Abstract - Janeiro a Julho de 2020
A cross-sectional analysis of the effects of everyday life situations on stuttering and associated physical features - MOTOR
J Pak Med Assoc. 2020 May;70(5):946-949.
Free full text: https://jpma.org.pk/PdfDownload/9827
Sikandar MZ, Naeem MW, Iqbal S, Nawaz H, Nawaz H, Ifthikar A, Ali Shah SI.
Central Park Medical College, Lahore, Pakistan; Services Institute of Medical Sciences Lahore, Pakistan.
Objective: To explore the effects that everyday situations of varying stress/anxiety have on stammering.
METHODS: The cross-sectional study was conducted in the first six months of 2018 at Central Park Medical College Lahore, and comprised people with stammer. The subjects were categorised into two groups on the basis of severity of symptoms assessed using the fluency severity rating scale. Group A had subjects with mild to moderate stammer, while Group B had those with moderate to severe stammer. An 8-point Likert scale was employed to evaluate responses towards 33 questions of which 30 were situation-based while 3 focussed on physical fitness, blinking and body jerks. SPSS 23 was used for data analysis.
RESULTS: Of the 56 subjects, there were 26(46.4%) in Group A, and 30(53.5%) in Group B. Higher degree of blinking and body jerks were found in Group B (p<0.05 each).
Conclusion: Subjects with severe stammer had more body jerks and blinking compared to those with mild to moderate condition.
PMID: 32400764 DOI: 10.5455/JPMA.16800
A descriptive analysis of assessment measures on the effectiveness of a comprehensive stuttering intervention approach: A single case study - TERAPIA
S Afr J Commun Disord. 2020 Apr 29;67(1):e1-e9.
Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203267/pdf/SAJCD-67-648.pdf
Karani TF, Mupawose A.
University of the Witwatersrand, Johannesburg.
BACKGROUND: For effective client outcomes, stuttering assessment and intervention approaches need to be aligned. This encompasses using assessment and intervention approaches that address the three multidimensional constructs of stuttering, namely core behaviours, secondary behaviours and negative feelings and attitudes.
OBJECTIVE: The study aimed to explore whether multiple assessment measures could be used to describe the effectiveness of a comprehensive stuttering intervention approach, undergirded by the International Classification of Functioning, Disability and Health (ICF) framework.
METHOD: A single-subject case design was employed with one male adult who stutters. Data was collected by administering the Stuttering Severity Instrument-Fourth Edition (SSI-4) and Overall Assessment of the Speaker's Experience of Stuttering-Adults (OASES-A) at three testing periods (pre-intervention, immediately post-intervention and 7 months post-intervention), and a semi-structured interview schedule immediately post-intervention. Descriptive statistics was used to analyse the SSI-4 and OASES-A, and thematic analysis was conducted to evaluate the participant's interview schedule responses.
RESULTS: The participant's total scores, impact scores and severity ratings of both the SSI-4 and OASES decreased across the three testing periods. The main theme of effectiveness of the comprehensive stuttering intervention to reduce aspects of disability emerged from the participant's responses.
CONCLUSION: Evaluation of the results from the assessment measures revealed that the comprehensive stuttering intervention approach was effective in reducing the participant's core behaviours, secondary behaviours and negative feelings and attitudes. Assessment and management of fluency disorders should promote a client-specific multidimensional approach that extends beyond the core behaviours and secondary behaviours, by addressing the underlying social and emotional facets of fluency disorders.
PMID: 32370524 DOI: 10.4102/sajcd.v67i1.648
A parent-report scale of behavioral inhibition: Validation and application to preschool-age children who do and do not stutter - EMOCIONAL
J Fluency Disord. 2020 Mar;63:105748. Epub 2020 Feb 1.
Ntourou K, DeFranco EO, Conture EG, Walden TA, Mushtaq N.
Vanderbilt University, United States; University of Colorado Boulder, United States; University of Oklahoma Health Sciences Center, United States.
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.
PMID: 32065916 PMCID: PMC7061916 [Available on 2021-03-01] DOI: 10.1016/j.jfludis.2020.105748
A systematic review of interventions for adults who stutter - TERAPIA
Fluency Disord. 2020;64:105766. published online ahead of print, 2020 Apr 30].
Brignell A, Krahe M, Downes M, Kefalianos E, Reilly S, Morgan AT. J
Murdoch Children's Research Institute, Parkville, Victoria, Australia; Griffith University, Gold Coast, Queensland, Australia; University of Melbourne, Parkville, Victoria, Australia
Purpose: To examine the effectiveness of (i) face to face interventions (ii) models of service delivery and (iii) psychological treatments combined with speech-focused interventions for adults who stutter.
Methods: Five electronic databases and three clinical trial registries were searched. Systematic reviews, randomised controlled trials (RCTs) and studies that applied an intervention with adults who stutter were included. Pharmaceutical interventions were excluded. Primary outcomes included a measure of stuttering severity. Risk of bias assessment was conducted on included studies and overall quality of the evidence was graded.
Results: Five RCTS, four registered trials and three systematic reviews met inclusion criteria. Intervention approaches included speech restructuring programs (e.g. Camperdown Program) and transcranial direct current stimulation (tDCS). One study investigated cognitive behaviour therapy (CBT) alongside speech restructuring. Overall, studies were classified low risk of bias and good quality. Speech restructuring was included in all but one study (tDCS study) and had the most evidence i.e. supported by the greatest number of RCTs. On average, stuttering frequency was reduced by 50-57 % using speech restructuring approaches. No study reduced stuttering to the same level as community controls who don't stutter. The study on tDCS reduced stuttering frequency by 22-27 %. Speech restructuring delivered via telehealth was non-inferior to face-to-face intervention. One study reported CBT was an effective adjunct to speech restructuring interventions.
Conclusion: Speech restructuring interventions were found to reduce stuttering in adults, however degree and maintenance of fluency varied. The body of evidence surrounding tDCS and psychological interventions is limited. Replication studies should be considered.
PMID: 32438123 DOI: 10.1016/j.jfludis.2020.105766
An articulatory study of differences and similarities between stuttered disfluencies and non-pathological disfluencies. - FALA
Clin Linguist Phon. 2020 Apr 26:1-21. [Epub ahead of print]
Didirková I, Le Maguer S, Hirsch F.
Université Paris 8, Saint-Denis, France; Université Paris 3 Sorbonne-Nouvell, Paris, CNRS, France; Trinity College Dublin, Dublin, Ireland; Université Paul-Valéry Montpellier, CNRS, France.
While stuttering-like disfluencies have long interested researchers, little is known about their articulatory realisation. Yet, such a description seems crucial in order to better understand the differences between stuttering-like and other disfluencies, and their underlying motor mechanisms. Hence, we aimed to compare the articulatory supraglottic activity in stuttered disfluencies with non-pathological disfluencies by using Electromagnetic Articulography (EMA) data. To achieve this comparison, two criteria were used for the description of articulatory activity during the disfluency. The first focused on the characterisation of the movements observable during the disfluency. This criterion gives an indication of the presence or absence of articulatory movement as well as interarticulator coupling. The second criterion provided information on the retention and anticipation of the sound preceding and following the disfluency. In order to strengthen our analysis, both criteria were examined using two complementary methodologies. The first was an expert-based analysis, while the second used a set of metrics based on velocity and acceleration. These analyses were conducted independently, and the final results of our study corresponded to the conclusions of the comparison of both methodology results. The results we obtained show that stuttered disfluencies and non-pathological disfluencies do have common characteristics. However, stuttered disfluencies and non-pathological disfluencies produced by Persons Who Stutter (PWS) present some particularities, mainly in terms of retention and anticipation, and the presence of spasmodic movements. Results are discussed in the light of different models of stuttering.
PMID: 32338079 DOI: 10.1080/02699206.2020.1752803
Amino acids profiles of children who stutter compared to their fluent sibling - CONCEITO
Int J Psychiatry Clin Pract. 2020 Mar 4:1-8. [Epub ahead of print]
Alqhazo M, Rashaid AB.
Jordan University of Science and Technology, Irbid, Jordan.
Purpose: This study scrutinises the abundances of 9 neurological-related amino acids of the scalp hair of 35 (5 females, 30 males) children who stutter and 30 normally fluent children (age and sex matched).Methods: Samples of hair from children who stutter aged (5-9 years) were collected from Speech Clinic at King Abdullah Hospital. The control subjects were selected from the same families of children who stutter to exclude the effect of nutritional, environmental, and biological factors. Amino Acid Analyser was used to measure the concentrations of amino acids in acid hydrolysed hair samples.
Results: results indicated that the concentrations of threonine, tyrosine, and isoleucine (p = 0.001, 0.001, 0.02 respectively) are lower in hair samples of people who stutter compared with samples of normal fluent speakers.
Conclusion: The findings of this study could introduce a new treatment protocol including the supplementation of reduced nutritional elements.
KEY POINTS: Concentrations of amino acids (threonine, isoleucine, and tyrosine) in the hair samples of people who stutter were significantly lower than the concentrations in the hair samples of control group. Concentrations of amino acids (histidine and glutamate) in hair samples of people who stutter were lower than control group with low significant values. The concentrations of amino acids (phenylalanine, serine, glycine, aspartate, glutamate) were not significantly different between hair samples of stuttering group and control group. The findings of the current study will be helpful in designing a new treatment method based on the supplementation of deficient amino acids.
PMID: 32129116 DOI: 10.1080/13651501.2020.1735447
Auditory temporal processing assessment in children with developmental stuttering - AUDITIVO
Int J Pediatr Otorhinolaryngol. 2020 Feb 6;132:109935 [Epub ahead of print]
Lotfi Y, Dastgerdi ZH, Farazi M, Moossavi A, Bakhshi E.
University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Iran University of Medical Sciences, Tehran, Iran.
OBJECTIVE: Stuttering is a developmental disorder of speech production with a dynamic and multifactorial nature. Scientific theories mentioned the role of auditory processing disorder in stuttering. Investigating the auditory processing in stuttering would provide insights into the mechanisms of stuttering. The details of basic auditory processing in children with stuttering (CWS) continue to remain uncertain. This study aimed to investigate the auditory temporal processing (ATP) in CWS and also its relationship with the stuttering severity.
METHODS: The participants of this comparative cross-sectional study were 54 CWS and 63 children without stuttering (CWOS). All children were between 7 and 12 years old. ATP ability of the participants was measured using the Backward Masking (BM), Duration Pattern (DP), and Gap in Noise (GIN) tests. Then, the groups were compared in terms of ATP results. The correlation between the scores of these tests and stuttering severity was assessed.
RESULTS: According to the results, CWS showed poorer performance on DP, BM and GIN tests when compared with CWOS. Moreover, the stuttering severity had a significant negative correlation with the DP scores and percentage of correct identification scores in GIN; whereas it had a significant positive correlation with the BM thresholds.
CONCLUSIONS: The results showed that some CWS have ATP disorder, which could exacerbate their stuttering. These findings highlighted the role of ATP disorder in stuttering.
PMID: 32058157 DOI: 10.1016/j.ijporl.2020.109935
Caregivers' Perceptions of Stuttering Impact in Young Children: Agreement in Mothers', Fathers' and Teachers' Ratings - INFANTIL
J Commun Disord . 2020 May 16;86:106001. Online ahead of print.
