Abstract - Agosto a Dezembro de 2023
A pilot study of an online self-compassion intervention for adults who stutter - TERAPIA
Int J Speech Lang Pathol. 2023 Aug 12;1-14. Online ahead of print.
Robyn L Croft, Courtney T Byrd
The University of Texas at Austin, Austin, TX, USA.
Purpose: The primary aim of this pilot study was to determine the preliminary effectiveness of an online self-compassion intervention for improving self-compassion and quality of life in adults who stutter. A secondary aim was to determine intervention acceptability and participant satisfaction.
Method: Participants included adults who stutter who completed an online self-compassion module once a week for six consecutive weeks. Pre- and post-intervention measures included the Self-Compassion Scale-Trait and the Overall Assessment of the Speaker's Experience of Stuttering. Participants also completed acceptability questionnaires weekly and post-intervention via quantitative and qualitative reports.
Result: Ten participants completed all six intervention modules, as well as pre- and post-intervention measures. Participants reported increased self-compassion and improved quality of life at post-intervention, as well as high intervention acceptability with regard to delivery format, content, duration, and relevance to stuttering and daily life. Individual variation was also observed across acceptability domains.
Conclusion: The present study provides pilot data supporting the use of online modules to increase self-compassion and decrease the negative impact of stuttering on the quality of life among adults who stutter. Future studies should employ larger sample sizes, compare outcomes to a control group, and determine if gains are maintained over time.
PMID: 37572047 DOI: 10.1080/17549507.2023.2236813
Amantadine-Induced Craniofacial Myoclonus: Distinctive Iatrogenic Dysarthria in Parkinson's Disease - FARMACOLOGIA
Review Mov Disord Clin Pract. 2023 Jul 14;10(9):1408-1413.
Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10525052/pdf/MDC3-10-1408.pdf
Iris Lin et al
University of Cincinnati Cincinnati Ohio USA; Toronto Western Hospital Toronto Ontario Canada.
Background: Amantadine is a widely prescribed medication in Parkinson's disease (PD). A distinctive craniofacial distribution of myoclonus with speech impairment is an underrecognized iatrogenic complication in amantadine-treated patients with PD.
Cases: We report 7 patients with idiopathic PD (disease duration, 6-21 years) who developed speech-induced craniofacial-predominant myoclonus with "stuttering-like" dysarthria and speech arrests days to months after amantadine initiation or dose increase. Renal insufficiency was identified as a risk factor in 4 cases. In all cases, reduction or discontinuation of amantadine markedly attenuated the myoclonus and restored speech intelligibility.
Literature review: Amantadine can induce subcortical segmental or generalized myoclonus. A report in 1996 of "vocal myoclonus" in an amantadine-treated patient with PD was the first observation of a focal distribution of myoclonus, particularly affecting speech. Since then, few cases of craniofacial myoclonus with speech impairment have been reported, none with accompanying video. With 1 exception, the craniofacial distribution was part of a generalized pattern of amantadine-induced myoclonus. Comorbid renal insufficiency is a recognized risk factor.
Conclusions: Speech-induced craniofacial myoclonus, with marked "stuttering-like" dysarthria and speech arrests, is a disabling iatrogenic complication in PD that resolves upon amantadine discontinuation.
PMID: 37772280 PMCID: PMC10525052 DOI: 10.1002/mdc3.13828
B - 13 A Written Stutter: a Case Study of Functional Neurologic Disorder - OUTRAS ÁREAS
Arch Clin Neuropsychol. 2023 Oct 8:acad067.220. Online ahead of print.
Laura Gramling, Erin I O'Connell, Shelley Peery
Objective: Functional neurologic disorder (FND) is a broad diagnostic construct that encompasses many heterogeneous conditions. The defining characteristic of FND is that the affected individual experiences symptoms for which there is no known biological mechanism. Often the symptoms are attributed to psychological factors. FND remains poorly understood, despite increased efforts to elucidate neural and neuropsychological correlates. To date, there have been only a few case studies published on acute onset of dysfluent writing that does not result in dysgraphia and is not associated with a major neurological event (i.e., stroke, or traumatic brain injury).
Methods: A 17-year-old, right-handed, White, cis-gender boy was referred to an outpatient neuropsychology private practice with a complaint of acute onset and progressive dysfluent and effortful writing without dysgraphia. A comprehensive neuropsychological evaluation was undertaken, and the patient's mother served as a collateral informant.
Results: Performance was grossly within normal limits with mild impairment in fine motor coordination. The patient evidenced a slowed, effortful writing style marked by initial hesitation followed by a smooth fluid motion. Clinical interview and measures of psychological functioning did not reveal any psychiatric conditions.
Conclusions: Parallels are drawn between this dysfluent writing style, which does not cause functional impairment, and a stutter. Neuroanatomical mechanisms are explored.
PMID: 37807390 DOI: 10.1093/arclin/acad067.220
"Behavioral and cognitive-affective features of stuttering in preschool-age children: Regression and exploratory cluster analyses" [Corrigendum to]
Published Erratum J Fluency Disord. 2023 Oct 16:106017.Online ahead of print.
Ryan A Millager, Mary S Dietrich, Robin M Jones
Vanderbilt University, Nashville, TN, United States.
No abstract available
The authors must correct the published description of the KiddyCAT. The previously published text states that the KiddyCAT is scored by “counting a child’s responses to the twelve yes (1)/no(0) items, with higher scores denoting more negative speech attitudes” (p. 6, Millager et al., 2023). Per the KiddyCAT test manual (Vanryckeghem & Brutten, 2007), however, six of the 12 test items must be reverse-scored, i.e., yes(0)/no(1). Specifically, items that indicate negative thinking are scored as 1, positive belief is scored as 0. Data for Millager et al. (2023) were scored in accordance with the scoring manual with no impact on findings or interpretation.
The authors would like to apologize for any inconvenience caused.
PMID: 37852862 DOI: 10.1016/j.jfludis.2023.106017
Clinical and Psychosocial Predictors of Post-Event Processing in Adults Who Stutter - TEMPERAMENTO
J Speech Lang Hear Res. 2023 Oct 10:1-21. Online ahead of print.
Robyn L Croft, Courtney T Byrd
The University of Texas at Austin.
Purpose: Post-event processing, defined by self-critical rumination following a stressful communication event, is significantly associated with reduced quality of life. However, despite its relevance to the stuttering experience, to date, only a few studies have investigated post-event processing among adults who stutter, and no study has identified clinical and psychosocial predictors of post-event processing. The purpose of this study was to determine the contributions of clinical markers of stuttering and psychosocial variables to post-event processing.
Method: Adults who stutter (N = 96) participated in two virtual sessions. After completing the Trier Social Stress Test, a standardized social stress task in Session 1, participants completed measures of post-event processing, clinical markers of stuttering (i.e., the experience of stuttering, self- and observer-rated stuttering severity), and psychosocial characteristics (i.e., self-perceived performance, self-esteem, social anxiety, trait, and state self-compassion) in Session 2.
Results: Hierarchical linear regression models indicated that a more negative experience of stuttering, higher self-rated stuttering severity, and greater social anxiety predicted more post-event processing. Greater self-perceived performance and state self-compassion predicted less rumination. Observer-rated severity, self-esteem, and trait self-compassion were not significantly associated with post-event processing behavior.
Conclusion: Findings reveal clinical and psychosocial variables to consider in the assessment and mitigation of post-event processing behavior in adults who stutter, and to bolster resiliency to social stress.
Supplemental material: https://doi.org/10.23641/asha.24223213.
PMID: 37816227 DOI: 10.1044/2023_JSLHR-23-00245
Clozapine-Induced Stuttering: Case Report and Literature Review - FARMACOLOGIA
Pharmacopsychiatry. 2023 Nov;56(6):240-243.
Full text: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2189-5597
Fares Jaballah, Amina Aissa, Uta Ouali, Yosra Zgueb, Rabaa Jomli
Avicenna Department (A), Razi Hospital, Tunis-El Manar University, Tunisia.
No abstract available
PMID: 37944562 DOI: 10.1055/a-2189-5597
Contemporary clinical conversations about stuttering: Neurodiversity and ableism - INFANTIL / SOCIAL
J Fluency Disord. 2023 Sep 19;78:106014. Online ahead of print.
