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A-88The Confusing Case of the Stuttering Sommelier. - OUTRAS ÁREAS
Arch Clin Neuropsychol. 2014 Sep;29(6):536. doi: 10.1093/arclin/acu038.88.
Banks S, Leger G.
OBJECTIVE:The accurate diagnosis of neurodegenerative disease frequently rests on neuropsychological data, although more recently there has been an increased emphasis on the inclusion of neuroimaging and fluid biomarkers. Despite our knowledge about neurodegenerative disease, in the case of frontotemporal dementias, autopsy data expose the misdiagnosis rate of specialized memory centers as being around 20%. The case presented here highlights some of the diagnostic complexities in differentiating between behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease.
METHOD: Mr. B is a 59 year old, right handed French Caucasian sommelier, who presented to neurology after his wife became concerned about some changes in behavior and a slip in his competence at work. Mr. B himself complains of a stutter. These symptoms began about 2 years ago and appear to be worsening. Neurological examination demonstrated gegenhalten and restriction in upward gaze. MRI showed bilateral temporal polar atrophy. CSF analysis has been inconsistent. The referring neurologist asked if the cognitive profile was supportive of his initial suspicion of bvFTD.
RESULTS:On testing, he demonstrated flat learning and no recall of verbal information, in addition to other memory deficits and impairment on tests of attention and executive function.
CONCLUSION(S):This case seemed from the history and neurological evaluation to be typical of bvFTD, but the neuropsychological profile, and later CSF findings suggest that frontal variant Alzheimer's disease could be a diagnostic consideration.
© The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
PMID: 25176750 [PubMed - in process]
Absolute and relative reliability of percent syllables stuttered and severity rating scales. - AVALIAÇÃO
J Speech Lang Hear Res. 2014 Aug;57(4):1284-95. doi: 10.1044/2014_JSLHR-S-13-0106.
Karimi H, O'Brian S, Onslow M, Jones M.
PURPOSE Percent syllables stuttered (%SS) and severity rating (SR) scales are measures in common use to quantify stuttering severity and its changes during basic and clinical research conditions. However, their reliability has not been assessed with indices measuring both relative and absolute reliability. This study was designed to provide such information. Relative reliability deals with the rank order of participants in a sample, while absolute reliability measures the closeness of scores to each other and to a hypothetical true score. METHOD Eighty-seven adult stuttering participants received a 10-minute unscheduled telephone call. Three experienced judges measured %SS, and also used a 9-point SR scale to measure stuttering severity from recordings of the telephone calls. RESULTS Relative intra-judge and inter-judge reliability were satisfactory for both scales. However, absolute intra-judge and inter-judge reliability were not satisfactory. Results showed that paired judge SR and %SS procedures improved absolute reliability compared to single judge measures. Additionally, the paired judge procedure improved relative reliability from high to very high levels. CONCLUSION Measurement of group changes of stuttering severity can be done in research contexts using either %SS or SR. However, for detecting changes within individuals using such measures, a paired-judge procedure is a more reliable method.
PMID: 24687162 [PubMed - as supplied by publisher]
An overview of managing stuttering in Japan. - SOCIAL
Am J Speech Lang Pathol. 2014 Nov;23(4):742-52. doi: 10.1044/2014_AJSLP-13-0085.
Chu SY, Sakai N, Mori K.
PURPOSE:The purpose of this article is to describe the rapid development of speech-language pathology in Japan since governmental licensing started in 1997 and to summarize the current trends in assessing and treating stuttering for preschoolers, school-age children, adolescents, and adults.
METHOD:The authors review relevant information about the current assessment and treatment services for people who stutter in Japan and discuss the issues and challenges faced by speech-language pathologists in managing stuttering.
CONCLUSION:It is predicted that as expertise in stuttering grows in Japan, the role of stuttering specialists in allied health, school districts, and research will increase.
PMID: 25036023 [PubMed - in process]
A review of brain circuitries involved in stuttering - NEUROCIÊNCIAS
Front Hum Neurosci. 2014 Nov 17;8:884. doi: 10.3389/fnhum.2014.00884. eCollection 2014.
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Craig-McQuaide A, Akram H, Zrinzo L, Tripoliti E
Imperial College School of Medicine London, UK; University College London London, UK ; National Hospital for Neurology and Neurosurgery London, UK.
Stuttering has been the subject of much research, nevertheless its etiology remains incompletely understood. This article presents a critical review of the literature on stuttering, with particular reference to the role of the basal ganglia (BG). Neuroimaging and lesion studies of developmental and acquired stuttering, as well as pharmacological and genetic studies are discussed. Evidence of structural and functional changes in the BG in those who stutter indicates that this motor speech disorder is due, at least in part, to abnormal BG cues for the initiation and termination of articulatory movements. Studies discussed provide evidence of a dysfunctional hyperdopaminergic state of the thalamocortical pathways underlying speech motor control in stuttering. Evidence that stuttering can improve, worsen or recur following deep brain stimulation for other indications is presented in order to emphasize the role of BG in stuttering. Further research is needed to fully elucidate the pathophysiology of this speech disorder, which is associated with significant social isolation.
PMID: 25452719 [PubMed] PMCID: PMC4233907 Free PMC Article
A simple case of chest pain: sensitizing doctors to patients with disabilities. - SOCIAL
Health Aff (Millwood). 2014 Oct;33(10):1868-71. doi: 10.1377/hlthaff.2013.1371.
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George Washington University Department of Emergency Medicine, in Washington, D.C.
A doctor who stutters confronts the stigma against patients-and providers-with disabilities.
Project HOPE—The People-to-People Health Foundation, Inc.
PMID: 25288431 [PubMed - in process]
A standalone Internet cognitive behavior therapy treatment for social anxiety in adults who stutter: CBTpsych - EMOCIONAL
J Fluency Disord. 2014 Sep;41:47-54. doi: 10.1016/j.jfludis.2014.04.001. Epub 2014 Apr 27.
Helgadóttir FD, Menzies RG, Onslow M, Packman A, O'Brian S.
Australian Stuttering Research Centre, The University of Sydney University, Australia.
PURPOSE:Social anxiety is common for those who stutter and efficacious cognitive behavior therapy (CBT) for them appears viable. However, there are difficulties with provision of CBT services for anxiety among those who stutter. Standalone Internet CBT treatment is a potential solution to those problems. CBTpsych is a fully automated, online social anxiety intervention for those who stutter. This report is a Phase I trial of CBTpsych.
METHOD:Fourteen participants were allowed 5 months to complete seven sections of CBTpsych. Pre-treatment and post-treatment assessments tested for social anxiety, common unhelpful thoughts related to stuttering, quality of life and stuttering frequency.
RESULTS:Significant post-treatment improvements in social anxiety, unhelpful thoughts, and quality of life were reported. Five of seven participants diagnosed with social anxiety lost those diagnoses at post-treatment. The two participants who did not lose social anxiety diagnoses did not complete all the CBTpsych modules. CBTpsych did not improve stuttering frequency. Eleven of the fourteen participants who began treatment completed Section 4 or more of the CBTpsych intervention.
CONCLUSIONS:CBTpsych provides a potential means to provide CBT treatment for social anxiety associated with stuttering, to any client without cost, regardless of location. Further clinical trials are warranted.
EDUCATIONAL OBJECTIVES:At the end of this activity the reader will be able to: (a) describe that social anxiety is common in those who stutter; (b) discuss the origin of social anxiety and the associated link with bullying; (c) summarize the problems in provision of effective evidence based cognitive behavior therapy for adults who stutter; (d) describe a scalable computerized treatment designed to tackle the service provision gap; (e) describe the unhelpful thoughts associated with stuttering that this fully automated computer program was able to tackle; (f) list the positive outcomes for individuals who stuttered that participated in this trial such as the reduction of social anxiety symptoms and improvement in the quality of life for individuals who stuttered and participated in this trial.
Copyright © 2014 Elsevier Inc. All rights reserved.
PMID: 25173456 [PubMed - indexed for MEDLINE]
A study of the role of the FOXP2 and CNTNAP2 genes in persistent developmental stuttering.- GENÉTICA
Neurobiol Dis. 2014 Sep;69:23-31. doi: 10.1016/j.nbd.2014.04.019. Epub 2014 May 5.
Han TU, Park J, Domingues CF, Moretti-Ferreira D, Paris E, Sainz E, Gutierrez J, Drayna D.
