Eliana Maria Nigro Rocha



ABSTRACTS - Janeiro a Julho de 2012

Ordem alfabética do título do artigo

A comparative investigation of the BigCAT and Erickson S-24 measures of speech-associated attitude. - AVALIAÇÃO
J Commun Disord. 2012 Jun 16. [Epub ahead of print]

Vanryckeghem M, Brutten GJ.
University of Central Florida, United States; Ghent University, Belgium.

The BigCAT and the Erickson S-24, self-report measures of communication attitude, were administered in a randomly determined order to 72 adults who stuttered (PWS) and 72 who did not (PWNS). The two groups of participants differed from each other to a statistically significant extent on both of these measures of speech-associated attitude, regardless of gender. However, the BigCAT showed a larger between-group difference and a greater effect size than was made apparent by the S-24. These findings, and the presence of a significant group by test interaction, suggest that the BigCAT is the more powerful of these two test procedures for discriminating the speech-associated attitude of PWS from that of PWNS. It follows from this that the BigCAT is likely a more useful attitudinal measure than the S-24 with respect to clinical decision making that relates to differential diagnostic assessment and the management of stuttering. Learning outcomes: The reader will be (1) introduced to the BigCAT, a communication attitude test for adults who do and do not stutter, (2) given comparative data on the BigCAT and the Erickson S-24, and provided with information on the discriminative power of these measures of speech-associated attitude, (3) made aware that gender does not significantly effect the results of either the BigCAT or the Erickson S-24.
PMID: 22763013
[PubMed - as supplied by publisher]

Acoustic analyses of diadochokinesis in fluent and stuttering children. - FALA
Clinics (Sao Paulo). 2012;67(5):409-14.
Free Full Text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC335125...

Juste FS, Rondon S, Sassi FC, Ritto AP, Colalto CA, Andrade CR.
Department of Physiotherapy, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

OBJECTIVES: The purpose of the study was to acoustically compare the performance of children who do and do not stutter on diadochokinesis tasks in terms of syllable duration, syllable periods, and peak intensity.
METHODS: In this case-control study, acoustical analyses were performed on 26 children who stutter and 20 agedmatched normally fluent children (both groups stratified into preschoolers and school-aged children) during a diadochokinesis task: the repetition of articulatory segments through a task testing the ability to alternate movements. Speech fluency was assessed using the Fluency Profile and the Stuttering Severity Instrument.
RESULTS: The children who stutter and those who do not did not significantly differ in terms of the acoustic patterns they produced in the diadochokinesis tasks. Significant differences were demonstrated between age groups independent of speech fluency. Overall, the preschoolers performed poorer. These results indicate that the observed differences are related to speech-motor age development and not to stuttering itself.
CONCLUSIONS: Acoustic studies demonstrate that speech segment durations are most variable, both within and between subjects, during childhood and then gradually decrease to adult levels by the age of eleven to thirteen years. One possible explanation for the results of the present study is that children who stutter presented higher coefficients of variation to exploit the motor equivalence to achieve accurate sound production (i.e., the absence of speech disruptions).
[PubMed - in process]

A crucial role for the cortico-striato-cortical loop in the pathogenesis of stroke-related neurogenic stuttering. - GAGUEIRA ADQUIRIDA
Hum Brain Mapp. 2012 Mar 25. [Epub ahead of print]

Theys C, De Nil L, Thijs V, van Wieringen A, Sunaert S.
ExpORL, Department of Neurosciences, Katholieke Universiteit Leuven, Belgium.

Neurogenic stuttering is an acquired speech disorder characterized by the occurrence of stuttering-like dysfluencies following brain damage. Because the onset of stuttering in these patients is associated with brain lesions, this condition provides a unique opportunity to study the neural processes underlying speech dysfluencies. Lesion localizations of 20 stroke subjects with neurogenic stuttering and 17 control subjects were compared using voxel-based lesion symptom mapping. The results showed nine left-hemisphere areas associated with the presence of neurogenic stuttering. These areas were largely overlapping with the cortico-basal ganglia-cortical network comprising the inferior frontal cortex, superior temporal cortex, intraparietal cortex, basal ganglia, and their white matter interconnections through the superior longitudinal fasciculus and internal capsule. These results indicated that stroke-induced neurogenic stuttering is not associated with neural dysfunction in one specific brain area but can occur following one or more lesion throughout the cortico-basal ganglia-cortical network. It is suggested that the onset of neurogenic stuttering in stroke subjects results from a disintegration of neural functions necessary for fluent speech.
PMID: 22451328
[PubMed - as supplied by publisher]

Alleviation of developmental stuttering following deep brain stimulation of the ventral intermediate nucleus of the thalamus.- NEUROCIÊNCIAS
Am J Psychiatry. 2012 Jul 1;169(7):759-60.
Free Full Text: http://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2012.12010016

Maguire GA, Ngo J, Fonsworth Iii PK, Doan J, Birch JA, Fineman I.
No abstract available.

[PubMed - in process]

A muscle spindle abnormity in one laryngeal muscle would be sufficient to cause stuttering. - MOTOR
Med Hypotheses. 2012 Apr 24. [Epub ahead of print]

Schuster SH, Schuster FM.
Römmelesweg 20, Kernen im Remstal, Germany.

Muscle spindles are increasingly recognized as playing a pivotal role in the cause of dystonia. This development and own laryngeal observations that support the idea of causally "well-intentioned"stuttering motivated us to present the following hypothesis: stuttering events compensate for a sensory problem that arises when the abductor/adductor ratio of afferent impulse rates from the posterior cricoarytenoid and lateral cricoarytenoid muscle spindles is abnormally reduced and processed for the occasional determination of the vocal fold position. This hypothesis implies that functional and structural brain abnormalities might be interpreted as secondary compensatory reactions. Verification of this hypothesis (using technologies such as microneurography, dissection and muscle afferent block) is important because its confirmation could relink dystonia and stuttering research, change the direction ofstuttering therapy and destigmatize stuttering radically.
PMID: 22537410
[PubMed - as supplied by publisher]

Arab school teachers' knowledge, beliefs and reactions regarding stuttering. - SOCIAL
J Fluency Disord. 2012 Mar;37(1):54-69. Epub 2011 Dec 21.

Abdalla FA, St Louis KO.
Department of Communication Sciences, College for Women, Kuwait University, Kuwait.

PURPOSE: Stereotypes toward stuttering and people who stutter (PWS) are widespread in the general public irrespective of age, level of education, culture, geographic location and profession. Negative attitudes held by persons of authority like teachers can lead to social, economic and educational obstacles in the lives of PWS.
METHOD: The current study used an Arabic translation of an adapted version of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) to explore Arab teachers' knowledge and attitudes toward stuttering as well as strategies they adopt to cope with the problem in class. The participants were 262 in-service and 209 pre-service public school teachers in Kuwait. The results are contrasted to those of Arab parents in Kuwait reported earlier.
RESULTS: Although many of the teachers knew a person who stutters well and were sensitive in their interactions with PWS, major findings of this study suggest that many were misinformed about the causes of stuttering and held stereotypical views about PWS, comparable to those reported in the literature. Very few differences were noted between opinions of teachers who were still in training and those who were practicing for an average of 11 years.
CONCLUSION: The study underscores the need for awareness campaigns that target not only teachers who are currently working but also those still in training to dispel misconceptions about stuttering and ensure a better educational environment for PWS. Educational objectives: At the end of this activity the reader will be able to: (1) describe knowledge of stuttering and attitudes toward students who stutter and classroom strategies perceived to be helpful by pre-service and in-service teachers in Kuwait; (2) identify stereotypes toward stuttering across cultures, professions and geographic locations; and (3) list similarities and differences in attitude and knowledge of stuttering between parents and teachers.
[PubMed - in process]

A role for inherited metabolic deficits in persistent developmental stuttering.- GENÉTICA
Mol Genet Metab. 2012 Jul 28. [Epub ahead of print]

Kang C, Drayna D.

Stuttering is a common but poorly understood speech disorder. Consistent evidence for the involvement of genetic factors in stuttering has motivated studies aimed at identifying causative genetic variants that could shed light on the underlying molecular and cellular deficits in this disorder. Such studies have begun to identify causative genes. The purpose of this review is to summarize the gene discoveries to date, and to cover the subsequent functional studies that are beginning to provide insights into how these gene mutations might cause stuttering. Surprisingly, the first variant genes to be associated with stuttering are those encoding the lysosomal targeting system, GNPTAB, GNPTG, and NAGPA. Although mutations in NAGPA have not been associated with a disorder in humans, mutations in GNPTAB and GNPTG cause mucolipidosis types II and III, which are rare autosomal recessive lysosomal storage disorders, associated with pathology of bone, connective tissue, liver, spleen, and brain. Analysis of mutations in these genes has so far identified predominantly missense mutations in stuttering, in contrast to the truncating and other mutations that result in very low GNPTAB/G enzyme activity and are historically associated with mucolipidosis. Genetic evidence for the role of lysosomal targeting mutations in stuttering has now been buttressed by biochemical studies of the mutant enzymes found in this disorder. While data on the GlcNAc-phosphotransferase encoded by GNPTAB/G remains limited and only suggestive, a study of the enzyme encoded by NAGPA has shown that the mutations found in stuttering reduce the overall cellular activity of this enzyme by about half, and that they result in deficits in intracellular processing and trafficking that lead to a reduced cellular half life. How these deficits result in the presumed speech-specific neuropathology associated with stuttering is not yet known. However these findings have opened several new lines of inquiry, including studies in mice carrying human stuttering mutations, that represent promising approaches to this disorder.
PMID: 22884963
[PubMed - as supplied by publisher]

Assessment of respondent acceptability for preference measures in stuttering. - SOCIAL
J Commun Disord. 2012 May 18. [Epub ahead of print]

Franic DM, Bothe AK, Bramlett RE.
Dept. of Clinical and Administrative Pharmacy, University of Georgia, Athens, USA.

PURPOSE: To assess the feasibility of using one or more of four standard economic preference measures to assess health-related quality of life in stuttering, by assessing respondents' views of the acceptability of those measures.
METHOD AND RESULTS: A graphic positioning scale approach was used with 80 adults to assess four variables previously defined as reflecting the construct of respondent acceptability (difficulty of decision making, clarity of text, reasonableness for decision making, and comfort in decision making) for four types of preference measurement approaches (rating scale, standard gamble, time trade-off, and willingness to pay). A multivariate repeated measures analysis of variance (p<.001) and follow-up univariate repeated measures analyses of variance (all p<.01) were all significant, indicating that respondents perceived differences among the preference measurement methods on all four acceptability variables.
CONCLUSION: The rating scale was perceived as the easiest, clearest, most reasonable, and most comfortable tool, but it is not a measure of utility (an economic term for desirability or worth). If utility is the objective, such as for cost-utility analyses in stuttering, then the present results suggest the use of standard gamble (rather than time trade-off). These results also support the use of willingness to pay assessments for cost-benefit analyses in stuttering. These findings supplement results previously obtained for other chronic conditions. Learning outcomes: The reader will be able to: (1) describe how four standard economic preference measures [rating scale (RS), time trade-off (TTO), standard gamble (SG), and willingness to pay (WTP)] can be used in economic analyses; (2) describe how RS, TTO, SG and WTP can be measured; and (3) describe how respondents perceive the use of RS, TTO, SG and WTP in measuring changes in stuttering.
[PubMed - as supplied by publisher]

A Stuttering Discovery of Lithium Toxicity – GAGUEIRA ADQUIRIDA
J Am Med Dir Assoc. 2012 Jun 30. [Epub ahead of print]

Sabillo S, Samala RV, Ciocon JO.
Department of Geriatrics, Cleveland Clinic Florida, Weston, FL.

An 86-year-old female nursing home resident was typically described by the nursing staff as alert, pleasant, and conversant, although disoriented to time and place at times. She was frequently seen in the hallways, often breaking into song with her melodious voice. Her past medical history was significant for dementia, epilepsy, and bipolar disorder, for which she took lithium carbonate. One day, she complained to her nurse that she had been stuttering, finding it difficult to complete a sentence, as well as sing. This persisted for 3 more months until a lithium level was checked, and came back elevated at 2.0 mmol/L (0.6 to 1.2 mmol/L). Lithium carbonate was promptly stopped and after about 2 weeks, her stuttering had completely resolved. We found considerable interest in this case, as lithium has rarely been associated with drug-induced stuttering. We reviewed drug-induced stuttering, enumerated the medications implicated in various case reports, and discussed its mechanisms and management.
PMID: 22749636
[PubMed - as supplied by publisher]

A stuttering education and bullying awareness and prevention resource: A feasibility study - SOCIAL
Language, Speech, and Hearing Services in Schools 2012

Marilyn Langevin, N. G. Narasimha Prasad
University of Alberta, Canadá

Purpose: This pretest-posttest study examined the feasibility of using a curriculum level stutteringeducation and bullying awareness and prevention resource to improve peer attitudes toward children who stutter and attitudes toward bullying. Knowledge about potential responses to bullying and students' liking of the program also were examined.
Method: Data were obtained from 608 participants who participated in the stuttering education and bullying prevention initiative that used the Teasing and Bullying: Unacceptable Behaviour (TAB) program. Participants completed the Peer Attitudes toward Children who Stutter Scale (PATCS), the Provictim scale, and bullying involvement and knowledge questionnaires.
Results: Statistically and practically significant improvements were found for both measures. Participants who did not know someone who stutters had higher change scores on the PATCS than children who knew someone who stutters. In general, children who were uninvolved in bullying had the most positive changes in attitudes and liked the program the most. Victims liked the program significantly more often than children who were perpetrators of bullying or were dually involved in bullying.
Conclusions: Findings suggest that TAB may have the potential to effect positive changes in peer attitudes toward children who stutter and attitudes toward bullying. Further research using a randomized experimental design is warranted.
JAMA & Archives

Atypical Auditory Potentials during a Delayed Naming Paradigm in Adults Who Stutter - AUDITIVO
G2 Clinical Neurophysiology

Jeffrey Mock, Anne Foundas and Edward Golob
Neurology Louisiana State University, Psychology Tulane University New Orleans LA

Objective: To determine if auditory event related potentials (ERPs) differ in adults who stutter (AWS) during a delayed word-picture naming paradigm.
Background One potential mechanism of stuttering is abnormal speech monitoring during speech preparation. Mock et al. (2011) developed a paradigm to evaluate monitoring during speech preparation using auditory ERPs. This paradigm was used to test the hypothesis that processing of speech sounds during speech preparation differs in AWS compared to matched controls.
Design/Methods: Twenty-four adults (12 AWS, 12 Controls) participated. EEG was recorded in two conditions (speech,control). In the speech condition participants viewed a cue word that allowed them to prepare their vocal response to a picture (1.5 sec delay). Cue words matched the targets on 90% of trials. In a control condition subjects passively viewed the same sequences but could not prepare a vocal response as all cues were 'XXXX' instead of a word. Auditory responsiveness at one of two time points (early (600 ms), late (1200 ms)) between the cue and picture was probed with an acoustic stimulus (tone or consonant-vowels, CVs). Vocal reaction times, ERPs, and estimated superior temporal gyrus current density were quantified.
Results: Relative to controls, AWS had longer vocal reaction times to mismatched targets. Late auditory probes elicited a fronto-central negative potential that was larger in the speech condition, and was reduced in AWS. ERPs and current density peaks around 200 ms in latency were delayed in AWS. ERP peaks between 50-100 ms to tones vs. CVs also differed among groups.
Conclusions: Results showed that AWS have atypical auditory cortical processing during speech preparation and passive viewing of stimuli. This supports the hypothesis that AWS have an atypically organized auditory cortex that might be associated with a risk for the development and maintenance of stuttering.
Supported by: Malcolm Fraser Foundation.