Rosalee Shenker, Naomi Rodgers, Barry Guitar, Mark Onslow
Private Practice, Montreal, Canada; University of Iowa, IA, USA; University of Vermont, Vermont, USA; University of Technology Sydney, NSW, Australia.
Purpose: To discuss issues about neurodiversity and ableism, and how they pertain to clinical management of stuttering, with particular reference to early childhood stuttering.
Methods: During a webinar this year, the issue emerged of how concepts of neurodiversity and ableism apply to early childhood stuttering during the pre-school years. It became apparent that this topic elicited disparate views and would be of particular interest to students of speech-language pathology. Consequently, the leaders of that webinar continued the conversation by written dialogue for the purpose of placing it on record.
Results: The discussants reached agreement on many points, but there was some diversity of viewpoint about how neurodiversity and ableism should apply to clinical practice with children who have recently begun to stutter.
PMID: 37769595 DOI: 10.1016/j.jfludis.2023.106014
Cost of Illness and Health-Related Quality of Life for Stuttering: Two Systematic Reviews - CONCEITO
J Speech Lang Hear Res. 2023 Sep 26;1-18. Online ahead of print.
Alicia Norman et al
Macquarie University Business School, North Ryde, New South Wales, Australia; University of Technology Sydney, New South Wales, Australia; University of Oxford, United Kingdom.
Purpose: For those who stutter, verbal communication is typically compromised in social situations. This may attract negative responses from listeners and stigmatization by society. These have the potential to impair health-related quality of life across a range of domains, including qualitative and quantitative impacts on speech output, mental health issues, and failure to attain educational and occupational potential. These systematic reviews were designed to explore this matter using traditional health economics perspectives of utility measures and cost of illness.
Method: Studies were included if they involved children, adolescents, or adults with stuttering as a primary diagnosis. The quality of life search strategy identified 2,607 reports, of which three were included in the quality of life analysis. The cost of illness search strategy identified 3,778 reports, of which 39 were included in the cost of illness analysis.
Results: Two of the three studies included in the quality of life analysis had a high risk of bias. When measured using utility scores, quality of life for people who stutter was in the range of those reported for chronic health conditions such as diabetes mellitus, cardiovascular disease, and cancer. However, there is little such evidence of quality of life impairment during the preschool years. Studies included in the cost of illness analysis carried considerable risk of bias overall.
Conclusions: For people who stutter, there are substantive direct and indirect costs of illness. These include impairment, challenges, and distress across many domains throughout life, including income, education, employment, and social functioning. Evidence of quality of life impairment using utility measures is extremely limited. If this situation is not remedied, the lifetime impairment, challenges, and distress experienced by those who stutter cannot be documented in a form that can be used to influence health policy and health care spending.
PMID: 37751681 DOI: 10.1044/2023_JSLHR-23-00072
Delphi Survey of Items for the Test of Stuttering Screening in Children (TSSC) - AVALIAÇÃO
Clin Pract Epidemiol Ment Health. 2023 Jul 26:19
Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10487328/pdf/CPEMH-19-E174501792305170.pdf
Aiswarya Liz Varghese, Radish Kumar Balasubramanium, Gagan Bajaj, Sudhin Karuppali, Unnikrishnan Bhaskaran
Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Purpose: Stuttering is a fluency disorder that mostly begins in childhood and affects many people in our societies. No standardized screening tools are available to check for stuttering in the Indian school-going population. Thus, the study aimed at developing a screening tool to identify children who stutter among the school-going population using a Delphi-based approach.
Methods: This study was carried out in four phases. During the first phase, five Speech Language Pathologists (SLPs) were asked about the need for screening and the nature & attributes of a stuttering screening test for school-going children. The second phase involved constructing appropriate stimuli for the screening tool based on expert opinion, relevant literature and students' academic textbooks. The third phase involved content validation of the speech elicitation stimuli by four teachers, five SLPs and an English Lecturer teaching in a university. The fourth phase encompassed the development of differential diagnosis criteria for stuttering identification in children using a rank analysis of the expert opinions.
Results: A stuttering screening stimuli comprising age, language and culture-specific reading, picture description and narration tasks for 1st to 10th-standard students was developed. The contents of the tool obtained satisfactory consensus of agreement among the panel of experts. Further, the tool outlined five critical diagnostic criteria which could differentially diagnose school-going children with stuttering from typically speaking counterparts using the developed material.
Conclusion: The developed screening tool could help practicing clinicians quickly identify stuttering in school-going populations. This would enable early identification and build up the statistical data to estimate the prevalence of stuttering among the school-going population. Further studies examining the psychometric properties of the developed test are in progress.
PMID: 37916211 PMCID: PMC10487328 DOI: 10.2174/17450179-v19-230615-2022-27
Effectiveness of Stuttering Modification Treatment in School-Age Children Who Stutter: A Randomized Clinical Trial - INFANTIL / TERAPIA
J Speech Lang Hear Res. 2023 Oct 6:1-15. Online ahead of print.
Anke Kohmäscher, Annika Primaßin, Sabrina Heiler, Patricia Da Costa Avelar, Marie-Christine Franken, Stefan Heim
FH Münster University of Applied Sciences, Germany; RWTH Aachen University, Germany; Erasmus University Medical Centre, Rotterdam, the Netherlands; Institute of Neuroscience and Medicine, Forschungszentrum Jülich, Germany.
Purpose: This study investigated the effectiveness of the stuttering modification intervention Kinder Dürfen Stottern (KIDS) in school-age children who stutter.
Method: Seventy-three children who stutter were included in this multicenter, two-group parallel, randomized, wait-list controlled trial with a follow-up of 12 months. Children aged 7-11 years were recruited from 34 centers for speech therapy and randomized to either the immediate-treatment group or the 3 months delayed-treatment group. KIDS was provided by 26 clinicians who followed a treatment manual. Although the primary outcome measure was the impact of stuttering (Overall Assessment of the Speaker's Experience of Stuttering-School-Age [OASES-S]), the secondary outcomes included objective and subjective data on stuttering severity.
Results: At 3 months postrandomization, the mean score changes of the OASES-S differed significantly between the experimental (n = 33) and control group (n = 29; p = .026). Furthermore, treatment outcomes up to 12 months were analyzed (n = 59), indicating large effects of time on the OASES-S score (p < .001, partial η2 = .324). This was paralleled by significant improvements in parental ratings and objective ratings (stuttering severity, frequency, and physical concomitants).
Conclusions: The significant short-term treatment effects in the OASES-S are in line with the (initial) focus of KIDS on cognitive and affective aspects of stuttering. Over 12 months, these changes were maintained and accompanied by behavioral improvements. The results suggest that individual treatment with KIDS is an adequate treatment option for this age group.
Supplemental material: https://doi.org/10.23641/asha.24207864.
PMID: 37801699 DOI: 10.1044/2023_JSLHR-23-00224
Eye movement as a simple, cost-effective tool for people who stutter: A case study - TERAPIA
Randomized Controlled Trial S Afr J Commun Disord. 2023 Aug 31;70(1)
Hilary D-L McDonagh, Patrick Broderick, Kenneth Monaghan
Faculty of Science, Atlantic Technological University, Sligo.
Background: Access to services remains the biggest barrier to helping the most vulnerable in the South African Stuttering Community. This novel stuttering therapy, harnessing an unconscious link between eye and tongue movement, may provide a new therapeutic approach, easily communicated and deliverable online.
Objectives: This study provides both objective and subjective assessments of the feasibility of this intervention. Assessment tools holistically address all components of stuttering in line with comprehensive treatment approaches: core behaviours, secondary behaviours, anticipation and reactions.
Method: On receipt of ethical approval, this single-subject case design recruited one adult (21-year-old) male with a developmental stutter (DS). The participant gave informed consent and completed four scheduled assessments: baseline, after 5-week training, 3 months post-intervention and 24 months post-completion. The study used objective assessment tools: Stuttering Severity Instrument-4 (SSI-4); Subjective-assessment tools: SSI-4 clinical use self-report tool (CUSR); Overall Assessment of Speaker's Experience of Stuttering (OASES-A); Premonitory Awareness in Stuttering (PAiS) and Self-Report Stuttering Severity* (SRSS) (*final assessment).