National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, USA; National Institute of Neurological Disorders and Stroke, NIH, Bethesda, USA; São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
A number of speech disorders including stuttering have been shown to have important genetic contributions, as indicated by high heritability estimates from twin and other studies. We studied the potential contribution to stuttering from variants in the FOXP2 gene, which have previously been associated with developmental verbal dyspraxia, and from variants in the CNTNAP2 gene, which have been associated with specific language impairment (SLI). DNA sequence analysis of these two genes in a group of 602 unrelated cases, all with familial persistent developmental stuttering, revealed no excess of potentially deleterious coding sequence variants in the cases compared to a matched group of 487 well characterized neurologically normal controls. This was compared to the distribution of variants in the GNPTAB, GNPTG, and NAGPA genes which have previously been associated with persistent stuttering. Using an expanded subject data set, we again found that NAGPA showed significantly different mutation frequencies in North Americans of European descent (p=0.0091) and a significant difference existed in the mutation frequency of GNPTAB in Brazilians (p=0.00050). No significant differences in mutation frequency in the FOXP2 and CNTNAP2 genes were observed between cases and controls. To examine the pattern of expression of these five genes in the human brain, real time quantitative reverse transcription PCR was performed on RNA purified from 27 different human brain regions. The expression patterns of FOXP2 and CNTNAP2 were generally different from those of GNPTAB, GNPTG and NAPGA in terms of relatively lower expression in the cerebellum. This study provides an improved estimate of the contribution of mutations in GNPTAB, GNPTG and NAGPA to persistent stuttering, and suggests that variants in FOXP2 and CNTNAP2 are not involved in the genesis of familial persistent stuttering. This, together with the different brain expression patterns of GNPTAB, GNPTG, and NAGPA compared to that of FOXP2 and CNTNAP2, suggests that the genetic neuropathological origins of stuttering differ from those of verbal dyspraxia and SLI.
PMID: 24807205 [PubMed - indexed for MEDLINE] PMCID: PMC4099264 [Available on 2015-09-01]
Atypical central auditory speech-sound discrimination in children who stutter as indexed by the mismatch negativity. - AUDITIVO
J Fluency Disord. 2014 Sep;41:1-11. doi: 10.1016/j.jfludis.2014.07.001. Epub 2014 Jul 15.
Jansson-Verkasalo E, Eggers K, Järvenpää A, Suominen K, Van den Bergh B, De Nil L, Kujala T
University of Turku, Finland; Oulu University Hospital, Finland; Thomas More University College Antwerp, Belgium; Tilburg University, The Netherlands; University of Leuven, Belgium; University of Toronto, Canada; University of Helsinki, Helsinki, Finland.
PURPOSE:Recent theoretical conceptualizations suggest that disfluencies in stuttering may arise from several factors, one of them being atypical auditory processing. The main purpose of the present study was to investigate whether speech sound encoding and central auditory discrimination, are affected in children who stutter (CWS).
METHODS:Participants were 10 CWS, and 12 typically developing children with fluent speech (TDC). Event-related potentials (ERPs) for syllables and syllable changes [consonant, vowel, vowel-duration, frequency (F0), and intensity changes], critical in speech perception and language development of CWS were compared to those of TDC.
RESULTS:There were no significant group differences in the amplitudes or latencies of the P1 or N2 responses elicited by the standard stimuli. However, the Mismatch Negativity (MMN) amplitude was significantly smaller in CWS than in TDC. For TDC all deviants of the linguistic multifeature paradigm elicited significant MMN amplitudes, comparable with the results found earlier with the same paradigm in 6-year-old children. In contrast, only the duration change elicited a significant MMN in CWS.
CONCLUSIONS:The results showed that central auditory speech-sound processing was typical at the level of sound encoding in CWS. In contrast, central speech-sound discrimination, as indexed by the MMN for multiple sound features (both phonetic and prosodic), was atypical in the group of CWS. Findings were linked to existing conceptualizations on stuttering etiology.
EDUCATIONAL OBJECTIVES:The reader will be able (a) to describe recent findings on central auditory speech-sound processing in individuals who stutter, (b) to describe the measurement of auditory reception and central auditory speech-sound discrimination, (c) to describe the findings of central auditory speech-sound discrimination, as indexed by the mismatch negativity (MMN), in children who stutter.
Copyright © 2014 Elsevier Inc. All rights reserved.
PMID: 25066139 [PubMed - indexed for MEDLINE]
Autonomic nervous system activity of preschool-age children who stutter. - INFANTIL
J Fluency Disord. 2014 Sep;41:12-31. doi: 10.1016/j.jfludis.2014.06.002. Epub 2014 Jul 6.
Jones RM, Buhr AP, Conture EG, Tumanova V, Walden TA, Porges SW.
Vanderbilt University, United States; University of Alabama, United States; Syracuse University, United States; University of North Carolina at Chapel Hill, United States.
PURPOSE:The purpose of this study was to investigate potential differences in autonomic nervous system (ANS) activity to emotional stimuli between preschool-age children who do (CWS) and do not stutter (CWNS).
METHODS:Participants were 20 preschool-age CWS (15 male) and 21 preschool-age CWNS (11 male). Participants were exposed to two emotion-inducing video clips (negative and positive) with neutral clips used to establish pre-and post-arousal baselines, and followed by age-appropriate speaking tasks. Respiratory sinus arrhythmia (RSA)-often used as an index of parasympathetic activity-and skin conductance level (SCL)-often used as an index of sympathetic activity-were measured while participants listened to/watched the audio-video clip presentation and performed a speaking task.
RESULTS:CWS, compared to CWNS, displayed lower amplitude RSA at baseline and higher SCL during a speaking task following the positive, compared to the negative, condition. During speaking, only CWS had a significant positive relation between RSA and SCL.
CONCLUSION:Present findings suggest that preschool-age CWS, when compared to their normally fluent peers, have a physiological state that is characterized by a greater vulnerability to emotional reactivity (i.e., lower RSA indexing less parasympathetic tone) and a greater mobilization of resources in support of emotional reactivity (i.e., higher SCL indexing more sympathetic activity) during positive conditions. Thus, while reducing stuttering to a pure physiological process is unwarranted, the present findings suggest that the autonomic nervous system is involved.
EDUCATIONAL OBJECTIVES:The reader will be able to: (a) summarize current empirical evidence on the role of emotion in childhood stuttering; (b) describe physiological indexes of sympathetic and parasympathetic activity; (c) summarize how preschool-age children who stutter differ from preschool-age children who do not stutter in autonomic activity; (d) discuss possible implications of current findings in relation to the development of childhood stuttering.
Copyright © 2014 Elsevier Inc. All rights reserved.
PMID: 25087166 [PubMed - indexed for MEDLINE] PMCID: PMC4150817 [Available on 2015-09-01]
Basal ganglia function, stuttering, sequencing, and repair in adult songbirds. - OUTRAS ÁREAS
Sci Rep. 2014 Oct 13;4:6590. doi: 10.1038/srep06590.
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Kubikova L, Bosikova E, Cvikova M, Lukacova K, Scharff C, Jarvis ED.
Slovak Academy of Sciences, Ivanka pri Dunaji, Slovakia; Freie Universität Berlin, Germany; Duke University Medical Center, Durham, NC, USA.
A pallial-basal-ganglia-thalamic-pallial loop in songbirds is involved in vocal motor learning. Damage to its basal ganglia part, Area X, in adult zebra finches has been noted to have no strong effects on song and its function is unclear. Here we report that neurotoxic damage to adult Area X induced changes in singing tempo and global syllable sequencing in all animals, and considerably increased syllable repetition in birds whose song motifs ended with minor repetitions before lesioning. This stuttering-like behavior started at one month, and improved over six months. Unexpectedly, the lesioned region showed considerable recovery, including immigration of newly generated or repaired neurons that became active during singing. The timing of the recovery and stuttering suggest that immature recovering activity of the circuit might be associated with stuttering. These findings indicate that even after juvenile learning is complete, the adult striatum plays a role in higher level organization of learned vocalizations.
PMID: 25307086 [PubMed - in process] PMCID: PMC4194444 Free PMC Article
Bruce P. Ryan (1932–2014) – A tribute
J Fluency Disord. 2014 Dec;42:43-4.
Ingham RJ, Ingham JC.
No abstract available.
PMID: 25614909 [PubMed - indexed for MEDLINE]
[Comorbidity of tics and stuttering]. - FARMACOLOGIA
Zh Nevrol Psikhiatr Im S S Korsakova. 2014;114(10):56-8.
[Article in Russian]
Surushkina SY, Chutko LS, Aitbekov KA, Nikishena IS, Bondarchuk YI.
OBJECTIVE: To determine the clinical presentations of stuttering in children with tics treated with noofen.
MATERIAL AND METHODS: Authors examined 181 children with tics, aged 7-13. Stuttering was identified in 23.2% of cases. Thirty children with tics and comorbid stuttering received noofen. RESULTS AND СONCLUSION: The prevalence of stuttering in children with tics was significantly higher than in the population. Stuttering was significantly more frequent in children with transient tics than chronic tics. Neurotic stuttering was recorded more frequently. The high efficacy of noofen was shown; the decrease in ticks was obtained in 80% of cases, the reduction of stuttering in 66.7% of cases. The data of clinical, psychological and neurophysiological studies, confirming the improvement of patients after treatment, are presented.
PMID: 25591517 [PubMed - indexed for MEDLINE]
CNV amplitude as a neural correlate for stuttering frequency: A case report of acquired stuttering. - NEUROCIÊNCIAS
Neuropsychologia. 2014 Oct 2;64C:349-359. doi: 10.1016/j.neuropsychologia.2014.09.036. [Epub ahead of print]
Vanhoutte S, Van Borsel J, Cosyns M, Batens K, van Mierlo P, Hemelsoet D, Van Roost D, Corthals P, De Letter M, Santens P.
