Danilo De Gregorio
- IRCCS, San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Gerald A. Maguire
- School of Medicine, American University of Health Sciences, Signal Hill, CA, United States
- CenExel CIT Research, Riverside, CA, United States
| | - Guy M. Goodwin
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - David Erritzoe
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Robin L. Carhart-Harris
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
- Psychedelics Division, Neuroscape, University of California, San Francisco, CA, United States
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Franken MC, Oonk LC, Bast BJEG, Bouwen J, De Nil L. Erasmus clinical model of the onset and development of stuttering 2.0. JOURNAL OF FLUENCY DISORDERS 2024; 80:106040. [PMID: 38493582 DOI: 10.1016/j.jfludis.2024.106040] [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: 05/12/2023] [Revised: 12/25/2023] [Accepted: 02/11/2024] [Indexed: 03/19/2024]
Abstract
A clinical, evidence-based model to inform clients and their parents about the nature of stuttering is indispensable for the field. In this paper, we propose the Erasmus Clinical Model of Stuttering 2.0 for children who stutter and their parents, and adult clients. It provides an up-to-date, clinical model summary of current insights into the genetic, neurological, motoric, linguistic, sensory, temperamental, psychological and social factors (be it causal, eliciting, or maintaining) related to stuttering. First a review is presented of current insights in these factors, and of six scientific theories or models that have inspired the development of our current clinical model. Following this, we will propose the model, which has proven to be useful in clinical practice. The proposed Erasmus Clinical Model of Stuttering visualizes the onset and course of stuttering, and includes scales for stuttering severity and impact, to be completed by the (parent of) the person who stutters. The pathway of the model towards stuttering onset is based on predisposing and mediating factors. In most children with an onset of stuttering, stuttering is transient, but if stuttering continues, its severity and impact vary widely. The model includes the circle of Engel (1977), which visualizes unique interactions of relevant biological, psychological, and social factors that determine the speaker's experience of stuttering severity and its impact. Discussing these factors and their interaction with an individual client can feed into therapeutic targets. The model is supplemented by a lifeline casus.
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Affiliation(s)
- Marie-Christine Franken
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Leonoor C Oonk
- StotterFonds, Nijkerk, the Netherlands; University of Applied Sciences, Department of Speech-Language Therapy, Utrecht, the Netherlands
| | | | - Jan Bouwen
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Luc De Nil
- Department of Speech-Language Pathology, University of Toronto, Canada; Rehabilitation Sciences Institute, University of Toronto, Canada.
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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.
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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
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Sakai N, Miyamoto S, Hara Y, Kikuchi Y, Kobayashi H, Takeyama T, Udaka J, Sudo D, Mori K. Multiple-Community-Based Epidemiological Study of Stuttering among 3-Year-Old Children in Japan. Folia Phoniatr Logop 2024:1-15. [PMID: 38697051 DOI: 10.1159/000539172] [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: 04/05/2023] [Accepted: 04/28/2024] [Indexed: 05/04/2024] Open
Abstract
INTRODUCTION Many epidemiological studies of the disorder of stuttering have been conducted during the 20th century, continuing during the current one. Unfortunately, only a few were carried out in Japan. This study aimed at assessing (1) the incidence and prevalence of stuttering in 3-year-old children in multiple Japanese communities and (2) factors associated with the onset of stuttering among these children. METHODS A questionnaire aimed at screening for the presence of stuttering was employed for 2,055 children aged 3 years, who underwent a standard nationwide health checkup. Positive responses were confirmed in several ways: (1) direct interviews and assessment of the child's speech, (2) confirmatory questionnaire, or (3) telephone interviews by licensed Speech Language Hearing Therapists. RESULTS Approximately 6.5% of the children were found to exhibit stuttering at the time of their health checkup. This figure rose to 8.9% after including individuals who previously, but not currently, were reported to have exhibited stuttering. Among the putative risk factors, higher stuttering odds (odds ratio, OR = 3.27) were detected in those with a family history of stuttering, those whose guardians had concerns about their child's development (OR = 1.75), and those with diagnosed diseases or disabilities (OR = 2.13). DISCUSSION/CONCLUSIONS It was concluded that, in Japan, both the risk of stuttering incidence (8.9%) in children up to, and including, the age of 3 years, as well as its prevalence (6.5%) in this population, was similar to those reported by recent studies in other countries. Additionally, our findings also confirmed that an increased risk for stuttering at age 3 is associated with a family history of stuttering.
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Affiliation(s)
- Naomi Sakai
- Department of Rehabilitation for Sensory Functions, National Rehabilitation Center for Persons with Disabilities Research Institute, Tokorozawa, Japan
| | - Shoko Miyamoto
- Faculty of Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yuki Hara
- School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Yoshikazu Kikuchi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroaki Kobayashi
- College of Human and Social Science, Kanazawa University, Kanazawa, Japan
| | - Takaaki Takeyama
- Udaka ENT Clinic, Myouzai, Japan
- Hachi Dental Clinic, Onojo, Japan
| | | | | | - Koichi Mori
- National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
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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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Hokstad S, Næss KAB. Stuttering in individuals with Down syndrome: a systematic review of earlier research. Front Psychol 2023; 14:1176743. [PMID: 38094702 PMCID: PMC10716236 DOI: 10.3389/fpsyg.2023.1176743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 10/09/2023] [Indexed: 07/19/2024] Open
Abstract
The main objective of this systematic review was to synthesize the evidence on the occurrence and characteristics of stuttering in individuals with Down syndrome and thus contribute knowledge about stuttering in this population. Group studies reporting outcome measures of stuttering were included. Studies with participants who were preselected based on their fluency status were excluded. We searched the Eric, PsychInfo, Medline, Scopus, and Web of Science Core Collection databases on 3rd January 2022 and conducted supplementary searches of the reference lists of previous reviews and the studies included in the current review, as well as relevant speech and language journals. The included studies were coded in terms of information concerning sample characteristics, measurement approaches, and stuttering-related outcomes. The appraisal tool for cross-sectional studies (AXIS) was used to evaluate study quality. We identified 14 eligible studies, with a total of 1,833 participants (mean = 131.29, standard deviation = 227.85, median = 45.5) between 3 and 58 years of age. The estimated occurrence of stuttering ranged from 2.38 to 56%, which is substantially higher than the estimated prevalence (1%) of stuttering in the general population. The results also showed that stuttering severity most often was judged to be mild-to-moderate and that individuals with Down syndrome displayed secondary behaviors when these were measured. However, little attention has been paid to investigating the potential adverse effects of stuttering for individuals with Down syndrome. We judged the quality of the evidence to be moderate-to-low. The negative evaluation was mostly due to sampling limitations that decreased the representability and generalizability of the results. Based on the high occurrence of stuttering and the potential negative effects of this condition, individuals with Down syndrome who show signs of stuttering should be referred to a speech and language pathologist for an evaluation of their need for stuttering treatment.
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Affiliation(s)
- Silje Hokstad
- Department of Education, Lillehammer, Inland Norway University of Applied Sciences, Lillehammer, Norway
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Kari-Anne B. Næss
- Department of Education, Lillehammer, Inland Norway University of Applied Sciences, Lillehammer, Norway
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Norman A, Lowe R, Onslow M, O'Brian S, Packman A, Menzies R, Schroeder L. Cost of Illness and Health-Related Quality of Life for Stuttering: Two Systematic Reviews. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4414-4431. [PMID: 37751681 DOI: 10.1044/2023_jslhr-23-00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
PURPOSE For those who stutter, verbal communication is typically compromised in social situations. This may attract negative responses from listeners and stigmatization by society. These have the potential to impair health-related quality of life across a range of domains, including qualitative and quantitative impacts on speech output, mental health issues, and failure to attain educational and occupational potential. These systematic reviews were designed to explore this matter using traditional health economics perspectives of utility measures and cost of illness. METHOD Studies were included if they involved children, adolescents, or adults with stuttering as a primary diagnosis. The quality of life search strategy identified 2,607 reports, of which three were included in the quality of life analysis. The cost of illness search strategy identified 3,778 reports, of which 39 were included in the cost of illness analysis. RESULTS Two of the three studies included in the quality of life analysis had a high risk of bias. When measured using utility scores, quality of life for people who stutter was in the range of those reported for chronic health conditions such as diabetes mellitus, cardiovascular disease, and cancer. However, there is little such evidence of quality of life impairment during the preschool years. Studies included in the cost of illness analysis carried considerable risk of bias overall. CONCLUSIONS For people who stutter, there are substantive direct and indirect costs of illness. These include impairment, challenges, and distress across many domains throughout life, including income, education, employment, and social functioning. Evidence of quality of life impairment using utility measures is extremely limited. If this situation is not remedied, the lifetime impairment, challenges, and distress experienced by those who stutter cannot be documented in a form that can be used to influence health policy and health care spending. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24168201.
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Affiliation(s)
- Alicia Norman
- Macquarie University Centre for the Health Economy, Macquarie University Business School, North Ryde, New South Wales, Australia
- Australian Institute for Health Innovation, Macquarie University, North Ryde, New South Wales, Australia
| | - Robyn Lowe
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Sue O'Brian
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Ann Packman
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Ross Menzies
- Australian Stuttering Research Centre, University of Technology Sydney, New South Wales, Australia
| | - Liz Schroeder
- Macquarie University Centre for the Health Economy, Macquarie University Business School, North Ryde, New South Wales, Australia
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
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Nilles C, Berg L, Fleming C, Martino D, Pringsheim T. Developmental stuttering, physical concomitants associated with stuttering, and Tourette syndrome: A scoping review. JOURNAL OF FLUENCY DISORDERS 2023; 77:105992. [PMID: 37393778 DOI: 10.1016/j.jfludis.2023.105992] [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: 01/21/2023] [Revised: 06/15/2023] [Accepted: 06/22/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND AND PURPOSE Developmental stuttering and Tourette syndrome (TS) are common neurodevelopmental disorders. Although disfluencies may co-occur in TS, their type and frequency do not always represent pure stuttering. Conversely, core symptoms of stuttering may be accompanied by physical concomitants (PCs) that can be confused for tics. This scoping review aimed to explore the similarities and differences between stuttering and tics in terms of epidemiology, comorbidities, phenomenology, evolution, physiopathology, and treatment. We also described the nature of PCs in stuttering and disfluencies in TS. METHODS A literature search on Medline, Embase and PsycInfo was executed in March 2022. From 426 studies screened, 122 were included in the review (a majority being narrative reviews and case reports). RESULTS TS and stuttering have several epidemiological, phenomenological, comorbidity, and management similarities suggesting shared risk factors and physiopathology (involving the basal ganglia and their connections with speech and motor control cortical regions). PCs in stuttering commonly involve the face (eyelids, jaw/mouth/lip movements) and sometimes the head, trunk and limbs. PCs can be present from early stages of stuttering and vary over time and within individuals. The function of PCs is unknown. Some individuals with TS have a distinct disfluency pattern, composed of a majority of typical disfluencies (mostly between-word disfluencies), and a mix of cluttering-like behaviors, complex phonic tics (e.g. speech-blocking tics, echolalia, palilalia), and rarely, atypical disfluencies. CONCLUSION Future investigations are warranted to better understand the complex relationships between tics and stuttering and address the management of disfluencies in TS and PCs in stuttering.
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Affiliation(s)
- Christelle Nilles
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Lindsay Berg
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Cassidy Fleming
- Pediatric Community Rehabilitation, Alberta Health Services, Calgary, Alberta, Canada
| | - Davide Martino
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada; Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada
| | - Tamara Pringsheim
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada; Mathison Centre for Mental Health Research and Education, Calgary, AB, Canada.