Linn Stokke Guttormsen, J Scott Yaruss, Kari-Anne B Næss
University of Oslo, Norway, Michigan State University, MI, United States.
Purpose: Prior studies have documented an adverse impact of stuttering on young children's lives. These studies have relied primarily on parent reports, though different caregivers may have unique experiences with children. To date, no study has examined teachers' perceptions of the impact in children below six years of age. Moreover, the agreement between mothers, fathers, and teachers in proxy ratings of impact has not been examined. Caregiver agreement is important to investigate because results from varying assessments of adverse impact can influence treatment recommendations. This study sought to gain an integrated insight into 1) teachers' perceptions and descriptions of the impact of stuttering on young children and 2) agreement in mothers', fathers', and teachers' perceptions of how stuttering affects young children.
Method: The mothers, fathers, and teachers of 35 young children who stutter (aged 2.0-6.0 years) completed the Overall Assessment of the Speaker's Experience of Stuttering - Caregivers (Parents and Kindergarten Teachers) (OASES-C; Guttormsen, Yaruss, & Næss, 2020). Teachers also responded to open-ended questions about their perceptions of the impact of stuttering on children's lives.
Results: Overall, teachers perceived stuttering to affect children's lives to a mild-to-moderate degree. The teachers described communication difficulty and reactions and how these changed across settings in kindergarten. Agreement on the four OASES-C sections and on the total score were calculated for 29 mother-teacher pairs, 29 father-teacher pairs, and 33 mother-father pairs. Results indicate good agreement between mothers and fathers and fair agreement between parents and teachers. Across caregiver pairs, agreement was high (good or excellent) when reporting on observable impact, while agreement was low (fair or poor) on ratings of internal impact.
Conclusion: The finding that teachers also perceive stuttering to have an adverse effect on young children adds to the literature of impact, particularly because the teachers reported observing impact in situations that are unique to the kindergarten setting. In line with previous literature on proxy reporting, our results indicate good agreement between caregivers observing the children in the same arena (mothers and fathers) and fair agreement between caregivers observing the children in different arenas (parents and teachers). The results indicate that information from more than one caregiver can contribute to an integrated assessment of impact across arenas.
PMID: 32474197 DOI: 10.1016/j.jcomdis.2020.106001
Clinical Trials of Adult Stuttering Treatment: Comparison of Percentage Syllables Stuttered With Self-Reported Stuttering Severity as Primary Outcomes - AVALIAÇÃO
J Speech Lang Hear Res. 2020 May 11:1-8. [Epub ahead of print]
O'Brian S, Heard R, Onslow M, Packman A, Lowe R, Menzies RG.
The University of Technology Sydney, Australia.
Purpose: In a companion paper, we found no statistical reason to favor percentage syllables stuttered (%SS) over parent-reported stuttering severity as a primary outcome measure for clinical trials of early stuttering. Hence, considering the logistical advantages of the latter measure, we recommended parent-reported stuttering severity for use as an outcome measure. The present report extends the prior analysis to a comparison of %SS with self-reported stuttering severity (SRSS) for use as an outcome measure in clinical trials of stuttering treatments for adults.
Method: We analyzed data from four randomized clinical trials for adults that incorporated %SS and SRSS data at prerandomization and at 6 months post randomization. We analyzed the distributions associated with the two measures, their agreement, and their estimates of effect sizes.
Results: The positively skewed distribution of %SS warrants much reservation about its value as a clinical trial outcome measure. This skew causes inherent instability because of spurious data associated with low scores, which occur commonly at the low end of such a distribution. This inherent instability is compounded by inherent problems with absolute reliability of %SS measures. These problems are reduced with the much more normal distribution of SRSS.
Conclusions: The logistical arguments in favor of SRSS apply similarly to adults as they do when parents report the stuttering severity of their children. However, there are statistical reasons to favor SRSS over %SS measures as a primary outcome of clinical trials with adult participants: SRSS has acceptable discriminant validity and a normal distribution, and it is less error prone than %SS. We recommend SRSS as a primary outcome for clinical trials of adults with stuttering.
Communication Attitude of Kannada-Speaking School-Age Children Who Do and Do Not Stutter - AVALIAÇÃO
Folia Phoniatr Logop. 2020 Feb 4:1-8. [Epub ahead of print]
Veerabhadrappa RC, Vanryckeghem M, Maruthy S.
All India Institute of Speech and Hearing, Mysore, India, University of Central Florida, Orlando, Florida, USA.
BACKGROUND: A large body of evidence suggests that the Communication Attitude Test (CAT) is a reliable and valid tool for assessing the speech-associated attitude of school-age children who stutter (CWS).
OBJECTIVE: The purpose of the present study was to adapt and validate the CAT for the Kannada-speaking school-age CWS.
METHODS: The original version of the CAT was forward- and back-translated by the first author. The Communication Attitude Test Kannada (CAT-K) was then administered to 293 children who do not stutter (CWNS) and 100 CWS. All children were native speakers of the Kannada language and were between the ages of 7 and 14 years. The Stuttering Severity Instrument-fourth edition (SSI-4) was used to estimate the severity of stuttering.
RESULTS: The data revealed that, in comparison to CWNS, the CWS' mean CAT-K score was significantly higher, and a significant effect of stuttering severity and age on mean attitude scores was observed. In addition, results showed that the CAT-K is a reliable and valid test.
CONCLUSION: The findings suggest the presence of a negative attitude in Kannada-speaking CWS and that the CAT-K is a useful tool in the assessment of Kannada school-age CWS. Given the need for speech-language pathologists to address a speech-associated negative attitude in CWS, incorporating the CAT-K as part of the diagnostic assessment of stuttering is valuable.
PMID: 32018262 DOI: 10.1159/000505423
Counting fast or slow, aloud or silently? A comparison of adult stutterers and non-stutterers - FALA
Cogn Process. 2020 Mar 16. [Epub ahead of print]
Plamondon M, Grondin S.
Université Laval, Quebec, QC, Canada.
This study assesses factors influencing the capacity to maintain a steady rhythm during explicit counting activities. There are three counting paces (count every 800, 1200, or 1600 ms) and three experimental conditions (count silently, aloud and aloud in the presence of someone). The study also assesses the effect of a speech disorder, namely stuttering, on this counting ability by comparing the performance of a group of adult stutterers (n = 21) to that of a group of adult non-stutterers (n = 24). For temporal variability, in addition to replicating the fact that counting more slowly leads to lower performance, the results show that there are benefits to expect when participants count aloud instead of silently. There is no main effect of group, but the interaction between the experimental condition, the counting pace, and the group is significant. Adult non-stutterers are better than adult stutterers in the silent and long time-interval conditions (1600 ms). The significantly higher variability at 1600 ms indicates a loss of efficiency in the capacity to keep time constant when counting is slow, and it is in this condition that stutterers will gain the most benefits from counting aloud instead of silently.
PMID: 32180059 DOI: 10.1007/s10339-020-00955-x
Crystal Structure of the Mannose-6-Phosphate Uncovering Enzyme - GENÉTICA
Structure. 2020 Feb 25. pii: S0969-2126(20)30042-3. [Epub ahead of print]
Gorelik A, Illes K, Nagar B.
McGill University, Montreal, Canada.
Most lysosomal hydrolytic enzymes reach their destination via the mannose-6-phosphate (M6P) pathway. The enzyme N-acetylglucosamine-1-phosphodiester α-N-acetylglucosaminidase (NAGPA, or "uncovering enzyme") catalyzes the second step in the M6P tag formation, namely the removal of the masking N-acetylglucosamine (GlcNAc) portion. Defects in this protein are associated with non-syndromic stuttering. To gain a better understanding of the function and regulation of this enzyme, we determined its crystal structure. The propeptide binds in a groove on the globular catalytic domain, blocking active site access. High-affinity substrate binding is enabled by a conformational switch in an active site loop. The protein recognizes the GlcNAc and phosphate portions of its substrate, but not the mannose moiety of the glycan. Based on enzymatic and 1H-NMR analysis, a catalytic mechanism is proposed. Crystallographic and solution scattering analyses suggest that the C-terminal domain forms a long flexible stem that extends the enzyme away from the Golgi membrane.
PMID: 32109365 DOI: 10.1016/j.str.2020.02.001
Delayed Auditory Feedback and Transcranial Direct Current Stimulation Treatment for the Enhancement of Speech Fluency in Adults Who Stutter: Protocol for a Randomized Controlled Trial - AUDITIVO
JMIR Res Protoc. 2020 Apr 21;9(4):e16646.
Free full text: https://www.researchprotocols.org/2020/4/e16646/pdf
Moein N, Mohamadi R, Rostami R, Nitsche M, Zomorrodi R, Ostadi A, Keshtkar A
Iran University of Medical Sciences, Tehran, Iran; University of Tehran, Tehran, Iran; Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; University of Toronto, Toronto, ON, Canada; University of Waterloo, Waterloo, ON, Canada; Tehran University of Medical Sciences, Tehran, Iran.
BACKGROUND: Stuttering is a complex speech disorder that affects speech fluency. Recently, it has been shown that noninvasive brain stimulation may be useful to enhance the results of fluency interventions in adults who stutter. Delayed auditory feedback (DAF) is a method to enhance speech fluency in individuals who stutter. Adjunctive interventions are warranted to enhance the efficacy of this intervention.
OBJECTIVE: Individuals who stutter have pathological activation patterns in the primary and secondary auditory areas. Consequently, in this study, we hypothesize that stimulation of these areas might be promising as an adjunctive method to fluency training via DAF to enhance speech therapy success in individuals with a stutter. We will systematically test this hypothesis in this study.
METHODS: This study is designed as a randomized, double-blind, sham-controlled clinical trial. All participants will receive DAF. The intervention group will additionally receive real transcranial direct current stimulation, while the control group will be exposed to sham stimulation. The assignment of the participants to one of these groups will be randomized. Before starting the treatment program, 2 preintervention assessments will be conducted to determine the severity of stuttering. Once these assessments are completed, each subject will participate in 6 intervention sessions. Postintervention assessments will be carried out immediately and 1 week after the last intervention session. Subsequently, to explore the long-term stability of the treatment results, the outcome parameters will be obtained in follow-up assessments 6 weeks after the treatment. The primary outcome measurement-the percentage of stuttered syllables-will be calculated in pre-, post-, and follow-up assessments; the secondary outcomes will be the scores of the following questionnaires: the Stuttering Severity Instrument-Fourth Edition and the Overall Assessment of the Speaker's Experience of Stuttering.
RESULTS: This protocol was funded in 2019 and approved by the Research Ethics Committee of the Iran University of Medical Sciences in June 2019. Data collection started in October 2019. As of February 2020, we have enrolled 30 participants. We expect data analysis to be completed in April 2020, and results will be published in summer 2020.
CONCLUSIONS: We anticipate that this study will show an adjunctive effect of transcranial direct current stimulation, when combined with DAF, on stuttering. This should include not only a reduction in the percentage of stuttered syllables but also improved physical behavior and quality of life in adults who stutter.