Results: The participant's scores improved across all assessment measures, which may reflect a holistic improvement. The participant reported that the tool was very useful. There were no negative consequences.
Conclusion: This case report indicates that this innovative treatment may be feasible. No adverse effects were experienced, and the treatment only benefited the participant. The results justify the design of a pilot randomised feasibility clinical trial. Contribution: The results indicate that this is a needed breakthrough in stuttering therapy as the instructions can be easily translated into any language. It can also be delivered remotely reducing accessibility barriers.
PMID: 37782243 DOI: 10.4102/sajcd.v70i1.968
Functional Speech and Voice Disorders: Approaches to Diagnosis and Treatment - CONCEITO
Review Neurol Clin. 2023 Nov;41(4):635-646. Epub 2023 Apr 20.
Keywords: (…) Psychogenic stutter (…)
Jennifer L Freeburn, Janet Baker
Massachusetts General Hospital, Boston, MA, USA; Flinders University, Adelaide, Randwick, NSW, Australia.
Historically, formal training for speech-language therapists (SLTs) in the area of functional speech and voice disorders (FSVD) has been limited, as has the body of empirical research in this content area. Recent efforts in the field have codified expert opinions on best practices for diagnosing and treating FSVD and have begun to demonstrate positive treatment outcomes. To provide comprehensive interventions for these complex conditions at the intersection of neurology, psychiatry, and other medical specialties, the SLT must not only build knowledge of diagnostic strategies and components of symptomatic treatment in FSVD but also embrace behavior change techniques and counseling strategies.
PMID: 37775195 DOI: 10.1016/j.ncl.2023.02.005
Gabapentin-Associated Movement Disorders: A Literature Review - FARMACOLOGIA
Review Medicines (Basel). 2023 Sep 6;10(9):52.
Jamir Pitton Rissardo, Ursula Medeiros Araujo de Matos, Ana Letícia Fornari Caprara
Cooper University Hospital, Camden, NJ, USA; Medicine Department, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; Medicine Department, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
Background: Gabapentin (GBP)-induced movement disorders (MDs) are under-recognized adverse drug reactions. They are commonly not discussed with patients, and their sudden occurrence can lead to misdiagnosis. This literature review aims to evaluate the clinical-epidemiological profile, pathological mechanisms, and management of GBP-associated MD.
Methods: Two reviewers identified and assessed relevant reports in six databases without language restriction between 1990 and 2023.
Results: A total of 99 reports of 204 individuals who developed a MD associated with GBP were identified. The MDs encountered were 135 myoclonus, 22 dyskinesias, 7 dystonia, 3 akathisia, 3 stutterings, 1 myokymia, and 1 parkinsonism. The mean and median ages were 54.54 (SD: 17.79) and 57 years (age range: 10-89), respectively. Subjects were predominantly male (53.57%). The mean and median doses of GBP when the MD occurred were 1324.66 (SD: 1117.66) and 1033 mg/daily (GBP dose range: 100-9600), respectively. The mean time from GBP-onset to GBP-associated MD was 4.58 weeks (SD: 8.08). The mean recovery time after MD treatment was 4.17 days (SD: 4.87). The MD management involved GBP discontinuation. A total of 82.5% of the individuals had a full recovery in the follow-up period.
Conclusions: Myoclonus (GRADE A) and dyskinesia (GRADE C) were the most common movement disorders associated with GBP.
PMID: 37755242 DOI: 10.3390/medicines10090052
Hand Preference in Stuttering: Meta-Analyses - PSICOMOTOR
Review Neuropsychol Rev. 2023 Oct 5. Online ahead of print.
Marietta Papadatou-Pastou, Anastasia-Konstantina Papadopoulou, Christos Samsouris, Annakarina Mundorf, Maria-Myrto Valtou, Sebastian Ocklenburg
National and Kapodistrian University of Athens, Athens, Greece; Academy of Athens, Athens, Greece; MSH Medical School Hamburg, Hamburg, Germany; University Bochum, Bochum, Germany.
Reduced hemispheric asymmetries, as well as their behavioral manifestation in the form of atypical handedness (i.e., non-right, left-, or mixed-handedness), are linked to neurodevelopmental disorders, such as autism spectrum disorder, and several psychiatric disorders, such as schizophrenia. One neurodevelopmental disorder that is associated with reduced hemispheric asymmetries, but for which findings on behavioral laterality are conflicting, is stuttering. Here, we report a series of meta-analyses of studies that report handedness (assessed as hand preference) levels in individuals who stutter (otherwise healthy) compared to controls. For this purpose, articles were identified via a search in PubMed, Scopus, and PsycInfo (13 June 2023). On the basis of k = 52 identified studies totaling n = 2590 individuals who stutter and n = 17,148 controls, five random effects meta-analyses were conducted: four using the odds ratio [left-handers (forced choice); left-handers (extreme); mixed-handers; non-right-handers vs. total)] and one using the standardized difference in means as the effect size. We did not find evidence of a left (extreme)- or mixed-handedness difference or a difference in mean handedness scores, but evidence did emerge, when it came to left-handedness (forced-choice) and (inconclusively for) non-right-handedness. Risk-of-bias analysis was not deemed necessary in the context of these meta-analyses. Differences in hand skill or strength of handedness could not be assessed as no pertinent studies were located. Severity of stuttering could not be used s a moderator, as too few studies broke down their data according to severity. Our findings do not allow for firm conclusions to be drawn on whether stuttering is associated with reduced hemispheric asymmetries, at least when it comes to their behavioral manifestation.
PMID: 37796428 DOI: 10.1007/s11065-023-09617-z
"I Just Want People to Think I'm Normal": An Interview Study of Young Swedish Women With Covert Stuttering - SOCIAL
Am J Speech Lang Pathol. 2023 Aug 18;1-19. Online ahead of print.
Ineke Samson, Jill Nyberg, Elisabeth Lindström, Ellika Schalling
Karolinska Institutet, Stockholm, Sweden; Danderyd Hospital, Stockholm, Sweden; Åbo Akademi University, Turkku, Finland; Uppsala University, Sweden.
Purpose: Research indicates that there is a tendency for females who stutter, more often than males, to use coping strategies that involve covering their stutter, for example, by avoiding situations that require verbal participation. The aim of the study is to increase knowledge about how covert stuttering develops and its impact on self-image and quality of life for women who stutter.
Method: Eleven young women who stutter covertly were interviewed, and data were subjected to qualitative content analysis. Background information was obtained from the self-report instruments measuring the impact of stuttering on different aspects of life (Overall Assessment of the Speaker's Experiences of Stuttering) and degree of perceived social anxiety (Liebowitz Social Anxiety Scale, Self-Report).
Results: Three main themes were identified: (a) managing stuttering, (b) personal aspects, and (c) stuttering as a phenomenon. Shame and a desire to fit in emerged as distinct motives for covering stuttering. The women described that stuttering controlled both life choices and everyday life. Development of self-image had been strongly negatively affected, resulting in social anxiety. The women expressed a particular vulnerability of being a woman who stutters, due to societal norms of female behavior and a lack of female role models who stutter.
Conclusions: The choice of coping strategy was motivated by a desire to "be normal." As a result, stuttering had come to dominate life and affect self-image and life choices. The study highlights the importance for clinicians to be alert to and aware of the fact that the experiences of women who stutter can lead them to develop coping strategies that have far-reaching negative consequences.
PMID: 37595785 DOI: 10.1044/2023_AJSLP-22-00354
Language sample analysis of conversation samples from school-age children who stutter: The role of syntactic factors in stuttering - INFANTIL / LINGUAGEM
J Commun Disord. 2023 Sep 6;106:106369. Online ahead of print.
Jayanthi Sasisekaran, Shriya Basu
University of Minnesota Twin Cities, Minneapolis, MN, United States; California State University Long Beach, CA, United States.
Introduction: The purpose of the study was to compare school-age children who stutter (CWS) and age-matched children who do not stutter (CWNS) in syntactic abilities and syntactic performance.