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McDonagh HDL, Broderick P, Monaghan K. Eye movement as a simple, cost-effective tool for people who stutter: A case study. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2023; 70:e1-e13. [PMID: 37782243 PMCID: PMC10476227 DOI: 10.4102/sajcd.v70i1.968] [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: 02/14/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Access to services remains the biggest barrier to helping the most vulnerable in the South African Stuttering Community. This novel stuttering therapy, harnessing an unconscious link between eye and tongue movement, may provide a new therapeutic approach, easily communicated and deliverable online. OBJECTIVES This study provides both objective and subjective assessments of the feasibility of this intervention. Assessment tools holistically address all components of stuttering in line with comprehensive treatment approaches: core behaviours, secondary behaviours, anticipation and reactions. METHOD On receipt of ethical approval, this single-subject case design recruited one adult (21-year-old) male with a developmental stutter (DS). The participant gave informed consent and completed four scheduled assessments: baseline, after 5-week training, 3 months post-intervention and 24 months post-completion. The study used objective assessment tools: Stuttering Severity Instrument-4 (SSI-4); Subjective-assessment tools: SSI-4 clinical use self-report tool (CUSR); Overall Assessment of Speaker's Experience of Stuttering (OASES-A); Premonitory Awareness in Stuttering (PAiS) and Self-Report Stuttering Severity* (SRSS) (*final assessment). RESULTS The participant's scores improved across all assessment measures, which may reflect a holistic improvement. The participant reported that the tool was very useful. There were no negative consequences. CONCLUSION This case report indicates that this innovative treatment may be feasible. No adverse effects were experienced, and the treatment only benefited the participant. The results justify the design of a pilot randomised feasibility clinical trial.Contribution: The results indicate that this is a needed breakthrough in stuttering therapy as the instructions can be easily translated into any language. It can also be delivered remotely reducing accessibility barriers.
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Affiliation(s)
- Hilary D-L McDonagh
- Department of Health and Nutritional Science, Faculty of Science, Atlantic Technological University, Sligo.
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11
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Neef NE, Angstadt M, Koenraads SPC, Chang SE. Dissecting structural connectivity of the left and right inferior frontal cortex in children who stutter. Cereb Cortex 2023; 33:4085-4100. [PMID: 36057839 PMCID: PMC10068293 DOI: 10.1093/cercor/bhac328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/12/2022] Open
Abstract
Inferior frontal cortex pars opercularis (IFCop) features a distinct cerebral dominance and vast functional heterogeneity. Left and right IFCop are implicated in developmental stuttering. Weak left IFCop connections and divergent connectivity of hyperactive right IFCop regions have been related to impeded speech. Here, we reanalyzed diffusion magnetic resonance imaging data from 83 children (41 stuttering). We generated connection probability maps of functionally segregated area 44 parcels and calculated hemisphere-wise analyses of variance. Children who stutter showed reduced connectivity of executive, rostral-motor, and caudal-motor corticostriatal projections from the left IFCop. We discuss this finding in the context of tracing studies from the macaque area 44, which leads to the need to reconsider current models of speech motor control. Unlike the left, the right IFCop revealed increased connectivity of the inferior posterior ventral parcel and decreased connectivity of the posterior dorsal parcel with the anterior insula, particularly in stuttering boys. This divergent connectivity pattern in young children adds to the debate on potential core deficits in stuttering and challenges the theory that right hemisphere differences might exclusively indicate compensatory changes that evolve from lifelong exposure. Instead, early right prefrontal connectivity differences may reflect additional brain signatures of aberrant cognition-emotion-action influencing speech motor control.
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Affiliation(s)
- Nicole E Neef
- Institute for Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA
| | - Simone P C Koenraads
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, Wytemaweg 80, 3015 CNRotterdam, the Netherlands
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA
- Department of Communicative Sciences and Disorders, Michigan State University, 1026 Red Cedar Road, East Lansing, MI 48824, USA
- Cognitive Imaging Research Center, Department of Radiology, Michigan State University, 846 Service Road, East Lansing, MI 48824, USA
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12
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Erdemir A, Walden TA, Tilsen S, Mefferd AS, Jones RM. A Preliminary Study of Speech Rhythm Differences as Markers of Stuttering Persistence in Preschool-Age Children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:931-950. [PMID: 36827517 PMCID: PMC10205104 DOI: 10.1044/2022_jslhr-22-00126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 09/15/2022] [Accepted: 12/01/2022] [Indexed: 05/25/2023]
Abstract
PURPOSE The purpose of this study was twofold: (a) to determine whether there are speech rhythm differences between preschool-age children who stutter that were eventually diagnosed as persisting (CWS-Per) or recovered (CWS-Rec) and children who do not stutter (CWNS), using empirical spectral analysis and empirical mode decomposition of the speech amplitude envelope, and (b) to determine whether speech rhythm characteristics close to onset are predictive of later persistence. METHOD Fifty children (3-4 years of age) participated in the study. Approximately 2-2.5 years after the experimental testing took place, children were assigned to the following groups: CWS-Per (nine boys, one girl), CWS-Rec (18 boys, two girls), and CWNS (18 boys, two girls). All children produced a narrative based on a text-free storybook. From the audio recordings of these narratives, fluent utterances were selected for each child from which seven envelope-based measures were extracted. Group-based differences on each measure as well as predictive analyses were conducted to identify measures that discriminate CWS-Per versus CWS-Rec. RESULTS CWS-Per were found to have a relatively higher degree of power in suprasyllabic oscillations and greater variability in the timing of syllabic rhythms especially for longer utterances. A logistic regression model using two speech rhythm measures was able to discriminate the eventual outcome of recovery versus persistence, with 80% sensitivity and 75% specificity. CONCLUSION Findings suggest that envelope-based speech rhythm measures are a promising approach to assess speech rhythm differences in developmental stuttering, and its potential for identification of children at risk of developing persistent stuttering should be investigated further.
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Affiliation(s)
- Aysu Erdemir
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Tedra A. Walden
- Department of Psychology, Vanderbilt University, Nashville, TN
| | - Sam Tilsen
- Department of Linguistics, Cornell University, Ithaca, NY
| | - Antje S. Mefferd
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Robin M. Jones
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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13
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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.
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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
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14
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Hokstad S, Næss KAB, Yaruss JS, Hoff K, Melle AH, Lervåg AO. Stuttering Behavior in a National Age Cohort of Norwegian First-Graders With Down Syndrome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:4133-4150. [PMID: 36302044 DOI: 10.1044/2022_jslhr-21-00605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE The aims of this study were to investigate the occurrence of stuttering behavior across time and to evaluate the relationship between stuttering behavior and language ability in children with Down syndrome. METHOD A national age cohort of Norwegian first graders with Down syndrome (N = 75) participated in the study. Speech samples from a story-retelling task and a picture book dialogue as well as standardized measures of vocabulary, grammar, and nonverbal mental ability were collected at two time points approximately 5 months apart. Stuttering behavior was evaluated through counting stuttering-like disfluencies and stuttering severity ratings. The relationship between stuttering behavior and language ability was investigated through hierarchical regression analysis. RESULTS The participants had stuttering severity ratings ranging from no stuttering behavior to severe and displayed all types of stuttering-like disfluencies. There were significant relationships between stuttering behavior and language ability at the first time point, whereas the relationships were not significant at the second time point. The stuttering severity ratings were significantly predicted by language ability across time, whereas the frequency of stuttering-like disfluencies was not. CONCLUSIONS The occurrence of stuttering behavior was high across the measures and time points; however, the relationship between stuttering behavior and language ability varied across these variables. Thus, the nature of the relationship does not seem to follow a strict pattern that can be generalized to all children across time.
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Affiliation(s)
- Silje Hokstad
- Department of Special Needs Education, University of Oslo, Norway
| | - Kari-Anne B Næss
- Department of Special Needs Education, University of Oslo, Norway
| | - J Scott Yaruss
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Karoline Hoff
- The National Service for Special Needs Education, Statped, Holmestrand, Norway
| | - Ane H Melle
- The National Service for Special Needs Education, Statped, Holmestrand, Norway
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15
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Boyce JO, Jackson VE, van Reyk O, Parker R, Vogel AP, Eising E, Horton SE, Gillespie NA, Scheffer IE, Amor DJ, Hildebrand MS, Fisher SE, Martin NG, Reilly S, Bahlo M, Morgan AT. Self-reported impact of developmental stuttering across the lifespan. Dev Med Child Neurol 2022; 64:1297-1306. [PMID: 35307825 DOI: 10.1111/dmcn.15211] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 02/05/2023]
Abstract
AIM To examine the phenomenology of stuttering across the lifespan in the largest prospective cohort to date. METHOD Participants aged 7 years and older with a history of developmental stuttering were recruited. Self-reported phenotypic data were collected online including stuttering symptomatology, co-occurring phenotypes, genetic predisposition, factors associated with stuttering severity, and impact on anxiety, education, and employment. RESULTS A total of 987 participants (852 adults: 590 males, 262 females, mean age 49 years [SD = 17 years 10 months; range = 18-93 years] and 135 children: 97 males, 38 females, mean age 11 years 4 months [SD = 3 years; range = 7-17 years]) were recruited. Stuttering onset occurred at age 3 to 6 years in 64.0%. Blocking (73.2%) was the most frequent phenotype; 75.9% had sought stuttering therapy and 15.5% identified as having recovered. Half (49.9%) reported a family history. There was a significant negative correlation with age for both stuttering frequency and severity in adults. Most were anxious due to stuttering (90.4%) and perceived stuttering as a barrier to education and employment outcomes (80.7%). INTERPRETATION The frequent persistence of stuttering and the high proportion with a family history suggest that stuttering is a complex trait that does not often resolve, even with therapy. These data provide new insights into the phenotype and prognosis of stuttering, information that is critically needed to encourage the development of more effective speech therapies. WHAT THIS PAPER ADDS Half of the study cohort had a family history of stuttering. While 75.9% of participants had sought stuttering therapy, only 15.5% identified as having recovered. There was a significant negative correlation between age and stuttering frequency and severity in adults.
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Affiliation(s)
- Jessica O Boyce
- Speech and Language, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Audiology and Speech Pathology, University of Melbourne, Parkville, VIC, Australia
| | - Victoria E Jackson
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia
| | - Olivia van Reyk
- Speech and Language, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Richard Parker
- Queensland Institute for Medical Research, Berghofer Medical Research Institute, Brisbane, Australia
| | - Adam P Vogel
- Department of Audiology and Speech Pathology, University of Melbourne, Parkville, VIC, Australia.,Centre for Neuroscience of Speech, University of Melbourne, Parkville, VIC, Australia.,Redenlab Inc, Melbourne, VIC, Australia
| | - Else Eising
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
| | - Sarah E Horton
- Speech and Language, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Audiology and Speech Pathology, University of Melbourne, Parkville, VIC, Australia
| | - Nathan A Gillespie
- Queensland Institute for Medical Research, Berghofer Medical Research Institute, Brisbane, Australia.,Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, VA, USA
| | - Ingrid E Scheffer
- Epilepsy Research Centre, Department of Medicine, University of Melbourne, Heidelberg, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - David J Amor
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.,Royal Children's Hospital
| | - Michael S Hildebrand
- Epilepsy Research Centre, Department of Medicine, University of Melbourne, Heidelberg, VIC, 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
| | - Nicholas G Martin
- Queensland Institute for Medical Research, Berghofer Medical Research Institute, Brisbane, Australia
| | - Sheena Reilly
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
| | - Melanie Bahlo
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia
| | - Angela T Morgan
- Speech and Language, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Audiology and Speech Pathology, University of Melbourne, Parkville, VIC, Australia.,Royal Children's Hospital
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16
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Darmody T, O'Brian S, Rogers K, Onslow M, Jacobs C, McEwen A, Lowe R, Packman A, Menzies R. Stuttering, family history and counselling: A contemporary database. JOURNAL OF FLUENCY DISORDERS 2022; 73:105925. [PMID: 35998418 DOI: 10.1016/j.jfludis.2022.105925] [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: 03/15/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Information about genetic influence is useful to when counselling parents or caregivers who have infants and children at risk for stuttering. Yet, the most comprehensive family aggregate database to inform that counselling is nearly four decades old (Andrews et al., 1983). Consequently, the present study was designed to provide a contemporary exploration of the relationship between stuttering and family history. METHODS Data were sourced from the Australian Stuttering Research Centre, comprising 739 participants who presented for assessment, treatment, or investigation of stuttering. Reported family history data were acquired from pedigrees collected during assessment. We sought to establish the relation of the following variables to family history of stuttering: incidence, proband sex, parent sex, stuttering severity, age, reported age of stuttering onset, and impact of stuttering. Data were analysed with chi-square tests for independence, logistic and linear regression models. RESULTS Results were broadly consistent with existing data, but the following findings were novel. Males and females who stutter have the same increased odds of having a father who stutters relative to a mother who stutters. Males had later stuttering onset than females, with genetic involvement in this effect. There was a greater impact of stuttering for females than males with a family history of stuttering. CONCLUSION These findings have clinical applications. Speech-language pathologists may have infant or child clients known to them who are at risk of beginning to stutter. Information from the present study can be applied to counselling parents or caregivers of such children about stuttering and family history.