Atypical brain torque in boys with developmental stuttering. - NEUROCIÊNCIAS
Dev Neuropsychol. 2012 Jul;37(5):434-52.

Mock JR, Zadina JN, Corey DM, Cohen JD, Lemen LC, Foundas AL.
Louisiana State University Health Sciences Center , New Orleans , Louisiana , USA.

The counterclockwise brain torque, defined as a larger right prefrontal and left parietal-occipital lobe, is a consistent brain asymmetry. Reduced or reversed lobar asymmetries are markers of atypical cerebral laterality and have been found in adults who stutter. It was hypothesized that atypical brain torque would be more common in children who stutter. Magnetic resonance imaging-based morphology measures were completed in boys who stutter (n = 14) and controls (n = 14), ages 8-13. The controls had the expected brain torque configurations whereas the boys who stutter were atypical. These results support the hypothesis that developmental stuttering is associated with atypical prefrontal and parietal-occipital lobe asymmetries.
[PubMed - in process]

Audiovocal integration in adults who stutter. - AUDITIVO
Int J Lang Commun Disord. 2012 Jul;47(4):451-6. Epub 2012 May 16.

Loucks T, Chon H, Han W.
University of Illinois at Urbana-Champaign, IL, USA, Chosun University, Gwangju, Hallym University, Gangwon-do, Korea.

Background: Altered auditory feedback can facilitate speech fluency in adults who stutter. However, other findings suggest that adults who stutter show anomalies in 'audiovocal integration', such as longer phonation reaction times to auditory stimuli and less effective pitch tracking.
Aims: To study audiovocal integration in adults who stutter using the pitch-shift paradigm.
Methods & Procedures: Fourteen adult stuttering participants and 16 normally fluent adults produced the vowel /a/while monitoring their own voice through earphones. Unanticipated pitch-shifts were applied in the upward or downward direction for 500 ms.
Outcomes & Results: Short latency pitch-shift responses (or pitch-shift responses) were elicited in all participants. In stuttering participants, vocal response onset latency was significantly delayed and amplitude tended to be reduced.
Conclusions & Implications: Atypical audiovocal responses could be associated with stuttering. It is not clear how audiovocal integration influences stuttering, but could signal inadequate activation of internal models.
[PubMed - in process]

Australian normative data for the Overall Assessment of the Speaker's Experience ofStuttering. - AVALIAÇÃO
J Fluency Disord. 2012 Jun;37(2):83-90. Epub 2011 Dec 29.

Blumgart E, Tran Y, Scott Yaruss J, Craig A.
Rehabilitation Studies Unit, Northern Clinical School, Sydney Medical School, The University of Sydney, Ryde, NSW. Australia.

People who stutter often report negative impacts on their wellbeing as a result of their chronic fluency disorder. The need for a comprehensive assessment of the wellbeing and experience of stuttering should be a prime consideration when measuring treatment outcomes. One such measure designed to evaluate wellbeing and aspects of the individual's experience of his or her stuttering is the Overall Assessment of the Speaker's Experience of Stuttering (OASES). Normative data for the OASES Adult version (OASES-A; and hereafter referred to simply as the OASES) has begun to be collected over the past 10 years, though none are available for an Australian population. This paper presents Australian normative data for the OASES for 200 adult males and females who stutter, aged between 18 and 85 years. Additionally, the influence of age, sex, and frequency of stuttering on the Australian OASES scores are also presented. No significant relationships between OASES scores were found for sex and age, which is in keeping with the USA original dataset. However, those participants who had more severe stuttering were more likely to have higher negative impacts for 'General Information', Communication in Daily Situations,' and for the overall OASES score. Implications for further research are discussed. Educational objectives: The reader will be able to: (i) describe the purpose of the Overall Experience of the Speaker's Experience ofStuttering for Adults (OASES), (ii) evaluate the relevance of the OASES to treatment planning and the evaluation of stuttering treatment outcomes in the adult population, and (iii) compare Australian normative dataset with the USA and Dutch normative datasets for the OASES.
PMID: 22531284
[PubMed - in process]

Autonomic arousal in adults who stutter prior to various reading tasks intended to elicit changes in stuttering frequency. - EMOCIONAL
Int J Psychophysiol. 2012 Jan;83(1):45-55. Epub 2011 Oct 30.

Bowers A, Saltuklaroglu T, Kalinowski J.
Department of Audiology and Speech Pathology, University of Tennessee, Knoxville, TN, USA.

This study examined relationships between anticipatory autonomic arousal and stuttering in four reading tasks. 13 adult persons who stutter (PWS) reported their 'feared' (expected to elicit more stuttering) sounds. They read phrases initiated by feared (F) and neutral (N) phonemes. Both stimuli sets were read solo (S) and with choral accompaniment (C), creating FS, FC, NS, and NC conditions. Skin conductance (SC) and heart rate (HR) measures were made during a 9s window that followed stimulus presentation and preceded speaking. Only SC measures produced significant differences across conditions. Choral conditions produced decreases in SC measures and stuttered trials. Feared conditions produced increases in SC but not stuttering. HR measures were variable, undifferentiated by condition, but produced a gradually increasing triphasic response pattern. No differences in anticipatory SC or HR measures were found in stuttered versus fluent trial comparisons. However, the NC condition, which eliminated stuttering, produced significantly lower SC measures than the fluent utterances in the other conditions (FS, FC, NS). Furthermore, SC measures from the fluent and stuttered trials were similar in these three conditions. These findings suggest that anticipatory autonomic arousal is better differentiated by the possibility of stuttering than by a fluent/stuttered speech outcome. Trials that produced anticipatory SC responses showed greater final HR deceleration, suggesting autonomic coactivation, a response pattern that is associated with aversive stimuli and herein, likely indicative of speech-related state anxiety. However, these physiological markers of anxiety appear to be neither necessary nor sufficient to induce observable stuttering.
PMID: 22044550
[PubMed - in process]

Brain activity in adults who stutter: Similarities across speaking tasks and correlations withstuttering frequency and speaking rate. - NEUROCIÊNCIAS
Brain Lang. 2012 May 5. [Epub ahead of print]

Ingham RJ, Grafton ST, Bothe AK, Ingham JC.
University of California, Santa Barbara, Santa Barbara, United States.

Many differences in brain activity have been reported between persons who stutter (PWS) and typically fluent controls during oral reading tasks. An earlier meta-analysis of imaging studies identified stutter-related regions, but recent studies report less agreement with those regions. A PET study on adult dextral PWS (n=18) and matched fluent controls (CONT, n=12) is reported that used both oral reading and monologue tasks. After correcting for speech rate differences between the groups the task-activation differences were surprisingly small. For both analyses only some regions previously considered stutter-related were more activated in the PWS group than in the CONT group, and these were also activated during eyes-closed rest (ECR). In the PWS group, stuttering frequency was correlated with cortico-striatal-thalamic circuit activity in both speaking tasks. The neuroimaging findings for the PWS group, relative to the CONT group, appear consistent with neuroanatomic abnormalities being increasingly reported among PWS.
PMID: 22564749
[PubMed - as supplied by publisher]

Brazilian version of the Overall Assessment of the Speaker's Experience of Stuttering - Adults protocol (OASES-A). - AVALIAÇÃO
J Soc Bras Fonoaudiol. 2012;24(2):145-51.
Free Full Text: (em português e inglês) http://www.scielo.br/scielo.php?script=sci_arttext...

Bragatto EL, Osborn E, Yaruss JS, Quesal R, Schiefer AM, Chiari BM.
University of Pittsburgh, Pittsburgh, PA, USA.

PURPOSE: To verify the applicability of the protocol Overall Assessment of the Speaker's Experience of Stuttering - Adults (OASES-A), translated into Brazilian Portuguese, in a sample of adults who stutter.
METHODS: The Brazilian Portuguese version of the OASES-A protocol was individually applied to 18 people who stutter. The classification of stuttering severity was based on the Stuttering Severity Instrument for Children and Adults (SSI-3) protocol. Translation and back-translation processes were carried out by specialists, considering semantic, conceptual, cultural, and idiomatic equivalences.
RESULTS: There was no correlation between the severity degrees of stuttering assessed by the SSI-3 protocol and the self-assessment performed using the OASES-A. Subjects reported impairments in perceived fluency; speech ability; level of knowledge about stuttering and treatment options; use of confrontational techniques; quality of life. They also mentioned having difficulty coping with emotional states such as anxiety and embarrassment, and with communication in daily situations.
CONCLUSION: The OASES-A protocol is useful in the assessment and treatment of stutterers, as it provides specialized speech-language pathologists with sutterers' self-perception regarding their communication difficulties and the impact of stuttering on their quality of life.
[PubMed - in process]

Brief Report: Treating Stuttering in an Adult with Autism Spectrum Disorder – OUTRAS ÁREAS
J Autism Dev Disord. 2012 Jul 12. [Epub ahead of print]

Brundage SB, Whelan CJ, Burgess CM.
Department of Speech and Hearing Science, George Washington University, Washington, USA.

Stuttering and autism can co-occur and when they do it presents a significant communication challenge. This study examined the effectiveness of a modified version of the fluency rules program (FRP; Runyan and Runyan, Stuttering and related disorders of fluency, in 2007) to reduce stuttering frequency in a man with autism spectrum disorder (ASD). The participant's percentage of stuttered words (%SW) was calculated during conversational interactions with multiple conversation partners both within and outside of the clinic treatment sessions. Visual inspection methods revealed a reduction in %SW from an average of 14.5 %SW during baseline to 2.07 %SW during the withdrawal phase. The mean baseline reduction in %SW from baseline to the second treatment phase was 91.8 %. The FRP holds promise for reducing %SW in persons with ASD who stutter.
PMID: 22790383
[PubMed - as supplied by publisher]

Camperdown Program for adults who stutter: a student training clinic Phase I trial. - TERAPIA
Int J Lang Commun Disord. 2012 Jul;47(4):365-72 Epub 2012 Mar 27.

Cocomazzo N, Block S, Carey B, O'Brian S, Onslow M, Packman A, Iverach L.
La Trobe University School of Human Sciences, Australia, University of Sydney, Australia.

Objectives: During speech pathology professional preparation there is a need for adequate student instruction with speech-restructuring treatments for adults. An important part of that clinical educational experience is to participate in a clinical setting that produces outcomes equivalent to those attained during clinical trials. A previous report showed that this is possible with a traditional, intensive speech-restructuring treatment. Considering the treatment process advantages and time efficiency of the Camperdown Program, it is arguably a compelling prospect for clinician education. Therefore, the present study is a Phase I trial of the treatment at a student university clinic, with a similar design to a previous report.
Aims: The present study is a Phase I trial of the treatment at a student university clinic, with a similar design to a previous report.
Methods & Procedures:  The design was a non-randomized Phase I clinical trial with 12 adult participants. Primary outcomes were per cent syllables stuttered (%SS) within and beyond the clinic, and speech naturalness scores from pre- and post-treatment stutter-free speech samples.
Outcomes & Results: Pooled %SS scores pre-treatment were 5.7, at immediate post-treatment were 1.0, and at 12 months post-treatment were 2.4. The group speech naturalness scores post-treatment did not increase to a clinically significant extent.
Conclusion & Implications: Results essentially replicate the previous study by producing similar outcomes to those attained with clinical trials. The Camperdown Program is recommended as a clinical environment for speech-restructuring speech pathology student training.
PMID: 22788223
[PubMed - in process]

Classification of types of stuttering symptoms based on brain activity. - NEUROCIÊNCIAS
PLoS One. 2012;7(6):e39747. Epub 2012 Jun 25.
Free Full Text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC338256...

Jiang J, Lu C, Peng D, Zhu C, Howell P.
State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, People's Republic of China.

Among the non-fluencies seen in speech, some are more typical (MT) of stuttering speakers, whereas others are less typical (LT) and are common to both stuttering and fluent speakers. No neuroimaging work has evaluated the neural basis for grouping these symptom types. Another long-debated issue is which type (LT, MT) whole-word repetitions (WWR) should be placed in. In this study, a sentence completion task was performed by twenty stuttering patients who were scanned using an event-related design. This task elicited stuttering in these patients. Each stuttered trial from each patient was sorted into the MT or LT types with WWR put aside. Pattern classification was employed to train a patient-specific single trial model to automatically classify each trial as MT or LT using the corresponding fMRI data. This model was then validated by using test data that were independent of the training data. In a subsequent analysis, the classification model, just established, was used to determine which type the WWR should be placed in. The results showed that the LT and the MT could be separated with high accuracy based on their brain activity. The brain regions that made most contribution to the separation of the types were: the left inferior frontal cortex and bilateral precuneus, both of which showed higher activity in the MT than in the LT; and the left putamen and right cerebellum which showed the opposite activity pattern. The results also showed that the brain activity for WWR was more similar to that of the LT and fluent speech than to that of the MT. These findings provide a neurological basis for separating the MT and the LT types, and support the widely-used MT/LT symptom grouping scheme. In addition, WWR play a similar role as the LT, and thus should be placed in the LT type.
PMID: 22761887
[PubMed - in process]

Clozapine-induced stuttering: a case report and analysis of similar case reports in the literature. – GAGUEIRA ADQUIRIDA
Gen Hosp Psychiatry. 2012 Apr 18. [Epub ahead of print]

Grover S, Verma AK, Nebhinani N.