Methods: Computerized Language Sample Analysis (LSA) was conducted on the conversation samples obtained from 46 school-age CWS and CWNS between 7 and 16 years (CWS, n = 23). Syntactic abilities were assessed using the Index of Productive Syntax (the IPsyn) and Developmental Sentence Scores (DSS) and mixed effects logistic regression analyses with participants as random effects were conducted to determine if the scores were predictive of group membership. Additionally, the groups were compared in the IPsyn subcategories to assess the use of syntactic structures. Syntactic performance was assessed by: (a) Categorizing the sentences from each conversation sample into high vs. low syntactic complexity categories based on DSS scores and comparing the sentence categories in % stuttered sentences (% SS); and (b) Comparing the groups in the proportion of phrase-level disfluencies (phrase repetitions vs. revisions) that are associated with syntactic planning.
Results: In terms of syntactic abilities, the IPsyn scores interacted with the number of utterances (sample size) used to compute the scores in predicting group membership. In comparison to the CWNS, the CWS obtained higher scores in the IPsyn and the sentence structure subcategory of the IPsyn that were independent of sample size. In terms of syntactic performance: (a) Significantly more sentences were stuttered in the high compared to the low syntactic sentence category; (b) Compared to the CWNS who demonstrated significantly more phrase revisions, the CWS showed comparable and fewer phrase revisions and repetitions. Additionally, post-hoc analysis showed that the CWS used significantly elaborated noun phrases and a similar trend was evident for verb phrase elaborations. A significant association between verb phrase elaborations and%SS was also obtained.
Conclusions: Findings from the IPsyn and the use of elaborate noun phrases, and to some extent verb phrases, suggested that the CWS used more complex syntax even in shorter conversational samples. More stuttered sentences in the high DSS sentence category, the use of fewer phrase revisions, and the association between stuttering and elaborated verb phrases in the CWS are interpreted to suggest the effects of syntactic planning and reformulation demands on fluency during ongoing articulation.
PMID: 37699262 DOI: 10.1016/j.jcomdis.2023.106369
Linguistic features of stuttering during spontaneous speech - FALA
J Fluency Disord. 2023 Sep 30:78:106016. Online ahead of print.
Haley J Warner, Ravi Shroff, Arianna Zuanazzi, Richard M Arenas, Eric S Jackson
New York University, New York, NY. USA; University of New Mexico, Albuquerque, NM, USA.
Purpose: Previous work shows that linguistic features (e.g., word length, word frequency) impact the predictability of stuttering events. Most of this work has been conducted using reading tasks. Our study examined how linguistic features impact the predictability of stuttering events during spontaneous speech.
Methods: The data were sourced from the FluencyBank database and consisted of interviews with 35 adult stutterers (27,009 words). Three logistic regression mixed models were fit as the primary analyses: one model with four features (i.e., initial phoneme, grammatical function, word length, and word position within a sentence), a second model with six features (i.e., the features from the previous model plus word frequency and neighborhood density), and a third model with nine features (i.e., the features from the previous model plus bigram frequency, word concreteness, and typical age of word acquisition). We compared our models using the Area Under the Curve statistic.
Results: The four-feature model revealed that initial phoneme, grammatical function, and word length were predictive of stuttering events. The six-feature model revealed that initial phoneme, word length, word frequency, and neighborhood density were predictive of stuttering events. The nine-feature model was not more predictive than the six-feature model.
Conclusion: Linguistic features that were previously found to be predictive of stuttering during reading were predictive of stuttering during spontaneous speech. The results indicate the influence of linguistic processes on the predictability of stuttering events such that words associated with increased planning demands (e.g., longer words, low frequency words) were more likely to be stuttered.
PMID: 37852018 DOI: 10.1016/j.jfludis.2023.106016
Mothers' and fathers' attitudes toward stuttering in the Middle East compared to Europe and North America - INFANTIL / AMBIENTE
Int J Lang Commun Disord. 2023 Sep 16. Online ahead of print.
Stephanie Hughes, Lejla Junuzovic-Zunic, Eman Mostafa, Mary Weidner, R Sertan Özdemir, Derek E Daniels, Haley Glover, Ayşenur Göksu, Ahmet Konrot, Kenneth O St Louis
ABC Stuttering Services, Auburn, Michigan, USA; Faculty of Education and Rehabilitation, University of Tuzla, Tuzla, Bosnia and Herzegovina; Phoniatric Unit, Ear, Nose and Throat Department, Sohag University Hospital, Sohag, Egypt; Pennsylvania Western University Edinboro, Edinboro, Pennsylvania, USA; Istanbul Medipol University, İstanbul, Türkiye; Wayne State University, Detroit, Michigan, USA; West Virginia Birth to Three, Morgantown, West Virginia, USA; Üsküdar University, İstanbul, Türkiye; West Virginia University, Morgantown, West Virginia, USA.
Background: Parents play a central role in the treatment of childhood stuttering. Addressing parental attitudes toward stuttering is helpful therapeutically. The extent to which differences in attitudes toward stuttering exist on the basis of sex, geographical region and parental status (e.g., parent of a stuttering child, parent of a nonstuttering child, nonparent) is unclear. Many studies investigating such factors have used the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) questionnaire. A large POSHA-S database has collected responses from over 20 000 people from 49 countries.
Aims: The aim of this study was to use the POSHA-S database to examine the extent to which the following variables influence attitudes toward stuttering: (a) parents' sex (mothers vs. fathers), (b) geographic region (Middle East vs. Europe and North America), (c) parents' children (stuttering vs. nonstuttering) and (d) parental status (parents versus nonparents).
Methods & procedures: Data used in this study were extracted from selected, relevant studies that administered the POSHA-S to respondents. The Overall Stuttering Scores were compared on the basis of sex and parent status (i.e., mothers and fathers; nonparent women and men) and were then compared within and across the two geographical areas. Group comparisons were performed using analysis of variance followed by independent t tests, and Cohen's d was calculated to determine effect sizes.
Outcomes & results: Statistically significant differences were observed upon the basis of geographical region. In general, male parents and nonparents tend to have more positive stuttering attitudes among the Middle Eastern samples while female parents and nonparents tend to show more positive attitudes in European and North American samples in the POSHA-S database. Effect sizes were small for all comparisons.
Conclusions & implications: The effect of geographic region and culture may predict sex-based differences among mothers' and fathers' attitudes toward stuttering; however, the clinical significance is unclear. Additional research is needed to better understand how children who stutter are affected by their parents' attitudes toward stuttering.
PMID: 37715532 DOI: 10.1111/1460-6984.12952
Multilingualism and neurodevelopmental disorders [Editorial] - LINGUAGEM
Free full text: https://www.frontiersin.org/articles/10.3389/fpsyg.2023.1267023/full
Ai Leen Choo, Sara Smith, Amy Pratt, Sibylla Leon Guerrero
Georgia State University, Atlanta, GA, United States; University of South Florida, Tampa, FL, United States; University of Cincinnati, Cincinnati, OH, United States; University of California, Irvine, Irvine, CA, United States.
No abstract available
PMID: 37655193 PMCID: PMC10466220
Norwegian speech-language pathologists treatment practices for preschool children who stutter: An explorative study - INFANTIL / TERAPIA
J Fluency Disord. 2023 Aug 5;77:105999. Online ahead of print.
Melanie Kirmess, Linn Stokke Guttormsen, Hilde Hofslundsengen, Kari-Anne Bottegaard Næss, Elaina Kefalianos
University of Oslo, Oslo, Norway; Oslo Metropolitan University Oslo, Norway; Western Norway University of Applied Sciences, Sogndal, Norway; University of Melbourne, Parkville, Australia.
Purpose: This study investigated the treatment practices of speech-language pathologists (SLPs) with preschool children who stutter to explore variations in service delivery and, consequently to better inform and support evidence-based practice.
Method: 121 Norwegian SLPs completed an online survey about stuttering treatment for preschool children aged up to six years. They reported on treatment training, choices, setting, dosage, and outcomes. Data was analysed descriptively. Correlation analyses between years of clinical experience and clinician perceived outcomes were conducted.