PMID: 32314973 DOI: 10.2196/16646
Developmental stuttering and the role of the supplementary motor cortex - NEUROCIÊNCIAS
J Fluency Disord. 2020 Apr 20;64:105763. [Epub ahead of print]
IRCCS Ospedale San Camillo, Venice, Italy.
Developmental stuttering is a frequent neurodevelopmental disorder with a complex neurobiological basis. Robust neural markers of stuttering include imbalanced activity of speech and motor related brain regions, and their impaired structural connectivity. The dynamic interaction of cortical regions is regulated by the cortico-basal ganglia-thalamo-cortical system with the supplementary motor area constituting a crucial cortical site. The SMA integrates information from different neural circuits, and manages information about motor programs such as self-initiated movements, motor sequences, and motor learning. Abnormal functioning of SMA is increasingly reported in stuttering, and has been recently indicated as an additional "neural marker" of DS: anatomical and functional data have documented abnormal structure and activity of the SMA, especially in motor and speech networks. Its connectivity is often impaired, especially when considering networks of the left hemisphere. Compatibly, recent data suggest that, in DS, SMA is part of a poorly synchronized neural network, thus resulting in a likely substrate for the appearance of DS symptoms. However, as evident when considering neural models of stuttering, the role of SMA has not been fully clarified. Herein, the available evidence is reviewed, which highlights the role of the SMA in DS as a neural "hub", receiving and conveying altered information, thus "gating" the release of correct or abnormal motor plans.
PMID: 32361030 DOI: 10.1016/j.jfludis.2020.105763
Developmental stuttering disappearance after iatrogenic lesion of the facial nerve.
J Neurosurg Sci. 2020 Mar 4. [Epub ahead of print]
De Bonis P, Busan P, D'ausilio A, Labanti S, Cavallo MA, Fadiga L.
University Hospital, Ferrara, Italy; Fondazione Ospedale San Camillo IRCCS, Venice, Italy; University of Ferrara, Ferrara, Italy; Italian Institute of Technology (IIT), Genoa, Italy.
No abstract available
PMID: 32141281 DOI: 10.23736/S0390-5616.19.04703-9
Disfluencies and Strategies Used by People Who Stutter During a Working Memory Task. -TERAPIA
J Speech Lang Hear Res. 2020 Mar 23;63(3):688-701. Epub 2020 Mar 18.
Arongna, Sakai N, Yasu K, Mori K.
Japan Society for the Promotion of Science, Tokyo; National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan; RIKEN Center for Brain Science, Wako, Japan; Tsukuba University of Technology, Japan.
Purpose Working memory (WM) deficits are implicated in various communication disorders, including stuttering. The reading span test (RST) measures WM capacity with the dual task of reading sentences aloud and remembering target words. This study demonstrates a difference in strategy between people who stutter (PWS) and people who do not stutter (PWNS) in performing the RST. The impact of the effective strategy and the stuttering-like disfluencies during the RST were investigated. Method Twenty-six PWS and 24 people who do not stutter performed the RST and a simple reading aloud task. After the RST, they were asked which strategy ("imagery" or "rehearsal") they had used in order to remember the target words during the task. Results The proportion of those who used an "imagery" strategy during the RST was significantly smaller in the PWS group. However, the RST scores of those who used an "imagery" strategy were significantly higher than the RST scores of those who used a "rehearsal" strategy in both groups. The "rehearsal" users were asked to undertake one more RST with an "imagery" strategy, which resulted in an increased score for both groups. The disfluency frequency of the PWS group was significantly reduced during the RST than during the oral reading task, irrespective of the employed strategy. Conclusions PWS tended to use the less effective verbal "rehearsal" strategy during the RST. The differential effects of switching strategies on the measured WM capacity and on the disfluency rate suggest that the enhanced fluency during the RST would be mostly attributable to the reduced attention to speech motor control. Therefore, the use of the "imagery" strategy and focusing on the contents of communication, away from speech motor control, should help PWS communicate better in daily conversation.
PMID: 32186949 DOI: 10.1044/2019_JSLHR-19-00393
Disruption of the Frontal Aslant Tract is Not Associated with Long-Term Postoperative Language Deficits: A Case Report - NEUROCIÊNCIAS
World Neurosurg. 2020 Jan;133:192-195. Epub 2019 Sep 28.
Young JS, Morshed RA, Mansoori Z, Cha S, Berger MS.
University of California, San Francisco.
BACKGROUND and Importance: The frontal aslant tract (FAT) is a white matter fiber pathway connecting the superior frontal gyrus to Broca area. This tract in the dominant hemisphere has been shown to play a role in speech initiation and production, and direct subcortical stimulation can induce stuttering and speech arrest in a patient. However, controversy remains as to whether disruption of this pathway will lead to a permanent language deficit and if it is even necessary to map this tract during tumor resections of the dominant frontal lobe.
CLINICAL PRESENTATION: Here, we report a case of a patient with a lower grade diffuse glioma invading the dominant FAT that was removed with an asleep craniotomy. In the immediate postoperative state, the patient had a transcortical motor dysphasia and was unable to initiate speech. These immediate language deficits quickly recovered, and the patient was neurological intact at the time of discharge a few days after surgery.
CONCLUSION: Given the high likelihood for a complete neurological recovery including transient aphasia, we propose that awake mapping for the purpose of identifying the dominant FAT is unnecessary during tumor resection and that disruption of this tract is not associated with any long-term language deficits.
PMID: 31574328 DOI: 10.1016/j.wneu.2019.09.128
Dose-Dependent Aripiprazole-Induced Stuttering in a Child With Mild Intellectual Disability - FARMACOLOGIA
Am J Ther. 2020 Mar 10 [Epub ahead of print]
Naguy A, Moodliar S, Elsori DH, Alamiri B.
Kuwait Centre for Mental Health (KCMH), Jamal Abdul-Nassir St, Shuwaikh, State of Kuwait; Learning Disability Milton Keynes University Hospital, Milton Keynes, Buckinghamshire, United Kingdom; Rhode Island Hospital, Brown University, Providence, RI; Al-Manara CAP Centre, KCMH, Kuwait; Tufts University, Medford.
No abstract available.
PMID: 32167942 DOI: 10.1097/MJT.0000000000001158
Effect of muscular activation on surrounding motor networks in developmental stuttering: A TMS study - PSICOMOTOR
Brain Lang. 2020 Mar 2;205:104774.[Epub ahead of print]
Busan P, Del Ben G, Tantone A, Halaj L, Bernardini S, Natarelli G, Manganotti P, Battaglini PP.
IRCCS Ospedale San Camillo, Venice, Italy; University of Trieste, Trieste, Italy; ABC® Balbuzie, Torino, Italy; University of Padua, Padua, Italy.
Previous studies regarding developmental stuttering (DS) suggest that motor neural networks are strongly affected. Transcranial magnetic stimulation (TMS) was used to investigate neural activation of the primary motor cortex in DS during movement execution, and the influence of muscle representations involved in movements on "surrounding" ones. TMS was applied over the contralateral abductor digiti minimi (ADM) motor representation, at rest and during the movement of homologue first dorsal interosseous muscles (tonic contraction, phasic movements cued by acoustic signalling, and "self-paced" movements). Results highlighted a lower cortico-spinal excitability of ADM in the left hemisphere of stutterers, and an enhanced intracortical inhibition in their right motor cortex (in comparison to fluent speakers). Abnormal intracortical functioning was especially evident during phasic contractions cued by "external" acoustic signals. An exaggerated inhibition of muscles not directly involved in intended movements, in stuttering, may be useful to obtain more efficient motor control. This was stronger during contractions cued by "external" signals, highlighting mechanisms likely used by stutterers during fluency-evoking conditions.
PMID: 32135384 DOI: 10.1016/j.bandl.2020.104774
Efficacy of Levetiracetam in Treatment of Childhood Stuttering - FARMACOLOGIA
Int J Prev Med. 2020 Feb 17;11:17. 2020.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7050220/?report=reader
Ghazavi M, Rastgu F, Nasiri J, Yaghini O.
Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan, Iran; Isfahan University of Medical Sciences, Isfahan, Iran.
BACKGROUND: Stuttering is a kind of speech disorder that affects about 1% of total population. As the origin of this disorder is not obviously diagnosed yet, various remedies have been practiced and among them different medicines have been studied, but unfortunately no significant effective drugs have been recognized yet. As stuttering imposes a great social and mental costs to the patients and their families, finding an effective medicine will help significantly. In this study we have focused on the effects of levetiracetam (LEV) treatment on children suffering from stuttering.
METHODS: In this clinical trial study, 30 children aged > 3 years (median 3.8 years) with stuttering and abnormal sleep electroencephalogram (EEG) were treated by LEV and followed-up for a minimum period of 6 weeks. The starting dose of 20 mg/kg/day was increased at an interval of 1 week by 20 mg/kg/day, if necessary, up to maximum dose of 60 mg/kg/day.
RESULTS: Overall LEV was effective in 70% of patients, decreasing stuttering to at least 50%. Three children (10%) became stuttering-free and only in one (3.3%) child an increase in stuttering was observed. There were statistically significant differences for efficacy in the presence of variables such as age groups, seizure, stuttering family history, and EEG data.
CONCLUSIONS: LEV is an effective drug for treatment of childhood stuttering in those that have abnormal sleep EEG.
PMID: 32175057 PMCID: PMC7050220 DOI: 10.4103/ijpvm.IJPVM_354_18
Evaluating parents' reactions to Children's stuttering using a Persian version of reaction to Speech Disfluency Scale - CONCEITO
Int J Pediatr Otorhinolaryngol. 2020 Apr 28;134 [Epub ahead of print]
Salehpoor A, Latifi Z, Tohidast SA.
Payame Noor University, Iran; Semnan University of Medical Sciences, Semnan, Iran.
OBJECTIVES: Stuttering is one of the most common speech disorders with many negative effects on children and their parents. The parents play a very important role in the treatment and management of children's stuttering. The parents' reactions to children's stuttering are pivotal in the exacerbation or improvement of stuttering. The present study aimed to investigate the parents' reactions to their children's stuttering using the Persian version of Reaction to Speech Disfluency Scale (RSDS).
METHODS: The present study was conducted in two stages; phase 1: translation and cultural adaptation of RSDS into Persian and phase 2: investigation of the reaction of parents to children's stuttering using the RSDS. The first phase of the study included the following steps, forward translation, backward translation, content validity, face validity, and reliability of the scale using internal consistency and test-retest reliability. The second phase of the study was to examine the reactions of 110 parents of 3-6-year-old children who stutter by using the RSDS. Data were analyzed using SPSS software.
RESULTS: The results of translation and cultural adaptation of the RSDS showed that the Persian version of RSDS has suitable validity. The internal consistency (Cronbach's alpha = 0.94) and the test-retest reliability (ICC = 0.98) were also appropriate for this scale. The most reactions of parents to children's stuttering were cognitive, emotional, and behavioral, respectively. The results of evaluating the maternal and paternal reactions separately indicated that the highest value of paternal reaction score was cognitive, behavioral and emotional reactions, respectively, while the highest value of maternal reaction score was cognitive, emotional and behavioral reactions, respectively. Differences between fathers and mothers were statistically significant only in emotional reaction subscale (P < 0.001). The mean overall score of the RSDS for all parents was 29, as well as 27.72 and 30.27 in fathers and mothers groups, respectively, but this differences between groups not statistically significant (P = 0.12). Comparing the scores between parents of boys and girls who stutter showed that the mean overall scores of cognitive, emotional, and behavioral subscales, and overall scores in the parents of girls who stutter was higher than in the parents of boys who stutter, and this difference was statistically significant in the emotional subscale and the overall score between the two groups (P < 0.05).