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Affiliation(s)
- Tara Darmody
- University of Technology Sydney, Graduate School of Health, NSW, Australia
| | - Sue O'Brian
- University of Technology Sydney, Australian Stuttering Research Centre, NSW, Australia
| | - Kris Rogers
- University of Technology Sydney, Graduate School of Health, NSW, Australia
| | - Mark Onslow
- University of Technology Sydney, Australian Stuttering Research Centre, NSW, Australia.
| | - Chris Jacobs
- University of Technology Sydney, Graduate School of Health, NSW, Australia
| | - Alison McEwen
- University of Technology Sydney, Graduate School of Health, NSW, Australia
| | - Robyn Lowe
- University of Technology Sydney, Australian Stuttering Research Centre, NSW, Australia
| | - Ann Packman
- University of Technology Sydney, Australian Stuttering Research Centre, NSW, Australia
| | - Ross Menzies
- University of Technology Sydney, Australian Stuttering Research Centre, NSW, Australia
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17
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O'Brian S, Jones M, Packman A, Onslow M, Menzies R, Lowe R, Cream A, Hearne A, Hewat S, Harrison E, Block S, Briem A. The Complexity of Stuttering Behavior in Adults and Adolescents: Relationship to Age, Severity, Mental Health, Impact of Stuttering, and Behavioral Treatment Outcome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2446-2458. [PMID: 35737907 DOI: 10.1044/2022_jslhr-21-00452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE This study investigated the complexity of stuttering behavior. It described and classified the complexity of stuttering behavior in relation to age, behavioral treatment outcomes, stuttering severity, anxiety-related mental health, impact of stuttering, and gender. METHOD For this study, a taxonomy was developed-LBDL-C7-which was based on the Lidcombe Behavioral Data Language of stuttering. It was used by five experienced judges to analyze the complexity of stuttering behavior for 84 adults and adolescents before and after speech restructuring treatment. Data were 3,100 stuttering moments, which were analyzed with nominal logistic regression. RESULTS The complexity of stuttering behavior appears not to change as a result of treatment, but it does appear to change with advancing age. Complexity of stuttering behavior was found to be independently associated with clinician stuttering severity scores but not with percentage of syllables stuttered or self-reported stuttering severity. Complexity of stuttering behavior was not associated with gender, anxiety, or impact of stuttering. CONCLUSION Clinical and research applications of these findings are discussed.
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Affiliation(s)
- Sue O'Brian
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Mark Jones
- Faculty of Health Sciences & Medicine, Bond University, Robina, Queensland, Australia
| | - Ann Packman
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Ross Menzies
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Robyn Lowe
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Angela Cream
- Sir Charles Gairdner Osborne Park Health Care Group, Osborne Park Hospital, Stirling, Western Australia, Australia
| | | | - Sally Hewat
- School of Humanities and Social Science, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Elisabeth Harrison
- Department of Linguistics, Macquarie University, Macquarie Park, New South Wales, Australia
| | - Susan Block
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Anne Briem
- LMU Klinikum, Ludwig Maximilian University of Munich, Germany
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18
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Koenraads SPC, Jansen PW, Baatenburg de Jong RJ, van der Schroeff MP, Franken MC. Bidirectional Associations of Childhood Stuttering With Behavior and Temperament. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4563-4579. [PMID: 34735297 DOI: 10.1044/2021_jslhr-20-00252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Behavior and temperament (e.g., emotional reactivity, self-regulation) have been considered relevant to stuttering and its developmental course, but the direction of this relation is still unknown. Knowledge of behavior difficulties and temperament in childhood stuttering can improve screening and intervention. The current study examined both directions of the relationship between stuttering and behavior difficulties and temperament and between persistent stuttering and behavior difficulties and temperament across childhood. METHOD This study was embedded in the Generation R Study, a population-based cohort from fetal life onward in the Netherlands. We analyzed data from 145 children (4.2%) with a history of stuttering (118 recovered, 27 persistent) and 3,276 children without such a history. Behavior and temperament were repeatedly assessed using parental questionnaires (Child Behavior Checklist) and Infant/Child Behavior Questionnaire between 0.5 and 9 years of age. Multiple logistic and linear regression analyses were performed. RESULTS Six-month-old children who were less able to "recover from distress," indicating poor self-regulation, were more likely to develop persistent stuttering later in childhood (odds ratio = 2.05, 95% confidence interval (CI) [1.03, 4.05], p = .04). In the opposite direction, children with a history of stuttering showed more negative affectivity (β = 0.19, 95% CI [0.02, 0.37], p = .03) at 6 years of age than children without such a history. Stuttering persistence was associated with increased internalizing behaviors (β = 0.38, 95% CI [0.03, 0.74], p = .04) and higher emotional reactivity (β = 0.53, 95% CI [0.09, 0.89], p = .02) at the age of 9 years. CONCLUSIONS Behavior and temperament were associated with stuttering persistency-seemingly as both predictor and consequence-but did not predict a history of stuttering. We suggest that children who persist in stuttering should be carefully monitored, and if behavioral or temperamental problems appear, treatment for these problems should be offered. Supplemental Material https://doi.org/10.23641/asha.16869479.
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Affiliation(s)
- Simone P C Koenraads
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Pauline W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands
| | - Robert Jan Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marc P van der Schroeff
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marie-Christine Franken
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
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19
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Park V, Onslow M, Lowe R, Jones M, O'Brian S, Packman A, Menzies RG, Block S, Wilson L, Harrison E, Hewat S. Psychological characteristics of early stuttering. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:622-631. [PMID: 33906547 DOI: 10.1080/17549507.2021.1912826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE The purpose of this study was to use psychological measures of pre-schoolers who stutter and their parents to inform causal theory development and influence clinical practices. This was done using data from a substantive clinical cohort of children who received early stuttering treatment. METHOD The cohort (N = 427) comprised parents and their children who were treated with the Lidcombe Program, the Westmead Program, and the Oakville Program. The study incorporated demographic information, stuttering severity, and child and parent psychological measures prior to treatment. RESULT The cohort revealed nothing unusual about behavioural and emotional functioning, or the temperaments, of pre-school children that would influence treatment, be targeted during treatment, or influence causal theory development. However, a third of parents were experiencing moderate to high life stressors at the time of seeking treatment, and half the parents failed first-stage screening for Anankastic Personality Disorder. CONCLUSION The present results are consistent with a number of previous reports that showed that the population of pre-schoolers who stutter have no unusual psychological profiles. Hence, these results suggest that the association between mental health and stuttering later in life is a consequence of the disorder rather than being a part of its cause. The finding of the life stress of parents who seek stuttering treatment for pre-school children has potential clinical importance and warrants further investigation. Further psychological research is required about parents of pre-school children who stutter, because half the parents in the cohort failed the screener for Anankastic Personality Disorder. This is of interest because a previous study associated screening failure for another personality disorder (Impulsive Personality Disorder) with treatment dropout for early childhood stuttering.
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Affiliation(s)
- Veronica Park
- Australian Stuttering Research Centre, The University of Sydney, Sydney, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, The University of Sydney, Sydney, Australia
| | - Robyn Lowe
- Australian Stuttering Research Centre, The University of Sydney, Sydney, Australia
| | - Mark Jones
- School of Population Health, The University of Queensland, St Lucia, Australia
| | - Sue O'Brian
- Australian Stuttering Research Centre, The University of Sydney, Sydney, Australia
| | - Ann Packman
- Australian Stuttering Research Centre, The University of Sydney, Sydney, Australia
| | - Ross G Menzies
- Australian Stuttering Research Centre, The University of Sydney, Sydney, Australia
| | - Susan Block
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Linda Wilson
- School of Community Health, Charles Sturt University, Albury, Australia
| | | | - Sally Hewat
- School of Humanities and Social Science, The University of Newcastle, Callaghan, Australia
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20
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Sjøstrand Å, Kefalianos E, Hofslundsengen H, Guttormsen LS, Kirmess M, Lervåg A, Hulme C, Bottegaard Næss KA. Non-pharmacological interventions for stuttering in children six years and younger. Cochrane Database Syst Rev 2021; 9:CD013489. [PMID: 34499348 PMCID: PMC8428330 DOI: 10.1002/14651858.cd013489.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Stuttering, or stammering as it is referred to in some countries, affects a child's ability to speak fluently. It is a common communication disorder, affecting 11% of children by four years of age. Stuttering can be characterized by sound, part word or whole word repetitions, sound prolongations, or blocking of sounds or airflow. Moments of stuttering can also be accompanied by non-verbal behaviours, including visible tension in the speaker's face, eye blinks or head nods. Stuttering can also negatively affect behavioural, social and emotional functioning. OBJECTIVES Primary objective To assess the immediate and long-term effects of non-pharmacological interventions for stuttering on speech outcomes, communication attitudes, quality of life and potential adverse effects in children aged six years and younger. Secondary objective To describe the relationship between intervention effects and participant characteristics (i.e. child age, IQ, severity, sex and time since stuttering onset) at pretest. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO, nine other databases and two trial registers on 16 September 2020, and Open Grey on 20 October 2020. There were no limits in regards to language, year of publication or type of publication. We also searched the reference lists of included studies and requested data on unpublished trials from authors of published studies. We handsearched conference proceedings and programmes from relevant conferences. SELECTION CRITERIA We included randomized controlled trials (RCTs) and quasi-RCTs that assessed non-pharmacological interventions for stuttering in young children aged six years and younger. Eligible comparators were no intervention, wait list or management as usual. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We identified four eligible RCTs, all of which compared the Lidcombe Program to a wait-list control group. In total, 151 children aged between two and six years participated in the four included studies. In the Lidcombe Program, the parent and their child visit a speech and language therapist (SLT) in a clinic. One study conducted clinic visits by telephone. In each clinic visit, parents were taught how to conduct treatment at home. Two studies took place in Australia, one in New Zealand and one in Germany. Two studies were conducted for nine months, one for 16 weeks and one for 12 weeks. The frequency of clinic visits and practice sessions at home varied within the programme. One study was partially funded by the Rotary Club, Wiesbaden, Germany; and one was funded by the National Health and Medical Research Council of Australia. One study did not report funding sources and another reported that they did not receive any funding for the trial. All four studies reported the outcome of stuttering frequency. One study also reported on speech efficiency, defined as articulation rate. No studies reported the other predetermined outcomes of this review, namely stuttering severity; communication attitudes; emotional, cognitive or psychosocial domains; or adverse effects. The Lidcombe Program resulted in a lower stuttering frequency percentage syllables stuttered (% SS) than a wait-list control group at post-test, 12 weeks, 16 weeks and nine months postrandomization (mean difference (MD) -2.16, 95% confidence interval (CI) -3.48 to -0.84, 4 studies, 151 participants; P = 0.001; very low-certainty evidence). However, as the Lidcombe Program is designed to take one to two years to complete, none of the participants in these studies had finished the complete intervention programme at any of the data collection points. We assessed stuttering frequency to have a high risk of overall bias due to high risk of bias in at least one domain within three of four included studies, and to have some concern of overall bias in the fourth, due to some concern in at least one domain. We found moderate-certainty evidence from one study showing that the Lidcombe Program may increase speech efficiency in young children. Only one study reported outcomes at long-term follow-up. The long-term effect of intervention could not be summarized, as the results for most of the children in the control group were missing. However, a within-group comparison was performed between the mean % SS at randomization and the mean % SS at the time of extended follow-up, and showed a significant reduction in frequency of stuttering. AUTHORS' CONCLUSIONS: This systematic review indicates that the Lidcombe Program may result in lower stuttering frequency and higher speech efficiency than a wait-list control group in children aged up to six years at post-test. However, these results should be interpreted with caution due to the very low and moderate certainty of the evidence and the high risk of bias identified in the included studies. Thus, there is a need for further studies from independent researchers, to evaluate the immediate and long-term effects of other non-pharmacological interventions for stuttering compared to no intervention or a wait-list control group.