There is limited literature reporting clozapine-associated stuttering. In this case report, we present a case of a young male who developed stuttering with clozapine, which improved with dose reduction. Computer-assisted searches on clozapine-induced stuttering yielded 16 cases, and analysis of these case reports suggests that stuttering may be linked to seizures or movement disorders, but other putative mechanisms may be at work, which need further research.
PMID: 22516217
[PubMed - as supplied by publisher]

Comments on recent developments in stuttering treatment maintenance research using the camperdown program. - TERAPIA
J Speech Lang Hear Res. 2012 Feb;55(1):306-9.

Ingham RJ.

PURPOSE: To review the contribution of recent studies on the Camperdown Program (O'Brian, Onslow, Cream, & Packman, 2003) for treating stuttering in adolescents and adults toward the problem of maintenance of treatment benefits.
METHOD: The procedures employed in those studies are reviewed with respect to the use of performance-contingent maintenance schedules, including their recent use in conjunction with social anxiety modification.
CONCLUSION: The design of the recent studies of the Camperdown Program confounds the effects of maintenance strategies and treatment outcome evaluation, thereby obscuring their contribution toward resolving the problem of maintenance.
PMID: 22354715
[PubMed - in process]

Communication attitudes of Japanese school-age children who stutter.- AVALIAÇÃO
J Commun Disord. 2012 Jun 16. [Epub ahead of print]

Kawai N, Healey EC, Nagasawa T, Vanryckeghem M.
Graduate School of Education, Hiroshima University, Higashi-Hiroshima, Japan.

Past research with the Communication Attitude Test (CAT) has shown it to be a valid and reliable instrument for assessing speech-associated attitude of children who stutter (CWS). However, in Japan, the CAT has not been used extensively to examine the communication attitude of CWS. The purpose of this study was to determine if a Japanese version of the CAT could differentiate between the communication attitude of Japanese elementary school CWS and children who do not stutter (CWNS). A Japanese translation of the 1991 version of the Communication Attitude Test-Revised (CAT-R) was used in this study. Eighty Japanese CWS and 80 gender- and grade level-matched CWNS participated in the study. The results showed that CWS had a significantly more negative communication attitude than CWNS. Both CWS and CWNS in 1st grade showed significantly more positive communication attitudes than children in 2nd, 3rd, 4th, 5th, and 6th grades. Furthermore, a link between stuttering severity and CWS' communication attitude was found. Additional research is needed to confirm the results of the current study, which indicate that the communication attitude of Japanese CWS becomes more negative as they get older. Learning outcomes: The reader will be able to: (1) Describe the process that was used to develop a Japanese version of the Communication Attitude Test (CAT-J). (2) Discuss attitude differences between Japanese children who stutter and those who do not and how grade level impacts a negative attitude toward communication. (3) Understand the link between stuttering severity and attitudes of Japanese children who stutter.
PMID: 22796115
[PubMed - as supplied by publisher]

Communicative and psychological dimensions of the KiddyCAT. - AVALIAÇÃO
J Commun Disord. 2012 Jan 24. [Epub ahead of print]

Clark CE, Conture EG, Frankel CB, Walden TA.
Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States.

PURPOSE: The purpose of the present study was to investigate the underlying constructs of the Communication Attitude Test for Preschool and Kindergarten Children Who Stutter (KiddyCAT; Vanryckeghem & Brutten, 2007), especially those related to awareness of stuttering and negative speech-associated attitudes.
METHOD: Participants were 114 preschool-age children who stutter (CWS; n=52; 15 females) and children who do not stutter (CWNS; n=62; 31 females). Their scores on the KiddyCAT were assessed to determine whether they differed with respect to talker group (CWS vs. CWNS), chronological age, younger versus older age groups, and gender. A categorical data principal components factor analysis (CATPCA) assessed the quantity and quality of the KiddyCAT dimensions.
RESULTS: Findings indicated that preschool-age CWS scored significantly higher than CWNS on the KiddyCAT, regardless of age or gender. Additionally, the extraction of a single factor from the CATPCA indicated that one dimension-speech difficulty-appears to underlie the KiddyCAT items.
CONCLUSIONS: As reported by its test developers, the KiddyCAT differentiates between CWS and CWNS. Furthermore, one factor, which appears related to participants' attitudes towards speech difficulty, underlies the questionnaire. Findings were taken to suggest that children's responses to the KiddyCAT are related to their perception that speech is difficult, which, for CWS, may be associated with relatively frequent experiences with their speaking difficulties (i.e., stuttering). Learning outcomes: After reading this article, the reader will be able to: (1) Better understand the concepts of attitude and awareness; (2) compare historical views with more recent empirical findings regarding preschool-age CWS' attitudes/awareness towards their stuttering; (3) describe the underlying dimension of the KiddyCAT questionnaire; (4) interpret KiddyCAT results and describe implications of those results.
PMID: 22333753
[PubMed - as supplied by publisher]

Construct validity of modified time-interval analysis in measuring stuttering and trained speaking patterns. - AVALIAÇÃO
J Fluency Disord. 2012 Mar;37(1):42-53. Epub 2011 Nov 23.

Alpermann A, Huber W, Natke U, Willmes K.
RWTH Aachen University, Germany; Zuyd University, The Netherlands.

PURPOSE: The aim of the present study was to examine the construct validity of modified time-interval analysis. This measure allows judgments on stuttered and fluent speech as well as trained speaking patterns and might be valuable for outcome studies.
METHOD: Construct validity was investigated in an intervention study with two treatment groups (24 clients received stuttering modification treatment, 30 clients received fluency modification treatment) and a control group (38 stuttering adults). All participants were interviewed during surprise phone calls before and after treatment; the speech samples were analyzed by means of modified time-interval analysis and stuttering frequency counts.
RESULTS: The outcomes confirmed prior hypotheses for the most part. First, the amount of trained speaking patterns after therapy was significantly higher in both treatment groups than in the control group. Secondly, longitudinal changes in the treatment groups met prior expectations based on differing treatment goals and exceeded the changes in the control group. Modified time-interval analysis was sufficiently sensitive to detect changes of speech fluency, but underestimated spontaneous fluent speech when trained speaking patterns were applied.
CONCLUSION: The present study supports construct validity of modified time-interval analysis in measuring stuttering and trained speaking patterns, but also reveals a lack of accuracy. Educational objectives: At the end of this activity the reader will be able to (a) explain different forms of validity in relation to the use of modified time-interval analysis, (b) evaluate whether construct validity of modified time-interval analysis has been supported by the outcomes of an intervention study and (c) describe the usefulness and limitations of modified time-interval analysis for future research.
[PubMed - in process]

Corpus callosum morphology in children who stutter. - NEUROCIÊNCIAS
J Commun Disord. 2012 Apr 4. [Epub ahead of print]

Choo AL, Chang SE, Zengin-Bolatkale H, Ambrose NG, Loucks TM.
Department of Speech and Hearing Science, University of Illinois at Urbana - USA.

Multiple studies have reported both functional and neuroanatomical differences between adults who stutter and their normally fluent peers. However, the reasons for these differences remain unclear although some developmental data suggest that structural brain differences may be present in school-age children who stutter. In the present study, the corpus callosum of children with persistent stuttering, children who recovered from stuttering and typically developing children between 9 and 12 years of age was compared to test if the presence of aberrant callosal morphology is implicated in this disorder. The total corpus callosum midsagittal area and area of each subsection consisting of the rostrum, anterior midbody, posterior midbody and splenium were measured using MIPAV (Medical Image Processing, Analysis, and Visualization). Voxel-based morphometry (VBM) was also used to compare white matter volume. No differences were detected in the corpus callosum area or white matter volume between children with persistent stuttering, children who recovered from stuttering and typically developing children. These results agree with dichotic listening studies that indicate children who stutter show the typical right ear advantage. Therefore, the neural reorganization across the midline shown in adults who stutter may be the result of long-term adaptations to persistent stuttering. Learning outcomes: Educational objectives: After reading this article, the reader will be able to: (1) summarize research findings on corpus callosum development; and (2) discuss the characteristics of corpus callosum anatomy in stuttering.
PMID: 22516042
[PubMed - as supplied by publisher]

Culture and listeners' gaze responses to stuttering. - SOCIAL
Int J Lang Commun Disord. 2012 Jul;47(4):388-97. Epub 2012 May 28.

Zhang J, Kalinowski J.
North Carolina Central University, Durham, USA, College of Allied Health Sciences, East Carolina University, Greenville, NC, USA.

Background: It is frequently observed that listeners demonstrate gaze aversion to stuttering. This response may have profound social/communicative implications for both fluent and stuttering individuals. However, there is a lack of empirical examination of listeners' eye gaze responses to stuttering, and it is unclear whether cultural background plays a role in regulating listeners' eye gaze response to stuttering. Aim: To examine listeners' eye gaze responses to stuttering speech relative to fluent speech in three cultural groups.
Methods & Procedures: Eighteen African-American, 18 European-American and 18 Chinese adults were audiovisually presented with three stuttering and three fluent speech samples, when an eye-tracking device simultaneously recorded their gaze behaviours. The targets of listeners' eye gaze included four regions of interest (ROIs) on the speaker's face: eyes, nose, mouth and outside (i.e., everything else). Listeners' per cent of gaze time, gaze fixation count and average duration of gaze fixation were analysed with repeated-measures ANOVAs regarding each ROI as functions of the speaker's fluency status and listeners' cultural background. Outcomes & Results: When observing stuttering speech, listeners tended to reduce gaze fixation duration on the speaker's eyes and increase their gaze time on the mouth. However, different from the two American groups, the Chinese group reduced their gaze time on the speaker's mouth. In addition, the Chinese participants' gaze behaviours were more focused on the ROI of outside, whereas the two American groups showed a similar focus on the ROIs of eyes and mouth. Conclusions & Implications: All groups of listeners responded to stuttering with gaze aversions mainly contributed to by a reduction in gaze fixation duration rather than gaze fixation number. This pattern of gaze aversion suggests that stuttering oppresses listeners with an emotional and/or cognitive overload. Attention shift and compensation strategies for speech signal degradation may also account for listeners' gaze responses to stuttering. Cultural differences in eye gaze responses to stuttering were observed mainly between Chinese and American listeners.
PMID: 22788225
[PubMed - in process]

Disfluencies in cluttered speech. - TAQUIFEMIA
J Fluency Disord. 2012 Mar;37(1):9-19. Epub 2011 Oct 14.

Myers FL, Bakker K, St Louis KO, Raphael LJ.
Adelphi University,Garden City, NY USA.

The purpose of this study was to examine the nature and frequency of occurrence of disfluencies, as they occur in singletons and in clusters, in the conversational speech of individuals who clutter compared to typical speakers. Except for two disfluency types (revisions in clusters, and word repetitions in clusters) nearly all disfluency types were virtually indistinguishable in frequency of occurrence between the two groups. These findings shed light on cluttering in several respects, foremost of which is that it provides documentation on the nature of disfluencies in cluttering. Findings also have implications for our understanding of the relationship between cluttering and typical speech, cluttering and stuttering, the Cluttering Spectrum Hypothesis, as well as the Lowest Common Denominator definition of cluttering. Educational objectives: At the end of this activity the reader will be able to: (a) identify types of disfluency associated with cluttered speech; (b) contrast disfluencies in cluttered speech with those associated with stuttering; (c) compare the disfluencies of typical speakers with those of cluttering; (d) explain the perceptual nature of cluttering.
PMID: 22325918
[PubMed - in process]

Dual diathesis-stressor model of emotional and linguistic contributions to developmental stuttering. - CONCEITO
J Abnorm Child Psychol. 2012 May;40(4):633-44.

Walden TA, Frankel CB, Buhr AP, Johnson KN, Conture EG, Karrass JM.
Vanderbilt University, Nashville, TN, USA

This study assessed emotional and speech-language contributions to childhood stuttering. A dual diathesis-stressor framework guided this study, in which both linguistic requirements and skills, and emotion and its regulation, are hypothesized to contribute to stuttering. The language diathesis consists of expressive and receptive language skills. The emotion diathesis consists of proclivities to emotional reactivity and regulation of emotion, and the emotion stressor consists of experimentally manipulated emotional inductions prior to narrative speaking tasks. Preschool-age children who do and do not stutter were exposed to three emotion-producing overheard conversations-neutral, positive, and angry. Emotion and emotion-regulatory behaviors were coded while participants listened to each conversation and while telling a story after each overheard conversation. Instances of stuttering during each story were counted. Although there was no main effect of conversation type, results indicated that stuttering in preschool-age children is influenced by emotion and language diatheses, as well as coping strategies and situational emotional stressors. Findings support the dual diathesis-stressor model of stuttering.
[PubMed - in process]

Efficacy of attention regulation in preschool-age children who stutter: A preliminary investigation. - ATENÇÃO
J Commun Disord. 2012 Apr 17. [Epub ahead of print]

Johnson KN, Conture EG, Walden TA.
Department of Communication Sciences and Disorders, James Madison University, United States.

PURPOSE: This preliminary investigation assessed the attentional processes of preschool-age children who do (CWS) and do not stutter (CWNS) during Traditional cueing and Affect cueing tasks.
METHOD: Participants consisted of 12 3- to 5-year-old CWS and the same number of CWNS (all boys). Both talker groups participated in two tasks of shifting and focusing attention: (a) Traditional cueing and (b) Affect cueing. The Affect cueing task was preceded by stress-heightening instructions intended to influence participants' emotionality. In both tasks participants provided non-speech motor responses (i.e., button pressing) to computer-presented target stimuli. Targets were preceded by a visual cue (i.e., highlighted box) occurring in the same (i.e., Valid trials) or opposite (i.e., Invalid trials) location as the target stimuli. Reaction times (RT) were measured (in ms) from the onset of the target stimuli to the onset of the non-speech motor response. Errors were tallied for both experimental conditions and were categorized by type.
RESULTS: Findings of this preliminary investigation indicated that there were no significant between-group differences in RT or frequency of erroneous responses. There were differences in error type that were correlated with RT for both CWS and CWNS when stress-heightening instructions were introduced.
CONCLUSION: Preliminary findings suggest that speed of attentional disengaging, shifting and re-engaging does not differ between preschool-age CWS and CWNS during the experimental paradigm employed in this study and that introducing stress-heightening instructions does affect components of performance for both preschool-age CWS and CWNS. Caveats for the present study include a limited sample size of young preschool-aged children as well as methodological concerns. Learning outcomes: Readers will be able to: (1) Define attention regulation and describe findings that investigate the role of attention regulation in developmental stuttering of preschool-age children; (2) Describe the components of attention regulation employed during a Posner Cueing Task; (3) Describe the findings of the present study in relation to other studies investigating attention regulation and developmental stuttering in preschool-age children.
PMID: 22560538
[PubMed - as supplied by publisher]

Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review. - PSICOMOTOR
Int J Clin Pract. 2012 Jan;66(1):98-112.