CONCLUSION: The parental cognitive and behavioral reactions to children's stuttering had the maximum and minimum frequency, respectively. The paternal reactions to their children's stuttering were different from maternal reactions. The parents of girls who stutter in all subscales had a greater reaction compared to the parents of boys who stutter. Given the importance of the reactions of parents to their children's stuttering, the results of the present study can help to complete the information of therapists and researchers in this field.
PMID: 32388081 DOI: 10.1016/j.ijporl.2020.110076
Executive Control in Adults Who Stutter: The Antisaccade Task - PSICOMOTOR
J Speech Lang Hear Res. 2020 May 20;1-12. Online ahead of print.
Zoi Gkalitsiou, Courtney Byrd, Zenzi Griffin
The University of Texas at Austin.
Purpose The purpose of this study was to investigate executive control in adults who stutter (AWS) and adults who do not stutter (AWNS) via a nonspeech paradigm, wherein eye movements were monitored (i.e., antisaccade task). Processes involved in an antisaccade task include working memory, attention, and voluntary motor control, but the task primarily provides insight into inhibitory control.
Method Seventeen AWS (14 men, three women; M = 23.41 years) and 17 AWNS (M = 23.29 years) were presented with a combination of prosaccade (i.e., looking toward a target) and antisaccade (i.e., suppress a reflexive saccade toward the target and look in the opposite direction) trials. The distance of the target from the center of the screen was also manipulated (i.e., 5.5o = short distance and 10.8o = long distance). Data for accuracy and reaction time of the first accurate saccade were collected and analyzed.
Results No difference was found between AWS and AWNS in accuracy or in reaction time. Both groups were more accurate in the prosaccade than the antisaccade trials and in the long compared to the short distance trials. Furthermore, both groups demonstrated longer saccade latencies for long compared to short distances and for antisaccade compared to prosaccade trials.
Conclusions Preliminary results do not support deficits in inhibition in AWS during a motorically simple, non-speech-related oculomotor task, but additional research is warranted.
Functional near-infrared spectroscopy for speech protocols: characterization of motion artifacts and guidelines for improving data analysis - FALA
Neurophotonics. 2020 Jan;7(1):015001. Epub 2020 Jan 10.
Free full text: https://www.spiedigitallibrary.org/journals/neurophotonics/volume-7/issue-01/015001/Functional-near-infrared-spectroscopy-for-speech-protocols--characterization-of/10.1117/1.NPh.7.1.015001.full?SSO=1
Novi SL, Roberts E, Spagnuolo D, Spilsbury BM, Price DC, Imbalzano CA, Forero E, Yodh AG, Tellis GM, Tellis CM, Mesquita RC.
University of Campinas, Institute of Physics, Campinas, São Paulo, Brazil; Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil; Misericordia University, Department of Speech-Language Pathology, Dallas, Pennsylvania, United States; University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States.
Monitoring speech tasks with functional near-infrared spectroscopy (fNIRS) enables investigation of speech production mechanisms and informs treatment strategies for speech-related disorders such as stuttering. Unfortunately, due to movement of the temporalis muscle, speech production can induce relative movement between probe optodes and skin. These movements generate motion artifacts during speech tasks. In practice, spurious hemodynamic responses in functional activation signals arise from lack of information about the consequences of speech-related motion artifacts, as well as from lack of standardized processing procedures for fNIRS signals during speech tasks. To this end, we characterize the effects of speech production on fNIRS signals, and we introduce a systematic analysis to ameliorate motion artifacts. The study measured 50 healthy subjects performing jaw movement (JM) tasks and found that JM produces two different patterns of motion artifacts in fNIRS. To remove these unwanted contributions, we validate a hybrid motion-correction algorithm based sequentially on spline interpolation and then wavelet filtering. We compared performance of the hybrid algorithm with standard algorithms based on spline interpolation only and wavelet decomposition only. The hybrid algorithm corrected 94% of the artifacts produced by JM, and it did not lead to spurious responses in the data. We also validated the hybrid algorithm during a reading task performed under two different conditions: reading aloud and reading silently. For both conditions, we observed significant cortical activation in brain regions related to reading. Moreover, when comparing the two conditions, good agreement of spatial and temporal activation patterns was found only when data were analyzed using the hybrid approach. Overall, the study demonstrates a standardized processing scheme for fNIRS data during speech protocols. The scheme decreases spurious responses and intersubject variability due to motion artifacts.
PMID: 31956662 PMCID: PMC6953699 [Available on 2021-01-10] DOI: 10.1117/1.NPh.7.1.015001
Functional Neurology After the Second World War: The Beginnings of Neurology on Screen (III) - GAGUEIRA ADQUIRIDA
Neurology. 2020 May 28;10.1212. Online ahead of print.
Eelco F M Wijdicks
Mayo Clinic, Rochester, MN.
Treatment of functional symptoms has a long history, and interventions were often used in soldiers returning from battle. On the 75th anniversary of the end of the Second World War, I review the portrayal of neurology in documentary film. Two documentaries were released in 1946 and 1948 (Let There Be Light and Shades of Gray, respectively), which showed a number of soldiers with functional neurology including paralysis, stuttering, muteness, and amnesia. The films showed successful treatments with hypnosis and sodium amytal by psychoanalytic psychiatrists. These documentaries link neurology with psychiatry and are remarkable examples of functional neurology and its treatment on screen.
PMID: 32467130 DOI: 10.1212/WNL.0000000000009593
Indicators of speech fluency in stuttering and in phonological disorder - AVALIAÇÃO
[Article in English, Portuguese; Abstract available in Portuguese from the publisher]
Codas. 2020 Apr 3;32(2):e20190002. doi: 10.1590/2317-1782/20192019002. eCollection 2020.
Free full text:
Alencar PBA, Palharini TA, Silva LMD, Oliveira CMC, Berti LC.
Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Marília (SP), Brasil.
Abstractin English, Portuguese
PURPOSE: To identify the indicators of speech fluency that differs subjects with stuttering, with phonological disorder, and with the two disorders in comorbidity.
METHODS: Thirty subjects aged 4-11 years old were divided into 3 groups, each one with 10 subjects: groups with developmental stuttering (SG), phonological disorder (PDG), and with two diagnoses in comorbidity (SPDG) participated in this study. The procedures were speech fluency and phonology evaluation. The data were submitted to statistical analysis.
RESULTS: Subjects from SG and SPDG showed a greater occurrence of stuttering-like disfluencies and total of disfluencies in relation to the subjects with PDG. Regarding to the other disfluencies, the three groups were similar. Subjects with PDG showed fewer monosyllabic word repetitions, part of word repetition and prolongations in relation to subjects from SG and SPDG. Blocks occurred more frequently in the two groups with stuttering (SG and SPDG) than in the group with PDG. Interjection occurred more frequently in subjects from SG than in PDG.
CONCLUSION: The PDG was the most differentiated in quantitative and qualitative terms in the three groups analyzed. The similarities and differences between the groups will assist the differential diagnosis and, consequently, will enable improved therapy. The presence of blocks represents an important marker for the diagnosis of stuttering.
PMID: 32267336 DOI: 10.1590/2317-1782/20192019002
Investigating resilience, perceived social support and trait anxiety levels of mothers of school-age children who stutter - AMBIENTE
Codas. 2020 Jan 13;32(2):e20190093
Free full text: http://www.scielo.br/pdf/codas/v32n2/2317-1782-codas-32-2-e20190093.pdf
Yaşar Ö, Vural-Batık M, Özdemir Ş.
Ondokuz Mayıs University, Samsun, Turkey; Hacettepe University, Ankara, Turkey.
PURPOSE: The attitude of mothers of children who stutter is believed to be crucial in the management of therapy process. Therefore, this study aimed at the description of resilience, perceived social support and trait anxiety levels of mothers of children with stuttering, as well as at the exploration of the relationship between them.
METHODS: The study sample consisted of 33 mothers of children with stuttering aged 6-12 years. The data were gathered using the following instruments: Mother Resilience Scale, Revised Parental Social Support Scale, State-trait Anxiety Inventory, Stuttering Severity Instrument-4, and a personal information form.
RESULTS: Resilience of mothers of children who stutter was high, whereas perceived social support and trait anxiety levels of the participants were lower. Mother's increased level of perceived social support resulted in increased resilience level and decreased trait anxiety level. The trait anxiety levels of mothers with a college degree were significantly lower than those of mothers with other education levels. No statistically significant correlation was observed between stuttering severity and the levels of resilience, perceived social support and trait anxiety.
CONCLUSION: Although mothers of stuttering children present the required skills to cope with the situation, it is believed that they need more social support. Consequently, offering professional support to mothers in the course of stuttering management and referring them to appropriate intervention programs are emphasized.
PMID: 31939494 DOI: 10.1590/2317-1782/20192019093
Involvement of the Cortico-Basal Ganglia-Thalamocortical Loop in Developmental Stuttering - CONCEITO
Front Psychol. 2020 Jan 28;10:3088.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997432/pdf/fpsyg-10-03088.pdf
Chang SE, Guenther FH.
University of Michigan, Ann Arbor, MI, United States; Boston University, Boston, MA, United States; Massachusetts Institute of Technology, Cambridge, MA, United States; Massachusetts General Hospital, Charlestown, MA, United States.
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.
PMID: 32047456 PMCID: PMC6997432 DOI: 10.3389/fpsyg.2019.03088
Lexical diversity and lexical skills in children who stutter - LINGUAGEM
J Fluency Disord. 2020 Jan 22;63:105747. [Epub ahead of print]
Luckman C, Wagovich SA, Weber C, Brown B, Chang SE, Hall NE, Bernstein Ratner N.
University of Maryland, College Park, MD,United States; University of Missouri, Columbia, MO,United States; Purdue University, West Lafayette, IN, United States; University of Michigan, Ann Arbor, MI, United States; University of Maine, Orono, ME, United States; University of Maryland, College Park, MD, United States.
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.
PMID: 32058092 DOI: 10.1016/j.jfludis.2020.105747
Loci of Stuttering of English- And Korean-speaking Children Who Stutter: Preliminary Findings - FALA
J Fluency Disord. 2020 Jun;64:105762. Epub 2020 May 5.
Dahye Choi, Hyunsub Sim, Hyeyeon Park, Chagit E Clark, Hanjoe Kim
University of South Alabama, USA, Ewha Womans University, Seoul, South Korea, Beyond Fluency, Asheville, NC, USA, University of Houston, TX, USA.
Purpose: The purpose of the study was to determine whether differences exist between young English- and Korean-speaking children who stutter (CWS) in the loci of stuttering.
Method: Participants were 10 Korean-speaking and 11 English-speaking CWS between the ages of 3 and 7 years. Participants produced narratives while viewing various picture scenes and a wordless picture book.