Ghent University, Ghent, Belgium; Veiga de Almeida University, Rio de Janeiro, Brazil; Ghent University Hospital, Ghent, Belgium; University College Ghent, Ghent, Belgium.
A neural hallmark of developmental stuttering is abnormal articulatory programming. One of the neurophysiological substrates of articulatory preparation is the contingent negative variation (CNV). Unfortunately, CNV tasks are rarely performed in persons who stutter and mainly focus on the effect of task variation rather than on interindividual variation in stutter related variables. However, variations in motor programming seem to be related to variation in stuttering frequency. The current study presents a case report of acquired stuttering following stroke and stroke related surgery in the left superior temporal gyrus. A speech related CNV task was administered at four points in time with differences in stuttering severity and frequency. Unexpectedly, CNV amplitudes at electrode sites approximating bilateral motor and left inferior frontal gyrus appeared to be inversely proportional to stuttering frequency. The higher the stuttering frequency, the lower the activity for articulatory preparation. Thus, the amount of disturbance in motor programming seems to determine stuttering frequency. At right frontal electrodes, a relative increase in CNV amplitude was seen at the test session with most severe stuttering. Right frontal overactivation is cautiously suggested to be a compensation strategy. In conclusion, late CNV amplitude elicited by a relatively simple speech task seems to be able to provide an objective, neural correlate of stuttering frequency. The present case report supports the hypothesis that motor preparation has an important role in stuttering.
Copyright © 2014 Elsevier Ltd. All rights reserved.
PMID: 25281310 [PubMed - as supplied by publisher]
Control and prediction components of movement planning in stuttering versus nonstuttering adults. - MOTOR
J Speech Lang Hear Res. 2014 Dec;57(6):2131-41. doi: 10.1044/2014_JSLHR-S-13-0333.
Daliri A, Prokopenko RA, Flanagan JR, Max L.
PURPOSE:Stuttering individuals show speech and nonspeech sensorimotor deficiencies. To perform accurate movements, the sensorimotor system needs to generate appropriate control signals and correctly predict their sensory consequences. Using a reaching task, we examined the integrity of these control and prediction components separately for movements unrelated to the speech motor system.
METHOD:Nine stuttering and 9 nonstuttering adults made fast reaching movements to visual targets while sliding an object under the index finger. To quantify control, we determined initial direction error and end point error. To quantify prediction, we calculated the correlation between vertical and horizontal forces applied to the object-an index of how well vertical force (preventing slip) anticipated direction-dependent variations in horizontal force (moving the object).
RESULTS:Directional and end point error were significantly larger for the stuttering group. Both groups performed similarly in scaling vertical force with horizontal force.
CONCLUSIONS:The stuttering group's reduced reaching accuracy suggests limitations in generating control signals for voluntary movements, even for nonorofacial effectors. Typical scaling of vertical force with horizontal force suggests an intact ability to predict the consequences of planned control signals. Stuttering may be associated with generalized deficiencies in planning control signals rather than predicting the consequences of those signals.
PMID: 25203459 [PubMed - in process] PMCID: PMC4270877 [Available on 2015-12-01]
Deep brain stimulation of the antero-medial globus pallidus interna for Tourette syndrome - OUTRAS ÁREAS
PLoS One. 2014 Aug 19;9(8):e104926. doi: 10.1371/journal.pone.0104926. eCollection 2014.
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Sachdev PS, Mohan A, Cannon E, Crawford JD, Silberstein P, Cook R, Coyne T, Silburn PA.
Prince of Wales Hospital, Randwick, NSW, Australia; The University of New South Wales, Sydney, Australia.=; North Shore Private Hospital, St. Leonards, Sydney, NSW, Australia; University of Queensland, Herston, QLD, Australia; St. Andrew's War Memorial Hospital, Spring Hill, QLD, Australia.
BACKGROUND:We have previously reported the results of Deep Brain Stimulation (DBS) of the antero-medial globus pallidus interna (GPi) for severe Tourette Syndrome (TS) in 11 patients. We extend this case series to 17 patients and a longer follow-up to a maximum of 46 months.
METHODS:17 patients (14 male; mean age 29.1 years, range 17-51 years) with severe and medically intractable TS were implanted with Medtronic quadripolar electrodes bilaterally in the antero-medial GPi. The primary outcome measure was the Yale Global Tic Severity Scale (YGTSS). Secondary outcome measures included the Yale-Brown Obsessive Compulsive Scale, Hamilton Depression Rating Scale, Gilles de la Tourette Quality of Life Scale and Global Assessment of Functioning. Follow up was at one month, three months and finally at a mean 24.1 months (range 8-46 months) following surgery.
RESULTS:Overall, there was a 48.3% reduction in motor tics and a 41.3% reduction in phonic tics at one month, and this improvement was maintained at final follow-up. 12 out of 17 (70.6%) patients had a>50% reduction in YGTSS score at final follow up. Only 8 patients required ongoing pharmacotherapy for tics post-surgery. Patients improved significantly on all secondary measures. Adverse consequences included lead breakage in 4 patients, infection (1), transient anxiety (2), dizziness (1), poor balance (1) and worsening of stuttering (1).
CONCLUSIONS:This case series provides further support that antero-medial GPi DBS is an effective and well tolerated treatment for a subgroup of severe TS, with benefits sustained up to 4 years.
PMID: 25136825 [PubMed - in process] PMCID: PMC4138156
Distinct phenotypes of speech and voice disorders in Parkinson's disease after subthalamic nucleus deep brain stimulation - OUTRAS ÁREAS
J Neurol Neurosurg Psychiatry. 2014 Oct 3. pii: jnnp-2014-308043. doi: 10.1136/jnnp-2014-308043. [Epub ahead of print]
Tsuboi T, Watanabe H, Tanaka Y, Ohdake R, Yoneyama N, Hara K, Nakamura R, Watanabe H, Senda J, Atsuta N, Ito M, Hirayama M, Yamamoto M, Fujimoto Y, Kajita Y, Wakabayashi T, Sobue G.
Nagoya University Graduate School of Medicine, Nagoya, Japan; Aichi-Gakuin University, Aichi, Japan;
OBJECTIVES:To elucidate the phenotypes and pathophysiology of speech and voice disorders in Parkinson's disease (PD) with subthalamic nucleus deep brain stimulation (STN-DBS).
METHODS:We conducted a cross-sectional study on 76 PD patients treated with bilateral STN-DBS (PD-DBS) and 33 medically treated PD patients (PD-Med). Speech and voice functions, electrode positions, motor function and cognitive function were comprehensively assessed. Moreover, speech and voice functions were compared between the on-stimulation and off-stimulation conditions in 42 PD-DBS patients.
RESULTS:Speech and voice disorders in PD-DBS patients were significantly worse than those in PD-Med patients. Factor analysis and subsequent cluster analysis classified PD-DBS patients into five clusters: relatively good speech and voice function type, 25%; stuttering type, 24%; breathy voice type, 16%; strained voice type, 18%; and spastic dysarthria type, 17%. STN-DBS ameliorated voice tremor or low volume; however, it deteriorated the overall speech intelligibility in most patients. Breathy voice did not show significant changes and stuttering exhibited slight improvement after stopping stimulation. In contrast, patients with strained voice type or spastic dysarthria type showed a greater improvement after stopping stimulation. Spastic dysarthria type patients showed speech disorders similar to spastic dysarthria, which is associated with bilateral upper motor neuron involvement. Strained voice type and spastic dysarthria type appeared to be related to current diffusion to the corticobulbar fibres.
CONCLUSIONS: Stuttering and breathy voice can be aggravated by STN-DBS, but are mainly due to aging or PD itself. Strained voice and spastic dysarthria are considered corticobulbar side effects.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permis....
PMID: 25280914 [PubMed - as supplied by publisher]
Effects of video exposure to cluttering on undergraduate students' perceptions of a person who clutters. - SOCIAL
Int J Lang Commun Disord. 2014 Dec 17. doi: 10.1111/1460-6984.12139. [Epub ahead of print]
Farrell LM, Blanchet PG, Tillery KL.
Department of Communication Disorders and Sciences, SUNY Fredonia, Fredonia, NY, USA.
BACKGROUND: Previous research suggests a negative stereotype toward people with fluency disorders (i.e. stuttering and/or cluttering), although recent findings suggest that exposure to an actual person who stutters (e.g. a live or video presentation) leads to more positive perceptions of some personality traits. However, there is a paucity of research examining perceptions of a person who clutters and whether these perceptions can be modified via video exposure to cluttering.
AIMS: To examine the effects of video exposure to cluttering on university students' perceptions of a person who clutters. It was hypothesized that participants in the video condition would rate personality traits more positively than those who did not view the video clip.
METHODS & PROCEDURES: A total of 105 undergraduate students served as participants; 54 were provided with written definition of cluttering, whereas 51 were provided with both a definition and short segment of an instructional DVD on cluttering. Students then rated a person who clutters on a variety of speech skills and personality scales.