Woodman JP, Moore NR.
Department of Health Sciences, University of York, York, UK.

BACKGROUND: Complementary medicine and alternative approaches to chronic and intractable health conditions are increasingly being used, and require critical evaluation.
OBJECTIVE: The aim of this review was to systematically evaluate available evidence for the effectiveness and safety of instruction in the Alexander Technique in health-related conditions.
METHODS: PUBMED, EMBASE, PSYCHINFO, ISI Web-of-Knowledge, AMED, CINHAL-plus, Cochrane library and Evidence-based Medicine Reviews were searched to July 2011. Inclusion criteria were prospective studies evaluating Alexander Technique instruction (individual lessons or group delivery) as an intervention for any medical indication/health-related condition. Studies were categorised and data extracted on study population, randomisation method, nature of intervention and control, practitioner characteristics, validity and reliability of outcome measures, completeness of follow-up and statistical analyses. Results:  Of 271 publications identified, 18 were selected: three randomised, controlled trials (RCTs), two controlled non-randomised studies, eight non-controlled studies, four qualitative analyses and one health economic analysis. One well-designed, well-conducted RCT demonstrated that, compared with usual GP care, Alexander Technique lessons led to significant long-term reductions in back pain and incapacity caused by chronic back pain. The results were broadly supported by a smaller, earlier RCT in chronic back pain. The third RCT, a small, well-designed, well-conducted study in individuals with Parkinson's disease, showed a sustained increased ability to carry out everyday activities following Alexander lessons, compared with usual care. The 15 non-RCT studies are also reviewed.
CONCLUSIONS: Strong evidence exists for the effectiveness of Alexander Technique lessons for chronic back pain and moderate evidence in Parkinson's-associated disability. Preliminary evidence suggests that Alexander Technique lessons may lead to improvements in balance skills in the elderly, in general chronic pain, posture, respiratory function and stuttering, but there is insufficient evidence to support recommendations in these areas.
[PubMed - indexed for MEDLINE]

Expressão de certeza e dúvida na gagueira: estudo dos aspectos temporais da fala - FALA
Rev. CEFAC, ahead of print Epub July 19, 201
Free full text em português: http://www.scielo.br/pdf/rcefac/2012nahead/111-11.pdf
Free full text em inglês: http://dx.doi.org/10.1590/S1516-18462012005000060

Leticia Correa Celeste; César Reis
FEAD - Belo Horizonte, MG, Brasil; Universidade Federal de Minas Gerais - UFMG - Belo Horizonte, MG, Brasil

OBJETIVO: examinar o papel da organização temporal do discurso na expressão das atitudes de certeza e dúvida em grupo de adultos com gagueira, comparando-a em um grupo de adultos fluentes.
MÉTODO: participaram desta pesquisa 24 indivíduos, sendo 12 com gagueira (GE1 e GE2) e 12 sem gagueira (GC). Foram coletadas amostras que teve como base um corpus de 10 frases chave que foram produzidas nas formas neutra, de dúvida e de certeza, totalizando 840 enunciados. A análise acústica foi realizada por meio do programa Praat e os seguintes parâmetros foram analisados: tempos e taxas de elocução e articulação, ocorrência e duração de pausas e disfluências, duração das vogais tônica e pré-tônica e ocorrência da vogal pós-tônica. A análise estatística foi realizada por meio dos testes Kruskall Wallis e qui-quadrado, com índice de significância de 95%.
RESULTADOS: a expressão da dúvida apresenta taxa de articulação mais baixa no grupo controle, seguida da forma neutra e de certeza, com diferenças estatisticamente significantes. Ainda no grupo controle, foi observado presença de pausas e disfluências somente na expressão de dúvida. No grupo experimental, a maior diferença encontrada foi na duração da vogal da sílaba tônica.
CONCLUSÃO: de uma forma geral, o GC variou mais sua organização temporal a fim de expressar as atitudes. No entanto, é possível observar também uma tendência semelhante no grupo de pessoas com gagueira. Quanto à velocidade de fala, ao retirar as pausas e as disfluências, vemos que tanto GE1 quanto GE2 diferenciam a certeza, articulando cada sílaba de forma mais rápida.

Factors affecting occupational advice for speakers who do and do not stutter. - SOCIAL
J Fluency Disord. 2012 Mar;37(1):25-41. Epub 2011 Nov 23.

Logan KJ, O'Connor EM.
Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, United States.

Factors affecting perceptions of occupational suitability were examined for speakers who stutter and speakers who do not stutter. In Experiment 1, 58 adults who do not stutter heard one of two audio recordings (less severe stuttering, more severe stuttering) of a speaker who stuttered. Participants rated the speaker's communicative functioning, personal attributes, and suitability for 32 occupations, along with perceptions of the occupations' speaking demands and educational requirements. Perceived speaking demand strongly affected occupational suitability ratings at both levels of stuttering severity. In Experiment 2, 58 additional adults who do not stutter heard a recording of another adult in one of two conditions (fluent speech, pseudo-stuttering), and provided the same ratings as in Experiment 1. In the pseudo-stuttering condition, participants' perceptions of occupational speaking demand again had a strong effect on occupational suitability ratings. In the fluent condition, suitability ratings were affected primarily by perceived educational demand; perceived speaking demand was of secondary importance. Across all participants in Experiment 2, occupational suitability ratings were associated with ratings of the speaker's personal attributes and communicative functioning. In both experiments, speakers who stuttered received lower suitability ratings for high speaking demand occupations than for low speaking demand occupations. Ratings for many high speaking occupations, however, fell just below the midpoint of the occupational suitability scale, suggesting that participants viewed these occupations as less appropriate, but not necessarily inappropriate, for people who stutter. Overall, the findings support the hypothesis that people who stutter may face occupational stereotyping and/or role entrapment in work settings. Educational objectives: At the end of this activity the reader will be able to (a) summarize main findings on research related to the work-related experiences of people who stutter, (b) describe factors that affect perceptions of which occupations are best suited for speakers who stutter and speakers who do not stutter, and (c) discuss how findings from the present study relate to previous findings on occupational advice for people who stutter.
PMID: 22325920
[PubMed - in process]

Gagueira na web: qualidade da informação/ Stuttering in the web: quality of information - SOCIAL
Rev. CEFAC, ahead of print Epub Apr 05, 2012

Priscilla Carla Menezes Silveira, Antônia Eliana dos Santos Costa, Cleone Cassemiro de Lima

OBJETIVO: avaliar as informações sobre gagueira em sites brasileiros na rede mundial de computadores visando, especificamente, investigar a qualidade das informações nos sites sobre gagueira e averiguar a natureza e conteúdo das informações dos sites.
MÉTODO: tratou-se de um estudo descritivo. Os sites foram selecionados por meio de uma busca no Google, por página somente no Brasil, usando como termo de busca "gagueira". Os 5 sites elegíveis foram averiguados quanto a sua natureza e conteúdo das informações e avaliados quanto à qualidade dessas informações, utilizando-se dos critérios da HONcode, por 2 pesquisadores, onde foi utilizado o índice de concordância de Kappa.
RESULTADOS: verificou-se principalmente que nenhum dos sites avaliados segue as exigências de todos os critérios.
CONCLUSÃO: não há qualidade em suas informações de acordo com os critérios propostos pela HONcode (2009).
SciELO Brasil

Gagueira: uma questão discursiva - SOCIAL
Trab. linguist. apl. vol.51 no.1 Campinas Jan./June 2012
Free full text: http://www.scielo.br/pdf/tla/v51n1/v51n1a08.pdf

Regina Maria Freire; Maria Cristina Pascalicchio Passos
PUC-SP, São Paulo (SP), Brasil

Este artigo propõe um dispositivo para teorizar a gagueira. Supõe-se que a gagueira emergiria na terceira posição do processo de aquisição de linguagem, quando podem ser observadas, nas produções das crianças, pausas, reformulações e autocorreções. Essas pausas, reformulações e autocorreções assemelham-se às repetições e hesitações que caracterizam a gagueira, gerando movimentos de estranhamento no Outro (Termo definido por Lacan como sendo o lugar do "tesouro dos significantes" ou o lugar do outro simbólico que afasta da cena o outro encarnado). Esse estranhamento pode levá-Lo a atribuir a essas repetições, pausas e hesitações, o estatuto de gagueira, ou seja, a cristalizar o manifesto, aprisionando-o ao patológico. Para dar sustentação a essa hipótese, entrevistaram-se as mães de quatro crianças gagas, cujos dizeres foram analisados alçando-se o dispositivo da Análise de Discurso de Linha francesa. Os achados apontam para os efeitos da interpretação do Outro sobre o gago e a urgência de se levar em conta a submissão da criança a um discurso, predominantemente autoritário. Concluindo, ao pensar a gênese da gagueira, seria primordial levar em conta: a) a interpretação que o Outro faz da fala da criança; b) como a criança ouve sua própria fala e c) a sobre determinação simbólica da linguagem - re-significando repetições e hesitações como inerentes ao processo de aquisição da linguagem pela criança.
Print version ISSN 0103-1813

Genetic bases of stuttering: the state of the art, 2011. - GENÉTICA
Folia Phoniatr Logop. 2012;64(1):34-47.
Free full text: http://content.karger.com/produktedb/produkte.asp?...

Kraft SJ, Yairi E.
Wayne State University, Detroit, MI, USA.

OBJECTIVE: The literature on the genetics of stuttering is reviewed with special reference to the historical development from psychosocial explanations leading up to current biological research of gene identification.
SUMMARY: A gradual progression has been made from the early crude methods of counting percentages of stuttering probands who have relatives who stutter to recent studies using entire genomes of DNA collected from each participant. Despite the shortcomings of some early studies, investigators have accumulated a substantial body of data showing a large presence of familial stuttering. This encouraged more refined research in the form of twin studies. Concordance rates among twins were sufficiently high to lend additional support to the genetic perspective of stuttering. More sophisticated aggregation studies and segregation analyses followed, producing data that matched recognized genetic models, providing the final ‘go ahead’ to proceed from the behavior/statistical genetics into the sphere of biological genetics. Recent linkage and association studies have begun to reveal contributing genes to the disorder.
CONCLUSION: No definitive findings have been made regarding which transmission model, chromosomes, genes, or sex factors are involved in the expression of stuttering in the population at large. Future research and clinical implications are discussed.
[PubMed - indexed for MEDLINE]

Hand Preference in Developmental Stuttering: A Test of the Geschwind-Galaburda Hypothesis of Hemispheric Specialization - SUPERFICIAL
D6 Behavioral Neurology: Other – American Academy of Neurology

Jesus Lovera, David Corey and Anne Foundas
Louisiana State University Health Sciences Center - University New Orleans LA

Objective: Our hypothesis was that people who stutter (PWS) are more likely to have atypical hand preference; to test this we measured the association of stuttering with gender and hand and foot preference.
Background Geschwind and Galaburda postulated that functional inter-hemispheric differences reflect the extent of anatomical differences. From this idea they postulated that atypical cerebral lateralization underlies stuttering and thus stuttering would be associated with both left-handedness and gender.
Design/Methods: Individuals on the Stuttering Foundation of America's mailing list were asked to complete a mail survey and to distribute it to acquaintances. The survey included questions about gender, demographics and stuttering as well as 42-item hand-preference and 12-item foot-preference inventories (HPI and FPI, respectively). Results were analyzed using logistic regression.
Results: Four-hundred-eighty-six subjects currently stuttered out of 863 responders. Handedness and gender were significant predictors of stuttering. Males were more likely to stutter than females [OR=7.7 95%CI(5,10) p<0.001]. Overall people who preferred their right hand or right foot were less likely to stutter [OR=0.7 95%CI(0.6,0.9) p <0.01 for a point increase in HPI; OR=0.8 95%CI(0.7,0.9) p<0.01 for a point increase in the FPI]. There was a gender x Handedness interaction (p=0.04); in females a difference in one point in the handedness inventory decreased the odds stuttering[OR=0.6 95%CI(0.9,0.3)] but no such difference occurred in males.
Conclusions: Our results confirm our hypothesis that atypical laterality, as reflected on scores from a handedness survey, is a predictor of stuttering. This relationship is complex due to its interaction with sex-linked factors. Handedness and sex-linked factors may influence cortical development in PWS. From our results we postulate that how females respond to higher estrogen or lower testosterone exposure in utero can lead to both atypical language organization and hand preference. The process leading to stuttering in males may be different affecting only language organization.
Supported by: Stuttering Foundation of America.

Hypnotically assisted diaphragmatic exercises in the treatment of stuttering: a preliminary investigation. - TERAPIA
Int J Clin Exp Hypn. 2012 Apr;60(2):175-205.

Kaya Y, Alladin A.
University of Selcuk , Konya , Turkey.

Abstract This preliminary study investigates the combined effect of intensive hypnotherapy and diaphragmatic exercises in the management of stuttering. Fifty-nine clients with stuttering were trained to practice abdominal weightlifting to strengthen their respiratory muscles and to improve their diaphragmatic movements. The weightlifting exercises involved lifting a dumbbell (2.0-4.0 kg) with the abdomen for 2 hours daily for 8 consecutive days. Hypnotherapy was utilized to alleviate anxiety, to boost self-confidence, and to increase motivation for weightlifting exercise. The pre- and postmeasures were statistically significant (p < .001). Results of the study provide support for the effectiveness of hypnotically assisted diaphragmatic training in the management of stuttering but should be further studied in controlled trials.
[PubMed - in process]

[Identifying language and communication disorders as part of the medical curriculum]. - SOCIAL
HNO. 2012 Mar;60(3):220-5.[Article in German]

Deuster D, Am Zehnhoff-Dinnesen A, Knief A, Matulat P, Bartha-Doering L, Fiori A, Schmidt CM.
Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Universitätsklinikum Münster, Münster, Deutschland

BACKGROUND: Like hearing loss, language and speech disorders can also lead to impaired communication. Speech and language disorders can occur at any age, for example as a specific language impairment, stuttering, dysarthria, and aphasia. Hence, irrespective of their speciality, there is a high probability that physicians will at some point encounter communication-impaired patients, be required to classify their disorder and refer them for appropriate therapy.
METHODS: A new module entitled 'communication disorders' consisting of two teaching units was integrated in the practical course 'ENT-phoniatrics-pedaudiology' for undergraduate clinical students in 2008. The learning objective of the first unit was to identify and classify communication disorders, presented using sound and video data, by means of simple criteria. The module was evaluated on the basis of questionnaires completed by 164 students.
RESULTS: On a scale of 1-7, the evaluation showed overall positive results with 6.54 (highest score) for professional competence and 5.32 (lowest score) for discussion. The overall score was 12.28 out of a possible maximum of 15 points.
CONCLUSION: The ability to identify communication impairments is an important medical skill. Since communication disorders are common diseases we suggest that this skill be incorporated in the medical curriculum. Thus we have introduced a module for communication disorders; its evaluation by students shows a high level of satisfaction in each category. After developing specific diagnostic indicators students were able to independently describe and identify communication disorders.
PMID: 22402903
[PubMed - in process]

Immediate effects of AAF devices on the characteristics of stuttering: A clinical analysis. - AUDITIVO
J Fluency Disord. 2012 Jun;37(2):122-34. Epub 2012 Feb 22.