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Affiliation(s)
- Åse Sjøstrand
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Elaina Kefalianos
- Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Australia
| | - Hilde Hofslundsengen
- Department of Language, Literature, Mathematics and Interpreting, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Linn S Guttormsen
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Melanie Kirmess
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Arne Lervåg
- Department of Education, University of Oslo, Oslo, Norway
| | - Charles Hulme
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- Department of Education, University of Oxford, Oxford, UK
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21
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Walsh B, Christ S, Weber C. Exploring Relationships Among Risk Factors for Persistence in Early Childhood Stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2909-2927. [PMID: 34260279 PMCID: PMC8740747 DOI: 10.1044/2021_jslhr-21-00034] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/13/2021] [Accepted: 04/07/2021] [Indexed: 05/31/2023]
Abstract
Purpose The purpose of this study is to investigate how epidemiological and clinical factors collectively predict whether a preschooler who is stuttering will persist or recover and to provide guidance on how clinicians can use these factors to evaluate a child's risk for stuttering persistence. Method We collected epidemiological and clinical measures from 52 preschoolers (M = 54.4 months, SD = 6.7 months; 38 boys and 14 girls) diagnosed as stuttering. We then followed these children longitudinally to document whether they eventually recovered or persisted in stuttering. Risk factors found to be significantly associated with stuttering persistence were used to build single and multiple variable predictive statistical models. Finally, we assessed each model's prediction capabilities by recording how accurate a model was in predicting a child's stuttering outcome-persisting or recovered. Results We found that a positive family history of stuttering, poorer performance on a standardized articulation/phonological assessment, higher frequency of stuttering-like disfluencies during spontaneous speech, and lower accuracy on a nonword repetition task were all significantly associated with an increased probability of persistence. The interaction between family history of stuttering and nonword repetition performance was also significant. The full multiple regression model incorporating all these risk factors resulted in the best fitting model with the highest predictive accuracy and lowest error rate. Conclusions For the first time, we show how multiple risk factors collectively predict the probability of stuttering persistence in 3- to 5-year-old preschool children who stutter. Using the full combination of risk factors to assess preschoolers who stutter yielded more accurate predictions of persistence compared to sparser models. A better understanding of the factors that underlie stuttering persistence will yield insight into the underpinnings of chronic stuttering and will help identify etiological targets for novel treatment approaches.
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Affiliation(s)
- Bridget Walsh
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Sharon Christ
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN
| | - Christine Weber
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
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22
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Sugathan N, Maruthy S. Predictive factors for persistence and recovery of stuttering in children: A systematic review. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:359-371. [PMID: 32933336 DOI: 10.1080/17549507.2020.1812718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The purpose of this study was to systematically review the available literature on various factors that can predict the persistence and recovery of stuttering in children. METHOD An electronic search yielded a total of 35 studies, which considered 44 variables that can be potential factors for predicting persistence and recovery. RESULT Among 44 factors studied, only four factors- phonological abilities, articulatory rate, change in the pattern of disfluencies, and trend in stuttering severity over one-year post-onset were identified to be replicated predictors of recovery of the stuttering. Several factors, such as differences in the second formant transition between fluent and disfluent speech, articulatory rate measured in phones/sec, etc., were observed to predict the future course of stuttering. However, these factors lack replicated evidence as predictors. CONCLUSION There is clear support only for limited factors as reliable predictors. Also, it is observed to be too early to conclude on several replicated factors due to differences in the age group of participants, participant sample size, and the differences in tools used in research that lead to mixed findings as a predictive factor. Hence there is a need for systematic and replicated testing of the factors identified before initiating their use for clinical purposes.
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Affiliation(s)
- Nirmal Sugathan
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, India
| | - Santosh Maruthy
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, Mysuru, India
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23
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Mollaei F, Mersov A, Woodbury M, Jobst C, Cheyne D, De Nil L. White matter microstructural differences underlying beta oscillations during speech in adults who stutter. BRAIN AND LANGUAGE 2021; 215:104921. [PMID: 33550120 DOI: 10.1016/j.bandl.2021.104921] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/14/2020] [Accepted: 01/18/2021] [Indexed: 06/12/2023]
Abstract
The basal ganglia-thalamocortical (BGTC) loop may underlie speech deficits in developmental stuttering. In this study, we investigated the relationship between abnormal cortical neural oscillations and structural integrity alterations in adults who stutter (AWS) using a novel magnetoencephalography (MEG) guided tractography approach. Beta oscillations were analyzed using sensorimotor speech MEG, and white matter pathways were examined using tract-based spatial statistics (TBSS) and probabilistic tractography in 11 AWS and 11 fluent speakers. TBSS analysis revealed overlap between cortical regions of increased beta suppression localized to the mouth motor area and a reduced fractional anisotropy (FA) in the AWS group. MEG-guided tractography showed reduced FA within the BGTC loop from left putamen to subject-specific MEG peak. This is the first study to provide evidence that structural abnormalities may be associated with functional deficits in stuttering and reflect a network deficit within the BGTC loop that includes areas of the left ventral premotor cortex and putamen.
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Affiliation(s)
- Fatemeh Mollaei
- Department of Speech-Language Pathology, University of Toronto, 500 University Street, Toronto, Ontario M5G 1V7, Canada; Program in Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada.
| | - Anna Mersov
- Department of Speech-Language Pathology, University of Toronto, 500 University Street, Toronto, Ontario M5G 1V7, Canada
| | - Merron Woodbury
- Program in Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada
| | - Cecilia Jobst
- Program in Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada
| | - Douglas Cheyne
- Department of Speech-Language Pathology, University of Toronto, 500 University Street, Toronto, Ontario M5G 1V7, Canada; Program in Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada; Institute of Medical Sciences and Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5S 2J7, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario M5T 1W7, Canada
| | - Luc De Nil
- Department of Speech-Language Pathology, University of Toronto, 500 University Street, Toronto, Ontario M5G 1V7, Canada; Rehabilitation Sciences Institute, Toronto, Ontario M5G 1V7, Canada
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24
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Kikuchi Y, Umezaki T, Adachi K, Sawatsubashi M, Taura M, Yamaguchi Y, Tsuchihashi N, Murakami D, Nakagawa T. Awareness of stuttering in Japanese children aged 3-7 years. Pediatr Int 2021; 63:150-153. [PMID: 32692895 DOI: 10.1111/ped.14405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/26/2020] [Accepted: 07/15/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Boey et al. (2009) devised a questionnaire for measuring children's awareness of stuttering and showed that even very young children were often aware of their stuttering. There has been no replication of studies using Boey et al.'s parent-reported questionnaire. The aim of this study was to test whether using Boey et al.'s seven questions, developed for a Dutch speaking population could be effective for measuring the awareness of stuttering in Japanese children. METHODS Participants were 54 children who stutter (CWS) aged 3-7 years. Parents answered seven questions about their child's awareness of stuttering according to the questions developed Boey et al. RESULTS: Parental-reported observations of the child responses citing at least one awareness incident were 76%. The percentage of stuttering children with awareness of their own speech difficulties, according to chronological age, were as follows: 70% at age 3 years; 67% at age 4 years; 75% at age 5 years; 81% at age 6 years; and 90% at age 7 years. CONCLUSIONS We found that even at age 3 years, many CWS were already aware of their stuttering. The similarity of the data with the seminal study by Boey et al. suggests that the question-based assessment is reproducible even in a country with a different spoken language. The seven questions in Boey et al. are useful for evaluating whether children's awareness of stuttering could contribute to a clinical decision as well as stuttering severity.
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Affiliation(s)
- Yoshikazu Kikuchi
- 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
| | - Kazuo Adachi
- Voice and Swallowing Center, Fukuoka Sanno Hospital, Fukuoka, Japan.,Adachi Otorhinolaryngology Clinic, Fukuoka, Japan
| | - Motohiro Sawatsubashi
- Department of Otorhinolaryngology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Masahiko Taura
- Department of Otorhinolaryngology, Fukuoka University Hospital, Fukuoka, Japan
| | - Yumi Yamaguchi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nana Tsuchihashi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Murakami
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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25
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Karahan Tığrak T, Kulak Kayıkcı ME, Kirazlı MÇ, Tığrak A. Emotional and behavioural problems of children and adolescents who stutter: Comparison with typically developing peers. LOGOP PHONIATR VOCO 2020; 46:186-192. [PMID: 33355015 DOI: 10.1080/14015439.2020.1855472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE There are several studies showing contradictory results on concurrent emotional and behavioural problems of children and adolescents who stutter (CAWS). This study aimed to identify whether there is a difference between Turkish-speaking CAWS and their typically developing peers (TDP) in emotional and behavioural problems. METHODS The study group consisted of 45 CAWS, aged between 3.40 and 15.92 years, and the control group consisted of 45 TDP, aged between 3.15 and 16.80 years. Participants were divided into three age groups: early childhood (0-6 years), middle childhood (7-11 years) and adolescence (12-18 years). CAWS and TDP were compared separately in each age group with Mann-Whitney U tests. Assessments of emotional and behavioural problems were conducted with the Child Behaviour Checklist (CBCL) for Ages 1.5-5 and the CBCL for Ages 6-18. RESULTS In early childhood, CAWS had significantly higher emotional reactivity, anxiety/depression, somatic complaints, withdrawal, sleep problems, attention problems and aggressive behaviour scores than TDP. In middle childhood and adolescence, CAWS had significantly higher anxiety/depression, withdrawal/depression, social problems, attention problems, rule-breaking behaviour and aggressive behaviour scores compared to TDP. In adolescence, somatic problems and thought problems scores were also significantly higher in AWS than TDP. CONCLUSIONS We concluded that emotional and behavioural problems associated with stuttering are noticeable from early childhood to adolescence. Cooperation with mental health professionals may be needed to improve the quality of speech therapy in CAWS.