Result: Sixty-eight percent of SLPs were trained in one or more stuttering treatment programs. The majority of SLPs (83 %) provided treatment in person in preschool centers; 59 % reported providing treatment once a week. Thirty-four percent of SLPs reported that they often or always delivered the whole treatment program. Treatment practice addressed various elements, including advising parents about language and communication strategies, supporting the child's self-image, and perceived outcomes. The SLPs reported their clinician perceived outcomes as 'always' or 'often' reduction of audible stuttering (70 %), reduced cognitive and emotional reactions (55 %), and improved communication skills (58 %). Factors influencing treatment choices were identified at the systemic level (e.g., work place regulations) and individual level (e.g., SLPs competency, child's best).
Conclusion: Stuttering treatment services in Norway differ from those reported in existing literature as treatment is given in preschool settings, only 34 % of SLPs deliver programs as intended whilst the majority use treatment elements only, and still experience positive changes. Provision is variable, and seems influenced by SLP training and competence.
PMID: 37562079 DOI: 10.1016/j.jfludis.2023.105999
Perceptions and experiences of Australian speech-language pathologists who use the Lidcombe Program with children who stutter - INFANTIL / LIDCOMBE
Int J Speech Lang Pathol. 2023 Sep 9;1-12. Online ahead of print.
Kate Bridgman, Shane Erickson
La Trobe University, Bundoora, Australia.
Purpose: Speech-language pathologists (SLPs) have varying levels of training and experience working with children who stutter (CWS). They often work in contexts and populations that require clinical management to take them beyond the borders of translating clinical trial protocols and evidence-based practice (EBP). This study sought to investigate the clinical experiences of Australian SLPs working with CWS, including their Lidcombe Program confidence and practices. Method: A cross-sectional online survey was completed by 215 Australian SLPs during 2017-2020. They were recruited prior to attending one of 14 workshops hosted by Speech Pathology Australia (SPA). Result: Participants worked in a range of contexts and were from all states and territories. The majority assessed and/or treated up to five CWS annually. Six predictor variables were considered for self-reported clinical confidence. The quantitative analysis identified that an SLP's previous training, reading the SPA stuttering management clinical guideline, and the annual number of CWS treated were found to significantly impact self-reported clinical confidence. Themes included: (1) client, family, service, and context factors that influence clinical decision-making; (2) SLP areas of clinical strength and aspects of paediatric stuttering management requiring further development; and (3) factors that impact Lidcombe Program success and modifications. Conclusion: This study has found that Australian SLPs working with CWS identify a range of important factors that impact their practice.
PMID: 37688534 DOI: 10.1080/17549507.2023.2241677
Perfil da fluência na fala espontânea, leitura e no reconto de textos de adultos que gaguejam - AVALIAÇÃO
Codas. 2023 Sep 25;35(5)
Free article :
Samuel Lopes da Silva, Luciana Mendonça Alves, Denise Brandão de Oliveira E Britto
Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil.
Objetivo: descrever o perfil da fluência em relação à tipologia das disfluências, velocidade e frequência de rupturas na fala espontânea, na leitura e no reconto; comparar o perfil da fluência em adultos que gaguejam na fala espontânea, na leitura e no reconto de texto.
Método: O trabalho é um estudo transversal comparativo com amostra composta por 15 adultos que gaguejam de ambos os sexos, com formação superior ou equivalente ao ensino fundamental II completo. Foram coletadas amostras nas tarefas de fala espontânea, leitura e reconto de texto por meio de video chamadas realizadas individualmente. As 200 primeiras sílabas expressas de cada tarefa foram transcritas e analisadas segundo o Protocolo de Avaliação do Perfil da Fluência (PAPF). O estudo comparou a frequência das disfluências comuns e gagas e a velocidade nas tarefas pesquisadas. Adotou-se o teste de Kruskal & Wallis em conjunto com o de comparações múltiplas de Duncan para comparar as medianas e verificar possíveis diferenças entre as tarefas pesquisadas com nível de significância de 5%.
Resultados: A tarefa de leitura apresentou menor número de disfluências comuns e percentual de descontinuidade de fala em relação às tarefas de fala espontânea e reconto. Não foram encontradas diferenças estatisticamente significantes entre as disfluências gagas nas três tarefas pesquisadas.
Este trabalho mostrou que existem diferenças na ocorrência das disfluências comuns - hesitações, interjeições e revisões - e no percentual de descontinuidade de fala durante a leitura oral de adultos que gaguejam em relação à fala espontânea e ao reconto de texto.
Predictors of Functional Communication Outcomes in Children With Idiopathic Motor Speech Disorders - OUTRAS ÁREAS
J Speech Lang Hear Res. 2023 Sep 6;1-16. Online ahead of print.
Aravind K Namasivayam, Hyunji Shin, Rosane Nisenbaum, Margit Pukonen, Pascal van Lieshout
University of Toronto, Ontario, Canada; Speech Research Centre, Toronto, Ontario, Canada; Unity Health Toronto, Ontario, Canada; The Speech and Stuttering Institute, Toronto, Ontario, Canada.
Purpose: The purpose of the study was to investigate child- and intervention-level factors that predict improvements in functional communication outcomes in children with motor-based speech sound disorders.
Method: Eighty-five preschool-age children with childhood apraxia of speech (n = 37) and speech motor delay (n = 48) participated. Multivariable logistic regression models estimated odds ratios and 95% confidence intervals for the association between minimal clinically important difference in the Focus on the Outcomes of Communication Under Six scores and multiple child-level (e.g., age, sex, speech intelligibility, Kaufman Speech Praxis Test diagnostic rating scale) and intervention-level predictors (dose frequency and home practice duration).
Results: Overall, 65% of participants demonstrated minimal clinically important difference changes in the functional communication outcomes. Kaufman Speech Praxis Test rating scale was significantly associated with higher odds of noticeable change in functional communication outcomes in children. There is some evidence that delivering the intervention for 2 times per week for 10 weeks provides benefit.
Conclusion: A rating scale based on task complexity has the potential for serving as a screening tool to triage children for intervention from waitlist and/or determining service delivery for this population.
PMID: 37672787 DOI: 10.1044/2023_JSLHR-23-00070
Profile of fluency in spontaneous speech, reading, and retelling of texts by adults who stutter - AVALIAÇÃO
Codas. 2023 Sep 25;35(5)
Free article :
Samuel Lopes da Silva, Luciana Mendonça Alves, Denise Brandão de Oliveira E Britto
Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil.
Purpose: to describe the profile of fluency concerning the typology of disfluencies, speed, and frequency of disruptions in spontaneous speech, reading, and retelling; to compare the fluency profile in adults who stutter in spontaneous speech, reading, and retelling of text.
Methods: The present work is a cross-sectional comparative study with a sample composed of 15 adults who stutter of both sexes, with higher education or equivalent to complete elementary school II. Samples were collected in the tasks of spontaneous speech, reading, and text retelling through video calls made individually with the participants. The first 200 syllables expressed in each task were transcribed and analyzed according to the Fluency Profile Assessment Protocol (FPAP). The study compared the frequency of common and stuttering disfluencies and the speed in the different tasks surveyed. The Kruskal & Wallis test was used together with Duncan's multiple comparisons test to compare the medians and verify possible differences between the tasks researched with a significance level of 5%.
Results: The reading task presented a lower number of common disfluencies and a percentage of speech discontinuity about spontaneous speech and retelling tasks. No statistically significant differences were found between stuttering disfluencies in the three tasks surveyed.
Conclusion: This study showed that there are differences in the occurrence of common disfluencies - hesitations, interjections, and revisions - and in the percentage of speech discontinuity during an oral reading of adults who stutter concerning spontaneous speech and text retelling.
PMID: 37792751 DOI: 10.1590/2317-1782/20232022009pt
Reduced stuttering for school-age children: A systematic review - INFANTIL / TERAPIA
Review J Fluency Disord. 2023 Sep 22;78:106015. Online ahead of print.
Georgina Johnson, Mark Onslow, Sarah Horton, Elaina Kefalianos
University of Melbourne, VIC, Australia; University of Technology Sydney, NSW, Australia; Murdoch Children's Research Institute, VIC, Australia.
Background: Treatment of school-age children (6-12 years of age) who stutter is a public health priority. Their clinical needs include a psychosocial focus and stuttering reduction. For the latter clinical need, there is a critical window of opportunity for these children warranting research attention.