Unger JP, Glück CW, Cholewa J.
University of Education Heidelberg, Heidelberg, Germany.

The present study investigated the immediate effects of altered auditory feedback (AAF) and one Inactive Condition (AAF parameters set to 0) on clinical attributes of stuttering during scripted and spontaneous speech. Two commercially available, portable AAF devices were used to create the combined delayed auditory feedback (DAF) and frequency altered feedback (FAF) effects. Thirty adults, who stutter, aged 18-68 years (M=36.5; SD=15.2), participated in this investigation. Each subject produced four sets of 5-min of oral reading, three sets of 5-min monologs as well as 10-min dialogs. These speech samples were analyzed to detect changes in descriptive features of stuttering (frequency, duration, speech/articulatory rate, core behaviors) across the various speech samples and within two SSI-4 (Riley, 2009) based severity ratings. A statistically significant difference was found in the frequency of stuttered syllables (%SS) during both Active Device conditions (p=.000) for all speech samples. The most sizable reductions in %SS occurred within scripted speech. In the analysis ofstuttering type, it was found that blocks were reduced significantly (Device A: p=.017; Device B: p=.049). To evaluate the impact on severe and mild stuttering, participants were grouped into two SSI-4 based categories; mild and moderate-severe. During the Inactive Condition those participants within the moderate-severe group (p=.024) showed a statistically significant reduction in overall disfluencies. This result indicates, that active AAF parameters alone may not be the sole cause of a fluency-enhancement when using a technical speech aid. Educational objectives: The reader will learn and be able to describe: (1) currently available scientific evidence on the use of altered auditory feedback (AAF) during scripted and spontaneous speech, (2) which characteristics of stuttering are impacted by an AAF device (frequency, duration, core behaviors, speech & articulatory rate, stuttering severity), (3) the effects of an Inactive Condition on people who stutter (PWS) falling into two severity groups, and (4) how the examined participants perceived the use of AAF devices.
PMID: 22531287
[PubMed - in process]

Immediate speech fluency improvement after application of the Digital Speech Aid instuttering patients. - AUDITIVO
Med Sci Monit. 2012 Jan;18(1):CR9-12.

Ratyñska J, Szkie³kowska A, Markowska R, Kurkowski M, Mularzuk M, Skar¿yñski H.
Audiology and Phoniatrics Clinic of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland

BACKGROUND:The Digital Speech Aid (DSA) is a pocket-sized device used for speech correction in stutterers. The device modifies the patient's auditory feedback with the use of Delayed Auditory Feedback (DAF) and Frequency-shifted Auditory Feedback (FAF). Both methods are well-known to improve speech fluency in stuttering persons. The aim of this study was to assess immediate disfluency reduction after application of the DSA.
MATERIAL/METHODS: The study included 335 patients aged 6-64 years with speech disfluency. DSA fitting was performed during 3-day hospitalization. Speech disfluency was assessed during reading, in dialogue and in monologue before fitting and after selection of optimal DAF and FAF parameters. Fluency improvement was assessed statistically with Student's t test for logarithms of the odds of disfluency presence without the DSA and with the DSA.
RESULTS: For all speaking situations, statistically significant improvement was achieved, with p<0.005. Immediate fluency improvement was observed in 82.1% of patients during reading, in 84.5% during dialogue, and in 81.2% during monologue. Values different from placebo (reliable improvement) were obtained in 66.9% of patients during reading, in 66.6% during dialogue, and in 63.9% during monologue.
CONCLUSIONS: The results show that the DSA is an effective tool for immediate disfluency reduction in stutterers.
[PubMed - in process]

Influences of Sentence Length and Syntactic Complexity on the Speech Motor Control of Children Who Stutter - CONCEITO
Journal of Speech, Language, and Hearing Research 2012

Megan K. MacPherson, Anne Smith
Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, Indiana

Purpose: To investigate the potential effects of increased sentence length and syntactic complexity on the speech motor control of children who stutter (CWS).
Method: Participants repeated sentences of varied length and syntactic complexity. Kinematic measures of articulatory coordination variability and movement duration during perceptually fluent speech were analyzed for 16 CWS and 16 typically developing children (CTD) between 4 and 6 years of age. Behavioral data from a larger pool of children were also examined.
Results: For both groups, articulatory coordination variability increased with sentence length. For syntactically simple sentences, CWS had higher coordination variability than CTD. There was no group difference in coordination variability for complex sentences. Coordination variability increased significantly with complexity for CTD, while that of CWS remained at the high level demonstrated for simple sentences. There was a trend for higher overall coordination variability in CWS, compared to CTD. For both groups, movement duration was greater for syntactically complex, as compared to simple, sentences.
Conclusions: Results indicate more variable speech motor coordination during fluent speech production in many CWS, as compared to CTD. Disproportionate effects of length and complexity on coordination variability and duration were not found for CWS. Considerable individual differences in performance were observed.
JSLHR Papers in Press

Investigating optimal intervention intensity with the Lidcombe Program of early stuttering intervention. - TERAPIA
Int J Speech Lang Pathol. 2012 Jul 2. [Epub ahead of print]

Packman A, Onslow M.
Australian Stuttering Research Centre, The University of Sydney , Sydney , Australia.

This paper addresses optimal intervention intensity in stuttering with reference to the Lidcombe Program of early stuttering intervention. This is an operant program in which the parent provides the actual treatment, for proscribed periods each day, in the child's everyday environment. The parent learns how to do this during weekly visits with the child to the speech-language pathologist. This program was chosen because it is supported by considerable research evidence. This evidence includes randomized controlled trials and file audits. Individual children vary in the time taken to reach the program criteria, with children with milder stuttering taking less time than children whose stuttering is more severe. Hence, the dose depends largely on stuttering severity. Other service delivery models for the Lidcombe Program have been investigated, including telehealth (distance delivery) and group delivery. While telehealth delivery was as efficacious as face-to-face delivery, 3-times more clinician hours were needed to achieve this. Group delivery of the program was also as efficacious as face-to-face delivery but required 30% less clinician time. The fact that treatment is delivered by parents but is directed by the speech-language pathologist raises interesting issues about what constitutes dose.
PMID: 22746985
[PubMed - as supplied by publisher]

Integrating functional measures with treatment: a tactic for enhancing personally significant change in the treatment of adults and adolescents who stutter - TERAPIA
American Journal of Speech-Language Pathology 2012

Roger J. Ingham , Janis C. Ingham, Anne K. Bothe
University of California, Santa Barbara - University of Georgia

Purpose: It is proposed that stuttering treatment, particularly for adult and adolescent persons who stutter, may benefit from more inventive and extensive use of functional measurement-measures that are also treatment agents. Such measures can be tailored to produce more personally significant and evidence-based treatment benefits. They may be especially useful when employed in conjunction with partial self-management and performance-contingent procedures.
Method: Previous approaches to the definition of treatment goals and the measurement of treatment outcomes are critically reviewed. Suggestions for improvements are presented within the framework of an evidence-based and relatively standardized stuttering treatment.
Results and Conclusions: Results from review of existing literature and from two case studies show that two specific personally significant problems, saying one's own name and addressing large audiences, were improved by implementing these strategies in treatment. Functional measures directly connected to treatment, and partially self-managed performance-contingent schedules, merit further research as methodologies suitable for conducting evidence-based and personally significant treatments with adults who stutter.
JAMA & Archives

Male versus female attitudes toward stuttering. - SOCIAL
J Commun Disord. 2012 May;45(3):246-53. Epub 2011 Dec 22.

St Louis KO.
Department of Speech Pathology and Audiology, West Virginia University, Morgantown, WV. USA.

PURPOSE: The study investigated the extent to which differences existed between public attitudes of males versus females.
METHOD: One hundred adults, 50 males and 50 females, were chosen at random from each of 50 study samples comprising a total of 3371 respondents in a database archive who had completed the Public Opinion Survey of Human Attribute-Stuttering (POSHA-S). None of the database samples included speech-language pathology students/practitioners or self-identified people who stutter.
RESULTS: Public attitudes were very similar between male and female respondents. None of the standard POSHA-S comparisons were significantly different statistically, even though a few trends for differences were observed between the males and females.
CONCLUSIONS: Attitudes as toward stuttering of adult males and females, as measured by the POSHA-S, are very similar. Learning outcomes: Readers of this article should be able to: describe the framework for reporting the results of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S); describe similarities and differences between attitudes toward stuttering of adult males and females on the POSHA-S.
[PubMed - in process]

Managing stuttering beyond the preschool years. - INFANTIL
Lang Speech Hear Serv Sch. 2012 Jul;43(3):338-43.

Nippold MA, Packman A.
Correspondence to Marilyn A. Nippold: nippold@uoregon.edu.

PURPOSE: This prologue serves to introduce a research forum composed of studies that address the topic of stuttering in school-age children and adolescents. Researchers are encouraged to continue to build the knowledge base that sustains evidence-based practice in this area.
METHOD: The nature of stuttering as it evolves from early childhood into the school years is briefly described. Beyond the preschool years, children are unlikely to spontaneously recover from stuttering, and they often go on to suffer negative consequences, academically and socially, because of their disorder. If they are to overcome or manage their stuttering successfully, school-age children and adolescents require high-quality treatment. Three data-based studies that address the topic of stuttering in school-age children or adolescents are described, the ongoing need for empirical evidence regarding the management of stuttering is emphasized, and several issues relevant to future studies in this area are discussed.
CONCLUSION: Progress has occurred in the management of stuttering in school-age children and adolescents. Nevertheless, important questions remain unanswered concerning the most effective techniques and strategies to use in helping students who stutter achieve more fluent and natural-sounding speech in their quest to become more confident and effective communicators.
PMID: 22778088
[PubMed - in process]

Measuring outcomes following the camperdown program for stuttering: a response to dr. Ingham. - TERAPIA
J Speech Lang Hear Res. 2012 Feb;55(1):310-2.

O'Brian S, Packman A, Onslow M, Menzies R.

PURPOSE: To respond to Dr. Ingham's letter to the editor, "Comments on Recent Developments inStuttering Treatment Maintenance Research Using the Camperdown Program," which appears in this issue of the Journal of Speech, Language, and Hearing Research.
METHOD: When a treatment program has a performance-contingent maintenance schedule, as the Camperdown Program has, participants vary greatly in the time taken to complete this schedule-up to 2 years or more, in some cases. We reject Dr. Ingham's position that outcomes be measured a year after individual participants conclude their maintenance for the very reasons he has argued many times in the literature.
CONCLUSION: We will continue to measure the outcomes of our clinical trials after a clinically meaningful period and at the same time for all participants.
PMID: 22354716
[PubMed - in process]

Nature and nurture in stuttering: a systematic review on the case of Moses. - HISTÓRIA
Neurol Sci. 2012 Mar 6. [Epub ahead of print]

Leon-Sarmiento FE, Paez E, Hallett M.
Smell and Taste Center, University of Pennsylvania, Philadelphia, USA

Stuttering is a disturbance of normal fluency of speech whose pathophysiology is still not well understood. We investigated one of the most ancient speech disorders in the biblical person Moses who lived in approximately 1300 BC. To get the most complete medical and non-medical information on Moses, we did systematic searches in the Holy Bible using the Bible-Discovery v2.3© software ( http://www.bible-discovery.com) looking for verses containing the terms "Moses", "Stuttering" and "Stutter"; and in PubMed/Medline database for manuscripts having the terms "Moses", "Bible" and "Stuttering". From the Bible search, 742 verses were found, of which 23 were relevant; three additional verses were found by hand search. Six papers discussing Moses's pathology were found in the PubMed search. The analysis of ancient descriptions in the light of current research suggests that stuttering is the most likely pathology Moses had, with clear evidence for both genetic origin and environmental triggers. Further, it was found that Moses practiced some "sensory tricks" that could be used to relieve his speech disorder which are, to our knowledge, the first "tricks" that successfully modulated a movement disorder described in the medical literature.
PMID: 22391676
[PubMed - as supplied by publisher]

Oral Sensorimotor Integration in Adults Who Stutter. - MOTOR
Folia Phoniatr Logop. 2012 May 15;64(3):116-121. [Epub ahead of print]

Loucks TM, De Nil LF.
University of Illinois at Urbana-Champaign, Champaign, Ill., USA.

Objective: To investigate the relationship between tendon vibration sensitivity and oral motor control in adults who stutter (AWS). Patients and Methods: Ten controls and 10 AWS first made jaw-opening movements from a closed-mouth position to an 18-mm target. Then, masseter tendon vibration was applied during jaw opening in a separate condition to test whether accuracy and/or variability is related to movement undershoot. Results: AWS made less accurate and more variable jaw movements than controls without visual feedback. Among the normally fluent adult participants, higher accuracy and lower variability were significantly related to masseter vibration undershoot, but significant correlations were not observed for AWS. Conclusion: These results suggest that increased tendon vibration sensitivity may be related to more refined oral motor control. Subtle sensorimotor limitations could be present instuttering that render speech more susceptible to breakdowns.
[PubMed - as supplied by publisher]

Palin Parent Child Interaction and the Lidcombe Program: Clarifying some issues - TERAPIA
J Fluency Disord. 2012 Mar;37(1):1-8. Epub 2011 Nov 23.

Onslow M, Millard S.
Australian Stuttering Research Centre, The University of Sydney, Australia.

PURPOSE: The authors used the "1000-bites" format (Onslow & Yaruss, 2007) to discuss two therapies used with preschool children who stutter: Palin Parent Child Interaction and the Lidcombe Program. The aim is to provide background to the therapies and to explore the differences and similarities between the approaches and research plans for them.
METHOD: The format is designed to give the reader the feeling of contemporaneous observation of conversation between the authors. To that end, the format guidelines are as follows: (1) alternating responses from two authors with no response greater than 100 words, (2) a maximum of 1000 words per author, (3) when one author has used 1000 words the other may complete 1000 words in a final response or opt to not issue a final response, (4) debate may be controversial and vigorous but must be collegial, and (5) a non-contemporaneous edit by an author to a response requires the agreement of the other author.
CONCLUSIONS: The "1000-bites" format achieved a collegial exchange between two discussants with differing opinions by creating a single work of shared authorship. Arguably, this format is more informative to clinicians than independent essays and rebuttals in a sequence of letters to the editor. One of its advantages is that it provides insights into the issue at stake by means of short and contemporaneous segments of spontaneous interaction. Educational objectives: At the end of this activity the reader will be able to (1) outline the different theoretical backgrounds of Palin Parent Child Interaction Therapy and the Lidcombe Program, (2) describe the different goals of the two treatments, (3) contrast the different methods for the two treatments, and (4) explain any commonalities between the two treatments.
PMID: 22325917
[PubMed - in process]

Parenting styles and attachment in school-aged children who stutter. - AMBIENTE
J Commun Disord. 2012 Mar;45(2):98-110. Epub 2011 Dec 9.