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Affiliation(s)
| | | | | | - Arcan Tığrak
- Department of Primary Education, Kütahya Dumlupınar University, Kütahya, Turkey
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26
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Singer CM, Hessling A, Kelly EM, Singer L, Jones RM. Clinical Characteristics Associated With Stuttering Persistence: A Meta-Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2995-3018. [PMID: 32772868 PMCID: PMC7890223 DOI: 10.1044/2020_jslhr-20-00096] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/01/2020] [Accepted: 06/03/2020] [Indexed: 05/07/2023]
Abstract
Purpose The purpose of this meta-analytic study was to identify clinical characteristics, defined as child factors that can be assessed by a speech-language pathologist as part of a routine speech-language evaluation that may differentiate children who persist in stuttering from children who eventually recover from stuttering. Clinical characteristics explored included sex, age at onset, family history of stuttering, stuttering frequency and severity, speech-language skills, and temperament. Method Studies were identified through electronic databases, journals, and reference lists of relevant reports (e.g., research articles). Eligible studies followed young children who stutter (i.e., under 6 years old) for at least 24 months, assessed a potential clinical marker at study entry, and determined talker group classification (i.e., persistent or recovered) at study completion. Sex and family history differences were estimated using risk ratios; all other differences were estimated using Hedges's g. Heterogeneity and methodological differences among studies were evaluated. Results Eleven studies (41 reports) met eligibility criteria. Persistent children were older at stuttering onset and exhibited higher frequencies of stuttering-like disfluencies, lower speech sound accuracy, and lower expressive and receptive language skills than recovered children. Males and children with a family history of stuttering were also more likely to persist. Conclusions Clinical characteristics were identified that are associated with increased risk for stuttering persistence. Future studies have the potential to translate these clinical characteristics into prognostic markers for stuttering persistence risk.
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Affiliation(s)
- Cara M. Singer
- Department of Communication Sciences and Disorders, Grand Valley State University, Grand Rapids, MI
| | - Alison Hessling
- Department of Communication Sciences and Disorders, Baylor University, Waco, TX
| | - Ellen M. Kelly
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
| | - Lisa Singer
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA
| | - Robin M. Jones
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
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27
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Tumanova V, Woods C, Razza R. The Role of Behavioral Inhibition for Conversational Speech and Language Characteristics of Preschool-Age Children Who Stutter. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:638-651. [PMID: 32073287 DOI: 10.1044/2019_ajslp-19-00026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The purpose of this study was to investigate whether preschool-age children who stutter (CWS) were more likely to exhibit a temperamental trait of behavioral inhibition (BI), a correlate of shyness, than children who do not stutter (CWNS) and whether this temperamental trait affected preschool-age children's speech fluency and language complexity during a conversation with an unfamiliar adult. Method Sixty-eight preschool-age children (31 CWS, 37 CWNS) participated. The degree of BI was assessed by measuring the latency to their sixth spontaneous comment and the number of all spontaneous comments during a conversation with an unfamiliar examiner (following Kagan et al.'s [1987] methodology). Parent report of shyness from the Children's Behavior Questionnaire served as an indirect measure of BI. Children's language complexity was assessed by measuring their mean length of utterance and the number of words spoken. For CWS, the frequency of stuttering and the negative impact of stuttering were also assessed. Results First, we found no between-group differences in the degree of BI across the behavioral observation measures. However, CWS were rated shyer by parents than CWNS. Second, for CWS only, higher BI was associated with less complex utterances and fewer words spoken. Third, for CWS, higher BI was associated with fewer stuttered disfluencies produced. Conclusions This study provides empirical evidence that BI to the unfamiliar may have salience for childhood stuttering as it affected the quantity and quality of language spoken with an unfamiliar adult. Clinical implications of high BI for the assessment and treatment of preschool-age stuttering are discussed.
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Affiliation(s)
- Victoria Tumanova
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | - Carly Woods
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | - Rachel Razza
- Department of Human Development and Family Studies, Syracuse University, NY
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28
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Luckman C, Wagovich SA, Weber C, Brown B, Chang SE, Hall NE, Bernstein Ratner N. Lexical diversity and lexical skills in children who stutter. JOURNAL OF FLUENCY DISORDERS 2020; 63:105747. [PMID: 32058092 PMCID: PMC7065723 DOI: 10.1016/j.jfludis.2020.105747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 01/03/2020] [Accepted: 01/20/2020] [Indexed: 05/24/2023]
Abstract
PURPOSE Numerous "small N" studies of language ability in children who stutter have produced differing conclusions. We combined test and spontaneous language data from a large cohort of children who stutter (CWS) and typically fluent peers, gathered from independent laboratories across the US, to appraise a variety of lexical measures. METHOD Standardized receptive and expressive vocabulary test data and spontaneous language samples from 99 pairs of CWS (ages 25-100 months), and age-, gender-, and SES-matched children who do not stutter (CWNS) were compared. Language sample transcripts were analyzed with four measures of lexical diversity. Correlations between lexical diversity measures and expressive vocabulary scores were also calculated. RESULTS On standardized tests of both receptive and expressive vocabulary, there were significant differences between CWS and CWNS. In contrast, on spontaneous language measures of lexical diversity, CWS did not differ in their lexical diversity, across analyses, compared to CWNS. Three of the four lexical diversity analyses, MATTR, VocD, and NDW, were significantly correlated with each other. CONCLUSIONS We were able to confirm prior findings of relative disadvantage on standardized vocabulary tests for a very large sample of well-matched CWS. However, spontaneous language measures of lexical diversity did not distinguish the groups. This relative weakness in CWS may emerge from task differences: CWS are free to encode their own spontaneous utterances but must comply with explicit lexical prompts in standardized testing situations.
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Affiliation(s)
- Courtney Luckman
- Department of Hearing and Speech Sciences, University of Maryland, College Park, MD, 20742, United States.
| | - Stacy A Wagovich
- Department of Speech, Language and Hearing Sciences, University of Missouri, Columbia, MO, 65211, United States
| | - Christine Weber
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, 47907, United States
| | - Barbara Brown
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, 47907, United States
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Nancy E Hall
- Department of Communication Sciences and Disorders, University of Maine, Orono, ME, 04469, United States
| | - Nan Bernstein Ratner
- Department of Hearing and Speech Sciences, University of Maryland, College Park, MD, 20742, United States.
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29
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Ntourou K, DeFranco EO, Conture EG, Walden TA, Mushtaq N. A parent-report scale of behavioral inhibition: Validation and application to preschool-age children who do and do not stutter. JOURNAL OF FLUENCY DISORDERS 2020; 63:105748. [PMID: 32065916 PMCID: PMC7061916 DOI: 10.1016/j.jfludis.2020.105748] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 12/02/2019] [Accepted: 01/03/2020] [Indexed: 05/27/2023]
Abstract
PURPOSE This two-part (i.e., Study 1, Study 2) study investigated behavioral inhibition (BI) in preschool-age children who do (CWS) and do not (CWNS) stutter. The purpose of Study 1 was to develop the Short Behavioral Inhibition Scale (SBIS), a parent-report scale of BI. The purpose of Study 2 was to determine, based on the SBIS, differences in BI between CWS and CWNS, and associations between BI and CWS's stuttering frequency, stuttering severity, speech-associated attitudes, and stuttering-related consequences/reactions. METHOD Participants in Study 1 were 225 CWS and 243 CWNS with the majority of them being included in Study 2. In Study 2, a speech sample was obtained for the calculation of stuttering frequency and severity, and the parents of a subset of CWS completed the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (Vanryckeghem & Brutten, 2007), and the Test of Childhood Stuttering Disfluency-Related Consequences Rating Scale (Gillam, Logan, & Pearson, 2009). RESULTS Study 1 analyses indicated that SBIS is a valid and reliable tool whose items assess a single, relatively homogeneous construct. In Study 2, CWS exhibited greater mean and extreme BI tendencies than CWNS. Also CWS with higher, compared to CWS with lower, BI presented with greater stuttering frequency, more severe stuttering, greater stuttering-related consequences, and more negative communication attitudes (for CWS older than 4 years of age). CONCLUSION Findings were taken to suggest that BI is associated with early childhood stuttering and that the SBIS could be included as part of a comprehensive evaluation of stuttering.
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Affiliation(s)
- Katerina Ntourou
- Department of Speech and Hearing Sciences, Vanderbilt University, United States.
| | - Elizabeth Oyler DeFranco
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, United States
| | - Edward G Conture
- Department of Speech and Hearing Sciences, Vanderbilt University, United States
| | - Tedra A Walden
- Department of Psychology and Human Development, Department of Speech and Hearing Sciences, Vanderbilt University, United States
| | - Nasir Mushtaq
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, United States
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30
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Unicomb R, Kefalianos E, Reilly S, Cook F, Morgan A. Prevalence and features of comorbid stuttering and speech sound disorder at age 4 years. JOURNAL OF COMMUNICATION DISORDERS 2020; 84:105976. [PMID: 32092590 DOI: 10.1016/j.jcomdis.2020.105976] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 12/17/2019] [Accepted: 02/09/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Stuttering and speech sound disorder may co-occur during early childhood, although the exact rate of comorbidity in a community-cohort sample remains unknown. In isolation, both disorders have the potential for long-term negative effects. Comorbidity rates of 16%-46% reported in previous studies were based on parent report, speech-language therapist surveys, case file audits or direct observation studies from clinical samples. Rigorous methodology utilising a prospective, longitudinal community-cohort design is required to support these previous findings. AIMS First, to identify the proportion of children with comorbid stuttering and speech sound disorder at 4 years of age drawn from a community-cohort study. Second, to compare demographic and clinical features of this comorbid diagnosis group compared to children with no diagnosis of either disorder, or those with either disorder in isolation. METHODS & PROCEDURES Participants were drawn from a prospective, longitudinal community cohort study (the Early Language in Victoria Study) at 4 years of age (n = 1607). Demographic and clinical features for comparison were theoretically driven and included: gender, birth history, feeding status, speech and language status, family history of communication difficulties, maternal education, maternal vocabulary, maternal mental health and socioeconomic status. OUTCOMES & RESULTS Of the 160 children diagnosed with stuttering between 2 and 4 years of age, 6.88 % (n = 11) also had a speech sound disorder. Given the small sample size and number of comparisons performed, there was insufficient evidence to rule out that group differences observed were not simply due to chance. CONCLUSIONS & IMPLICATIONS The prevalence of comorbid stuttering and speech sound disorder was lower in a community cohort compared to that reported in clinical studies. Higher rates reported in clinical samples may be due to increased parental help-seeking behaviour when the two disorders co-occur. Subsequently, these children may present to clinics more frequently. Accurate representation of prevalence allows for population specific research on best practice assessment and intervention. Currently little is known about how best to manage this caseload, therefore more research is required in this area, including the determination of prognostic variables to provide efficient and effective management.
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Affiliation(s)
- Rachael Unicomb
- Discipline of Speech Pathology, The University of Newcastle, Australia.
| | - Elaina Kefalianos
- Department of Audiology and Speech Pathology, The University of Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia
| | - Sheena Reilly
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia; Murdoch Children's Research Institute, Melbourne, Australia
| | - Fallon Cook
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Angela Morgan
- Department of Audiology and Speech Pathology, The University of Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia
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Chang SE, Guenther FH. Involvement of the Cortico-Basal Ganglia-Thalamocortical Loop in Developmental Stuttering. Front Psychol 2020; 10:3088. [PMID: 32047456 PMCID: PMC6997432 DOI: 10.3389/fpsyg.2019.03088] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 12/31/2019] [Indexed: 01/14/2023] Open
Abstract
Stuttering is a complex neurodevelopmental disorder that has to date eluded a clear explication of its pathophysiological bases. In this review, we utilize the Directions Into Velocities of Articulators (DIVA) neurocomputational modeling framework to mechanistically interpret relevant findings from the behavioral and neurological literatures on stuttering. Within this theoretical framework, we propose that the primary impairment underlying stuttering behavior is malfunction in the cortico-basal ganglia-thalamocortical (hereafter, cortico-BG) loop that is responsible for initiating speech motor programs. This theoretical perspective predicts three possible loci of impaired neural processing within the cortico-BG loop that could lead to stuttering behaviors: impairment within the basal ganglia proper; impairment of axonal projections between cerebral cortex, basal ganglia, and thalamus; and impairment in cortical processing. These theoretical perspectives are presented in detail, followed by a review of empirical data that make reference to these three possibilities. We also highlight any differences that are present in the literature based on examining adults versus children, which give important insights into potential core deficits associated with stuttering versus compensatory changes that occur in the brain as a result of having stuttered for many years in the case of adults who stutter. We conclude with outstanding questions in the field and promising areas for future studies that have the potential to further advance mechanistic understanding of neural deficits underlying persistent developmental stuttering.