OUTCOMES & RESULTS: Independent samples t-tests yielded no significant group differences in ratings of any speech skills or personality traits. However, a significantly greater number of students who viewed the video clip reported a reluctance to hire a person who clutters specifically because of the individual's fluency disorder. Additionally, participants who did not view the video clip reported having more previous instructors who cluttered than those who did view the video clip; this increased familiarity with persons who clutter may have impacted perceptions of a person who clutters.
CONCLUSIONS & IMPLICATIONS: The present results indicate that viewing the brief video clip did not significantly influence ratings towards more positive perceptions, but also did not influence ratings to be significantly more negative on any traits. Further research is needed to compare the differences in the perceptions of listeners who have had long-term exposure to cluttered speech with those of listeners who have had brief exposure. Implications discussed include the impact of prior exposure to fluency disorders, as well as potential confusion between cluttering and 'fast speech'. These two factors may have influenced the identification rate of individuals with who clutter in the present study, which may have affected perceptions of a person who clutters.
© 2014 Royal College of Speech and Language Therapists.
PMID: 25521169 [PubMed - as supplied by publisher]
End-word dysfluencies in young children: a clinical report. - AVALIAÇÃO
Folia Phoniatr Logop. 2014;66(3):115-25. doi: 10.1159/000365247. Epub 2014 Oct 21.
MacMillan V, Kokolakis A, Sheedy S, Packman A.
Stuttering Unit, South Western Sydney Local Health District, Bankstown, N.S.W., Australia.
OBJECTIVE: We report on 12 children with end-word dysfluencies (EWDs). Our aim was to document this little-reported type of dysfluency and to develop a possible explanation for them and how they relate to developmental stuttering.
METHOD: Audio recordings were made for 9 of the 12 children in the study. The EWDs were identified by consensus of two specialist speech pathologists and confirmed on acoustic displays. A segment of participant 1's speech was transcribed, including phonetic transcription of EWDs.
RESULTS: The EWDs typically consisted of repetitions of the nucleus and/or the coda. However, there were also some EWDs that consisted of fixed postures on the nucleus (when in final position) or coda. We also report on the infrequent occurrence of broken words. Ten of the 12 children also stuttered, with 9 of them coming from four families, each with a history of stuttering.
CONCLUSION: This study indicates that EWDs may be more prevalent than previously thought, but they may go largely unnoticed due to their perceptually fleeting nature. The hypothesis was developed that EWDs be regarded as another type of developmental dysfluency, along with stuttering and cluttering. Ideas for further research are suggested. © 2014 S. Karger AG, Basel.
PMID: 25342122 [PubMed - in process]
English-only treatment of bilingual speakers who stutter: Generalization of treatment effects from English to Mandarin. - TERAPIA
Int J Speech Lang Pathol. 2014 Nov 28:1-10. [Epub ahead of print]
Lim VP, Lincoln M, Onslow M, Chan YH.
Speech Therapy Department, Singapore General Hospital , Singapore.
Purpose: Speech language pathologists often do not speak the dominant language of their clients and so the language of treatment is an important consideration. This research investigated whether stuttering treatment delivered in English resulted in reductions in stuttering in English and Mandarin bilingual Singaporean speakers. Method: Participants were 19 English-Mandarin bilinguals who stuttered. They received a speech re-structuring intensive program (IP) delivered in English only. Three 10-minute conversations in English and Mandarin, sampled at pre-treatment, immediately post IP, 4 weeks post IP and 12 weeks post IP, were analysed by two English-Mandarin bilingual clinicians for percentage of syllables stuttered (%SS). Result: After English-only treatment, stuttering reductions were found to generalize to Mandarin. Stuttering reductions were significantly higher in English compared to Mandarin at 4 weeks post-IP, but there was no significant difference in the stuttering reductions between languages at the end of IP and at 12 weeks post-IP. Mean %SS scores for English and Mandarin were comparable with the outcome data reported for a similar intensive speech-restructuring program for monolingual English-speaking adults. Conclusion: The results of this study show that stuttering reductions can be achieved in two languages following treatment in one language only. Future research in this area is proposed.
PMID: 25430634 [PubMed - as supplied by publisher]
Expressive Language Intratest Scatter of Preschool-Age Children Who Stutter. - LINGUAGEM
Contemp Issues Commun Sci Disord. 2014 Spring;41:110-119.
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Millager RA, Conture EG1 Walden TA, Kelly EM
PURPOSE: The purpose of this study was to assess intratest scatter (variability) on standardized tests of expressive language by preschool-age children who do (CWS) and do not stutter (CWNS).
METHOD: Participants were 40 preschool-age CWS and 46 CWNS. Between-group comparisons of intratest scatter were made based on participant responses to the Expressive subtest of the Test of Early Language Development - 3 (TELD-Exp; Hresko, Reid, & Hamill, 1999) and the Expressive Vocabulary Test 2 (EVT-2; Williams, 2007). Within-group correlational analyses between intratest scatter and stuttering frequency and severity were also conducted for CWS.
RESULTS: Findings indicated that, for CWS, categorical scatter on the EVT-2 was positively correlated with their stuttering frequency. No significant between-group differences in intratest scatter were found on the TELD-Exp or the EVT-2.
CONCLUSIONS: Consistent with earlier findings, variability in speech-language performance appears to be related to CWS' stuttering, a finding taken to suggest an underlying cognitive-linguistic variable (e.g., cognitive load) may be common to both variables.
PMID: 25520550 [PubMed] PMCID: PMC4266111
Extrapontine Myelinolysis in a patient with Primary Adrenal Insufficiency - OUTROS
Acta Neurol Taiwan. 2014 Dec;23(4):146-52.
Wu JW, Wang PN, Lirng JF, Hsu RW, Chen WT.
PURPOSE:To report the development of estrapontine myelinolysis (EPM) in a patient with adrenal insufficiency and review similar in the literature.
CASE REPORT:A 49-year-old female with insufficiency presented with acute dysarthria, stuttering, and parkinsonism. She received isotonic saline hydration for adrenal crisis and hyponatremia 18 days before the onset of symtoms. The brain MRI and MRS showed demyelination at bilateral basal ganglia and the thalamus, which was compatible with EPM and resolved within 3 months after steroid treatment.
CONCLUSION:Development of acute parkinsonism after rapid correction of hyponatremia may indicate the occurrence of EPM and underlying adrenal insufficiency should be excluded in these patients.
PMID: 26106753 [PubMed - indexed for MEDLINE]
Extraversion and communication attitude in people who stutter: A preliminary study. - AVALIAÇÃO
J Fluency Disord. 2014 Dec;42:13-20. doi: 10.1016/j.jfludis.2014.08.001. Epub 2014 Sep 6.
Stipdonk L, Lieftink A, Bouwen J, Wijnen F.
Erasmus University Medical Center, Rotterdam, The Netherlands; Utrecht University, Utrecht, The Netherlands.
PURPOSE:The aim of the study was to determine the correlation between the personality trait extraversion and the communication attitude in people who stutter (PWS).
METHOD:Thirty PWS completed Erickson's Communication Attitude Scale (S-24) (Andrews & Cutler, 1974) as well as a Dutch adaptation of the extraversion scale of the NEO Five-Factor Inventory (Hoekstra, Ormel, & Fruyt, 1996).
RESULTS:The communication attitude scores correlated significantly with the extraversion scores: PWS with a more negative communication attitude were more introvert and PWS with a more positive attitude were more extravert.
CONCLUSION:This result suggests that the S-24 is not only sensitive to communication attitude in relation to speech impairment, but also to the respondent's degree of extraversion. Consequently, assessment of communication attitude needs to be re-thought so as to take personality factors into account.
EDUCATIONAL OBJECTIVES:Readers should be able to: (a) describe the difference between temperament and personality; (b) describe what the S-24 Communication Attitude Scale measures in PWS; (c) describe how the personality trait extraversion may influence the communication attitude in PWS; (d) describe how the extraversion scale is correlated to the communication attitude scale according to the authors of this article.
Copyright © 2014 Elsevier Inc. All rights reserved.
PMID: 25239798 [PubMed - indexed for MEDLINE]
Science. 2014 Dec 5;346(6214):1258. doi: 10.1126/science.346.6214.1258346.6214.1258.
Free Full text
University of Alabama.
PMID: 25477466 [PubMed - indexed for MEDLINE]
Fluency profile: comparison between Brazilian and European Portuguese speakers. - AVALIAÇÃO
Codas. 2014 Nov-Dec;26(6):444-6. doi: 10.1590/2317-1782/20142014184. Epub 2014 Dec 1.
Free full text em inglês e em português
Alves e Castro BS, Martins-Reis Vde O, Baptista AC, Celeste LC.
Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Universidade do Algarve, Algarve, Portugal; Universidade de Brasília, Brasília, DF, Brazil.