Lau SR, Beilby JM, Byrnes ML, Hennessey NW
School of Psychology and Speech Pathology, Curtin University, Perth, Australia.

Parental input has been described as influential in early childhood stuttering yet the exact nature of this influence remains equivocal. The present study aimed to examine whether quantitative measures of parenting styles, parent and peer attachment patterns, and parent- and self-reported child behaviour could differentiate between school-aged children who stutter (CWS) (n=10) and their fluent peers (n=10). In addition, qualitative individual semi-structured interviews with all CWS were conducted to gain insight into their life experiences and reflections in relation to stuttering. The interviews were classified into ancillary themes of school, peers and parents. Quantitative findings revealed that CWS perceived their parents with significantly lower attachment, particularly in relation to trust, and parents of CWS perceived their children with significantly higher maladjustments than fluent counterparts. Qualitative themes emerged pertaining to attitudes, perceptions and relationships with teachers, peers and parents, with consistent experiences of teasing and bullying reported as a consequence of the stutter. The majority of participants recounted frustration with the nature in which their parents attempted to remediate their stuttering. Collectively, these findings highlight imperative management considerations for school-aged CWS and their parents. The usefulness of quantitative and qualitative research paradigms is also emphasised. Learning outcomes: The reader will be able to: (1) identify themes associated with the impact a childhood stutter has on parent and peer relationships; (2) identify how the quality of the parent child relationship is influenced by parenting styles and attachment; and (3) discuss the clinical implications of the results for children who stutter and their families.
PMID: 22205038
[PubMed - in process]

Phonation interval modification and speech performance quality during fluency-inducing conditions by adults who stutter. - TERAPIA
J Commun Disord. 2012 Feb 6. [Epub ahead of print]

Ingham RJ, Bothe AK, Wang Y, Purkhiser K, New A.
University of California, Santa Barbara, United States.

PURPOSE: To relate changes in four variables previously defined as characteristic of normally fluent speech to changes in phonatory behavior during oral reading by persons who stutter (PWS) and normally fluent controls under multiple fluency-inducing (FI) conditions.
METHOD: Twelve PWS and 12 controls each completed 4 ABA experiments. During A phases, participants read normally. B phases were 4 different FI conditions: auditory masking, chorus reading, whispering, and rhythmic stimulation. Dependent variables were the durations of accelerometer-recorded phonated intervals; self-judged speech effort; and observer-judged stuttering frequency, speech rate, and speech naturalness. The method enabled a systematic replication of Ingham et al. (2009).
RESULTS: All FI conditions resulted in decreased stuttering and decreases in the number of short phonated intervals, as compared with baseline conditions, but the only FI condition that satisfied all four characteristics of normally fluent speech was chorus reading. Increases in longer phonated intervals were associated with decreased stuttering but also with poorer naturalness and/or increased speech effort. Previous findings concerning the effects of FI conditions on speech naturalness and effort were replicated.
CONCLUSIONS: Measuring all relevant characteristics of normally fluent speech, in the context of treatments that aim to reduce the occurrence of short-duration PIs, may aid the search for an explanation of the nature of stuttering and may also maximize treatment outcomes for adults who stutter. Learning outcomes: The reader will be able to (1) understand the differential effects of four well established fluency-inducing conditions on the quality of fluency of adult PWS and controls, (2) learn how intervals of phonation are modified during these conditions and (3) how the duration of specific intervals of phonation may be identified for their potential application in stuttering treatment.
PMID: 22365886
[PubMed - as supplied by publisher]

Phonological priming in adults who stutter. - FALA
J Fluency Disord. 2012 Jun;37(2):91-105. Epub 2012 Jan 17.

Vincent I, Grela BG, Gilbert HR.
Department of Communication Sciences, University of Connecticut, Storrs, United States.

The purpose of this study was to compare the speed of phonological encoding between adults who stutter (AWS) and adults who do not stutter (ANS). Fifteen male AWS and 15 age- and gender-matched ANS participated in the study. Speech onset latency was obtained for both groups and stuttering frequency was calculated for AWS during three phonological priming tasks: (1) heterogeneous, during which the participants' single-word verbal responses differed phonemically; (2) C-homogeneous, during which the participants' response words shared the initial consonant; and (3) CV-homogeneous, during which the participants' response words shared the initial consonant and vowel. Response words containing the same C and CV patterns in the two homogeneous conditions served as phonological primes for one another, while the response words in the heterogeneous condition did not. During each task, the participants produced a verbal response after being visually presented with a semantically related cue word, with cue-response pairs being learned beforehand. The data showed that AWS had significantly longer speech onset latency when compared to ANS in all priming conditions, priming had a facilitating effect on word retrieval for both groups, and there was no significant change in stuttering frequency across the conditions for AWS. This suggests that phonological encoding may play no role, or only a minor role, in stuttering. Educational objectives: The reader will be able to: (1) describe previous research paradigms that have been used to assess phonological encoding in adults and children who stutter; (2) explain performance similarities and differences between adults who do and do not stutter during various phonological priming conditions; (3) compare the present findings to past research that examined the relationship between phonological encoding and stuttering.
PMID: 22531285
[PubMed - in process]

Psychogenic Stuttering and Other Acquired Nonorganic Speech and Language Abnormalities. - EMOCIONAL
Arch Clin Neuropsychol. 2012 Jul 11. [Epub ahead of print]

Binder LM, Spector J, Youngjohn JR.
Department of Neurology, Oregon Health and Science University, Beaverton, OR, USA.

Three cases are presented of peculiar speech and language abnormalities that were evaluated in the context of personal injury lawsuit or workers compensation claims of brain dysfunction after mild traumatic brain injuries. Neuropsychological measures of effort and motivation showed evidence of suboptimal motivation or outright malingering. The speech and language abnormalities of these cases probably were not consistent with neurogenic features of dysfluent speech including stuttering or aphasia. We propose that severe dysfluency or language abnormalities persisting after a single, uncomplicated, mild traumatic brain injury are unusual and should elicit suspicion of a psychogenic origin.
PMID: 22789718
[PubMed - as supplied by publisher]

Readability of patient-reported outcome questionnaires for use with persons who stutter. - AVALIAÇÃO
J Fluency Disord. 2012 Mar;37(1):20-4. Epub 2011 Nov 3.

Zraick RI, Atcherson SR, Brown AM.
University of Arkansas, Little Rock, AR, USA.

OBJECTIVE: The purpose of this study was to examine the readability of several published patient-reported outcome (PRO) questionnaires for use with persons who stutter, and to compare the readability results to existing data about average reading levels for English-speaking adults living in the United States.
DESIGN: Published PRO questionnaires were identified that are traditionally completed by persons whostutter in a self-administered format.
METHOD: Reading grade levels were analyzed using the Flesch Reading Ease, FOG, and FORCAST formulas as computed by a readability calculations software package. Descriptive statistics were computed across the questionnaires.
RESULTS: The results of this study demonstrate that many of the PRO questionnaires exceeded the fifth to sixth grade reading levels recommended by health literacy experts.
CONCLUSIONS: The clinician should consider the average reading level needed to understand a particular PRO questionnaire when administering it to a patient or their proxy. Likewise, developers of PRO questionnaires should consider reading level of respondents and include information about this when reporting psychometric data.
EDUCATIONAL OBJECTIVES: The reader will get an overview over the literature on patient-reported outcome (PRO) questionnaires and their use with persons who stutter and will be able to: (1) define readability, (2) describe how reading levels are determined for a given PRO questionnaire, (3) list the strengths and limitations of readability assessment in the evaluation of persons who stutter and (4) analyze the role of readability assessment in future PRO questionnaire development.
PMID: 22325919
[PubMed - in process]

Recounting the K-12 school experiences of adults who stutter: A qualitative analysis. - SOCIAL
J Fluency Disord. 2012 Jun;37(2):71-82. Epub 2011 Dec 24.

Daniels DE, Gabel RM, Hughes S.
Wayne State University, Farnsworth, Detroit, United States.

This study qualitatively explored the primary and secondary (K-12) school experiences of adults who stutter. The primary investigator conducted semi-structured interviews with 11 participants, a first focus group interview with 6 participants, and a second focus group interview with 4 participants. Participants discussed the various ways in which stuttering affected their personality; emotional and psychological experiences in the context of school; academic and learning experiences; classroom participation; teacher and peer relationships; speech therapy experiences; school activity involvement; and post-educational experiences. Results suggest that school is a complex cultural environment in which students must engage on academic and social levels. People who stutter may experience observable and unobservable challenges as they navigate the complexity of school. Educational objectives: After reading this article, the reader will be able to: (1) provide a rationale for the need to explore the school experiences of people who stutter; (2) describe the major themes associated with the school experiences of participants in the study; and (3) discuss how knowledge of school experiences can be useful to classroom teachers and speech-language pathologists.
PMID: 22531283
[PubMed - in process]

Reduced speech perceptual acuity for stop consonants in individuals who stutter. - AUDITIVO
J Speech Lang Hear Res. 2012 Feb;55(1):276-89. Epub 2012 Jan 31.

Neef NE, Sommer M, Neef A, Paulus W, von Gudenberg AW, Jung K, Wüstenberg T.

PURPOSE: In individuals who stutter (IWS), speech fluency can be enhanced by altered auditory feedback, although it has adverse effects in control speakers. This indicates abnormalities in the auditory feedback loop in stuttering. Current motor control theories on stuttering propose an impaired processing of internal forward models that might be related to a blurred auditory-to-motor translation. Although speech sound perception is an essential skill to form internal models, perceptual acuity has not been studied in IWS so far. The authors tested the stability of phoneme percepts by analyzing participants' ability to identify voiced and voiceless stop consonants.
METHOD: Two syllable continua were generated by systematic modification of the voice onset time. The authors determined speech perceptual acuity by means of discriminatory power in 25 IWS and 24 matched control participants by determining the phoneme boundaries and by quantifying the interval of voice onset times for which phonemes were perceived ambiguously.
RESULTS: In IWS, discriminatory performance was weaker and less stable over time when compared with control participants. In addition, phoneme boundaries were located at longer voice onset times in IWS.
CONCLUSION: Persistent developmental stuttering is associated with less reliable phonological percepts, supporting current theories regarding the sensory-motor interaction in human speech.
PMID: 22337496
[PubMed - in process]

Research and development on a public attitude instrument for stuttering. - SOCIAL
J Commun Disord. 2012 Mar;45(2):129-46. Epub 2011 Dec 9.

St Louis KO.
West Virginia University, Morgantown, WV, USA.

This paper summarizes research associated with the development of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S), a survey instrument designed to provide a worldwide standard measure of public attitudes toward stuttering. Pilot studies with early experimental prototypes of the POSHA-S are summarized that relate to questionnaire rating scale prototypes, test-retest reliability, construct validity, item analysis and final item selection, translation to other languages, internal consistency, sampling procedures, manner of administration, and sample size. Future research and public service uses of the POSHA-S are discussed, especially for comparisons using its growing database archive. Learning outcomes: Readers of this article should be able to: (1) describe the purposes of the International Project on Attitudes Toward Human Attributes (IPATHA) initiative, (2) describe procedures to determine reliability and validity of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S), (3) describe factor analysis and other strategies to select items from the POSHA-E1 and POSHA-E2 pilot studies for the final POSHA-S, and (4) describe uses of the POSHA-S database archive in studies of public attitudes toward stuttering.
PMID: 22205037
[PubMed - in process]

Resting-state brain activity in adult males who stutter.- NEUROCIÊNCIAS
PLoS One. 2012;7(1):e30570. Epub 2012 Jan 20.
Free full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC326283...

Xuan Y, Meng C, Yang Y, Zhu C, Wang L, Yan Q, Lin C, Yu C.
Department of Anatomy, Tianjin Medical University, Tianjin, China.

Although developmental stuttering has been extensively studied with structural and task-based functional magnetic resonance imaging (fMRI), few studies have focused on resting-state brain activity in this disorder. We investigated resting-state brain activity of stuttering subjects by analyzing the amplitude of low-frequency fluctuation (ALFF), region of interest (ROI)-based functional connectivity (FC) and independent component analysis (ICA)-based FC. Forty-four adult males with developmental stuttering and 46 age-matched fluent male controls were scanned using resting-state fMRI. ALFF, ROI-based FCs and ICA-based FCs were compared between male stuttering subjects and fluent controls in a voxel-wise manner. Compared with fluent controls, stuttering subjects showed increased ALFF in left brain areas related to speech motor and auditory functions and bilateral prefrontal cortices related to cognitive control. However, stuttering subjects showed decreased ALFF in the left posterior language reception area and bilateral non-speech motor areas. ROI-based FC analysis revealed decreased FC between the posterior language area involved in the perception and decoding of sensory information and anterior brain area involved in the initiation of speech motor function, as well as increased FC within anterior or posterior speech- and language-associated areas and between the prefrontal areas and default-mode network (DMN) in stuttering subjects. ICA showed that stuttering subjects had decreased FC in the DMN and increased FC in the sensorimotor network. Our findings support the concept that stuttering subjects have deficits in multiple functional systems (motor, language, auditory and DMN) and in the connections between them.
PMID: 22276215
[PubMed - in process]

Sex-Linked & Handedness Effects: Do Temporal-Parietal Asymmetry Patterns Diverge in Adults Who Stutter? (P02.053)- NEUROCIÊNCIAS
D4 Behavioral Neurology: Language/Praxis

Anne Foundas and David Corey
Children's Hospital New Orleans LA , Psychology Tulane University New Orleans LA

Objective: To determine whether sex-linked or handedness factors may be associated with divergent temporal-parietal asymmetry patterns in adults who stutter (AWS) compared to matched controls.
Background: Developmental stuttering is more common in males than females (5:1 in adults) and in non-right handers. There is evidence that these factors mediate anatomical relationships (PT, planum temporale; PAR, posterior ascending ramus). Therefore, we hypothesized that typical configurations (Leftward PT, Rightward PAR) would be found in male controls, whereas female controls and adults who stutter (AWS) would have atypical configurations. We postulated that these relationships would be modified by degree of handedness (defined by Hand Preference Inventory scores, HPI).
Design/Methods: Participants included Controls (n=44, 1/2 men) and AWS (n=19, 3 females) matched on age (Mean = 31.4) and education (Mean = 16.6); 1/3 non-right handers. Volumetric MRI scans were acquired; neuropsychological assessments were completed. The full extent of the PT and PAR were measured and volumes were computed as % of hemisphere volume. Asymmetry (AQ) was computed: (Left-Right)/[(Left + Right)(.5)].
Results: PT-AQ and PAR-AQ were correlated (r2 = -.424). The association did not vary in male and female Controls, nor did the association vary when AWS were compared to Controls. PT-AQ and PAR-AQ did not predict HPI, but left PT volume was predicted by HPI score (p<.0001). Left PT volume explained 14% of the variability in HPI scores. As left PT volume increased by 1SD, HPI decreased by .38SDs.
Conclusions: Although we did not find any differences in AWS, our results support the postulate that left PT size may be an important determinant of the relationship of language and manual preference. Hemispheric specialization for language is associated with handedness in right-handers as the crossed-motor pathways for manual dexterity and skill are left lateralized. A major question is how these functional representations diverge in people who are not strongly right-handed.
Supported by: NIH DC04957; Malcolm Fraser Foundation.