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Affiliation(s)
- Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Department of Radiology, Cognitive Imaging Research Center, Michigan State University, East Lansing, MI, United States
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, United States
| | - Frank H. Guenther
- Department of Speech, Language and Hearing Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
- Department of Biomedical Engineering, Boston University, Boston, MA, United States
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA, United States
- Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United States
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32
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Benito-Aragón C, Gonzalez-Sarmiento R, Liddell T, Diez I, d'Oleire Uquillas F, Ortiz-Terán L, Bueichekú E, Chow HM, Chang SE, Sepulcre J. Neurofilament-lysosomal genetic intersections in the cortical network of stuttering. Prog Neurobiol 2020; 184:101718. [PMID: 31669185 PMCID: PMC6938554 DOI: 10.1016/j.pneurobio.2019.101718] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 08/03/2019] [Accepted: 10/12/2019] [Indexed: 02/02/2023]
Abstract
The neurobiological underpinnings of stuttering, a speech disorder characterized by disrupted speech fluency, remain unclear. While recent developments in the field have afforded researchers the ability to pinpoint several genetic profiles associated with stuttering, how these specific genetic backgrounds impact neuronal circuits and how they generate or facilitate the emergence of stuttered speech remains unknown. In this study, we identified the large-scale cortical network that characterizes stuttering using functional connectivity MRI and graph theory. We performed a spatial similarity analysis that examines whether the topology of the stuttering cortical network intersects with genetic expression levels of previously reported genes for stuttering from the protein-coding transcriptome data of the Allen Human Brain Atlas. We found that GNPTG - a gene involved in the mannose-6-phosphate lysosomal targeting pathways - was significantly co-localized with the stuttering cortical network. An enrichment analysis demonstrated that the genes identified with the stuttering cortical network shared a significantly overrepresented biological functionality of Neurofilament Cytoskeleton Organization (NEFH, NEFL and INA). The relationship between lysosomal pathways, cytoskeleton organization, and stuttering, was investigated by comparing the genetic interactome between GNPTG and the neurofilament genes implicated in the current study. We found that genes of the interactome network, including CDK5, SNCA, and ACTB, act as functional links between lysosomal and neurofilament genes. These findings support the notion that stuttering is due to a lysosomal dysfunction, which has deleterious effects on the neurofilament organization of the speech neuronal circuits. They help to elucidate the intriguing, unsolved link between lysosomal mutations and the presence of stuttering.
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Affiliation(s)
- Claudia Benito-Aragón
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; University of Navarra School of Medicine, University of Navarra, Pamplona, Navarra, Spain
| | - Ricardo Gonzalez-Sarmiento
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; University of Navarra School of Medicine, University of Navarra, Pamplona, Navarra, Spain
| | - Thomas Liddell
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; University of Exeter, Exeter, England, UK
| | - Ibai Diez
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Neurotechnology Laboratory, Tecnalia Health Department, Tecnalia, Derio, Basque Country, Spain
| | - Federico d'Oleire Uquillas
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Laura Ortiz-Terán
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Elisenda Bueichekú
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Neuropsychology and Functional Neuroimaging Group, Department of Basic Psychology, Universitat Jaume I, Castellón, Spain
| | - Ho Ming Chow
- Department of Psychiatry, University of Michigan, Michigan, USA; Katzin Diagnostic and Research PET/MRI Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Michigan, USA; Cognitive Imaging Research Center, Department of Radiology, Michigan State University, East Lansing, MI, USA
| | - Jorge Sepulcre
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
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Tendera A, Rispoli M, Senthilselvan A, Loucks TM. Early Speech Rate Development: A Longitudinal Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:4370-4381. [PMID: 31830834 DOI: 10.1044/2019_jslhr-19-00145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Our knowledge of speech rate development remains inadequate because of limited longitudinal data and lack of data from children under age 3;0 (years;months). The purpose of this longitudinal study was to test the pattern of speech rate development between ages 2;0 and 3;0. Method Speech rate was assessed at 4 time points between ages 2;0 and 3;0. The analysis employed multilevel models to characterize the development of speech rate (syllables per second), phonemes per second (PPS), length of active declarative sentences, and mean length of utterance. Results The results indicate a significant linear increase in speech rate, PPS, length of active declarative sentences, and mean length of utterance occurring over the 1-year period. Male and female children differed in speech rate, PPS, and utterance length, suggesting sex is a potential factor in early speech rate development. Conclusions Our findings indicate that the speech motor system develops rapidly during the period when grammar emerges. Speech rate has the potential to be an important metric for understanding typical speech development and speech disorders.
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Affiliation(s)
- Anna Tendera
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Matthew Rispoli
- Department of Speech and Hearing Science, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign
| | | | - Torrey M Loucks
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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Sjøstrand Å, Kefalianos E, Hofslundsengen H, Guttormsen LS, Kirmess M, Lervåg A, Hulme C, Naess KAB. Non-pharmacological interventions for stuttering in children aged between birth and six years. Hippokratia 2019. [DOI: 10.1002/14651858.cd013489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Åse Sjøstrand
- University of Oslo; Department of Special Needs Education; Mail box 1140 Blindern Oslo Norway 0318
| | - Elaina Kefalianos
- University of Melbourne; Department of Audiology and Speech Pathology; 550 Swanston Street Parkville Victoria Australia 3052
| | - Hilde Hofslundsengen
- Western Norway University of Applied Sciences; Faculty of Education, Arts and Sports; Pb. 133 Sogndal Norway 6856
| | - Linn S Guttormsen
- University of Oslo; Department of Special Needs Education; Mail box 1140 Blindern Oslo Norway 0318
| | - Melanie Kirmess
- University of Oslo; Department of Special Needs Education; Mail box 1140 Blindern Oslo Norway 0318
| | - Arne Lervåg
- University of Oslo; Department of Education; Mail box 1140 Blindern Sem Saelandsvei 7 Oslo Norway 0318
| | - Charles Hulme
- University of Oslo; Department of Special Needs Education; Mail box 1140 Blindern Oslo Norway 0318
- University of Oxford; Department of Education; 15 Norham Gardens Oxford UK OX2 6PY
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Rocha MS, Yaruss JS, Rato JR. Temperament, Executive Functioning, and Anxiety in School-Age Children Who Stutter. Front Psychol 2019; 10:2244. [PMID: 31636587 PMCID: PMC6788391 DOI: 10.3389/fpsyg.2019.02244] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 09/19/2019] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to examine temperament dimensions, executive functioning ability, and anxiety levels in school-age children who stutter and their non-stuttering peers. Participants were 100 Portuguese children aged 7 to 12 years (M = 9.13; SD = 1.70), including 50 children who stutter and 50 children who do not stutter. Analyses, which were performed separately for younger and older participants, sought to identify correlations between key variables. Temperament was evaluated through a parent questionnaire, executive functioning was evaluated through children’s responses on a performance test, and anxiety level was assessed through a self-perception scale. On the temperament measure, comparisons between children who stutter and their non-stuttering peers revealed that older children who stutter exhibited significantly higher scores on the Anger/Frustration, Impulsivity, and Sadness subscales, and lower averages on the Attention/Focusing, Perceptual sensitivity, and Soothability/Falling Reactivity subscales. On the executive functioning task, comparisons revealed that the group of younger children who stutter exhibited significantly higher average execution times than their non-stuttering peers. There were no statistically significant differences in anxiety between children who stutter and children who do not stutter, and there were no statistically significant correlations between temperament factors and measures of executive functioning. Children who stutter experienced lower ability to orient attention and greater emotional reactivity compared with their non-stuttering peers. Significant correlations were found between executive functioning and age and among the temperament factors themselves. These results, which support the need for a multidimensional view of stuttering, were interpreted in the context of the Dual Diathesis – Stressor model. Findings indicate that temperament and executive functioning abilities may contribute to the development of stuttering.
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Affiliation(s)
- Mónica Soares Rocha
- Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal
| | - J Scott Yaruss
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, United States
| | - Joana R Rato
- Centre for Interdisciplinary Research in Health, Catholic University of Portugal, Lisbon, Portugal
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Lucey J, Evans D, Maxfield ND. Temperament in Adults Who Stutter and Its Association With Stuttering Frequency and Quality-of-Life Impacts. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:2691-2702. [PMID: 31318628 PMCID: PMC6802908 DOI: 10.1044/2019_jslhr-s-18-0225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/14/2018] [Accepted: 05/02/2019] [Indexed: 06/10/2023]
Abstract
Purpose The study aim was to determine whether self-reported temperament traits differentiate adults who stutter (AWS) from adults who do not stutter (AWNS). Additionally, associations between temperament and stuttering frequency, and between temperament and quality of life impacts of stuttering, were investigated in AWS. Method Self-reported temperament traits were documented for 33 AWS and 43 AWNS using the Adult Temperament Questionnaire (ATQ; Evans & Rothbart, 2007). Quality-of-life impacts of stuttering were assessed using the Overall Assessment of the Speaker's Experience with Stuttering (Yaruss & Quesal, 2010). Stuttering frequency was calculated from 100-word monologue and reading samples. Results A between-groups difference in scores on the ATQ Positive Affect subscale was nominally significant (i.e., before correcting for multiple tests) and also approached statistical significance after Bonferroni correction. Positive Affect scores were lower for AWS, and the size of this trending effect was moderate. Within AWS, a statistically significant positive correlation was found between impact scores on the General Information section of the Overall Assessment of the Speaker's Experience with Stuttering and ATQ Frustration subscale scores after Bonferroni correction. No associations were detected between temperament traits and stuttering frequency. Conclusions Results reveal a nontrivial tendency for AWS to experience decreased positive affect compared to AWNS. In addition, increased frustration was found to be associated with reduced general knowledge about stuttering in AWS. Neither effect has been previously reported for adults or children who stutter. Finally, self-reported temperament traits were not found to vary with stuttering frequency in adults, consistent with previous results for AWS.
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Affiliation(s)
- Jaclyn Lucey
- Department of Communication Sciences & Disorders, University of South Florida, Tampa
| | - David Evans
- Departments of Oncologic Sciences and Psychology, University of South Florida, Tampa
- Moffitt Cancer Center, Tobacco Research & Intervention Program, Tampa, FL
| | - Nathan D. Maxfield
- Department of Communication Sciences & Disorders, University of South Florida, Tampa
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Nippold MA. Language development in children who stutter: A review of recent research. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 21:368-376. [PMID: 29642734 DOI: 10.1080/17549507.2018.1457721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 02/22/2018] [Accepted: 03/22/2018] [Indexed: 06/08/2023]
Abstract
Purpose: This article reviews recent studies that examined the controversial claim that children who stutter (CWS), as a group, have weaker language skills than children who do not stutter (CWNS). The article was an effort to address the conflicting conclusions of two previous reviews of the research in this area. Method: Studies published in research journals during the past 7 years (2011-2018) were located through a systematic review of the literature. Each study was analysed to determine how well it supported the claim that CWS, as a group, have weaker language skills than CWNS. Result: The evidence was not convincing to support this controversial claim. Rather, the review indicated that CWS performed as well as or better than CWNS on formal language tasks. Conclusion: The claim that language weaknesses are linked to children's stuttering is not well supported by recently published studies. Alternative interpretations of the literature are offered.