Results: Findings indicated that Korean-speaking CWS stuttered more on content than function words whereas English-speaking CWS stuttered more on function than content words. Furthermore, both Korean- and English-speaking CWS tended to stutter more on utterance-initial words. These findings appear to be related to the differences in linguistic/syntactic structures between Korean and English. Specifically, in the Korean-speaking CWS's narratives, most utterance-initial words (73.60 %) were content words whereas in the English-speaking CWS's narratives, most utterance-initial words (83.57 %) were function words.
Conclusion: These preliminary findings, although in need of replication with a larger sample size, seem to suggest that the word class (i.e., content/function words) contributions to stuttering loci are more language-specific whereas the word position (i.e., utterance-initial position) contributions to stuttering loci are more language-nonspecific. Given that the true characteristics of stuttering may be rather language-nonspecific than language-specific, further research may need to focus more on stuttering loci related to word position than word class.
PMID: 32445988 DOI: 10.1016/j.jfludis.2020.105762
Long-latency Auditory Evoked Potential in Children With Stuttering - AUDITIVO
[Article in English, Portuguese] Potenciais evocados auditivos de longa latência em crianças com gagueira
Einstein (Sao Paulo). 2020 Jun 3;18:eAO5225.
Free full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279890/pdf/2317-6385-eins-18-eAO5225.pdf
Gislaine Machado Jerônimo 1, Ana Paula Rigatti Scherer 1, Pricila Sleifer 1
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Objective: To analyze the latency and the amplitude values of Mismatch Negativity and P300 cognitive potential in children with stuttering, with no auditory complaints, with auditory thresholds within the normality range, comparing them to the findings of a Control Group.
Methods: A cross-sectional study involving 50 children of both sexes, 15 with stuttering and 35 without stuttering, aged 6 to 11 years, with no diagnosis of ear pathology or other diseases. All children were submitted to peripheral audiological evaluation (meatoscopy, pure tone testing, speech audiometry, and acoustic immittance measures) and a central audiological evaluation (investigation of the Mismatch Negativity and P300 cognitive potential). For the evaluation of fluency, all children with stuttering had a specific history taken and were video recorded in a spontaneous speech. Afterwards, the transcription was done, followed by speech analysis to classify children according the severity of stuttering.
Results: There was a significant difference in the latencies of Mismatch Negativity and P300 cognitive potential, as well as in the amplitude of Mismatch Negativity.
Conclusion: There was a significant delay in the latencies of Mismatch Negativity and P300 cognitive potential, as well as increase in the amplitude of the Mismatch Negativity in children with stuttering when compared to children in the Control Group. Changes in the morphology of the waves were found in the Stuttering Group.
PMID: 32578676 PMCID: PMC7279890
Natural recovery from stuttering for a clinical cohort of pre-school children who received no treatment. - AVALIAÇÃO
Int J Speech Lang Pathol. 2020 Apr 22:1-9 [Epub ahead of print]
Carey B, Onslow M, O'brian S.
The University of Sydney, NSW, Australia.
Purpose: The natural stuttering recovery rate by adulthood is high. Community cohort studies suggest a much lower rate during the first 18 months after onset, but this may be different for clinical cohorts of pre-school aged children. The present research and case presentations add to data reported by Franken et al. by investigating early natural recovery for a clinical cohort.
Method: Participants were 16 pre-school children presenting to a clinic with stuttering onset 1-15 months earlier. The children were studied for a mean of 19.4 months (84.3 weeks) using parent report and clinician identification of stuttering from recorded conversations. The children received no treatment during the study. Data were obtained for each participant and are presented graphically.
Result: Experienced speech-language pathologists detected stuttering in the recordings of 3 of 4 children identified as recovered by their parents. Only 1 of the 16 children (6.3%) was confirmed as recovered.
Conclusion: There is no reason to believe that the early natural recovery rate for clinically presenting children is different from community cohorts. Parent report of natural recovery during the pre-school years needs to be confirmed by clinician observation of the child's speech; otherwise, there is risk of harmful false negative identification. The present data support the Yairi et al. different recovery pathways for children who stutter.
PMID: 32316786 DOI: 10.1080/17549507.2020.1746399
Neural Correlates of Vocal Pitch Compensation in Individuals Who Stutter - AUDITIVO
Front Hum Neurosci. 2020 Feb 25;14:18. 2020.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053555/pdf/fnhum-14-00018.pdf
Sares AG, Deroche MLD, Ohashi H, Shiller DM, Gracco VL.
McGill University, Montreal, QC, Canada; Centre for Research on Brain, Language, and Music, Montreal, QC, Canada; Concordia University, Montreal, QC, Canada; Haskins Laboratories, New Haven, CT, United States; Université de Montréal, Montreal, QC, Canada.
Stuttering is a disorder that impacts the smooth flow of speech production and is associated with a deficit in sensorimotor integration. In a previous experiment, individuals who stutter were able to vocally compensate for pitch shifts in their auditory feedback, but they exhibited more variability in the timing of their corrective responses. In the current study, we focused on the neural correlates of the task using functional MRI. Participants produced a vowel sound in the scanner while hearing their own voice in real time through headphones. On some trials, the audio was shifted up or down in pitch, eliciting a corrective vocal response. Contrasting pitch-shifted vs. unshifted trials revealed bilateral superior temporal activation over all the participants. However, the groups differed in the activation of middle temporal gyrus and superior frontal gyrus [Brodmann area 10 (BA 10)], with individuals who stutter displaying deactivation while controls displayed activation. In addition to the standard univariate general linear modeling approach, we employed a data-driven technique (independent component analysis, or ICA) to separate task activity into functional networks. Among the networks most correlated with the experimental time course, there was a combined auditory-motor network in controls, but the two networks remained separable for individuals who stuttered. The decoupling of these networks may account for temporal variability in pitch compensation reported in our previous work, and supports the idea that neural network coherence is disturbed in the stuttering brain.
PMID: 32161525 PMCID: PMC7053555 DOI: 10.3389/fnhum.2020.00018
Neural Indices Mediating Rhyme Discrimination Differ for Some Young Children Who Stutter Regardless of Eventual Recovery or Persistence - AUDITIVO
J Speech Lang Hear Res. 2020 Apr 17:1-18. [Epub ahead of print]
Gerwin KL, Weber C.
Purdue University, West Lafayette, IN.
Purpose: Previous studies of neural processing of rhyme discrimination in 7- to 8-year-old children who stutter (CWS) distinguished children who had recovered, children who had persisted, and children who did not stutter (CWNS; Mohan & Weber, 2015). Here, we investigate neural processing mediating rhyme discrimination for early acquired real words in younger CWS and CWNS (4;1-6;0 years;months), when rhyming abilities are newly emerging, to examine possible relationships to eventual recovery (CWS-eRec) and persistence in stuttering (CWS-ePer).
Method: Children performed a rhyme discrimination task while their event-related brain potentials were recorded. CWNS, CWS-eRec, and CWS-ePer had similar speech and language abilities. Inclusionary criteria incorporated at least 70% accuracy for rhyme discrimination. Analyses focused on the mean amplitude of the N400 component elicited by rhyming and nonrhyming words in anterior and posterior regions of interest. Results: CWNS, CWS-eRec, and CWS-ePer displayed a classic event-related potential rhyme effect for rhyme discrimination characterized by larger amplitude, posteriorly distributed N400s elicited by nonrhyming targets compared to rhyming targets. CWNS displayed a more robust anterior rhyme effect compared to the CWS groups with a larger amplitude N400 anteriorly for the rhyming targets. This effect was more consistent across individual CWNS than CWS. Conclusions The groups of CWNS, CWS-eRec, and CWS-ePer, who had all developed rhyming discrimination abilities, exhibited similar underlying neural processes mediating phonological processing of early acquired words for the classic central-parietal rhyme effect. However, individual variability of the anterior rhyme effect suggested differences in specific aspects of phonological processing for some CWS-eRec and CWS-ePer compared to CWNS.
New Medications for Neuropsychiatric Disorders - FARMACOLOGIA
Psychiatr Clin North Am. 2020 Jun;43(2):399-413. Epub 2020 Apr 8.
Harika M Reddy , Joshua S Poole, Gerald A Maguire, Stephen M Stahl
University of California Riverside School of Medicine, Riverside, CA, USA; Neuroscience Education Institute, CA, USA; University of California San Diego, CA, USA.
This article seeks to summarize the mechanisms of action, clinical trials, and FDA approval status of several psychiatric medications that are either newly available or in the FDA approval process. This article highlights medications that demonstrate novel mechanisms of action, examines nonpsychiatric medications that are being used to augment existing psychiatric treatments, and elucidates treatments for illnesses that have not previously received FDA indications.
PMID: 32439029 DOI: 10.1016/j.psc.2020.02.008
Otorhinolaryngologists nominated for the Nobel Prize 1901-1940 - HISTÓRIA
Eur Arch Otorhinolaryngol. 2020 Feb 8. [Epub ahead of print]
Hansson N, Drobietz M, Mudry A.
Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany; Stanford University School of Medicine, USA.
PURPOSE: Several scholars with links to ENT have received the Nobel Prize in physiology or medicine. This overview takes into account ENT Nobel nominees, who never received the award.
METHODS: Drawing a comparison on the nominations collected in the archive of the Nobel Committee for physiology or medicine in Stockholm, the Nobel archive database and secondary literature; the paper analyzes for the first time the nominations of Hans Schmid (Stettin), Hermann Gutzmann (Berlin), Karl Wittmaack (Hamburg), and Chevalier Jackson (Chicago). We also bring up nomination letters written by prominent German nominators such as Hermann Schwartze (one of the founders of this journal) and August Lucae.
RESULTS: Hans Schmid was the first surgeon to be brought up in a Nobel Prize nomination for an ENT procedure (1901), but since he had passed away 5 years earlier he was not evaluated by the Nobel Committee. Hermann Gutzmann was a strong candidate in 1917 and reached the shortlist because of his pioneering work on stutter, but no Nobel Prize in physiology or medicine was awarded that year. In the 1930's, both Karl Wittmaack and Chevalier Jackson were repeatedly nominated for ENT research.
CONCLUSION: Nobel Prize nominations are to date underused sources that shed new light on some scholars in ENT history.
PMID: 32036407 DOI: 10.1007/s00405-020-05833-y
Potenciais evocados auditivos de longa latência em crianças com gagueira - AUDITIVO
Einstein (Sao Paulo). 2020 Jun 3;18:eAO5225.
[Article in English, Portuguese] Long-latency Auditory Evoked Potential in Children With Stuttering
Free PMC article: https://journal.einstein.br/wp-content/uploads/articles_xml/2317-6385-eins-18-eAO5225/2317-6385-eins-18-eAO5225-pt.x57660.pdf
Gislaine Machado Jerônimo, Ana Paula Rigatti Scherer, Pricila Sleifer
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Objetivo: Analisar os valores de latência e amplitude do Mismatch Negativity e potencial cognitivo P300 em crianças com gagueira, sem queixas auditivas, com limiares auditivos dentro dos padrões de normalidade, comparando aos achados de um Grupo Controle.