The purpose of the study was to compare the speech fluency of Brazilian Portuguese speakers with that of European Portuguese speakers. The study participants were 76 individuals of any ethnicity or skin color aged 18-29 years. Of the participants, 38 lived in Brazil and 38 in Portugal. Speech samples from all participants were obtained and analyzed according to the variables of typology and frequency of speech disruptions and speech rate. Descriptive and inferential statistical analyses were performed to assess the association between the fluency profile and linguistic variant variables. We found that the speech rate of European Portuguese speakers was higher than the speech rate of Brazilian Portuguese speakers in words per minute (p=0.004). The qualitative distribution of the typology of common dysfluencies (p<0.001) also discriminated between the linguistic variants. While a speech fluency profile of European Portuguese speakers is not available, speech therapists in Portugal can use the same speech fluency assessment as has been used in Brazil to establish a diagnosis of stuttering, especially in regard to typical and stuttering dysfluencies, with care taken when evaluating the speech rate.
PMID: 25590905 [PubMed - in process]
Functional connectivity changes in adults with developmental stuttering: a preliminary study using quantitative electro-encephalography - NEUROCIÊNCIAS
Front Hum Neurosci. 2014 Oct 13;8:783. doi: 10.3389/fnhum.2014.00783. eCollection 2014.
Joos K, De Ridder D, Boey RA, Vanneste S.
University Hospital Antwerp Antwerp, Belgium ; University of Antwerp, Antwerp, Belgium; University of Otago Dunedin, New Zealand ; Sint Augustinus Hospital Antwerp, Belgium; The University of Texas at Dallas Richardson, TX, USA.
INTRODUCTION: Stuttering is defined as speech characterized by verbal dysfluencies, but should not be seen as an isolated speech disorder, but as a generalized sensorimotor timing deficit due to impaired communication between speech related brain areas. Therefore we focused on resting state brain activity and functional connectivity.
METHOD: We included 11 patients with developmental stuttering and 11 age matched controls. To objectify stuttering severity and the impact on quality of life (QoL), we used the Dutch validated Test for Stuttering Severity-Readers (TSS-R) and the Overall Assessment of the Speaker's Experience of Stuttering (OASES), respectively. Furthermore, we used standardized low resolution brain electromagnetic tomography (sLORETA) analyses to look at resting state activity and functional connectivity differences and their correlations with the TSS-R and OASES.
RESULTS: No significant results could be obtained when looking at neural activity, however significant alterations in resting state functional connectivity could be demonstrated between persons who stutter (PWS) and fluently speaking controls, predominantly interhemispheric, i.e., a decreased functional connectivity for high frequency oscillations (beta and gamma) between motor speech areas (BA44 and 45) and the contralateral premotor (BA6) and motor (BA4) areas. Moreover, a positive correlation was found between functional connectivity at low frequency oscillations (theta and alpha) and stuttering severity, while a mixed increased and decreased functional connectivity at low and high frequency oscillations correlated with QoL.
DISCUSSION: PWS are characterized by decreased high frequency interhemispheric functional connectivity between motor speech, premotor and motor areas in the resting state, while higher functional connectivity in the low frequency bands indicates more severe speech disturbances, suggesting that increased interhemispheric and right sided functional connectivity is maladaptive.
PMID: 25352797 [PubMed] PMCID: PMC4195313 Free PMC Article
Group lidcombe program treatment for early stuttering: a randomized controlled trial. - TERAPIA EM GRUPO
J Speech Lang Hear Res. 2014 Oct;57(5):1606-18. doi: 10.1044/2014_JSLHR-S-13-0090.
Arnott S, Onslow M, O'Brian S, Packman A, Jones M, Block S.
PURPOSE:This study adds to the Lidcombe Program evidence base by comparing individual and group treatment of preschoolers who stutter.
METHOD:A randomized controlled trial of 54 preschoolers was designed to establish whether group delivery outcomes were not inferior to the individual model. The group arm used a rolling group model, in which a new member entered an existing group each time a vacancy became available. Assessments were conducted prerandomization and 9 months and 18 months postrandomization.
RESULTS:There was no evidence of a difference between treatment arms for measures of weeks or clinic visits required, percent syllables stuttered, or parent severity ratings. However, children in the group arm consumed around half the number of speech-language pathologist hours compared with children treated individually. In addition, children in the group progressed more quickly after the treating speech-language pathologist became more practiced with the group model, suggesting the group results are conservative estimates.
CONCLUSIONS:Group delivery of the Lidcombe Program is an efficacious alternative to the individual model. Parents responded favorably to the group model, and the treating speech-language pathologists found group treatment to be more taxing but clinically gratifying.
PMID: 24824991 [PubMed - in process]
Health-related quality of life of preschool children who stutter. - AVALIAÇÃO
J Fluency Disord. 2014 Dec;42:1-12. doi: 10.1016/j.jfludis.2014.09.001. Epub 2014 Oct 17.
de Sonneville-Koedoot C, Stolk EA, Raat H, Bouwmans-Frijters C, Franken MC.
Erasmus University, The Netherlands; Erasmus University Medical Center, CA Rotterdam, The Netherlands.
PURPOSE: The purpose of this study is to compare the health-related quality of life (HrQoL) of preschool children who stutter (CWS) and a reference population of children who do not stutter, and to evaluate the association between stuttering severity and HrQoL.
METHODS: Baseline data were used from 197 children participating in a multicenter Randomized Clinical Trial in the Netherlands. Information on stuttering severity and time since onset (TSO) of stuttering was obtained from the baseline evaluation by speech- and language therapists. Stuttering severity was measured using the SSI-3. HrQoL was assessed using proxy versions of two Child Health Questionnaires (ITQOL-97 and CHQ-PF28), the Health Utility Index 3 (HUI3) and the EuroQoL EQ-VAS (EQ-VAS).
RESULTS: While the outcomes on the EQ-VAS and the HUI3 showed that the HrQoL of CWS is slightly poorer than that of the Dutch reference population, results on the different dimensions of the CHQ-instruments did not reveal any difference in scores between stuttering children and reference groups. Within the group of CWS, two ITQOL-97 and four CHQ-PF28 scales showed statistically different scores for children in different SSI stuttering severity or TSO categories. However, the effect sizes showed that these differences were so small that they could be considered negligible.
CONCLUSION: The results of this study do not reveal a diminished HrQoL for preschool CWS. Future research should include a larger cohort of children with severe stuttering, study the longitudinal course of HrQoL and incorporate additional parameters such as the characteristics of the child and his environment.
EDUCATIONAL OBJECTIVES:The reader will be able to: (a) summarize the current evidence base on HrQoL in people who stutter; (b) describe the HrQoL of preschool CWS on different HrQoL measures; (c) describe the relationship between stuttering severity and HrQoL in preschool CWS.
Copyright © 2014 Elsevier Inc. All rights reserved.
PMID: 25453187 [PubMed - indexed for MEDLINE]
Incidence of developmental speech dysfluencies in individuals with Parkinson's disease. - OUTRAS ÁREAS
Folia Phoniatr Logop. 2014;66(3):132-7. doi: 10.1159/000368751. Epub 2014 Nov 19.
Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
OBJECTIVE:The aim of this study was to investigate the incidence of developmental speech dysfluencies in individuals with Parkinson's disease (PD).
BACKGROUND: The possible relationship between PD and dysfluencies such as stuttering has engaged researchers for many years. However, whether there is a higher-than-expected incidence of reported childhood stuttering in adults with a diagnosis of PD is unknown.
PARTICIPANTS AND METHODS:A questionnaire including items regarding present and former speech difficulties was answered by 280 individuals with PD.
RESULTS:The total number of persons who reported that they had stuttered (often or sometimes) before the age of 10 years was 11, corresponding to 3.9%. The number of persons who reported unusually fast speech before the age of 10 years was 17, corresponding to 6.1%. The reported incidence of childhood stuttering in this group was consequently not higher than that in previously published reports on childhood stuttering (approx. 5%). The frequency of unusually fast speech was notable, but the lack of a control group made it difficult to conclude on the significance of that finding.
CONCLUSION: Although no direct comparison between self-reported incidences of childhood dysfluencies and published incidence figures regarding childhood stuttering can be made, different possible relationships between speech dysfluency and basal ganglia dysfunction are discussed. © 2014 S. Karger AG, Basel.
PMID: 25413693 [PubMed - in process]
Korean speech-language pathologists' attitudes toward stuttering according to clinical experiences. - SOCIAL
Int J Lang Commun Disord. 2014 Nov;49(6):771-9. doi: 10.1111/1460-6984.12093. Epub 2014 Jul 17.
Catholic University of Daegu, Kyungsan-si, Kyungsangbuk-do, Korea.
BACKGROUND: Negative attitudes toward stuttering and people who stutter (PWS) are found in various groups of people in many regions. However the results of previous studies examining the influence of fluency coursework and clinical certification on the attitudes of speech-language pathologists (SLPs) toward PWS are equivocal. Furthermore, there have been few empirical studies on the attitudes of Korean SLPs toward stuttering.
AIMS:To determine whether the attitudes of Korean SLPs and speech-language pathology students toward stuttering would be different according to the status of clinical certification, stuttering coursework completion and clinical practicum in stuttering.
METHODS & PROCEDURES: Survey data from 37 certified Korean SLPs and 70 undergraduate students majoring in speech-language pathology were analysed. All the participants completed the modified Clinician Attitudes Toward Stuttering (CATS) Inventory.