Purpose: The purpose of the review is to guide future clinical research by establishing (a) what interventions are associated with stuttering reduction for school-age children (b) the reported immediate and longer-term effects of those interventions, and (c) the level of evidence for these interventions in terms of study design.
Methods: Fourteen databases and three conference proceedings were searched for interventions used to reduce stuttering in school-age children. Primary outcomes were mean stuttering reductions pre-treatment, immediately post-treatment, and any follow-up assessments.
Results: Of the 4305 studies identified from the databases, 67 studies met inclusion criteria. Five different treatment approaches were reported in the literature that might reduce stuttering for a school-age child, but with varying effect sizes. These include (a) operant methods, (b) speech restructuring, (c) combined operant methods and speech restructuring, (d) machine-driven treatments, and (e) treatments with a cognitive behaviour therapy component.
Conclusions: Operant methods warrant investigation in future clinical trial research, as do variants of speech restructuring. Hybrid approaches showed encouraging results, including speech restructuring variants combined with operant methods or with cognitive behaviour therapy. However, evidence is preliminary only at Phase I and II trials. Several treatments with reported clinical promise have been overlooked for decades and require further investigation.
PMID: 37776613 DOI: 10.1016/j.jfludis.2023.106015
Resolution of stuttering during ketamine treatment: a case report - FARMACOLOGIA
J Med Case Rep. 2023 Oct 10;17(1):447.
Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10563367/pdf/13256_2023_Article_4158.pdf
Dan Bolton, Tegest Hailu, Christina A Porucznik
Washington State Office of Financial Management, Olympia, WA, USA; Providence SoundHomeCare and Hospice, Lacey, WA, USA; University of Utah, Salt Lake City, UT, USA.
Background: Stuttering may include repetition of words in whole or part, difficulty saying words, and elongated pauses in speech. Approximately 5% of children stutter for a period lasting 6 months or more. Most of those children stop stuttering as they approach adulthood, but the condition persists in approximately 1% of adults. The cause of stuttering is unknown. Adults who stutter face substantial burdens in many aspects of their lives. Stutterers may choose not to pursue meaningful employment opportunities, may not be hired for positions they seek, or may be denied promotions or positive performance evaluations. Stuttering can cause physical tension from fear of speaking. Social challenges arise when a person who stutters is seen as less capable or of lower intelligence than fluent speakers. Stuttering causes emotional difficulties through the frustration and embarrassment that disfluent speakers feel. Stutterers may experience a general loss of self-esteem and personal satisfaction in life. Speech therapy is the primary intervention for stuttering. Medications have been investigated as treatments for stuttering, but no medication has been identified that has widespread effectiveness.
Case presentation: A 60-year-old white non-Hispanic woman who had been a near lifelong stutterer was prescribed ketamine for an unrelated condition and experienced an almost immediate resolution of her stuttering.
Conclusions: Many possible pharmacological treatments for stuttering have been studied. Some medications appear to be effective in some patients; some appear to be more generally effective but have negative side effects. No reporting in relevant literature has addressed a possible role for ketamine in stuttering treatment. On the basis of this case report, research on the effect of ketamine on stuttering would be useful. Any effective treatment for stuttering would have a significant positive effect on quality of life for persons who stutter.
PMID: 37817273 PMCID: PMC10563367 DOI: 10.1186/s13256-023-04158-8
Self-perceived outcomes of informative and apologetic self-disclosure: A mixed methods study - SOCIAL
J Commun Disord. 2023 Oct 26:106:106387. Online ahead of print.
Megan M Young, Courtney T Byrd, Rodney Gabel
The University of Texas at Austin, Austin, TX, United States of America; Binghamton University, Binghamton, NY, United States of America.
Purpose: Self-disclosure statements that are informative, rather than apologetic, have been demonstrated to improve listener perceptions of adults who stutter (Byrd et al., 2017). The purpose of the present study is to investigate the benefits of self-disclosure from the perspective of the speaker and to determine whether self-disclosure statement type is associated with self-perceived outcomes of use.
Method: A total of 156 adults who stutter completed a survey adapted from a previous study investigating affective, behavioral, and cognitive outcomes of voluntary stuttering. Survey responses were analyzed using descriptive and inferential statistics to determine if there was a significant relationship between self-disclosure statement type and self-reported outcomes. Additionally, responses to two open-ended questions relating to timing of self-disclosure and self-disclosure experiences in general were analyzed using reflexive thematic analysis.
Results: Self-disclosure was perceived as beneficial in at least one context by 96.8 % of respondents. Respondents who used an informative self-disclosure statement were more likely to agree that self-disclosure increased confidence and were less likely to report attempting to conceal or avoid stuttering than respondents who used an apologetic self-disclosure statement. Themes relating to additional aspects of self-disclosure experiences included personalized use, social connection, acceptance of stuttering, challenging cognitive distortions, communication is easier, self-empowerment, humor, voluntary stuttering, and vulnerability to prejudice.
Conclusion: Similar to studies investigating the influence of self-disclosure on listener perceptions, informative self-disclosure is associated with greater self-perceived benefits than apologetic self-disclosure for adults who stutter.
PMID: 37918083 DOI: 10.1016/j.jcomdis.2023.106387
Social anxiety disorder in adolescents who stutter: A risk for school refusal - EMOCIONAL
Pediatr Int. 2023 Jan-Dec;65(1):e15622.
Yoshikazu Kikuchi et al
Kyushu University, Fukuoka, Japan; University of Teacher Education Fukuoka, Fukuoka, Japan; University of Nagasaki, Nagasaki, Japan; Fussa Dai-nana Elementary School, Tokyo, Japan; Fukuoka Sanno Hospital, Fukuoka, Japan; Adachi Otorhinolaryngology Clinic, Fukuoka, Japan; Fukuoka University Hospital, Fukuoka, Japan; International University of Health and Welfare, Fukuoka, Japan.
Background: Stuttering is a childhood-onset fluency disorder. Part of the counseling for middle and high school students with persistent stuttering is related to school refusal. Anxiety disorders are known to contribute to school refusal. However, it is not known whether social anxiety disorder (SAD) is a factor in school refusal among adolescents who stutter.
Methods: In our first study, we examined the relationship between school refusal and SAD in 84 middle and high school students who stutter; 26% of the 84 students were in the school refusal group and the remaining 74% were in the school attendance group. The second study examined whether SAD was associated with 10 factors related to speech and stuttering frequency using the Japanese version of the Liebowitz Social Anxiety Scale for Children and Adolescents to determine the presence of SAD. Of the 84 students in the first study, 40 participated in the second study.
Results: The school refusal group of adolescents who stutter had significantly higher rates of SAD than the school attendance group. Fifty percent of adolescents who stutter met the criteria for SAD. Moreover, adolescents who stutter with SAD had significantly higher scores on the items "When speaking in public, do you experience tremors in your limbs?" and "After you stutter, do you have negative thoughts about yourself?" than the adolescents who stutter without SAD.
Conclusions: When examining adolescents who stutter, checking for comorbid SAD may lead to better support. Moreover, noticing their repetitive negative thinking, nervousness, and trembling during speech may help to resolve SAD.
PMID: 37690080 DOI: 10.1111/ped.15622
Solution-Focused Brief Therapy for Stuttering in the Public Schools: Children Solve Their Own Stuttering Problems in This Case Study - TERAPIA
Lang Speech Hear Serv Sch. 2023 Aug 2;1-14. Online ahead of print.
Boston Public Schools, MA.
Purpose: This clinical focus article follows the case studies of three school-age children who stutter in solution-focused brief therapy (SFBT), highlighting treatment features and demonstrating positive outcomes. Empowerment and self-agency are emphasized as desired characteristics. Children searched within themselves and acted to influence therapy results. Techniques such as self-disclosure and fluency shaping were incorporated into this approach.
Method: In a public school district, participants with moderate-to-severe stuttering used the Clinical Use of Self-Reports to measure their perceived stuttering severity across various contexts and audiences. The speech-language pathologist (SLP) provided verbal feedback/contingencies including personalized questions, supportive statements, and positive gestures/comments. The students identified a stuttering problem, implemented the suggested techniques in clinic and in their natural environments, and shared pertinent feedback during the following therapy sessions.