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Affiliation(s)
- Marilyn A Nippold
- Communication Disorders and Sciences Program, College of Education, University of Oregon , Eugene , OR , USA
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Onslow M, Lowe R. After the RESTART trial: six guidelines for clinical trials of early stuttering intervention. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:517-528. [PMID: 30773736 DOI: 10.1111/1460-6984.12463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The Rotterdam Evaluation Study of Stuttering Therapy randomized trial (RESTART) was seminal, comparing the Lidcombe Program with RESTART Demands and Capacities Model-based treatment (RESTART-DCM) for pre-school age children who stutter. AIMS To critique the methods of the RESTART trial to develop guidelines for its systematic replication and extension. Beyond that, to contribute to the refinement of existing methodological guidelines for early stuttering intervention. METHOD The discussion is organized around methodological issues of primary outcomes, treatment completion, clinician allegiance, treatment fidelity, age exclusions and no-treatment control reasoning. MAIN CONTRIBUTION We recommend six methodological guidelines to guide future clinical trials comparing the Lidcombe Program with RESTART-DCM, which can be applied to clinical trials of other early stuttering intervention methods: (1) incorporate a continuous measure of primary outcome; (2) ensure that all children in clinical trials have completed treatment; (3) eliminate potential bias due to clinician allegiance; (4) establish treatment fidelity within and beyond the clinic; (5) include children younger than 3 years in clinical trials; and (6) establish an estimate of treatment effect size at some stage of treatment development. CONCLUSION In addition to guiding future clinical research comparing RESTART-DCM and Lidcombe Program treatment, these recommendations may extend to influence positively other treatment developments for early stuttering.
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Affiliation(s)
- Mark Onslow
- Australian Stuttering Research Centre, The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
| | - Robyn Lowe
- Australian Stuttering Research Centre, The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia
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Kraft SJ, Lowther E, Beilby J. The Role of Effortful Control in Stuttering Severity in Children: Replication Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:14-28. [PMID: 30517950 PMCID: PMC6503866 DOI: 10.1044/2018_ajslp-17-0097] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 01/08/2018] [Accepted: 05/16/2018] [Indexed: 05/17/2023]
Abstract
Background In 2014, Kraft et al. assessed the temperament, home environment, and significant life events of 69 North American children who stutter to examine the combined and compounded effects of these individualized factors on mediating overt stuttering severity. The temperament domain of effortful control was singularly found to be significantly predictive of stuttering severity. Purpose Because of the clinical significance of the initial study's findings, a replication study with a different, larger cohort of children who stutter was warranted to validate the reported outcomes. Method The current study assesses 98 children who stutter, ages 2;4 to 12;6 (years; months, M = 6;7), recruited from Perth, Australia. Results The results support the previous findings of Kraft, Ambrose, and Chon (2014) , with effortful control remaining the sole significant contributor to variability in stuttering severity, as rated by both parents and clinicians. Conclusion These cumulative and consistent outcomes support the need to develop targeted intervention strategies that specifically strengthen aspects of effortful control as a means to support positive therapeutic change in children who stutter.
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Affiliation(s)
- Shelly Jo Kraft
- Behavioral Speech & Genetics Lab, Department of Communication Sciences and Disorders, Wayne State University, Detroit, MI
| | - Emily Lowther
- Behavioral Speech & Genetics Lab, Department of Communication Sciences and Disorders, Wayne State University, Detroit, MI
| | - Janet Beilby
- Social Work and Speech Pathology, School of Occupational Therapy, Curtin University, Perth, Australia
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Ajdacic-Gross V, Bechtiger L, Rodgers S, Müller M, Kawohl W, von Känel R, Mutsch M, Rössler W, Seifritz E, Castelao E, Strippoli MPF, Vandeleur C, Preisig M, Howell P. Subtypes of stuttering determined by latent class analysis in two Swiss epidemiological surveys. PLoS One 2018; 13:e0198450. [PMID: 30086147 PMCID: PMC6080750 DOI: 10.1371/journal.pone.0198450] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 05/18/2018] [Indexed: 02/03/2023] Open
Abstract
Aims Associations between stuttering in childhood and a broad spectrum of risk factors, associated factors and comorbidities were examined in two large epidemiological studies. Subtypes of stuttering were then identified based on latent class analysis (LCA). Methods Data were from two representative Swiss population samples: PsyCoLaus (N = 4,874, age 35–82 years) and the ZInEP Epidemiology Survey (N = 1,500, age 20–41 years). Associations between stuttering and sociodemographic characteristics, familial aggregation, comorbidity and psychosocial risk / associated factors were investigated in both samples. LCAs were conducted on selected items from people in both samples who reported having stuttered in childhood. Results Initial analyses linked early anxiety disorders, such as separation anxiety disorder and overanxious disorder, to stuttering (PsyCoLaus). ADHD was associated with stuttering in both datasets. In the analyses of risk / associated factors, dysfunctional parental relationships, inter-parental violence and further childhood adversities were mutual predictors of stuttering. Moreover, comorbidities were seen with hay fever, asthma, eczema and psoriasis (PsyCoLaus). Subsequent LCA identified an unspecific group of persons who self-reported that they stuttered and a group defined by associations with psychosocial adversities (ZINEP, PsyCoLaus) and atopic diseases (PsyCoLaus). Conclusions The two subtypes of developmental stuttering have different risk / associated factors and comorbidity patterns. Most of the factors are associated with vulnerability mechanisms that occur early in life and that have also been linked with other neurodevelopmental disorders. Both psychosocial and biological factors appear to be involved in the etiopathogenesis of stuttering.
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Affiliation(s)
- Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- ZInEP, The Zurich Program for Sustainable Development of Mental Health Services, University of Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- * E-mail: (VA); (PH)
| | - Laura Bechtiger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- ZInEP, The Zurich Program for Sustainable Development of Mental Health Services, University of Zurich, Zurich, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- ZInEP, The Zurich Program for Sustainable Development of Mental Health Services, University of Zurich, Zurich, Switzerland
| | - Wolfram Kawohl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- ZInEP, The Zurich Program for Sustainable Development of Mental Health Services, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Margot Mutsch
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- ZInEP, The Zurich Program for Sustainable Development of Mental Health Services, University of Zurich, Zurich, Switzerland
- Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
- Institute of Psychiatry, Laboratory of Neuroscience (LIM27), University of Sao Paulo, Sao Paulo, Brazil
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | | | - Caroline Vandeleur
- Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
| | - Peter Howell
- Department of Experimental Psychology, University College, London, United Kingdom
- * E-mail: (VA); (PH)
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Erdemir A, Walden TA, Jefferson CM, Choi D, Jones RM. The effect of emotion on articulation rate in persistence and recovery of childhood stuttering. JOURNAL OF FLUENCY DISORDERS 2018; 56:1-17. [PMID: 29443691 PMCID: PMC5963974 DOI: 10.1016/j.jfludis.2017.11.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/27/2017] [Accepted: 11/16/2017] [Indexed: 05/13/2023]
Abstract
PURPOSE This study investigated the possible association of emotional processes and articulation rate in pre-school age children who stutter and persist (persisting), children who stutter and recover (recovered) and children who do not stutter (nonstuttering). METHODS The participants were ten persisting, ten recovered, and ten nonstuttering children between the ages of 3-5 years; who were classified as persisting, recovered, or nonstuttering approximately 2-2.5 years after the experimental testing took place. The children were exposed to three emotionally-arousing video clips (baseline, positive and negative) and produced a narrative based on a text-free storybook following each video clip. From the audio-recordings of these narratives, individual utterances were transcribed and articulation rates were calculated. RESULTS Results indicated that persisting children exhibited significantly slower articulation rates following the negative emotion condition, unlike recovered and nonstuttering children whose articulation rates were not affected by either of the two emotion-inducing conditions. Moreover, all stuttering children displayed faster rates during fluent compared to stuttered speech; however, the recovered children were significantly faster than the persisting children during fluent speech. CONCLUSION Negative emotion plays a detrimental role on the speech-motor control processes of children who persist, whereas children who eventually recover seem to exhibit a relatively more stable and mature speech-motor system. This suggests that complex interactions between speech-motor and emotional processes are at play in stuttering recovery and persistency; and articulation rates following negative emotion or during stuttered versus fluent speech might be considered as potential factors to prospectively predict persistence and recovery from stuttering.
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Affiliation(s)
| | | | | | - Dahye Choi
- University of South Alabama, United States
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Shimada M, Toyomura A, Fujii T, Minami T. Children who stutter at 3 years of age: A community-based study. JOURNAL OF FLUENCY DISORDERS 2018; 56:45-54. [PMID: 29602051 DOI: 10.1016/j.jfludis.2018.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 02/14/2018] [Accepted: 02/16/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Lack of social resources to support children who stutter may be due, in part, to the absence of epidemiological data regarding stuttering. This study investigated the proportion of three-year-old children who stutter in a city located in Hokkaido, a northern island of Japan. METHODS The speech of individual children was assessed as part of a routine, government-conducted health care examination for 3-year-old children. The number of children screened was 2274, or 94.4% of all children in the city. The first author participated in the health care examination, and followed up all of the children who were found to stutter. RESULTS At 3 years of age, 1.41% of the children exhibited stuttering; 82.8% of these children subsequently did not exhibit stuttering six months later. Boys were 1.57 times more likely to stutter than girls, but they had only 86% of the probability of reported or observed fluency seen in girls six months later. Significantly higher probability of later fluency was observed in children who exhibited normal, rather than delayed, language development at the 1.5-year health checkup preceding the 3-year health checkup. CONCLUSION The proportion of three-year-old children who stutter and fluency status 6 months later are reported for a large cohort of Japanese children in Hokkaido. Language skills at 1;6 year may potentially be a factor in natural recovery or persistence; because of limitations in our study design, this assumption requires additional study. This is the first preliminary study to determine the proportion of three-year-old children who stutter in a Japanese community.
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Affiliation(s)
- Michiko Shimada
- Sapporo Medical Technology, Welfare, and Dentistry Professional Training, College of Nishino Gakuen School Foundation, Minami 5, Nishi 11, Chuoku, Sapporo 064-0805, Japan
| | - Akira Toyomura
- Graduate School of Health Sciences, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
| | - Tetsunoshin Fujii
- Graduate School of Letters, Hokkaido University, Kita 10, Nishi 7, Kita-ku, Sapporo 060-0810, Japan
| | - Takayuki Minami
- Minami-Tsukisamu Elementary School, Tsukisamu Nishi 4-8, Toyohira-ku, Sapporo 062-0024, Japan; Japan Stuttering Genyukai Association, Minami-Otsuka 1-30-15, Toshima-ku, Tokyo 170-0005, Japan
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Tchoungui Oyono L, Pascoe M, Singh S. The Prevalence of Speech and Language Disorders in French-Speaking Preschool Children From Yaoundé (Cameroon). JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1238-1250. [PMID: 29710276 DOI: 10.1044/2018_jslhr-l-16-0400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 01/11/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this study was to determine the prevalence of speech and language disorders in French-speaking preschool-age children in Yaoundé, the capital city of Cameroon. METHOD A total of 460 participants aged 3-5 years were recruited from the 7 communes of Yaoundé using a 2-stage cluster sampling method. Speech and language assessment was undertaken using a standardized speech and language test, the Evaluation du Langage Oral (Khomsi, 2001), which was purposefully renormed on the sample. A predetermined cutoff of 2 SDs below the normative mean was applied to identify articulation, expressive language, and receptive language disorders. Fluency and voice disorders were identified using clinical judgment by a speech-language pathologist. RESULTS Overall prevalence was calculated as follows: speech disorders, 14.7%; language disorders, 4.3%; and speech and language disorders, 17.1%. In terms of disorders, prevalence findings were as follows: articulation disorders, 3.6%; expressive language disorders, 1.3%; receptive language disorders, 3%; fluency disorders, 8.4%; and voice disorders, 3.6%. CONCLUSION Prevalence figures are higher than those reported for other countries and emphasize the urgent need to develop speech and language services for the Cameroonian population.