Métodos: Estudo transversal, do qual participaram 50 crianças de ambos os sexos, sendo 15 com gagueira e 35 sem gagueira, entre 6 e 11 anos de idade, sem diagnóstico de patologias otológicas ou outras doenças. Todas as crianças realizaram avaliação audiológica periférica (meatoscopia, audiometria tonal, audiometria vocal e medidas de imitância acústica) e avaliação audiológica central (Mismatch Negativity e potencial cognitivo P300). Para avaliação da fluência, as crianças com gagueira realizaram anamnese específica, seguida da filmagem de uma fala espontânea, que foi transcrita e analisada quanto à severidade da gagueira.
Resultados: Houve diferença significativa nas latências do Mismatch Negativity e do potencial cognitivo P300, assim como na amplitude do Mismatch Negativity.
Conclusão: Verificou-se atraso nas latências do Mismatch Negativity e potencial cognitivo P300 nas crianças com gagueira, assim como aumento na amplitude do Mismatch Negativity, ao serem comparados com crianças do Grupo Controle. No Grupo com Gagueira foram igualmente identificadas alterações na morfologia das ondas.
PMID: 32578676 PMCID: PMC7279890
Pediatrician Referral Practices for Children Who Stutter - INFANTIL
Am J Speech Lang Pathol. 2020 May 28;1-19. Online ahead of print.
Katherine L Winters, Courtney T Byrd
The University of Texas at Austin.
Purpose: Given the marked increase in evidence-based information regarding the nature/treatment of stuttering, coupled with the fact that pediatricians tend to be one of the initial points of contact for parents who suspect their preschool-age child may stutter, this study explored pediatricians' (a) accuracy in identifying children who may stutter and (b) likelihood of referring children who present with a profile indicative of stuttering to speech-language pathologists.
Method: Pediatricians recruited nationally through professional organizations completed a 5- to 7-min online survey that probed stuttering identification and referral practices via responses to experimental case vignettes. Each vignette featured a 4-year-old boy with a family history of stuttering whose mother reported signs of stuttering and manipulation of two factors: stuttering during the pediatrician visit (or not) and negative communication attitude (or not).
Results Our findings suggest pediatricians' identification and referral of children who may stutter is largely prompted by observation of overt speech behaviors and/or negative communication attitude. Participants' gender, years in practice, and experience working with children who stutter did not influence likelihood of referral.
Conclusions Results indicate pediatricians are less likely to implement a "wait and see" approach with young children who stutter today than in the past. Unlike other common child onset diagnoses, however, parent report of atypical behavior does not yield pediatrician referral to a specialist. Future education and advocacy efforts directed toward pediatricians should emphasize inclusion of factors other than direct observation of stuttering behavior that may warrant referral (e.g., parent report).
PMID: 32464074 DOI: 10.1044/2020_AJSLP-19-00058
Prevalence and features of comorbid stuttering and speech sound disorder at age 4 years - CONCEITO
J Commun Disord. 2020 Feb 13;84:105976. [Epub ahead of print]
Unicomb R, Kefalianos E, Reilly S, Cook F, Morgan A.
The University of Newcastle, Australia; The University of Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Griffith University, Queensland, Australia.
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.
PMID: 32092590 DOI: 10.1016/j.jcomdis.2020.105976
Prolonged Migraine Stuttering Aura: Structural, Functional, and Video Neuroimaging Study of an Atypical Migraine Aura. A Case Report - GAGUEIRA ADQUIRIDA
Headache. 2020 Apr;60(4):776-780. Epub 2020 Mar 5.
Rodríguez-Castro E, Lagorio AN, Bejarano-García A, Aguiar P, Cortés J, Leira R.
Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Universidad de Santiago de Compostela, Santiago de Compostela, Spain.
BACKGROUND: Stuttering is a disorder in the rhythm of speech characterized by an involuntary repetition, prolongation, and cessation of sounds. Neurogenic acquired stuttering is a very rare disorder which could result from different conditions with the involvement of several brain locations.
CASE REPORT: A 16-year-old male presented to our Hospital with headache associated with blurred vision followed by right-sided facial and upper limb tingling, clumsiness of right arm, and a complete inability to formulate language which evolved in the next minutes into an intense speech disorder characterized by persistent stuttering. Urgent brain magnetic resonance imaging showed a prominence of venous vasculature in left hemisphere in susceptibility weighted imaging sequence. A fluorodeoxyglucose-positron emission tomography revealed a bilateral occipital, temporal, and parietal hypometabolism. With the suspicion of migraine aura, analgesic treatment was administered. Symptoms progressively resolved inside 10 hours. Five months later he experienced a similar episode.
CONCLUSION: This case report represents a diagnostic challenge and suggests the inclusion of stuttering within the neurological manifestations of higher cortical dysfunction that can be found as a result of migraine aura.
PMID: 32141076 DOI: 10.1111/head.13780
Recovery and Relapse: Perspectives From Adults Who Stutter - AVALIAÇÃO
J Speech Lang Hear Res. 2020 Jun 29;1-15. Online ahead of print.
Seth E Tichenor, J Scott Yaruss
Michigan State University
Purpose Recovery and relapse relating to stuttering are often defined in terms of the presence or absence of certain types of speech disfluencies as observed by clinicians and researchers. However, it is well documented that the experience of the overall stuttering condition involves more than just the production of stuttered speech disfluencies. This study sought to identify what recovery and relapse mean to people who stutter based on their own unique experiences to account for both the stuttering behaviors and the broader adverse impact of the condition.
Method In this study, 228 adults who stutter participated in a mixed-methods exploration of the terms "recovery" and "relapse." Participants categorized themselves on whether they considered themselves to have recovered or experienced relapse. Data were analyzed thematically through the lens of the speaker self-categorizations to determine how adults who stutter define recovery and relapse regarding stuttering. Results Results indicate that, to adults who stutter, recovery from stuttering is associated with increases in positive affective/emotional, behavioral, and cognitive reactions to the condition and simultaneous decreases in associated negative constructs. These group-level definitions did not change as a function of whether respondents reported that they had experienced recovery or relapse themselves.
Discussion Recovery or relapse from stuttering behaviors can occur independently from recovery or relapse from the broader adverse impact related to the condition, suggesting that researchers and clinicians should consider recovery and relapse as involving more than just a reduction or an increase in observable behaviors. These findings support recent research evidence further specifying the many individual phenotypes of stuttering, in that pathways to recovery and relapse can be experienced in different ways for people with different stuttering phenotype profiles.
PMID: 32598208 DOI: 10.1044/2020_JSLHR-20-00010
Relative Contributions to Overall Impact of Stuttering in Adults Using the Overall Assessment of the Speaker's Experience of Stuttering (OASES) - AVALIAÇÃO
J Fluency Disord. 2020 Jun 13;65:105775. Online ahead of print.
Patrick M Briley , Heather Harris Wright , Kevin O'Brien , Charles Ellis
East Carolina University, Greenville, NC, USA.
Purpose: Comprehensive assessment of stuttering requires consideration of a wide range of behaviors that impact outcomes, and the Overall Assessment of the Speaker's Experience of Stuttering (OASES) is an assessment tool that accomplishes such. The purpose of this study was to determine how the individual components of the test contribute to the OASES' impact score.
Method: Data collected at a university speech-language and hearing clinic from 29 adults were used for a relative weight analysis (RWA). RWA was utilized to determine the relative contributions of the OASES' subtests to the OASES' impact score. Confidence intervals for the individual relative weights were calculated for each OASES subtest and significance tests based on bootstrapping with 10,000 replications.
Results: Differences were present in contributions of the OASES' subtests to the OASES' overall impact score, where the following explained a significant amount of variance in the OASES' impact score: Speaker's Reactions; Daily Communication; and Quality of Life. However, contribution of the subtest, "General Information", was not significant.
Conclusion: Through examination of relative contributions to the impact of stuttering using the OASES, this project has identified differences in contributors to the overall impact of the disorder of stuttering. This information is beneficial to researchers and clinicians alike in that it gives specific guidance into what determines increased impact in adults who stutter (AWS). Future works should pursue clarification of these differences with an end goal of identifying and overcoming barriers to positive outcomes while also identifying and nurturing facilitators to optimal management.
PMID: 32569881 DOI: 10.1016/j.jfludis.2020.105775
Resilience in people who stutter: Association with covert and overt characteristics of stuttering - EMOCIONAL
J Fluency Disord. 2020 Mar 9;64:105761. [Epub ahead of print]
Freud D, Amir O.
Tel-Aviv University, Israel.
PURPOSE: Recent literature stresses the importance of resilience, as a trait, for successful coping with life's difficulties or stressors. However, only a limited number of studies were conducted on resilience among people-who-stutter (PWS). These studies did not examine the association between resilience and the specific characteristics of stuttering. This study was, therefore, aimed to directly examine the association between resilience and measures of both the covert and overt characteristics of stuttering.
METHOD: Thirty adults who stutter completed the Connor-Davidson Resilience Scale (CD-RISC) and the Overall Assessment of Speaker's Experience of Stuttering - Adults (OASES-A). In addition, stuttering severity of all participants was quantified using the Stuttering Severity Instrument-4 (SSI-4). The associations between all measures were examined statistically.
RESULTS: A strong and significant association was found between the participants' scores on the CD-RISC and the OASES-A (r= -.79, p < .001). In contrast, no significant correlation was found between the participants' scores in the CD-RISC and the SSI-4 (r = .02, p > .05). Within our cohort, no significant association was observed between the participants' gender and age and their resilience levels (p > 0.05).
CONCLUSION: This study demonstrates the role of resilience in shaping the individual's experience with stuttering. Results also show that the individuals' resilience levels do not necessarily predict stuttering severity per se, or its overt manifestations but can predict the individuals' subjective perception of his/her stuttering. This highlights the importance of addressing and promoting resilience among PWS in stuttering therapy.
PMID: 32179250 DOI: 10.1016/j.jfludis.2020.105761
Sexual Crime Against Schoolchildren With Disabilities: A Nationwide Prospective Birth Cohort Study - SOCIAL
J Interpers Violence. 2020 Jul 1;886260520934442. Online ahead of print.
Mogens Nygaard Christoffersen
VIVE-The Danish Center for Social Science Research, Copenhagen K, Denmark.
Numerous studies have shown that the rate of sexual victimization against children with disabilities is higher than the rate for children without disabilities. The study focuses on examining sexual crime against children with disabilities and explaining differences in victimization to elucidate to what extent types of disability, family disadvantages, gender, high-risk behavior, and location influence adolescents' risk of sexual victimization. Data are based on a national study of reported sexual crime against children in Denmark aged between 7 and 18 years using total birth cohorts (N = 679,683). The statistical analysis is a discrete-time Cox model. An extended list of potential risk factors was included in the analysis to adjust for confounding. The potentially confounding risk factors were collected independently from various population-based registers, for example, employment statistics, housing statistics, education statistics, income compensation benefits, and population statistics (e.g., gender, age, location). Hospital records with information on types of disability based on the national inpatient register and national psychiatric register were collected independently of the collection of law enforcement records about reported sexual offenses under the Danish Central Crime Register. Among total birth cohorts, 8,039 persons or 1.18%. were victims of a reported sexual crime once or several times. Children with intellectual disabilities were more likely to be victimized of a reported sexual crime than non-disabled children were: attention-deficit/hyperactivity disorder (ADHD), odds ratio: 3.7 (3.5-3.9); mental retardation, odds ratio: 3.8 (3.6-4.0); and autism, odds ratio: 3.8 (3.6-4.0). This contrasts with children with speech disability, stuttering, and dyslexia who were less likely to be victimized when adjusted for family vulnerability and other confounding risk factors. Intellectual disability and family vulnerability, for example, parental substance abuse, parental violence, family separation, the child in care, and parental unemployment, indicate an increased risk of being a victim of a sexual crime, while speech disability seems to be ensuring protection.