OUTCOMES & RESULTS: Results showed that the diagnosogenic view was still accepted by many participants. Significant differences were found in seven out of 46 CATS Inventory items according to the certification status. In addition significant differences were also found in three items and one item according to stuttering coursework completion and clinical practicum experience in stuttering, respectively.
CONCLUSIONS & IMPLICATIONS: Clinical and educational experience appears to have mixed influences on SLPs' and students' attitudes toward stuttering. While SLPs and students may demonstrate more appropriate understanding and knowledge in certain areas of stuttering, they may feel difficulty in their clinical experience, possibly resulting in low self-efficacy.
© 2014 Royal College of Speech and Language Therapists.
PMID: 25039429 [PubMed - in process]
Practice and retention of nonwords in adults who stutter - FALA
J Fluency Disord. 2014 Sep;41:55-71. doi: 10.1016/j.jfludis.2014.02.004. Epub 2014 Mar 6.
Free Full Text
Sasisekaran J, Weisberg S.
University of Minnesota, United States
PURPOSE:We investigated short-term practice and retention of nonwords in 10 adults who stutter (Mean age=30.7 years, SD=15.1) and age and sex-matched 10 control participants (Mean age=30.8 years, SD=14.9).
METHODS:Participants were required to repeat nonwords varying in length (3, 4, and 6 syllables), phonotactic constraint (PC vs. NPC, on 3-syllable nonwords only), and complexity (simple, complex). They were tested twice with 1h gap between sessions.
RESULTS:Logistic mixed model of speech accuracy revealed that the AWS showed a significantly lower probability of correct responses with increasing length and complexity. Analysis of speech kinematics revealed practice effects within Session 1 in AWS seen as a reduction in movement variability for the 3-syllable nonwords; the control group was performing at ceiling at this length. For the 4-syllable nonwords, the control group showed a significant reduction in movement variability with practice, and retained this reduction in Session 2, while the AWS group did not show practice or retention. Group differences were not evident at the 6-syllable level.
CONCLUSIONS: Group differences in speech accuracy suggest differences in phonemic encoding and/or speech motor processes. Group differences in changes in movement variability within and between sessions suggest reduced practice and retention in AWS. Relevance of the combined use of both behavioral and kinematic measures to interpret the nature of the skill acquisition deficit in persons who stutter is discussed.
EDUCATIONAL OBJECTIVES:At the end of this activity the reader will be able to: (a) summarize the process of skill acquisition; (b) discuss the literature on skill acquisition deficits in adults who stutter, (c) summarize the differences between AWS and control participants in speech accuracy and speech kinematics with short-term practice and retention of nonwords, (d) discuss potential research directions in the area of skill acquisition in AWS.
Copyright © 2014 Elsevier Inc. All rights reserved.
PMID: 25173457 [PubMed - indexed for MEDLINE] PMCID: PMC4156135
Preschool speech articulation and nonword repetition abilities may help predict eventual recovery or persistence of stuttering. - INFANTIL
J Fluency Disord. 2014 Sep;41:32-46. doi: 10.1016/j.jfludis.2014.06.001. Epub 2014 Jun 16.
Spencer C, Weber-Fox C.
Purdue University, United States.
PURPOSE:In preschool children, we investigated whether expressive and receptive language, phonological, articulatory, and/or verbal working memory proficiencies aid in predicting eventual recovery or persistence of stuttering.
METHODS:Participants included 65 children, including 25 children who do not stutter (CWNS) and 40 who stutter (CWS) recruited at age 3;9-5;8. At initial testing, participants were administered the Test of Auditory Comprehension of Language, 3rd edition (TACL-3), Structured Photographic Expressive Language Test, 3rd edition (SPELT-3), Bankson-Bernthal Test of Phonology-Consonant Inventory subtest (BBTOP-CI), Nonword Repetition Test (NRT; Dollaghan & Campbell, 1998), and Test of Auditory Perceptual Skills-Revised (TAPS-R) auditory number memory and auditory word memory subtests. Stuttering behaviors of CWS were assessed in subsequent years, forming groups whose stuttering eventually persisted (CWS-Per; n=19) or recovered (CWS-Rec; n=21). Proficiency scores in morphosyntactic skills, consonant production, verbal working memory for known words, and phonological working memory and speech production for novel nonwords obtained at the initial testing were analyzed for each group.
RESULTS:CWS-Per were less proficient than CWNS and CWS-Rec in measures of consonant production (BBTOP-CI) and repetition of novel phonological sequences (NRT). In contrast, receptive language, expressive language, and verbal working memory abilities did not distinguish CWS-Rec from CWS-Per. Binary logistic regression analysis indicated that preschool BBTOP-CI scores and overall NRT proficiency significantly predicted future recovery status.
CONCLUSION:Results suggest that phonological and speech articulation abilities in the preschool years should be considered with other predictive factors as part of a comprehensive risk assessment for the development of chronic stuttering.
EDUCATIONAL OBJECTIVES:At the end of this activity the reader will be able to: (1) describe the current status of nonlinguistic and linguistic predictors for recovery and persistence of stuttering; (2) summarize current evidence regarding the potential value of consonant cluster articulation and nonword repetition abilities in helping to predict stuttering outcome in preschool children; (3) discuss the current findings in relation to potential implications for theories of developmental stuttering; (4) discuss the current findings in relation to potential considerations for the evaluation and treatment of developmental stuttering.
Copyright © 2014 Elsevier Inc. All rights reserved.
PMID: 25173455 [PubMed - indexed for MEDLINE] PMCID: PMC4150085 [Available on 2015-09-01]
Prevalence of risk factors for stuttering among boys: analytical cross-sectional study. - AVALIAÇÃO
Sao Paulo Med J. 2014;132(3):152-7. Epub 2014 Apr 14.
Free full text
Oliveira CM, Nogueira PR.
Universidade Estadual Paulista, Marília, São Paulo, Brazil.
CONTEXT AND OBJECTIVE:There have been few studies on the risk factors for subgroups of stuttering. The aim of this study was to characterize the risk factors for developmental familial stuttering among boys who stutter and who do not stutter, such as disfluency types, associated quality and communication factors, emotional and physical stress, familial attitudes and personal reactions.
DESIGN AND SETTING:Analytical cross-sectional study with a control group, performed at the Fluency Studies Laboratory of the Department of Speech and Hearing Disorders of a public university.
METHODS:The parents of 40 age-matched stuttering and non-stuttering boys took part in this study. The participants were divided into two groups: stuttering children (SC) and non-stuttering children (NSC), with ages between 6 years 0 months and 11 years 11 months. Initially, all of the participants underwent a fluency assessment and then data were gathered using the Protocol for the Risk of Developmental Stuttering.
RESULTS:There were no differences in the physical stress distribution factors and personal reactions between the groups. Inappropriate familial attitudes were presented by 95% of the SC and 30% of the NSC. Four risk factors analyzed were not shown by the NSC, namely stuttering-like disfluency, quality factors, physical stress and emotional stresses.
CONCLUSIONS:The findings suggest that the presence of stuttering-like disfluency, associated quality and communication factors, emotional stress and inappropriate family attitudes are important risk factors for familial developmental stuttering among boys.
PMID: 24760215 [PubMed - indexed for MEDLINE]
Public attitudes toward-and identification of-cluttering and stuttering in Norway and Puerto Rico. - SOCIAL
J Fluency Disord. 2014 Dec;42:21-34. doi: 10.1016/j.jfludis.2014.05.005. Epub 2014 Jun 19.
St Louis KO, Sønsterud H, Carlo EJ, Heitmann RR, Kvenseth H.
West Virginia University, Morgantown, WV, USA; Statped, Department of Speech and Language Disorders, Oslo, Norway; University of Puerto Rico, San Juan, Puerto Rico, USA; Statped Vest, Bergen, Norway; International Cluttering Association, Trondheim, Norway.
PURPOSE:The study sought to compare public attitudes toward cluttering versus stuttering in Norway and Puerto Rico and to compare respondents' identification of persons known with these fluency disorders.
METHOD: After reading lay definitions of cluttering and stuttering, three samples of adults from Norway and three from Puerto Rico rated their attitudes toward cluttering and/or stuttering on modified versions of the POSHA-Cl (for cluttering) and POSHA-S (for stuttering). They also identified children and adults whom they knew who either or both manifested cluttering or stuttering.
RESULTS:Attitudes toward cluttering were essentially unaffected by rating either cluttering only or combined cluttering and stuttering on the same questionnaire in both countries. The same was also true of stuttering. Attitudes were very similar toward both disorders although slightly less positive for cluttering. Norwegian attitudes toward both disorders were generally more positive than Puerto Rican attitudes. The average respondent identified slightly more than one fluency disorder, a higher percentage for stuttering than cluttering and higher for adults than children. Cluttering-stuttering was rarely identified.
CONCLUSION: Given a lay definition, this study confirmed that adults from diverse cultures hold attitudes toward cluttering that are similar to-but somewhat less positive than-their attitudes toward stuttering. It also confirmed that adults can identify cluttering among people they know, although less commonly than stuttering. Design controls in this study assured that consideration of stuttering did not affect either the attitudes or identification results for cluttering.