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Affiliation(s)
- Lilly Tchoungui Oyono
- Division of Communication Sciences and Disorders, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Michelle Pascoe
- Division of Communication Sciences and Disorders, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Shajila Singh
- Division of Communication Sciences and Disorders, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
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Selim AM, Elhaig MM, Moawed SA, El-Nahas E. Modeling the potential risk factors of bovine viral diarrhea prevalence in Egypt using univariable and multivariable logistic regression analyses. Vet World 2018; 11:259-267. [PMID: 29657414 PMCID: PMC5891837 DOI: 10.14202/vetworld.2018.259-267] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 01/29/2018] [Indexed: 12/24/2022] Open
Abstract
Aim The present cross-sectional study was conducted to determine the seroprevalence and potential risk factors associated with Bovine viral diarrhea virus (BVDV) disease in cattle and buffaloes in Egypt, to model the potential risk factors associated with the disease using logistic regression (LR) models, and to fit the best predictive model for the current data. Materials and Methods A total of 740 blood samples were collected within November 2012-March 2013 from animals aged between 6 months and 3 years. The potential risk factors studied were species, age, sex, and herd location. All serum samples were examined with indirect ELIZA test for antibody detection. Data were analyzed with different statistical approaches such as Chi-square test, odds ratios (OR), univariable, and multivariable LR models. Results Results revealed a non-significant association between being seropositive with BVDV and all risk factors, except for species of animal. Seroprevalence percentages were 40% and 23% for cattle and buffaloes, respectively. OR for all categories were close to one with the highest OR for cattle relative to buffaloes, which was 2.237. Likelihood ratio tests showed a significant drop of the -2LL from univariable LR to multivariable LR models. Conclusion There was an evidence of high seroprevalence of BVDV among cattle as compared with buffaloes with the possibility of infection in different age groups of animals. In addition, multivariable LR model was proved to provide more information for association and prediction purposes relative to univariable LR models and Chi-square tests if we have more than one predictor.
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Affiliation(s)
- Abdelfattah M Selim
- Department of Animal Medicine (Infectious Diseases), Faculty of Veterinary Medicine, Benha University, P.O. Box 13736, Toukh, Egypt
| | - Mahmoud M Elhaig
- Department of Animal Medicine (Infectious Diseases), Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Sherif A Moawed
- Department of Animal Wealth Development, Biostatistics Division, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ehab El-Nahas
- Department of Virology, Faculty of Veterinary Medicine, Benha University, P.O. Box 13736, Toukh, Egypt
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Law T, Packman A, Onslow M, To CKS, Tong MCF, Lee KYS. The Topography of Stuttering in Cantonese. Folia Phoniatr Logop 2018; 69:110-117. [PMID: 29462821 DOI: 10.1159/000481254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/03/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This is the first study to investigate the behavioral nature (topography) of stuttering in Cantonese. Cantonese, a Sino-Tibetan language, is both tonal and syllable-timed. Previous studies of stuttering topography have mainly been in Western languages, which are mainly stress-timed. METHODS Conversational speech samples were collected from 24 native Cantonese-speaking adults who stuttered. Six consecutive stuttering moments from each participant were analyzed using the Lidcombe behavioral data language (LBDL). A complexity analysis based on the LBDL was developed to indicate the proportion of multiple-behavior stuttering moments for each participant. RESULTS There was no significant difference in the frequency of the 7 LBDL behaviors. Almost half the stuttering moments across participants were reported as complex, containing more than 1 stuttering behavior, and stuttering complexity correlated significantly with stuttering severity. CONCLUSIONS These preliminary findings require replication because of their important theoretical and clinical implications. Differences in topography across languages have the potential to contribute to our understanding of the nature of stuttering. Clinically, the recognition of such differences may assist practitioners in identifying stuttering, for example when screening for early stuttering. The LBDL complexity score developed in this study has the potential to be used in other languages.
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Affiliation(s)
- Thomas Law
- Australian Stuttering Research Centre, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.,Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ann Packman
- Australian Stuttering Research Centre, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Carol K-S To
- Division of Speech and Hearing Sciences, The University of Hong Kong, Hong Kong, Hong Kong
| | - Michael C-F Tong
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Kathy Y-S Lee
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Nippold MA. Stuttering in Preschool Children: Direct Versus Indirect Treatment. Lang Speech Hear Serv Sch 2018; 49:4-12. [DOI: 10.1044/2017_lshss-17-0066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 09/12/2017] [Indexed: 11/09/2022] Open
Abstract
Purpose
The purpose of this article is to discuss the controversial topic of stuttering in preschool children and how to evaluate the options for treatment, emphasizing the role of external research evidence.
Method
A hypothetical but realistic case study of a 3-year-old boy who stutters is described. Two contrasting approaches to treatment are presented, the Lidcombe Program (LP) and the demands and capacities model (DCM). Studies published in peer-reviewed research journals that have examined the effectiveness of each approach are summarized and critiqued.
Results
The review indicates that the LP is the preferred treatment approach for stuttering in preschool children and that it offers the best opportunity for rapid success.
Conclusion
The LP should be carried out by knowledgeable, experienced, and flexible speech-language pathologists who are able to accommodate the individual needs and differences of every child and family.
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Kefalianos E, Onslow M, Packman A, Vogel A, Pezic A, Mensah F, Conway L, Bavin E, Block S, Reilly S. The History of Stuttering by 7 Years of Age: Follow-Up of a Prospective Community Cohort. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:2828-2839. [PMID: 28979988 DOI: 10.1044/2017_jslhr-s-16-0205] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 06/01/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE For a community cohort of children confirmed to have stuttered by the age of 4 years, we report (a) the recovery rate from stuttering, (b) predictors of recovery, and (c) comorbidities at the age of 7 years. METHOD This study was nested in the Early Language in Victoria Study. Predictors of stuttering recovery included child, family, and environmental measures and first-degree relative history of stuttering. Comorbidities examined at 7 years included temperament, language, nonverbal cognition, and health-related quality of life. RESULTS The recovery rate by the age of 7 years was 65%. Girls with stronger communication skills at the age of 2 years had higher odds of recovery (adjusted OR = 7.1, 95% CI [1.3, 37.9], p = .02), but similar effects were not evident for boys (adjusted OR = 0.5, 95% CI [0.3, 1.1], p = .10). At the age of 7 years, children who had recovered from stuttering were more likely to have stronger language skills than children whose stuttering persisted (p = .05). No evident differences were identified on other outcomes including nonverbal cognition, temperament, and parent-reported quality of life. CONCLUSION Overall, findings suggested that there may be associations between language ability and recovery from stuttering. Subsequent research is needed to explore the directionality of this relationship.
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Affiliation(s)
- Elaina Kefalianos
- Department of Audiology and Speech Pathology, University of Melbourne, Victoria, Australia
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Centre for Neuroscience of Speech, The University of Melbourne, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, University of Sydney, Australia
| | - Ann Packman
- Australian Stuttering Research Centre, University of Sydney, Australia
| | - Adam Vogel
- Department of Audiology and Speech Pathology, University of Melbourne, Victoria, Australia
- Centre for Neuroscience of Speech, The University of Melbourne, Australia
- Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Angela Pezic
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Fiona Mensah
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Australia
- Royal Children's Hospital, Parkville, Victoria, Australia
| | - Laura Conway
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Australia
| | - Edith Bavin
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Susan Block
- School of Human Communication Sciences, La Trobe University, Bundoora, Victoria, Australia
| | - Sheena Reilly
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Australia
- Menzies Health Institute Queensland, Griffith University, Nathan, Australia
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Arenas RM, Walker EA, Oleson JJ. Developmental Stuttering in Children Who Are Hard of Hearing. Lang Speech Hear Serv Sch 2017; 48:234-248. [PMID: 28915514 PMCID: PMC5944374 DOI: 10.1044/2017_lshss-17-0028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/24/2017] [Accepted: 06/23/2017] [Indexed: 02/03/2023] Open
Abstract
Purpose A number of studies with large sample sizes have reported lower prevalence of stuttering in children with significant hearing loss compared to children without hearing loss. This study used a parent questionnaire to investigate the characteristics of stuttering (e.g., incidence, prevalence, and age of onset) in children who are hard of hearing (CHH). Method Three hundred three parents of CHH who participated in the Outcomes of Children With Hearing Loss study (Moeller & Tomblin, 2015) were sent questionnaires asking about their child's history of stuttering. Results One hundred ninety-four parents of CHH responded to the survey. Thirty-three CHH were reported to have stuttered at one point in time (an incidence of 17.01%), and 10 children were still stuttering at the time of survey submission (a prevalence of 5.15%). Compared to estimates in the general population, this sample displayed a significantly higher incidence and prevalence. The age of onset, recovery rate, and other characteristics were similar to hearing children. Conclusions Based on this sample, mild to moderately severe hearing loss does not appear to be a protective factor for stuttering in the preschool years. In fact, the incidence and prevalence of stuttering may be higher in this population compared to the general population. Despite the significant speech and language needs that children with mild to moderately severe hearing loss may have, speech-language pathologists should appropriately prioritize stuttering treatment as they would in the hearing population. Supplemental Material https://doi.org/10.23641/asha.5397154.
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Affiliation(s)
- Richard M Arenas
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque
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Smith A, Weber C. How Stuttering Develops: The Multifactorial Dynamic Pathways Theory. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:2483-2505. [PMID: 28837728 PMCID: PMC5831617 DOI: 10.1044/2017_jslhr-s-16-0343] [Citation(s) in RCA: 154] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 02/21/2017] [Accepted: 04/19/2017] [Indexed: 05/12/2023]
Abstract
Purpose We advanced a multifactorial, dynamic account of the complex, nonlinear interactions of motor, linguistic, and emotional factors contributing to the development of stuttering. Our purpose here is to update our account as the multifactorial dynamic pathways theory. Method We review evidence related to how stuttering develops, including genetic/epigenetic factors; motor, linguistic, and emotional features; and advances in neuroimaging studies. We update evidence for our earlier claim: Although stuttering ultimately reflects impairment in speech sensorimotor processes, its course over the life span is strongly conditioned by linguistic and emotional factors. Results Our current account places primary emphasis on the dynamic developmental context in which stuttering emerges and follows its course during the preschool years. Rapid changes in many neurobehavioral systems are ongoing, and critical interactions among these systems likely play a major role in determining persistence of or recovery from stuttering. Conclusion Stuttering, or childhood onset fluency disorder (Diagnostic and Statistical Manual of Mental Disorders, 5th edition; American Psychiatric Association [APA], 2013), is a neurodevelopmental disorder that begins when neural networks supporting speech, language, and emotional functions are rapidly developing. The multifactorial dynamic pathways theory motivates experimental and clinical work to determine the specific factors that contribute to each child's pathway to the diagnosis of stuttering and those most likely to promote recovery.
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Affiliation(s)
- Anne Smith
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana
| | - Christine Weber
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana
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Reilly S, Cook F, Bavin EL, Bretherton L, Cahir P, Eadie P, Gold L, Mensah F, Papadopoullos S, Wake M. Cohort Profile: The Early Language in Victoria Study (ELVS). Int J Epidemiol 2017; 47:11-20. [DOI: 10.1093/ije/dyx079] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sheena Reilly
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Fallon Cook
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Edith L Bavin
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Lesley Bretherton
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- The Royal Children’s Hospital, Parkville, Victoria, Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Petrea Cahir
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Patricia Eadie
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Melbourne Graduate School of Education, The University of Melbourne, Parkville, Victoria, Australia
| | - Lisa Gold
- School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
- Centre for Community Child Health, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Fiona Mensah
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- The Royal Children’s Hospital, Parkville, Victoria, Australia
| | | | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics and The Liggins Institute, The University of Auckland, Auckland, New Zealand
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