PMID: 32608304 DOI: 10.1177/0886260520934442
Speech-Language Pathologists' Comfort Level With Use of Term "Stuttering" During Evaluations - AVALIAÇÃO
Am J Speech Lang Pathol. 2020 Mar 31:1-10. [Epub ahead of print]
Byrd CT, Werle D, St Louis KO.
The University of Texas at Austin; West Virginia University, Morgantown.
Purpose: Speech-language pathologists (SLPs) anecdotally report concern that their interactions with a child who stutters, including even the use of the term "stuttering," might contribute to negative affective, behavioral, and cognitive consequences. This study investigated SLPs' comfort in providing a diagnosis of "stuttering" to children's parents/caregivers, as compared to other commonly diagnosed developmental communication disorders.
Method: One hundred forty-one school-based SLPs participated in this study. Participants were randomly assigned to one of two vignettes detailing an evaluation feedback session. Then, participants rated their level of comfort disclosing diagnostic terms to parents/caregivers. Participants provided rationale for their ratings and answered various questions regarding academic and clinical experiences to identify factors that may have influenced ratings.
Results: SLPs were significantly less likely to feel comfortable using the term "stuttering" compared to other communication disorders. Thematic responses revealed increased experience with a specific speech-language population was related to higher comfort levels with using its diagnostic term. Additionally, knowing a person who stutters predicted greater comfort levels as compared to other clinical and academic experiences.
Conclusions: SLPs were significantly less comfortable relaying the diagnosis "stuttering" to families compared to other speech-language diagnoses. Given the potential deleterious effects of avoidance of this term for both parents and children who stutter, future research should explore whether increased exposure to persons who stutter of all ages systematically improves comfort level with the use of this term.
PMID: 32233922 DOI: 10.1044/2020_AJSLP-19-00081
Suppression for Delayed Auditory Feedback in Adults Who Do and Do Not Stutter - AUDITIVO
Front Hum Neurosci. 2020 Apr 24;14:150.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193705/pdf/fnhum-14-00150.pdf
Toyomura A, Miyashiro D, Kuriki S, Sowman PF
Gunma University, Maebashi, Japan; Gunma University Hospital, Maebashi, Japan; Hokkaido University, Hokkaido, Japan; Macquarie University, Sydney, NSW, Australia.
Speech-induced suppression is the normal, relative amplitude reduction of the auditory evoked potential for self-, compared to externally-generated, auditory stimulation. It remains controversial as to whether adults who stutter exhibit expected auditory modulation during speech; some studies have reported a significant difference between stuttering and fluent groups in speech-induced suppression during speech movement planning, while others have not. We compared auditory evoked potentials (N1 component) for auditory feedback arising from one's own voice (Speaking condition) with passive listening to a recording of one's own voice (Listening condition) in 24 normally-fluent speakers and 16 adults who stutter under various delayed auditory feedback (DAF) time conditions (100 ms, 200 ms, 500 ms, and 1,000 ms). We presented the participant's own voice with a delay, immediately after presenting it without a delay. Our working hypothesis was that the shorter the delay time, the more likely the delayed sound is perceived as self-generated. Therefore, shorter delay time conditions are proposed to result in relatively enhanced suppression of the auditory system.
Results showed that in fluent speakers, the shorter the delay time, the more the auditory evoked potential in the Speaking condition tended to be suppressed. In the Listening condition, there was a larger evoked potential with shorter delay times. As a result, speech-induced suppression was only significant at the short delay time conditions of 100 and 200 ms. Adults who stutter did not show the opposing changes in the Speaking and Listening conditions seen in the fluent group. Although the evoked potential in the Listening condition tended to decrease as the delay time increased, that in the Speaking condition did not show a distinct trend, and there was a significant suppression only at 200 ms delay. For the 200 ms delay condition, speakers with more severe stuttering showed significantly greater speech-induced suppression than those with less severe stuttering. This preliminary study suggests our methods for investigating evoked potentials by presenting own voice with a delay may provide a clue as to the nature of auditory modulation in stuttering.
Surface Electrical Stimulation for Persistent Stuttering and Concomitant Orofacial Disorders: A Multiple Case Study - TERAPIA
Percept Mot Skills. 2020 Mar 31:31512520915027. [Epub ahead of print]
Brazilian Fluency Institute, Sao Paulo, Brazil.
This multiple case study analysis describes the immediate effects on speech fluency of transcutaneous electrical nerve stimulation (TENS) applied to participants with persistent stuttering and concomitant orofacial disorders. Study participants were 14 adolescents and adults who stuttered and had jaw clenching bruxism or mouth breathing. Participants experienced low-frequency TENS applied at mild motor level for 20 minutes with electrodes placed at the lower third of the face (Area A), submandibular region (Area B), posterior neck (Area C), or shoulder girdle (Area D) with speech fluency assessed immediately before and after each stimulation.For participants with stuttering and bruxism, AB stimulation reduced the median frequency of syllables stuttered by 27% and reduced the median duration of the three highest stuttering moments by 29%. In addition, for participants with stuttering and mouth breathing, CD stimulation reduced the median duration of the three highest stuttering moments by 28% and increased their median speech rate by 113%. As a single session of TENS may help participants with stuttering and concomitant orofacial disorders better use fluency shaping techniques, the therapeutic potential of TENS for treating stuttering should be further investigated.
PMID: 32233734 DOI: 10.1177/0031512520915027
Temperament and Early Stuttering Intervention: Two Perspectives - TERAPIA
J Fluency Disord. 2020 May 11;64:105765. Online ahead of print.
Mark Onslow, Ellen M Kelly
University of Technology Sydney, Australia, Vanderbilt University, USA.
Purpose: To discuss clinical applications of research findings about temperament and early stuttering.
Method: A "1000-bytes" format (Onslow & Millard, 2012) was used to provide readers with contemporaneous observation of a "conversation" between the authors. The conversation is proceeded by a prologue and followed by concluding statements from each author.
Results: One author contended that comprehensive, multidimensional assessment of temperament domains is essential during clinical management of early stuttering, and the results of that assessment are best incorporated into a multifactorial treatment approach. The other author contested that view, arguing that such an approach is not empirically justifiable at present.
Conclusions: The authors agree about the salience of research on temperament and early stuttering but have different perspectives about the topic when applied to providing health care for early stuttering.
PMID: 32442826 DOI: 10.1016/j.jfludis.2020.105765
The Application of EEG Mu Rhythm Measures to Neurophysiological Research in Stuttering. - NEUROCIÊNCIAS
Front Hum Neurosci. 2020 Jan 10;13:458.
Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6965028/pdf/fnhum-13-00458.pdf
Jenson D, Bowers AL, Hudock D, Saltuklaroglu T.
Washington State University, Spokane, WA, United States; University of Arkansas, Fayetteville, AR, United States; Idaho State University, Pocatello, ID, United States; University of Tennessee Health Science Center, Knoxville, TN, United States.
Deficits in basal ganglia-based inhibitory and timing circuits along with sensorimotor internal modeling mechanisms are thought to underlie stuttering. However, much remains to be learned regarding the precise manner how these deficits contribute to disrupting both speech and cognitive functions in those who stutter. Herein, we examine the suitability of electroencephalographic (EEG) mu rhythms for addressing these deficits. We review some previous findings of mu rhythm activity differentiating stuttering from non-stuttering individuals and present some new preliminary findings capturing stuttering-related deficits in working memory. Mu rhythms are characterized by spectral peaks in alpha (8-13 Hz) and beta (14-25 Hz) frequency bands (mu-alpha and mu-beta). They emanate from premotor/motor regions and are influenced by basal ganglia and sensorimotor function. More specifically, alpha peaks (mu-alpha) are sensitive to basal ganglia-based inhibitory signals and sensory-to-motor feedback. Beta peaks (mu-beta) are sensitive to changes in timing and capture motor-to-sensory (i.e., forward model) projections. Observing simultaneous changes in mu-alpha and mu-beta across the time-course of specific events provides a rich window for observing neurophysiological deficits associated with stuttering in both speech and cognitive tasks and can provide a better understanding of the functional relationship between these stuttering symptoms. We review how independent component analysis (ICA) can extract mu rhythms from raw EEG signals in speech production tasks, such that changes in alpha and beta power are mapped to myogenic activity from articulators. We review findings from speech production and auditory discrimination tasks demonstrating that mu-alpha and mu-beta are highly sensitive to capturing sensorimotor and basal ganglia deficits associated with stuttering with high temporal precision. Novel findings from a non-word repetition (working memory) task are also included. They show reduced mu-alpha suppression in a stuttering group compared to a typically fluent group. Finally, we review current limitations and directions for future research.
PMID: 31998103 PMCID: PMC6965028 DOI: 10.3389/fnhum.2019.00458
The effect of tele-speech therapy on treatment of stuttering - TERAPIA
Disabil Rehabil Assist Technol. 2020 Apr 17:1-6 [Epub ahead of print]
Eslami Jahromi M, Ahmadian L, Bahaadinbeigy K.
Kerman University of Medical Sciences, Kerman, Iran.
Purpose: The aim of this study was to evaluate the effect of tele-speech therapy on the recovery of patients with a stutter.
Methods: This research was an interventional study conducted on the patients visiting two rehabilitation centres. In this study, patients with a stutter participated in the tele-speech therapy sessions via Skype. Stuttering Severity Instrument-Fourth Edition was used to determine the severity of stutter before and after the intervention.
Results: The results showed a significant difference in the mean scores of stuttering severity before and after tele-speech therapy (p = 0.001). Our findings showed a mean reduction of 13.8% in stuttering scores. More than half of the patients (56.6%) reported a "high" and "very high" satisfaction with this treatment method.
Conclusions: Tele-speech therapy is an effective way for the treatment of stuttering patients irrespective of their age, gender, and educational background. This method can improve patient's speech and reduce stuttering.
Implications for Rehabilitation: Tele-rehabilitation is an effective way to treat stuttering.Tele-speech therapy can be implemented for any group of stuttering patients.Participants were satisfied with the tele-rehabilitation intervention.Tele-speech therapy accelerates the treatment process.Tele-speech therapy eliminates patient travels to speech therapies.
PMID: 32299263 DOI: 10.1080/17483107.2020.1754475
The Effects of Different Sources of Stuttering Disclosure on the Perceptions of a Child Who Stutters - TERAPIA
Lang Speech Hear Serv Sch. 2020 Apr 16:1-16 [Epub ahead of print]
Snyder G, Williams MG, Adams C, Blanchet P.
The University of Mississippi, University; The University of Texas at Dallas, Richardson; Baylor University, Waco, TX.
Purpose This study measured between-group differences in perceived speech skills and personality characteristics of a 12-year-old boy who stutters as a function of a factual stuttering disclosure statement, delivered by the boy who stutters, his "mother," or his "teacher."