Results: Participants solved stuttering problems and took charge of their own treatment. After 5 weeks of SFBT, the 18-year-old demonstrated sufficient problem-solving skills to agree to be discharged from the program. The remaining two students exhibited growth toward their individualized goals. They showed curiosity about their own stuttering situations and applied innovative strategies, in the outside world, that had been practiced and formulated in their therapy sessions.
Conclusions: The participants engaged in conversations with the SLP, teachers, peers, and family members. They documented conversations, reflections, performance scales, and personal goals in their journals. During therapy sessions, the children clarified real-life goals and tried out techniques for managing their stuttering difficulties. In addition, they completed the Clinical Use of Self-Reports to assess their communication values, successes, and challenges.
PMID: 37532244 DOI: 10.1044/2023_LSHSS-22-00172
Speech disfluencies in bilingual Greek-English young adults - LINGUAGEM
J Fluency Disord. 2023 Aug 23;78:106001. Online ahead of print.
Zoi Gkalitsiou, Danielle Werle
The University of Texas at Austin, USA.
Purpose: The purpose of this study was to investigate the frequency and types of disfluencies in Greek-English bilingual adults across naturalistic speech samples and compare frequency and types of disfluencies between the participants' L1 and L2.
Methods: Participants in the study included 26 Greek-English bilingual young adults. All participants were sequential bilinguals, whose first language was Greek and second language was English. Two speech samples were collected in each language, a conversational and a narrative sample, which were subsequently analyzed for the frequency and types of disfluencies.
Results: Results indicated that participants produced more typical disfluencies in English compared to Greek across speaking samples. The most frequent types of disfluencies were filled pauses and vowel prolongations (without tension or struggle) across speaking samples and languages.
Conclusion: Our results revealed differences in the types and frequencies of disfluencies produced in participants' native compared to their second language. Results add to the growing body of literature addressing the manifestation of speech disfluencies in bilingual speakers.
PMID: 37660637 DOI: 10.1016/j.jfludis.2023.106001
Statistical Information Affects Spoken Word Recognition of Tone Languages in Stutterers: Evidence From an Auditory-Perceptual Gating Study - AUDITIVO
J Speech Lang Hear Res. 2023 Aug 30;1-17. Online ahead of print.
Jiaqiang Zhu, Jing Shao, Caicai Zhang, Fei Chen, Seth Wiener
The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China; Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China; Hunan University, Changsha, China; Carnegie Mellon University, Pittsburgh, PA.
Purpose: Previous studies have shown that individuals who stutter exhibit abnormal speech perception in addition to disfluent production as compared with their nonstuttering peers. This study investigated whether adult Chinese-speaking stutterers are still able to use knowledge of statistical regularities embedded in their native language to recognize spoken words and, if so, how much acoustic information is needed to trigger this information.
Method: Seventeen stutterers and 20 typical, nonstuttering controls participated in a gating experiment. All participants listened to monosyllabic words that consisted of syllables and lexical tones and were segmented into eight successive gates. These words differed in syllable token frequency and syllable-tone co-occurrence probability in line with a Chinese spoken word corpus. The correct syllable-only, correct tone-only, correct syllable-tone word, and correct syllable-incorrect tone responses were analyzed between the two groups using mixed-effects models.
Results: Stutterers were less accurate overall than controls, with fewer correct syllables, tones, and their combination as words. However, stutterers showed consistent and reliable perceptual patterns triggered by statistical information of speech, as reflected by more accurate responses to high-frequency syllables, high-probability tones, and tone errors all in manners similar to those of nonstuttering controls.
Conclusions: Stutterers' atypical speech perception is not due to a lack of statistical learning. Stutterers were able to perceive spoken words with phonological tones based on statistical regularities embedded in their native speech. This finding echoes previous production studies of stuttering and lends some support for a link between perception and production. Implications of pathological, diagnostic, and therapeutic conditions of stuttering are discussed.
PMID: 37647655 DOI: 10.1044/2023_JSLHR-23-00123
[Stuttering in Children: A Primary Health Care Perspective] - SOCIAL
[Article in Portuguese]
Comment Acta Med Port. 2023 Nov 2;36(11):767-768.
Free article: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20352/15247
Sara Nabais, Carolina Reis Penedo, Susana Corte-Real
Agrupamento de Centros de Saúde de Lisboa Ocidental e Oeiras. Oeiras. Portugal.
No abstract available
PMID: 37924317 DOI: 10.20344/amp.20352
The Fifth Croatia Stuttering Symposium: Part II. Natural recovery from early stuttering - INFANTIL / AVALIAÇAIO
J Fluency Disord. 2023 Oct 21:78:106018. Online ahead of print.
Mark Onslow, Robyn Lowe, Suzana Jelčić Jakšić, Ann Packman, Ellen Kelly, Verity MacMillan, Gabrielle Hodes
University of Technology Sydney, NSW, Australia; University of Rijeka, Croatia; The Stuttering Foundation, United States; South Western Sydney Local Health District, Australia; Ingham Institute for Applied Medical Research, Australia.
Purpose: The Fifth Croatia Stuttering Symposium of 2022 continued the Fourth Croatia Stuttering Symposium 2019 theme of the connection between research and clinical practice. At the 2022 Symposium, there were 145 delegates from 21 countries. This paper documents the contents of the second of three Symposium modules.
Methods: The module topic was that some children with early stuttering will recover naturally. A clinical situation was considered where a parent of a 3-year-old child asked if a clinician can predict whether their child will recover from stuttering without treatment.
Results: A distinguished scholar presented a 5-minute video interpretation of research about this topic. Three master clinicians then each presented a 2-minute video demonstration of how that research might be applied in a clinical situation. Following that, the convenors moderated a discussion between the distinguished scholar, master clinicians, and delegates regarding the research and how it applies to clinical practice.
PMID: 37898032 DOI: 10.1016/j.jfludis.2023.106018
The Fifth Croatia Stuttering Symposium: Part III. Mental health and early stuttering - INFANTIL / EMOCIONAL
J Fluency Disord. 2023 Aug 2;77:106000. Online ahead of print.
Mark Onslow, Robyn Lowe, Suzana Jelčić Jakšić, Marie-Christine Franken, Anna Hearne, Irma Uijterlinde, Kurt Eggers
University of Technology Sydney, NSW, Australia; University of Rijeka, Croatia; Erasmus University Medical Center, the Netherlands; Stottercentrum Utrecht, the Netherlands; Ghent University, Department of Rehabilitation Sciences, Belgium; Thomas More University College, Belgium; Turku University, Finland.
Purpose: The Fifth Croatia Stuttering Symposium of 2022 continued the Fourth Croatia Stuttering Symposium 2019 theme of the connection between research and clinical practice. At the 2022 Symposium, there were 145 delegates from 21 countries. This paper documents the contents of the third of three Symposium modules.
Methods: The module topic was mental health and early stuttering, and that pre-schoolers who stutter are at risk of developing mental health issues. A clinical situation was considered where a parent of a 3-year-old child asked a clinician what the early signs of mental health issues might be for a child who stutters.
Results: A distinguished scholar presented a 5-minute video interpretation of research about this topic. Three master clinicians then each presented a 2-minute video demonstration of how that research might be applied in a clinical situation. Following that, the convenors moderated a discussion between the distinguished scholar, master clinicians, and delegates regarding the research and how it applies to clinical practice.
PMID: 37586168 DOI: 10.1016/j.jfludis.2023.106000
The relation between long latency cortical auditory evoked potentials and stuttering severity in stuttering school-age children - AUDITIVO
Int J Pediatr Otorhinolaryngol. 2023 Dec:175:111766.
Engy Samy Elhakeem, Rania Mohamed Abdou Mohamed Mustafa, Mohamed Aziz Mohamed Talaat, Alaa Mamdouh Abdelhamed Radwan, Mirhan Eldeeb
Alexandria University, Egypt
Background: Disturbances in auditory processing and feedback have been suggested to play a role in the pathogenesis of developmental stuttering. Long latency cortical auditory evoked potentials in response to non-linguistic and linguistic stimuli can be used to investigate these disturbances. There were differences between developmental stuttering patients. However, there is no solid evidence of these differences to date.