Speech Disfluency in School-age Children's Conversational and Narrative Discourse - INFANTIL
Lang Speech Hear Serv Sch. 2012 Jan 23. [Epub ahead of print]

Courtney T. Byrd - The University of Texas, Austin, TX
Kenneth J. Logan - University of Florida, Gainesville, FL
Ronald B. Gillam - Utah State University, Logan, UT

Purpose: This study was designed to (a) compare the speech fluency of school-age children who do and do not stutter (CWS and CWNS, respectively) within two standard diagnostic speaking contexts (conversation and narration) while also controlling for speaking topic, and (b) examine the extent to which children's performance on such discourse tasks is affected by age.
Method: Participants were 44 school-aged children who were divided evenly into four groups, depending upon their age (older, younger) and fluency status (CWS, CWNS). Children conversed with an examiner about a series of pictures, and then told a story about the same pictures.
Results: School-age children who stutter produced more instances of atypical (stuttering-like) disfluencies in the narrative context than in the conversational context. Younger school-age children produced more typical (non-stuttering-like) disfluencies in the conversational sample than older school-age children. Age did not affect the frequency of children's stuttering-like disfluencies in either the conversational or the narrative contexts.
Clinical Implications: These findings suggest that narration may offer a relatively efficient way of eliciting stuttering-like disfluencies during the assessment of stuttering. Thus, this type of sample should be considered in addition to the standard conversational sample.
PMID: 22269580
[PubMed - as supplied by publisher]

Stopping speech suppresses the task-irrelevant hand. - PSICOMOTOR
Brain Lang. 2012 Mar;120(3):412-5. Epub 2011 Dec 27.

Cai W, Oldenkamp CL, Aron AR.
Department of Psychology, University of California, San Diego, USA.

Some situations require one to quickly stop an initiated response. Recent evidence suggests that rapid stopping engages a mechanism that has diffuse effects on the motor system. For example, stopping the hand dampens the excitability of the task-irrelevant leg. However, it is unclear whether this 'global suppression' could apply across wider motor modalities. Here we tested whether stopping speech leads to suppression of the task-irrelevant hand. We used Transcranial Magnetic Stimulation over the primary motor cortex with concurrent electromyography from the hand. We found that when speech was successfully stopped the motor evoked potential from the task-irrelevant hand was significantly reduced compared to when the participant failed to stop speaking, or responded on non stop signal trials, or compared to baseline. This shows that when speech is quickly stopped, there is a broad suppression across the motor system. This has implications for the neural basis of speech control and stuttering.
PMID: 22206872
[PubMed - in process]

Studies in a consanguineous family reveal a novel locus for stuttering on chromosome 16q. - GENÉTICA
Hum Genet. 2012 Feb;131(2):311-3. Epub 2011 Dec 29.

Raza MH, Amjad R, Riazuddin S, Drayna D.
National Institute on Deafness and Other Communication Disorders (NIDCD), Bethesda, MD, USA.

No abstract available
PMID: 22205390
[PubMed - in process]

Stuttering and Language Ability in Children: Questioning the Connection - LINGUAGEM
American Journal of Speech-Language Pathology 2012

Marilyn A. Nippold
University of Oregon, Eugene, Oregon, USA

Purpose: This article explains why it is reasonable to question the view that stuttering and language ability in children are linked, the so-called "stuttering-language connection."
Method: Studies that focused on syntactic, morphologic, and lexical development in children who stutter(CWS) are examined for evidence to support the following claims: 1) that CWS, as a group, are more likely to have disordered or weak language skills ("language deficits") than children who do not stutter(CWNS); (2) that language deficits play a causal role in the onset of stuttering; and (3) that stuttering, over time, restricts children's language development.
Results: Analysis of the evidence suggests that CWS, like CWNS, show the full range of language abilities (high, average, low); that language deficits are not associated with stuttering onset or persistence; and that stuttering has little or no impact on language development.
Conclusions: A connection between stuttering and language ability was not supported. An alternative perspective is that CWS have a compromised motor control system that makes it difficult to move forward in speech and that the tie to language lies not in a deficient linguistic system but in difficulty expressing the intended meaning via a fully functional speech system.
JAMA & Archives

Stuttering characteristics of German-English bilingual speakers. - FALA
Clin Linguist Phon. 2012 Jul;26(7):597-612.

Schäfer M, Robb MP.
Department of Communication Disorders , University of Canterbury , Christchurch , New Zealand.

The purpose of this study was to examine stuttering behavior in German-English bilingual people who stutter (PWS), with particular reference to the frequency of stuttering on content and function words. Fifteen bilingual PWS were sampled who spoke German as the first language (L1) and English as a second language (L2). Conversational speech was sampled in each language and analyzed for the percentage of overall stuttering-like disfluencies and distribution of stuttering on content and function words. Significantly more stuttering was found to occur in L2 compared to L1. Stuttering occurred significantly more often on content words compared to function words in L1. No significant difference between stuttering on function and content words was observed in L2. Examination across L1 and L2 found a significantly greater percentage of stuttering on function words in L2 compared to L1, and a significantly lower percentage of stuttering on content words in L2 compared to L1. The characteristics of stuttering in L2 could not be differentiated on the basis of an L2 proficiency measure. The differences observed in the amount of stuttering between L1 and L2 suggest that stuttering in bilingual speakers is closely related to language dominance, with features of stuttering in L2 indicative of a less developed language system.
PMID: 22690716
[PubMed - in process]

Stuttering, disability and the higher education sector in Australia. - SOCIAL
Int J Speech Lang Pathol. 2012 Jun 4. [Epub ahead of print]

Meredith G, Packman A, Marks G.
University of Ballarat , Ballarat , Australia.

The aim of this study was to ascertain the extent to which Australian public universities and their associated disability liaison services offer web-based information for current or prospective students who stutter. The disability pages of the websites of all 39 public universities in Australia were visited and the information about disability services assessed according to 12 criteria developed by the authors. Results indicate that there is a dearth of information on Australian university websites available for students or prospective students who stutter. Only 13% of the sites reported any form of alternative teaching and assessment procedures for speech-impaired students and only 51% of 39 disability liaison officers responded when contacted by email. Such a student could not make an informed choice to enrol in a university based upon the information on disability services available on public Australian university websites.
PMID: 22657943
[PubMed - as supplied by publisher]

Stuttering: Genetic updates and a case report. - GENÉTICA
Adv Biomed Res. 2012;1:14.. Epub 2012 May 11.
Free full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC350701...

Nouri N, Nouri N, Abdali H, Shafie M, Karimi H.
Molecular Genetic Laboratory, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Developmental stuttering is a common disorder of speech dissiliency that is characterized by excessive repetitions of sounds, syllables, and monosyllabic words, as well as sound prolongations and complete blockages of the vocal tract. About 60 million people are affected and it is more common between the age of 3 and 6, when children begin forming sentences and connecting thoughts verbally. There are three types of stuttering known as developmental stuttering, neurogenic stuttering, and psychogenic stuttering. The exact pathophysiology of developmental stuttering is unknown; however, various family and twin studies have repeatedly implicated heredity as a major factor in the etiology of stuttering. It is clear that the genetic influence is not in the form of an exact single gene effect such as autosomal recessive, autosomal dominant, or x-linked in all families; however, in all of the inheritance forms it is influenced by sex with higher occurrence in males than females at a ratio of 4:1 in older children and adults. Recently special genetic locus has been determined on several autosomal chromosomes related to developmental stuttering. In this report, the proband is a 20-year-old boy was referred to our clinic for premarriage genetic counseling; he has been affected since 3 years and now is under cure. three generation study of his family show 13 individuals are affected by stuttering. For the first it occurred in the proband's grandfather and after this time about all of affected cases has been seen in consanguineous marriages. Therefore, the genetical inheritance of stuttering is crystal clear in this family and autosomal recessive inheritance pattern is proposed. Totally in such families with repeated occur of stuttering, we cannot account it as a multifactorial disorder.
[PubMed - in process]

Stuttering treated with olanzapine: a case report. - FARMACOLOGIA
Actas Esp Psiquiatr. 2012 Jul;40(4):231-3. Epub 2012 Jul 1.
Free full text: http://www.actaspsiquiatria.es/repositorio//14/78/...
Mozos-Ansorena A, Pérez-García M, Portela-Traba B, Tabernero-Lado A, Pérez-Pérez J.
Unidad de Salud Mental de Conxo.

Introduction. Spasmophemia, also called stuttering or stammering, is a speech disorder characterized by impairment of the rhythm of words whose classical symptoms are blocks and repetitions. Methodology. We describe the case of a male patient, his evolution and therapeutic strategies and review the current literature on the subject. Results. A 33-year-old patient was referred to our Mental Health Unit by his family doctor due to “speech problems and difficulty expressing ideas. His symptoms had worsened in recent weeks, with increase in his state of anxiety.” Standing out in the consultation to the doctor, the patient experienced multiple blocks in expressing words, using circumlocutions and monosyllabic repetitions that made it very difficult to conduct the interview. Anticipatory anxiety and occasional obsessions of repeated checking also stand out. After six weeks of treatment with olanzapine 5 mg/daily, the patient showed significant improvement both in the fluency and anticipatory anxiety with decreased repetitions, blocking, interjections and broken words. Discussion. Spasmophemia has been associated with dopaminergic hyperactivity, so that studies have been conducted with atypical antipsychotics. Fundamentally, olanzapine and risperidone have revealed promising results. Furthermore, several studies have shown that these patients have higher rates of anxiety. That is why antidepressants and antianxiety drugs such as clomipramine, paroxetine, fluoxetine, citalopram, sertraline and alprazolam have been used. Conclusion. Treatment with olanzapine, 5HT-2 and D1/ D2 antagonist, significantly improved the clinical picture as Boyd et al. have described in their systematic review. Key words: Spasmophemia, Speech Disorder, Atypical Antipsychotics, Olanzapine.
PMID: 22851483
[PubMed - in process]

Syllable-timed speech treatment for school age children who stutter : A Phase I trial - TERAPIA
Language, Speech, and Hearing Services in Schools 2012

Cheryl Andrews ; Sue O'Brian, Elisabeth Harrison, Mark Onslow, Ann Packman, Ross Menzies
The University of Sydney, Australia ; Macquarie University, Australia

Purpose: This clinical trial determined the outcomes of a simple syllable timed speech (STS) treatment for school age children who stutter.
Method: Participants were 10 stuttering children from 6–11 years of age. Treatment involved training the parent and child to use STS at near normal speech rates. The technique was practiced in the clinic and at home with the parent during everyday conversations.
Results: Nine months after commencing treatment, stuttering had reduced by more than 50% for half the children, with two children attaining 81% and 87% reduction. Using intention-to-treat analysis, there was a clinically and statistically significant reduction in stuttering for the group even when a withdrawn participant was included. These results were mostly confirmed by self-reported stuttering severity ratings and supported by improved avoidance and quality of life scores. There was considerable individual variation in response to the treatment.
Conclusions: STS shows promise as a treatment for some school age children who stutter. As a fluency technique, it is simple to learn and simple to teach and the children in this study appeared to enjoy the treatment. The efficacy of the treatment could likely be improved with modifications.
JAMA & Archives

The effects of concurrent cognitive load on phonological processing in adults who stutter - FALA
Journal of Speech, Language, and Hearing Research 2012

Robin M. Jones, Robert A. Fox, Ewa Jacewicz
The Ohio State University - Ohio - USA

Purpose: To determine whether phonological processing in adults who stutter (AWS) is disrupted by increased amounts of cognitive load in a concurrent attention-demanding task.
Methods: Nine AWS and nine adults who do not stutter (AWNS) participated. Using a dual-task paradigm, word pairs were presented for rhyme judgments and, concurrently, letter strings for memory recall. The rhyme judgment task manipulated rhyming type (rhyming/non-rhyming) and orthographic representation (similar, dissimilar). The memory recall task varied stimulus complexity (no letters, three letters, five letters). Rhyme judgment accuracy and reaction time (RT) assessed the phonological processing and letter recall accuracy measured the memory recall.
Results: For rhyme judgments, AWS were as accurate as AWNS and the increase in the cognitive load did not affect rhyme judgment accuracy of either group. Significant group differences were found in RTs (AWS's delays were 241 ms greater). RTs of AWS were also slower in the most demanding rhyme condition and varied with the complexity of the memory task. Accuracy of letter recall of AWS was comparatively worse in the most demanding 5-letter condition.
Conclusions: Phonological and cognitive processing of AWS is more vulnerable to disruptions caused by increased amounts of cognitive load in concurrent attention-demanding tasks.
JAMA & Archives

The effects of duration and frequency of occurrence of voiceless fricatives on listeners' perceptions of sound prolongations. - SOCIAL
J Commun Disord. 2012 Mar 6. [Epub ahead of print]

Kawai N, Healey EC, Carrell TD.
The Center for Special Needs Education Research and Practice, Hiroshima University, Japan.