Method Two hundred seventeen college-aged adults were randomly assigned to one of four groups, including a control group (no stuttering disclosure) and three experimental groups (child disclosure, mother disclosure, and teacher disclosure). Participants in the control condition viewed a brief video of a 12-year-old boy who stutters. For the experimental conditions, participants viewed a brief factual stuttering disclosure video (delivered by the child, mother, or teacher), followed by the same minute-long video of a boy who stutters used in the control condition. Following the videos, participants completed surveys relative to their perception of the boy's speech skills and personality characteristics.
Results Results support previous research citing benefits of stuttering disclosure. Significant between-group differences in both perceived speech skills and personality characteristics were observed when stuttering was disclosed by not only the child who stutters but also his teacher. When stuttering was disclosed by the mother, limited positive attitudinal differences were observed in speech skills; as a matter of fact, a number of personality characteristics were perceived more negatively as a function of stuttering disclosure by the mother.
Conclusions While results were generally most positive when the boy disclosed his own stuttering, data from this study support the efficacy of verbal stuttering disclosure provided by a teacher as a means of improving perceptions associated with stuttering. Accordingly, data support the notion that children who stutter will experience an improved quality of life when taught effective self-disclosure strategies by both parents and professionals, and that professionals (but not necessarily parents) can effectively disclose their clients' stuttering during this mentorship and self-advocacy process.
PMID: 32302261 DOI: 10.1044/2020
The Link Between Amitriptyline and Movement Disorders: Clinical Profile and Outcome - FARMACOLOGIA
Ann Acad Med Singapore. 2020 Apr;49(4):236-251.
Free article ???
Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
Federal University of Santa Maria, Brazil.
Introduction: Amitriptyline (AMT) is a tricyclic antidepressant. In this review, we evaluate the clinical and epidemiological profile, pathological mechanisms and management of AMT-associated movement disorders.
Materials and methods: A search for relevant reports in 6 databases was performed. Studies that reported patients developed only ataxia or tremor after AMT use were excluded.
Results: A total of 48 reports on 200 cases were found. AMT-associated movement disorders included myoclonus (n = 26), dyskinesia (n = 11), dystonia (n = 8), stutter (n = 5), akathisia (n = 3) and restless legs syndrome (n = 1). For less well-defined cases, 99 patients had dyskinesia, 19 had psychomotor disturbances, 3 had myoclonus, 11 had dystonia, 12 had Parkinsonism and 1 each had akathisia and extrapyramidal symptoms. Mean and standard deviation (SD) and median ages were 45.40 years (SD 16.78) and 40 years (range 3.7-82 years), respectively. Over half were women (58.13%) and the most common indication was depression. Mean and median AMT doses were 126 mg (SD 128.76) and 75 mg (range 15-800 mg), respectively. In 68% of patients, onset of movement disorders was <1 month; time from AMT withdrawal to complete recovery was <1 month in 70% of cases. A weak negative linear correlation (r = -0.0904) was found between onset of movement disorders and AMT dose. AMT withdrawal was the most common treatment.
Conclusion: Amitriptyline is associated with various movement disorders, particularly myoclonus, dystonia and dyskinesias. Stutters and restless legs syndrome are some of the less common associations.
The Neurocognition of Developmental Disorders of Language - NEUROCIÊNCIAS
Annu Rev Psychol. 2020 Jan 4; 71: 389-417. Epub 2019 Jul 23
Ullman MT, Earle FS, Walenski M, Janacsek K.
Georgetown University, Washington; University of Delaware, Newark, Delaware, USA; Northwestern University, Evanston, Illinois, USA; Eotvos Lorand University (ELTE), Budapest, Hungary; Hungarian Academy of Sciences, Budapest, Hungary.
Developmental disorders of language include developmental language disorder, dyslexia, and motor-speech disorders such as articulation disorder and stuttering. These disorders have generally been explained by accounts that focus on their behavioral rather than neural characteristics; their processing rather than learning impairments; and each disorder separately rather than together, despite their commonalities and comorbidities. Here we update and review a unifying neurocognitive account-the Procedural circuit Deficit Hypothesis (PDH). The PDH posits that abnormalities of brain structures underlying procedural memory (learning and memory that rely on the basal ganglia and associated circuitry) can explain numerous brain and behavioral characteristics across learning and processing, in multiple disorders, including both commonalities and differences. We describe procedural memory, examine its role in multiple aspects of language, and then present the PDH and relevant evidence across language-related disorders. The PDH has substantial explanatory power, and both basic research and translational implications. Expected final online publication date for the Annual Review of Psychology Volume 71 is January 4, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
PMID: 31337273 DOI: 10.1146/annurev-psych-122216-011555
The Pharmacologic Treatment of Stuttering and Its Neuropharmacologic Basis - FARMACOLOGIA
Front Neurosci. 2020 Mar 27;14:158. doi: 10.3389/fnins.2020.00158. eCollection 2020.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118465/pdf/fnins-14-00158.pdf
Maguire GA, Nguyen DL, Simonson KC, Kurz TL.
University of California, Riverside, Riverside, CA, United States.
Stuttering is a DSM V psychiatric condition for which there are no FDA-approved medications for treatment. A growing body of evidence suggests that dopamine antagonist medications are effective in reducing the severity of stuttering symptoms. Stuttering shares many similarities to Tourette's Syndrome in that both begin in childhood, follow a similar male to female ratio of 4:1, respond to dopamine antagonists, and symptomatically worsen with dopamine agonists. In recent years, advances in the neurophysiology of stuttering have helped further guide pharmacological treatment. A newer medication with a novel mechanism of action, selective D1 antagonism, is currently being investigated in FDA trials for the treatment of stuttering. D1 antagonists possess different side-effect profiles than D2 antagonist medications and may provide a unique option for those who stutter. In addition, VMAT-2 inhibitors alter dopamine transmission in a unique mechanism of action that offers a promising treatment avenue in stuttering. This review seeks to highlight the different treatment options to help guide the practicing clinician in the treatment of stuttering.
PMID: 32292321 PMCID: PMC7118465
The Recovery Rate of Early Stuttering - CONCEITO
J Fluency Disord. 2020 Jun;64:105764. Epub 2020 May 8.
Jóhanna T Einarsdóttir, Kathryn Crowe, Sigfús Helgi Kristinsson, Thora Másdóttir
University of Iceland, Reykjavik, Iceland, Charles Sturt University, Bathurst, Australia, University of South Carolina, Columbia, South Carolina, United States.
Purpose: Across studies there is great variability in reported rates of stuttering recovery. This study examined the impact that different definitions of recovery had on calculation of recovery rates and factors associated with recovery within the same sample of children.
Method: Speech samples and parents and child reports of their experiences of stuttering were collected from 38 children who stuttered aged 2-5 years of age (Occassion-1) and again at 9-13 years of age (Occassion-2). Four different criteria for recovery that were developed representing variations in criteria reported in previous research were applied to data from these children.
Results: . The majority of the participants (82%) showed very little disfluent speech (<1% syllables stuttered) at Occasion 2. Recovery rate varied greatly depending on the criteria used, ranging from 13.2%-94.7%. Definitions ordered from least to greatest recovery that were (a) parent and clinician report no stuttering and no stuttering observed (13.2 %); (b) ≤1% syllables stuttered; severity rated at ≤1; parent, clinician, and child report recovery (55.3 %); (c) ≤1% syllables stuttered; severity rated at ≤1; parent and clinician report recovery (71.1 %); (d) <3.0 % syllables stuttered (94.7 %). Five participants were considered recovered and two were considered persistent stutters across all criteria. Different factors were associated with recovery from stuttering depending on the criterion used.
Conclusion: The concept of recovery from stuttering is complex and estimations of recovery rate are likely to be greatly affected by differences in definitions and measurement across studies. This has a flow-on effect in determining the factors associated with recovery from stuttering.
PMID: 32445989 DOI: 10.1016/j.jfludis.2020.105764
The Role of Behavioral Inhibition for Conversational Speech and Language Characteristics of Preschool-Age Children Who Stutter - EMOCIONAL
Am J Speech Lang Pathol. 2020 Feb 14:1-14. [Epub ahead of print]
Tumanova V, Woods C, Razza R.
Syracuse University, NY.
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  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.
PMID: 32073287 DOI: 10.1044/2019_AJSLP-19-00026
The Speaker's Experience of Stuttering: Measuring Spontaneity - TERAPIA
J Speech Lang Hear Res. 2020 Mar 26:1-19. [Epub ahead of print]
Constantino CD, Eichorn N, Buder EH, Beck JG, Manning WH.
Florida State University, Tallahasse; University of Memphis, Tennessee.
Purpose This study measures the experience of spontaneous speech in everyday speaking situations. Spontaneity of speech is a novel concept developed to account for the subjective experience of speaking. Spontaneous speech is characterized by little premeditation and effortless production, and it is enjoyable and meaningful. Attention is not directed on the physical production of speech. Spontaneity is intended to be distinct from fluency so that it can be used to describe both stuttered and fluent speech. This is the first study to attempt to measure the concept of spontaneity of speech.
Method The experience sampling method was used with 44 people who stutter. They were surveyed five times a day for 1 week through their cell phones. They reported on their perceived spontaneity, fluency, and speaking context.
Results Results indicate that spontaneity and fluency are independent, though correlated, constructs that vary with context. Importantly, an increase in spontaneity significantly decreases the adverse impact of stuttering on people's lives. Fluency did not significantly affect adverse life impact of stuttering.
Conclusion Findings support a theoretical construct of spontaneity that is distinct from speech fluency and that can inform our views of stuttering and approaches to stuttering treatment.
PMID: 32213101 DOI: 10.1044/2019_JSLHR-19-00068
Toward a better understanding of the process of disclosure events among people who stutter - TERAPIA
J Fluency Disord. 2020 Jan 8:105746. [Epub ahead of print]
Boyle MP, Gabel R
Montclair State University, Bloomfield, NJ, United States; University of Toledo, Toledo, OH, United States.
PURPOSE: The purpose of this study was to identify components of disclosure events among people who stutter, and identify possible relations between these components in order to understand how disclosure events unfold.
METHOD: Twelve adults who stutter participated in semi-structured interviews focused on disclosure of stuttering. Participants were purposefully selected due to their self-reported history of disclosing stuttering. Qualitative content analysis using a grounded theory approach helped to identify relevant themes and subthemes related to the process of disclosure of stuttering.
RESULTS: The findings describe the complex process of disclosure as being comprised of antecedents (including considerations about when and why to disclose), the disclosure event itself (including the content and form of the disclosure, most and least helpful methods of disclosure, as well as immediate listener reactions), and the perceived outcomes of the disclosure at individual, dyadic, and societal/contextual levels. These components of the process are linked and affect one another, resulting in a feedback loop. Disclosure methods are context-dependent and not mutually exclusive within individuals who stutter.
CONCLUSION: Professionals and advocates gaining a more nuanced understanding of the process of disclosure events can increase their ability to help people who stutter make optimal decisions about disclosure. Making good disclosure decisions can help PWS improve their quality of life and reduce a variety of environmental communicative barriers.
PMID: 31932095 DOI: 10.1016/j.jfludis.2020.105746