EDUCATIONAL OBJECTIVES:The reader will be able to: (a) describe the effects-or lack thereof-of considerations of stuttering on attitudes toward cluttering; (b) describe differences in public identification of children and adults who either clutter or stutter; (c) describe differences between attitudes toward cluttering and stuttering in Norway and Puerto Rico.
Copyright © 2014 Elsevier Inc. All rights reserved.
PMID: 25465413 [PubMed - indexed for MEDLINE]
Safety behaviors and speech treatment for adults who stutter. - TERAPIA
J Speech Lang Hear Res. 2014 Aug;57(4):1308-13. doi: 10.1044/2014_JSLHR-S-13-0041.
Helgadottir FD, Menzies RG, Onslow M, Packman A, O'Brian S.
PURPOSE Those with anxiety use safety behaviors when attempting to prevent negative outcomes. There is evidence that these behaviors contribute to the persistence of anxiety disorders. Safety behaviors have been prominent in the cognitive behavior therapy literature during the last decade, particularly with social phobia management. However, nothing is known of safety behavior use by those who stutter. This is surprising given the high prevalence of social phobia in the stuttering population who seek clinical help.
METHOD Clinical psychologists and speech-language pathologists (SLPs) created a list of safety behaviors that might be used by adults during treatment for stuttering. Participants were 160 SLPs who were asked if they advised adults who stutter to use any of these safety behaviors.
RESULTS SLPs commonly recommend safety behaviors during stuttering management. Factor structures were found for the following five safety behavior categories: (1) general safety behaviors, (2) practice and rehearsal, (3) general avoidance, (4) choosing safe and easy people, and (5) control related safety behaviors.
CONCLUSIONS There is a need to determine the frequency with which adults who receive stuttering treatment follow these clinician recommendations. Additionally, there is a need to experimentally determine whether following such recommendations prevents fear extinction at long-term follow-up.
PMID: 24687147 [PubMed - as supplied by publisher]
School-age children with specific language impairment produce more speech disfluencies than their peers. - AVALIAÇÃO
Codas. 2014 Nov-Dec;26(6):439-43. doi: 10.1590/2317-1782/20142014095. Epub 2014 Dec 1.
Free full text em inglês e em português
Befi-Lopes DM, Cáceres-Assenço AM, Marques SF, Vieira M.
Department of Physiotherapy, Speech-Language Pathology and Audiology, and Occupational Therapy, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
PURPOSE: To compare the occurrence of speech disfluencies during narrative production in children with specific language impairment (SLI) and their age-matched peers.
METHODS: The study included 60 children aged between 7 and 10 years, 40 with typical language development and 20 with SLI. For data collection, a series of 15 stories was used, each one represented by pictures composed of four scenes. Narratives were transcripted and the speech disfluencies presented on them were classified as stuttering-like disfluencies (part-word repetition, single-syllable word repetition, and dysrhythmic phonation - prolongations, blocks and broken words) or other disfluencies (interjection, revision/abandoned utterances, and multisyllable/phrase repetition). The disfluency categories were compared in each group and its occurrence was also compared between groups.
RESULTS: The occurrence of stuttering-like and other disfluencies did not differ among children with typical language development, whereas children with SLI produced other disfluencies. Between-group comparison showed that children with SLI produced more disfluencies of both types than their age-matched peers.
CONCLUSION: Children with SLI showed more speech disfluencies during narrative production than their age-matched peers, and the most common disfluencies used by them were not typical of people who stutter (interjection, revision/abandoned utterances, and multisyllable/phrase repetition).
PMID: 25590904 [PubMed - in process]
Scores on Riley's stuttering severity instrument versions three and four for samples of different length and for different types of speech material. - AVALIAÇÃO
Clin Linguist Phon. 2014 Dec;28(12):912-26. doi: 10.3109/02699206.2014.926991. Epub 2014 Jun 18.
Todd H, Mirawdeli A, Costelloe S, Cavenagh P, Davis S, Howell P.
Division of Psychology and Language Sciences, University College London, London, UK
Riley stated that the minimum speech sample length necessary to compute his stuttering severity estimates was 200 syllables. This was investigated. Procedures supplied for the assessment of readers and non-readers were examined to see whether they give equivalent scores. Recordings of spontaneous speech samples from 23 young children (aged between 2 years 8 months and 6 years 3 months) and 31 older children (aged between 10 years 0 months and 14 years 7 months) were made. Riley's severity estimates were scored on extracts of different lengths. The older children provided spontaneous and read samples, which were scored for severity according to reader and non-reader procedures. Analysis of variance supported the use of 200-syllable-long samples as the minimum necessary for obtaining severity scores. There was no significant difference in SSI-3 scores for the older children when the reader and non-reader procedures were used. Samples that are 200-syllables long are the minimum that is appropriate for obtaining stable Riley's severity scores. The procedural variants provide similar severity scores.
PMID: 24938354 [PubMed - in process]
Self-perception of people who stutter regarding their experiences and results of stuttering treatments. - TERAPIA
Codas. 2014 Sep-Oct;26(5):415-20.
Free Full Text em inglês e em português
de Andrade CR, Cunha MC, Juste FS, Ritto AP, de Almeida BP
Universidade de São Paulo - USP, São Paulo, SP, Brasil; Pontifícia Universidade Católica de São Paulo - PUC-SP, São Paulo, SP, Brasil.
PURPOSE: To investigate the opinion about stuttering treatments in people who stutter, based on their answers to two open questions.
METHODS: The participants were 40 adults of both genders, with self-reported stuttering. During the first phase of the research, we contacted two Brazilian nongovernmental organizations: the Brazilian Stuttering Association (ABRAGAGUEIRA) and the Brazilian Fluency Institute (IBF). These associations agreed to participate and were responsible for sending the research questions to their members via electronic mail. The first contact with the participants elucidated the purpose and method of our research and, after obtaining informed consent from participants, the two questions were sent. The research questions involved their opinion about cure, treatments to which the participants had been submitted, and their outcome.
RESULTS: After analysis, the answers obtained indicated that people who stutter believe in a cure for stuttering; that the ideal therapy would be the one that led to the disappearance of the symptoms; and the most frequently reported professional to treat the disorder is the speech-language pathologist. The results also indicated that although most of the participants had undergone speech-language treatment for stuttering, neither significant improvements were observed nor satisfaction was positive.
CONCLUSION:The results indicate that the answers presented by the participants were not based on scientific knowledge about the disorder but on their wish that "something could happen" to make stuttering "disappear." Although in this study we did not investigate the type of treatment to which the patients were submitted, the results suggest that the factors that contribute to an effective treatment are contentious.
PMID: 25388076 [PubMed - in process]
Speech evoked auditory brainstem response in stuttering. - AUDITIVO
Scientifica (Cairo). 2014;2014:328646. doi: 10.1155/2014/328646. Epub 2014 Aug 19.
Free Full Text
Tahaei AA, Ashayeri H, Pourbakht A, Kamali M.
Iran University of Medical Sciences, Tehran, Iran
Auditory processing deficits have been hypothesized as an underlying mechanism for stuttering. Previous studies have demonstrated abnormal responses in subjects with persistent developmental stuttering (PDS) at the higher level of the central auditory system using speech stimuli. Recently, the potential usefulness of speech evoked auditory brainstem responses in central auditory processing disorders has been emphasized. The current study used the speech evoked ABR to investigate the hypothesis that subjects with PDS have specific auditory perceptual dysfunction. Objectives. To determine whether brainstem responses to speech stimuli differ between PDS subjects and normal fluent speakers. Methods. Twenty-five subjects with PDS participated in this study. The speech-ABRs were elicited by the 5-formant synthesized syllable/da/, with duration of 40 ms. Results. There were significant group differences for the onset and offset transient peaks. Subjects with PDS had longer latencies for the onset and offset peaks relative to the control group. Conclusions. Subjects with PDS showed a deficient neural timing in the early stages of the auditory pathway consistent with temporal processing deficits and their abnormal timing may underlie to their disfluency.
PMID: 25215262 [PubMed] PMCID: PMC4152961
Stuttering candidate genes DRD2 but not SLC6A3 is associated with developmental dyslexia in Chinese population.- GENÉTICA
Behav Brain Funct. 2014 Sep 1;10(1):29. doi: 10.1186/1744-9081-10-29.
Free Full Text
Chen H, Wang G, Xia J, Zhou Y, Gao Y, Xu J, Huen MS, Siok WT, Jiang Y, Tan LH, Sun Y.
National Engineering Research Center for Beijing Biochip Technology, Beijing, China. email@example.com.
BACKGROUND:Dyslexia is a polygenic developmental disorder characterized by difficulties in reading and spelling despite normal intelligence, educational backgrounds and perception. Increasing evidences indicated that dyslexia may share similar genetic mechanisms with other speech and language disorders. We proposed that stuttering candidate genes, DRD2 and SLC6A3, might be associated with dyslexia.
METHODS AND RESULTS:The study was conducted in an unrelated Chinese cohort with 502 dyslexic cases and 522 healthy controls. In total, 23 Tag SNPs covering the two genes were selected for genotyping through Tagger program. Association analysis was performed on each SNP alone and in haplotypes. One SNP markers in DRD2 showed significant association with developmental dyslexia.