The present study examined listeners' identification and rating of words in passages as stuttered when the duration and frequency of occurrence of sound prolongations were manipulated. Thirty-six participants listened to a 219-word passage containing voiceless fricatives digitally increased from their normal durations to 200, 300, and 420ms. Listeners heard one of three passages that contained 5%, 10% or 15% altered stimuli within the passage. In Condition 1, listeners identified words considered stuttered. In Condition 2, listeners rated specifically selected words in the passage relative to the extent they considered the words stuttered. The results showed that (1) both the duration and the frequency of occurrence of the altered phonemes within the paragraph length material had an impact on listeners' perception of words identified as a sound prolongation; (2) listeners gave significantly higher ratings in Condition 2 than Condition 1 when determining if a word was stuttered or produced fluently. The implications of these results are discussed. Learning outcomes: After reading this article, the reader will be able to: (1) Describe the past literature on listener perceptions of stuttering. (2) Differentiate between listener's perceptions of sound prolongations that are altered in duration and frequency of occurrence. (3) Describe how paragraph-length speech material compares to past research that has used isolated utterances.
PMID: 22436827
[PubMed - as supplied by publisher]

The Efficiency of Attentional Networks in Children who Stutter.- ATENÇÃO
J Speech Lang Hear Res. 2012 Jan 9. [Epub ahead of print]

Eggers K, De Nil LF, Van den Bergh BR.
Dept. of Speech-Language Therapy and Audiology, Lessius University College, Belgium.

PURPOSE: The purpose of this study was to evaluate if previously reported questionnaire-based differences in self-regulatory behaviors (Eggers, De Nil, & Van den Bergh, 2009, 2010) between children who stutter (CWS) and children who do not stutter (CWNS) would also be reflected in their underlying attentional networks.
METHOD: Participants consisted of 41 CWS (mean age = 6;09 years) and 41 CWNS (mean age = 6;09 years) ranging from 4;00 to 9;00 years of age. Participants were matched on age and gender. The efficiency of the attentional networks was assessed by using the computerized Attention Network Test (Fan, McCandliss, Sommer, Raz, & Posner, 2002).
RESULTS: Primary results indicated that CWS had a significantly lower efficiency of the orienting network compared to CWNS, whereas no differences were found on the alerting or executive control network.
CONCLUSIONS: Current findings corroborate previously found differences in self-regulatory behavior and were taken to suggest a possible role for attentional processes in developmental stuttering.
PMID: 22232392
[PubMed - as supplied by publisher]

The experiences of living with a sibling who stutters: A preliminary study. - SOCIAL
J Fluency Disord. 2012 Jun;37(2):135-48. Epub 2012 Feb 22.

Beilby JM, Byrnes ML, Young KN.
School of Psychology and Speech Pathology, Curtin University, , Perth, Western Australia, Australia.

Stuttering impacts on the child in a variety of ways, notably in terms of communicative impairment and psychosocial impact. In addition, the stuttering disorder has a holistic impact, affecting those with whom the child who stutters lives. Within the family constellation, the closest person to the individual who stutters is often their sibling. This study investigated the experiences of fluent siblings of children who stutter to examine the impact that stuttering may have on their lives. A mixed methods research design incorporated qualitative semi-structured interviews and quantitative questionnaires. The results of the qualitative investigation revealed four aspects of children's lives that were affected by having a sibling who stuttered: the relationship between siblings, the impact on the fluent sibling, the impact on the parent relationship with both children, and the impact on the sibling's relationship with others. Findings revealed that siblings of children who stutter exhibited strongly negative emotions, and differing levels of responsibility associated with their involvement in the actual stuttering management programme. Furthermore, for the fluent sibling, secondary to having a brother or sister who stuttered, communication with and attention from their parents was variable. The results of the quantitative component of the study revealed children who stutter and their siblings demonstrated significantly greater closeness, and concurrently, increased conflict and status disparity than did the control fluent sibling dyads. The parents of the experimental sibling dyads also demonstrated significantly greater partiality towards a child, namely the child who stuttered, than did the parents of the control sibling dyads. Educational objectives: The reader will be able to: (1) identify the themes associated with having a sibling who stutters; (2) identify how the quality of the sibling relationship differs between sibling dyads that do and do not consist of a sibling who stutters; and (3) discuss the clinical implications of the results with regards to working with children who stutter and their families.
[PubMed - in process]

The impact of adolescent stuttering on educational and employment outcomes: Evidence from a birth cohort study. - SOCIAL
J Fluency Disord. 2012 Jun;37(2):106-21. Epub 2012 Feb 8.

McAllister J, Collier J, Shepstone L.
University of East Anglia, Norwich NR4 7TJ, United Kingdom.

PURPOSE: In interview and survey studies, people who stutter report the belief that stuttering has had a negative impact on their own education and employment. This population study sought objective evidence of such disadvantage for people who stutter as a group, compared with people who do not stutter.
METHOD: A secondary analysis of a British birth cohort dataset was used in the study. At age 16, there were 217 cohort members who were reported by their parents to stutter, and 15,694 cohort members with no known history of stuttering or other speech problems. Data were analysed concerning factors associated with report of stuttering at 16, school leaving age, highest qualification, unemployment early in working life, pay at age 23 and 50, and social class of job at age 23 and 50.
RESULTS: Those who stuttered at 16 were statistically more likely than those who did not stutter to be male, to have poorer cognitive test scores, and to have been bullied. There were no significant effects ofstuttering on educational outcomes. For employment outcomes, the only significant association withstuttering concerned socioeconomic status of occupation at 50, with those who had been reported to stutter having lower-status jobs.
DISCUSSION: These findings fail to support the belief that stuttering has a negative impact on education and employment. The higher likelihood of those who stutter working in lower-status positions may reflect their preference for avoiding occupations perceived to require good spoken communication abilities. Therapeutic implications are discussed. Educational objectives: The reader will be able to describe (a) prior work on the impact of stuttering on education and employment, (b) some characteristics of the National Child Development Study (NCDS), (c) the effect of stuttering on school leaving age and highest educational qualification in NCDS, (d) the effect of stuttering on employment outcomes in NCDS: unemployment by age 23, pay at 23 and 50, and socioeconomic status of occupation at 23 and 50.
PMID: 22531286
[PubMed - in process]

The influence of anticipation of word misrecognition on the likelihood of stuttering. - OUTROS
J Commun Disord. 2012 Mar 17. [Epub ahead of print]

Brocklehurst PH, Lickley RJ, Corley M.
University of Edinburgh, Edinburgh, Scotland, United Kingdom.

This study investigates whether the experience of stuttering can result from the speaker's anticipation of his words being misrecognized. Twelve adults who stutter (AWS) repeated single words into what appeared to be an automatic speech-recognition system. Following each iteration of each word, participants provided a self-rating of whether they stuttered on it and the computer then provided feedback implying its correct or incorrect recognition of it. Each word was repeated four times. Unbeknown to participants, 'Correct' and 'Incorrect' recognition of words by the system was pre-determined and bore no relation to the actual quality of participants' iterations of those words. For words uttered in the 'Correct recognition' condition, the likelihood of AWS self-reporting stuttering on a word diminished across iterations, whereas for words in the 'Incorrect recognition' condition it remained static. On the basis of the findings it is argued that: (a) in AWS, the anticipation that a word will be misrecognized increases the relative likelihood of stuttering on that word in the future; and (b) this effect is independent of the degree of difficulty inherent in the formulation and motor execution of the word itself, although it may interact with it. Mechanisms that can account for these findings and yet are also congruent with the wider range of evidence from psycholinguistic and speech motor control domains are discussed. It is concluded that stuttered disfluencies may best be explained as resulting from the inappropriate functioning of covert repair and/or variable release threshold mechanisms in response to the anticipation of communication failure. Learning outcomes: This article informs readers about two different theoretical approaches to explaining developmental stuttering: (1) stuttering as an adaptation response to an underlying impairment; and (2) stuttering as an anticipatory struggle response. It describes how these approaches account for different symptoms of the disorder, and proposes that both theoretical approaches are needed in order to fully account for the range of symptoms and experimental findings associated with stuttering.
[PubMed - as supplied by publisher]

The influence of phonetic complexity on stuttered speech.- FALA
Clin Linguist Phon. 2012 Jul;26(7):646-59.
Coalson GA, Byrd CT, Davis BL.
Department of Communication Sciences and Disorders, The University of Texas at Austin, Austin, TX , USA.
The primary purpose of this study was to re-examine the influence of phonetic complexity on stuttering in young children through the use of the Word Complexity Measure (WCM). Parent-child conversations were transcribed for 14 children who stutter (mean age = 3 years, 7 months; SD = 11.20 months). Lexical and linguistic factors were accounted for during the analysis. Results indicate that phonetic complexity, as measured by WCM, did not exhibit a significant influence on the likelihood of stuttering. Findings support previous data that suggest stuttering in preschool-age children does not appear significantly related to phonetic complexity of the production.
PMID: 22690719
[PubMed - in process]

The role of the DRD2 C957T polymorphism in neuroticism in persons who stutter and healthy controls. - GENÉTICA
Neuroreport. 2012 Jan 18. [Epub ahead of print]

Montag C, Bleek B, Faber J, Reuter M.
Departments of Psychology, University of Bonn, Bonn, Germany.

The present study investigates for the first time the influence of the DRD2 C957T polymorphism on personality in persons who stutter. In a recent study, the CC genotype of this single nucleotide polymorphism has been associated with stuttering, which could not be replicated in a follow-up study. Here, we demonstrate, in N=105 persons who stutter, that carriers of the CC and the CT genotype significantly have the highest neuroticism scores. This shows that the inclusion of personality measures in the investigation of the biological underpinnings of stuttering represents an important new avenue. In healthy control persons, a sex by C+/- allele interaction effect could be demonstrated. Female but not male carriers of the C+ variant report the highest neuroticism scores. Because neuroticism has been reported to be associated with stuttering before, the present data support the idea that this personality trait acts as an endophenotype for stuttering, contributing towards bridging the gap from gene variation to the complex pathology. This idea is supported by an additional path model showing that the polymorphism DRD2 C957T influences the self-reported severity of stuttering mainly by its influence on neuroticism (independent of the variable sex).
PMID: 22262089
[PubMed - as supplied by publisher]

Weak Responses to Auditory Feedback Perturbation during Articulation in Persons Who Stutter: Evidence for Abnormal Auditory-Motor Transformation. - AUDITIVO
PLoS One. 2012;7(7):e41830. Epub 2012 Jul 23

Free full text: http://www.plosone.org/article/info%3Adoi%2F10.137...
Cai S, Beal DS, Ghosh SS, Tiede MK, Guenther FH, Perkell JS.

Boston University, Boston, Massachusetts, United States of America.
Previous empirical observations have led researchers to propose that auditory feedback (the auditory perception of self-produced sounds when speaking) functions abnormally in the speech motor systems of persons who stutter (PWS). Researchers have theorized that an important neural basis of stuttering is the aberrant integration of auditory information into incipient speech motor commands. Because of the circumstantial support for these hypotheses and the differences and contradictions between them, there is a need for carefully designed experiments that directly examine auditory-motor integration during speech production in PWS. In the current study, we used real-time manipulation of auditory feedback to directly investigate whether the speech motor system of PWS utilizes auditory feedback abnormally during articulation and to characterize potential deficits of this auditory-motor integration. Twenty-one PWS and 18 fluent control participants were recruited. Using a short-latency formant-perturbation system, we examined participants' compensatory responses to unanticipated perturbation of auditory feedback of the first formant frequency during the production of the monophthong [¥å]. The PWS showed compensatory responses that were qualitatively similar to the controls' and had close-to-normal latencies (¡¬150 ms), but the magnitudes of their responses were substantially and significantly smaller than those of the control participants (by 47% on average, p<0.05). Measurements of auditory acuity indicate that the weaker-than-normal compensatory responses in PWS were not attributable to a deficit in low-level auditory processing. These findings are consistent with the hypothesis that stuttering is associated with functional defects in the inverse models responsible for the transformation from the domain of auditory targets and auditory error information into the domain of speech motor commands.

Webcam delivery of the Camperdown Program for adolescents who stutter: A Phase I trial.- TERAPIA
Lang Speech Hear Serv Sch. 2012 Jan 9. [Epub ahead of print]

Carey B, O'Brian S, Onslow M, Packman A, Menzies R.
Australian Stuttering Research Centre, The University of Sydney.

Aim: This Phase I clinical trial explored the viability of webcam Internet delivery of the Camperdown Program for adolescents who stutter. Methods and Procedures Participants were three adolescents aged 13, 15, and 16 years with moderate-severe stuttering. Each was treated with the Camperdown Program delivered by webcam with no clinic attendance. Primary outcomes were percentage of syllables stuttered (%SS) and number of treatment sessions to maintenance. Secondary outcomes were speech naturalness, situation avoidance, self-reported stuttering severity, and parent and adolescent satisfaction. Data were collected before treatment and at 1 day, 6 months, and 12 months post-treatment.
RESULTS: Treatment was completed with means of 18 sessions and 11 clinician hours. Group mean reduction of stuttering from pre- to immediately post-treatment was 83%, from pre-treatment to 6 months post-treatment was 93%, and from pre-treatment to 12 months post-treatment was 74%. Self-reported stuttering severity ratings confirmed these results. Post-treatment speech naturalness for participants fell within the range of three matched controls. However, avoidance of speech situations showed no corresponding improvements for two of the participants.
CONCLUSIONS: The service delivery model was efficacious and efficient as well as appealing to all participants and parents. Results justify a Phase II trial of the delivery model.
PMID: 22232423
[PubMed - as supplied by publisher]

WEBINO and the Return of the King's Speech. - GAGUEIRA ADQUIRIDA
J Neurol Sci. 2012 Apr 15;315(1-2):153-5. Epub 2011 Dec 15.

Beh SC, Frohman EM.
Department of Neurology, University of Texas Southwestern Medical Center at Dallas, United States.

We present a 69year-old man with hypertension who developed the sudden onset of horizontal binocular diplopia and stuttering of speech. On examination, bilateral exotropia (i.e. 'wall-eyed') was observed in the primary position. Attempted horizontal saccades revealed bilateral internuclear ophthalmoplegia; all consistent with the wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) syndrome. Convergence, vertical saccades and vestibular ocular reflexes were likewise impaired. Pupillary and levator palpebrae superioris functions were intact. Mild left-sided dysmetria, intention tremor and dysdiadochokinesia were elicited. Conspicuously, further characterization of the patient's history revealed that he had stuttered as a child, but it had resolved in adolescence. Brain MRI revealed an acute infarction of the mesencephalic and upper pontine tegmentum involving the periaqueductal gray region and the medial longitudinal fasciculus bilaterally with greater involvement of the left. Like the WEBINO syndrome, re-emergent developmental stuttering is a rare neurologic phenomenon. To our knowledge, this is the first case report of a mesencephalic and upper pontine infarction causing both syndromes. We discuss the pathobiological underpinnings of the WEBINO syndrome and neurogenic stuttering and in relationship to this unusual case.
PMID: 22178081
[PubMed - in process]

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