Objective: This study aims to determine whether there is a statistically significant difference in component P1-N1-P2 of long latency cortical auditory evoked potentials between stuttering school-aged children and non-stuttering children. In addition, the study aims to investigate the relationship between these potentials and objective quantitative measures of stuttering.
Method: The study included two groups, patients and controls, consisting of 40 subjects aged 6-12 years. For the cases group, the severity of stuttering symptoms and P1-N1-P2 responses to a non-linguistic stimulus were evaluated. In addition, the P1-N1-P2 responses of the matched control group were evaluated.
Results: The P1-N1 responses were similar in both study groups, while P2 response was shorter in the patient group, but the difference was not statistically significant compared to the control group. N1 latency has the only statistically significant correlation with the percentage of repetitions, prolongation, and blocks. The female cases had a decreased, not statistically significant, latency than the male cases group.
Conclusion: In contrast to the previous finding, the study revealed a non-statistically significant different P1-N1, a non-statistically significant reduced P2 response to a non-linguistic stimulus, in CWS, in as evidence for basic auditory processing. The study also revealed a significant correlation between N1 latency and proportion of the repetition symptoms.
PMID: 37875046 DOI: 10.1016/j.ijporl.2023.111766
TranStutter: A Convolution-Free Transformer-Based Deep Learning Method to Classify Stuttered Speech Using 2D Mel-Spectrogram Visualization and Attention-Based Feature Representation - AVALIAÇÃO
Sensors (Basel). 2023 Sep 22;23(19):8033
Free PMC article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10575465/pdf/sensors-23-08033.pdf
Krishna Basak, Nilamadhab Mishra, Hsien-Tsung Chang
VIT Bhopal University, Sehore, India; Chang Gung University, Taoyuan, Taiwan; Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Stuttering, a prevalent neurodevelopmental disorder, profoundly affects fluent speech, causing involuntary interruptions and recurrent sound patterns. This study addresses the critical need for the accurate classification of stuttering types. The researchers introduce "TranStutter", a pioneering Convolution-free Transformer-based DL model, designed to excel in speech disfluency classification. Unlike conventional methods, TranStutter leverages Multi-Head Self-Attention and Positional Encoding to capture intricate temporal patterns, yielding superior accuracy. In this study, the researchers employed two benchmark datasets: the Stuttering Events in Podcasts Dataset (SEP-28k) and the FluencyBank Interview Subset. SEP-28k comprises 28,177 audio clips from podcasts, meticulously annotated into distinct dysfluent and non-dysfluent labels, including Block (BL), Prolongation (PR), Sound Repetition (SR), Word Repetition (WR), and Interjection (IJ). The FluencyBank subset encompasses 4144 audio clips from 32 People Who Stutter (PWS), providing a diverse set of speech samples. TranStutter's performance was assessed rigorously. On SEP-28k, the model achieved an impressive accuracy of 88.1%. Furthermore, on the FluencyBank dataset, TranStutter demonstrated its efficacy with an accuracy of 80.6%. These results highlight TranStutter's significant potential in revolutionizing the diagnosis and treatment of stuttering, thereby contributing to the evolving landscape of speech pathology and neurodevelopmental research. The innovative integration of Multi-Head Self-Attention and Positional Encoding distinguishes TranStutter, enabling it to discern nuanced disfluencies with unparalleled precision. This novel approach represents a substantial leap forward in the field of speech pathology, promising more accurate diagnostics and targeted interventions for individuals with stuttering disorders.
PMID: 37836863 PMCID: PMC10575465 DOI: 10.3390/s23198033
Unique Patterns of Bilingual Speech: Factors Affecting Disfluency Rates in Russian-Hebrew Bilingual Children - INFANTIL / BILINIGUISMO
J Speech Lang Hear Res. 2023 Nov 6:1-17. Online ahead of print.
Sveta Fichman, Cahtia Adelman, Carmit Altman
Hadassah Academic College, Jerusalem, Israel; Talpiot College of Education, Holon, Israel; Hadassah University Medical Center, Jerusalem, Israel; Faculty of Education, Bar-Ilan University, Ramat Gan, Israel.
Purpose: Bilingual children often demonstrate a high rate of disfluencies, which might impact the diagnostic evaluation of fluency disorders; however, research on the rates and types of disfluencies in bilinguals' two languages is limited. The purpose of this research is to profile disfluencies of two types, stuttering-like disfluencies (SLDs) and other disfluencies (ODs), in the speech of Russian-Hebrew bilingual typically developing children, focusing on cross-linguistic differences and the effect of language proficiency in both languages.
Method: Spontaneous narratives based on the Frog, Where Are You? (Mayer, 1969) picture book were collected in both languages from 40 bilingual Russian-Hebrew children aged 5;6-6;6 (years;months). The transcribed narratives were coded for SLD (sound, syllable, and monosyllabic word repetitions) and OD (multisyllabic word/phrase repetitions, interjections, and revisions), and their frequencies per 100 syllables were calculated.
Results: Overall, most children had a percentage of SLD and OD below the cutoff point and within the existing criteria for stuttering diagnosis established based on monolingual data, but several children exceeded this stuttering criterion. Monosyllabic word repetitions (part of SLD) and interjections (part of OD) were more frequent in Hebrew than in Russian. Lower proficiency was associated with a higher percentage of monosyllabic word repetitions and of interjections in both languages.
Conclusions: Bilingual disfluency criteria are needed, since based on the existing monolingual criteria, some children might be erroneously assessed as children who stutter, thus leading to overdiagnosis. The results support the claim that proficiency is an important factor in the production of disfluencies.
PMID: 37931116 DOI: 10.1044/2023_JSLHR-23-00048
Voice analysis in healthy subjects and patients with neurologic disorders: Editorial - OUTRAS ÁREAS
Editorial Front Neurol. 2023 Sep 28:14:1288370.
Free PMC article: https://www.frontiersin.org/articles/10.3389/fneur.2023.1288370/full
Antonio Suppa, Giovanni Costantini, Pedro Gomez-Vilda, Giovanni Saggio
Sapienza University of Rome, Rome, Italy; 2IRCCS Neuromed Institute, Pozzilli, Italy; University of Rome Tor Vergata, Rome, Italy; Universidad Politécnica de Madrid, Madrid, Spain.
PMID: 37840929 PMCID: PMC10569294
Why do people who stutter attend stuttering support groups? - TERAPIA EM GRUPO
S Afr J Commun Disord. 2023 Aug 3;70(1):e1-e8.
Nicola E Bloye, Shabnam S Abdoola, Casey J Eslick
Faculty of Humanities, University of Pretoria, Pretoria.
Background: Stuttering support groups (SSGs) have been a long-standing invaluable resource for people who stutter (PWS) but research into SSGs is only emerging. Speech-language therapists (SLTs) need further insight to successfully facilitate SSGs.
Objectives: To determine PWS' perspectives regarding why they attend SSGs in South Africa.
Method: Thirteen PWS who attend SSGs, between 20 and 58 years old, were a part of this qualitative study. Purposive sampling was utilised. Semi-structured telephonic interviews were used and data was analysed thematically.
Results: Four themes, namely, 'altered perceptions', 'increased sense of community', 'support group reciprocity', and 'support group environment, participants and topics', were identified. The results yielded clinical implications which included SLTs encouraging: (1) improved perceptions of being a PWS through education and self-empowerment, (2) PWS' connections between meetings to increase the sense of community, (3) reciprocity in meetings, (4) sharing personal stories to promote learning and general self-management and (5) support, praise and education to empower and encourage PWS. This study's findings show that SSGs helped PWS accept their stutter and gain confidence. This study showcased how SSGs can help PWS manage their fluency and gain confidence. Additionally, this study supports current research which suggests that dysfluency and social-emotional well-being should be equally addressed.
Conclusion: Recommendations were generated from PWS' perspectives and included focusing discussions on fluency, emotions and sharing personal stories. Insights from PWS helped better inform SLTs of their role within SSGs including guiding and facilitating conversations.Contribution: People who stutters' perspectives can be used in clinical practice to help SLTs meet the needs of PWS and guide best practice when facilitating SSGs.
PMID: 37782242 DOI: 10.4102/sajcd.v70i1.958
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