CONCLUSION:These findings indicate that polymorphism of DRD2 gene may be a risk factor of developmental dyslexia in the Chinese population.
PMID: 25178928 [PubMed - in process] PMCID: PMC4236612
Stuttering, induced fluency, and natural fluency: A hierarchical series of activation likelihood estimation meta-analyses. - NEUROCIÊNCIAS
Brain Lang. 2014 Dec;139:99-107. doi: 10.1016/j.bandl.2014.10.002. Epub 2014 Nov 12.
Budde KS, Barron DS, Fox PT.
UT Health Science Center, San Antonio, TX, United States; Yale University, New Haven, CT, United States; University of Texas Health Science Center at San Antonio, United States; South Texas Veterans Health Care System, United States; University of Hong Kong, Hong Kong, China.
Developmental stuttering is a speech disorder most likely due to a heritable form of developmental dysmyelination impairing the function of the speech-motor system. Speech-induced brain-activation patterns in persons who stutter (PWS) are anomalous in various ways; the consistency of these aberrant patterns is a matter of ongoing debate. Here, we present a hierarchical series of coordinate-based meta-analyses addressing this issue. Two tiers of meta-analyses were performed on a 17-paper dataset (202 PWS; 167 fluent controls). Four large-scale (top-tier) meta-analyses were performed, two for each subject group (PWS and controls). These analyses robustly confirmed the regional effects previously postulated as "neural signatures of stuttering" (Brown, Ingham, Ingham, Laird, & Fox, 2005) and extended this designation to additional regions. Two smaller-scale (lower-tier) meta-analyses refined the interpretation of the large-scale analyses: (1) a between-group contrast targeting differences between PWS and controls (stuttering trait); and (2) a within-group contrast (PWS only) of stuttering with induced fluency (stuttering state).
Copyright © 2014 Elsevier Inc. All rights reserved.
PMID: 25463820 [PubMed - in process]
Stuttering, temperament and anxiety: Data from a community cohort aged 2-4 years. - EMOCIONAL
J Speech Lang Hear Res. 2014 Aug;57(4):1314-22. doi: 10.1044/2014_JSLHR-S-13-0069
Kefalianos E, Onslow M, Ukoumunne O, Block S, Reilly S.
PURPOSE:The purpose of this study was to ascertain if and when temperament differences, including precursors of anxiety, emerge before onset and during stuttering development.
METHOD We prospectively studied temperament characteristics of a community cohort of stuttering (N = 183) and control (N = 1,261) children.
RESULTS: No significant differences were found at 2, 3, or 4 years of age between stuttering and control children for approach or at 3 or 4 years for easy/difficult temperament. Both of these measures are precursors of anxiety. We found significant differences for reactivity and persistence at 3 years. Stuttering children were less reactive to environmental stimuli and had a reduced ability to attend to a task until completion. There was no evidence of this difference for persistence at 4 years. Reactivity was not measured at 4 years.
CONCLUSION: Based on parents' responses to the Short Temperament Scale, stuttering preschoolers did not have innately different temperaments to control children on those temperament traits measured from 2-4 years. They showed no signs of temperament precursors of anxiety before stuttering onset or shortly after. Results suggest, at most, that temperament is influenced somehow during the period after stuttering onset, but with a waning developmental influence subsequently.
PMID: 24687124 [PubMed - as supplied by publisher]
The frontal aslant tract underlies speech fluency in persistent developmental stuttering. - NEUROCIÊNCIAS
Brain Struct Funct. 2014 Oct 26. [Epub ahead of print]
Kronfeld-Duenias V, Amir O, Ezrati-Vinacour R, Civier O, Ben-Shachar M.
The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Israel.
The frontal aslant tract (FAT) is a pathway that connects the inferior frontal gyrus with the supplementary motor area (SMA) and pre-SMA. The FAT was recently identified and introduced as part of a "motor stream" that plays an important role in speech production. In this study, we use diffusion imaging to examine the hypothesis that the FAT underlies speech fluency, by studying its properties in individuals with persistent developmental stuttering, a speech disorder that disrupts the production of fluent speech. We use tractography to quantify the volume and diffusion properties of the FAT in a group of adults who stutter (AWS) and fluent controls. Additionally, we use tractography to extract these measures from the corticospinal tract (CST), a well-known component of the motor system. We compute diffusion measures in multiple points along the tracts, and examine the correlation between these diffusion measures and behavioral measures of speech fluency. Our data show increased mean diffusivity in bilateral FAT of AWS compared with controls. In addition, the results show regions within the left FAT and the left CST where diffusivity values are increased in AWS compared with controls. Last, we report that in AWS, diffusivity values measured within sub-regions of the left FAT negatively correlate with speech fluency. Our findings are the first to relate the FAT with fluent speech production in stuttering, thus adding to the current knowledge of the functional role that this tract plays in speech production and to the literature of the etiology of persistent developmental stuttering.
PMID: 25344925 [PubMed - as supplied by publisher]
Understanding perceptions of stuttering among school-based speech-language pathologists: An application of attribution theory. - SOCIAL
J Commun Disord. 2014 Nov-Dec;52:143-55. doi: 10.1016/j.jcomdis.2014.06.003. Epub 2014 Jul 7.
Department of Communication Sciences and Disorders, Oklahoma State University, OK, USA.
INTRODUCTION:The purpose of this study was to investigate whether attribution theory could explain speech-language pathologists (SLPs) perceptions of children with communication disorders such as stuttering. Specifically, it was determined whether perceptions of onset and offset controllability, as well as biological and non-biological attributions for communication disorders were related to willingness to help, sympathy, and anger toward children with these disorders. It was also of interest to determine if blame for stuttering was related to perceived controllability of stuttering and negative attitudes toward people who stutter (PWS).
METHOD:A survey was developed to measure perceived onset and offset controllability, biological and non-biological attributions, willingness to help, sympathy, and anger toward middle school children with developmental stuttering, functional articulation disorders, and cerebral palsy. In addition, a scale was developed to measure blame and negative attitudes toward PWS in general. Surveys were mailed to 1000 school-based SLPs. Data from 330 participants were analyzed.
RESULTS:Supporting the hypotheses of attribution theory, higher perceived onset and offset controllability of the disorder was linked to less willingness to help, lower sympathy, and more anger across conditions. Increased biological attributions were associated with more reported sympathy. Increased blame for stuttering was linked to higher perceived controllability of stuttering, more dislike of PWS, and more agreement with negative stereotypes about PWS.
CONCLUSIONS:Educating SLPs about the variable loss of control inherent in stuttering could improve attitudes and increase understanding of PWS. Reductions in blame may facilitate feelings of sympathy and empathy for PWS and reduce environmental barriers for clients. Learning outcomes Readers should be able to: (1) identify the main principles of Weiner's attribution theory (2) identify common negative perceptions of people who stutter (3) describe how disorders of stuttering, articulation disorders, and cerebral palsy are differentiated in terms of perceived onset and offset controllability, and biological and non-biological attributions (4) describe relationships between perceived onset and offset controllability of disorders and sympathy, anger, and willingness to help.
Copyright © 2014 Elsevier Inc. All rights reserved.
PMID: 25042750 [PubMed - in process]
Webcam delivery of the Camperdown program for adolescents who stutter: a phase II trial. - TERAPIA
Lang Speech Hear Serv Sch. 2014 Oct;45(4):314-24. doi: 10.1044/2014_LSHSS-13-0067.
Am J Speech Lang Pathol. 2014 Aug 5. doi: 10.1044/2014_LSHSS-13-0067. [Epub ahead of print]
Carey B, O'Brian S, Lowe R, Onslow M.
PURPOSE:This Phase II clinical trial examined stuttering adolescents' responsiveness to the Webcam-delivered Camperdown Program.
METHOD:Sixteen adolescents were treated by Webcam with no clinic attendance. Primary outcome was percentage of syllables stuttered (%SS). Secondary outcomes were number of sessions, weeks and hours to maintenance, self-reported stuttering severity, speech satisfaction, speech naturalness, self-reported anxiety, self-reported situation avoidance, self-reported impact of stuttering, and satisfaction with Webcam treatment delivery. Data were collected before treatment and up to 12 months after entry into maintenance.
RESULTS:Fourteen participants completed the treatment. Group mean stuttering frequency was 6.1 %SS (range, 0.7-14.7) pretreatment and 2.8 %SS (range, 0-12.2) 12 months after entry into maintenance, with half the participants stuttering at 1.2 %SS or lower at this time. Treatment was completed in a mean of 25 sessions (15.5 hr). Self-reported stuttering severity ratings, self-reported stuttering impact, and speech satisfaction scores supported %SS outcomes. Minimal anxiety was evident either pre- or post-treatment. Individual responsiveness to the treatment varied, with half the participants showing little reduction in avoidance of speech situations.
CONCLUSIONS:The Webcam service delivery model was appealing to participants, although it was efficacious and efficient for only half. Suggestions for future stuttering treatment development for adolescents are discussed.
PMID: 25091362 [PubMed - in process]
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