Accuracy of parent identification of stuttering occurrence

Background: Clinicians rely on parents to provide information regarding the onset and development of stuttering in their own children. The accuracy and reliability of their judgments of stuttering is therefore important and is not well researched.

Aim: To investigate the accuracy of parent judgements of stuttering in their own children’s speech when compared with judgements made by the parents of normally fluent children and experienced clinicians.

Methods & Procedures: Twenty parents of children who stutter made judgements of stuttering during repeated presentations of 3-min audio-visual samples of their children. Twenty control parents of children (age and gender matched) who do not stutter also assessed the children who stutter speech samples.

Outcomes & Results: The parents of both the children who stutter and those who do not stutter displayed high levels of judgement accuracy (parents, of children who stutter percentage agreement mean (standard deviation) = 90.9 (6.02); parents of children who do not stutter = 86.4 (9.7)) and consistency (90.3-90.6%) in judging stuttering in young children. But the parents of children who stutter showed significantly higher levels of accuracy (t(59) = 4.63, p<0.0001; d = 0.8) in judging stuttered intervals than the children who do not stutter parents.

Conclusions & Implications: Parents of children who stutter may be both accurate and reliable in identifying brief intervals of speech containing stuttering and non-stuttering in their own children.

from the International Journal of Language and Communication Disorders

Comparisons of stuttering frequency during and after speech initiation in unaltered feedback, altered auditory feedback and choral speech conditions

Background: Stuttering is prone to strike during speech initiation more so than at any other point in an utterance. The use of auditory feedback (AAF) has been found to produce robust decreases in the stuttering frequency by creating an electronic rendition of choral speech (i.e., speaking in unison). However, AAF requires users to self-initiate speech before it can go into effect and, therefore, it might not be as helpful as true choral speech during speech initiation.

Aims: To examine how AAF and choral speech differentially enhance fluency during speech initiation and in subsequent portions of utterances.

Methods & Procedures: Ten participants who stuttered read passages without altered feedback (NAF), under four AAF conditions and under a true choral speech condition. Each condition was blocked into ten 10 s trials separated by 5 s intervals so each trial required ‘cold’ speech initiation. In the first analysis, comparisons of stuttering frequencies were made across conditions. A second, finer grain analysis involved examining stuttering frequencies on the initial syllable, the subsequent four syllables produced and the five syllables produced immediately after the midpoint of each trial.

Outcomes & Results: On average, AAF reduced stuttering by approximately 68% relative to the NAF condition. Stuttering frequencies on the initial syllables were considerably higher than on the other syllables analysed (0.45 and 0.34 for NAF and AAF conditions, respectively). After the first syllable was produced, stuttering frequencies dropped precipitously and remained stable. However, this drop in stuttering frequency was significantly greater (approximately 84%) in the AAF conditions than in the NAF condition (approximately 66%) with frequencies on the last nine syllables analysed averaging 0.15 and 0.05 for NAF and AAF conditions, respectively. In the true choral speech condition, stuttering was virtually (approximately 98%) eliminated across all utterances and all syllable positions.

from the International Journal of Language and Communication Disorders

Effects of word frequency and phonological neighborhood characteristics on confrontation naming in children who stutter and normally fluent peers

In a prior study (Newman & Bernstein Ratner, 2007), we examined the effects of word frequency and phonological neighborhood characteristics on confrontation naming latency, accuracy and fluency in adults who stutter and typically-fluent speakers. A small difference in accuracy favoring fluent adults was noted, but no other patterns differentiated fluent speaker responses from those obtained from the adults who stutter. Because lexical organization or retrieval differences might be more easily observed in less mature language users, we replicated the experiment using 15 children who stutter (ages 4;10 16;2) and age-and gender-matched peers. Results replicated the earlier study: the two groups of participants showed strikingly similar patterns of responses based on word frequency and neighborhood characteristics. There were also no differences in naming accuracy overall between the two groups. Given our results and those of other researchers who have explored the impact of neighborhood variables on lexical retrieval in people who stutter, we suggest that differences between language production in PWS and fluent speakers are not likely to involve atypical phonological organization of lexical neighborhoods.

from Journal of Fluency Disorders

Risk factors for stuttering: a secondary analysis of a large data base

The spectrum of risk and concomitant factors in stuttering is generally thought to be wide and heterogeneous. However, only a few studies have examined these factors using information from large databases. We examined the data on 11,905 Swiss conscripts from 2003. All cases with high psychiatric screening scores indicating “caseness” for a psychiatric disorder were excluded, among them potential malingerers, so that 9,814 records remained. The analyses rely on self-reported information about stuttering in childhood, problems at birth, problems in school, mental disorders of parents and relatives, childhood adversity and socio-demographic information. Statistical modelling was done using logistic regression and path analysis models. Risk factors determined in the logistic regression include premature birth, probable attention deficit hyperactive disorder, alcohol abuse of the parents, obsessive–compulsive disorder in parents and relatives, having a disabled mother and having a parent from a foreign country. There is no overwhelmingly strong risk factor; all odds ratios are about 2 or below. In conclusion, large databases are helpful in revealing less obvious and less frequent risk factors for heterogeneous disorders such as stuttering. Obviously, not only secondary analyses, but also systematical large scale studies would be required to complete the complex epidemiological puzzle in stuttering. An extensive examination of young adults who were initially assessed in childhood might provide the most promising design.

from the European Archives of Psychiatry and Clinical Neuroscience

Speech Disruptions in Relation to Language Growth in Children Who Stutter: An Exploratory Study

Young children with typical fluency demonstrate a range of disfluencies, or speech disruptions. One type of disruption, revision, appears to increase in frequency as syntactic skills develop. To date, this phenomenon has not been studied in children who stutter (CWS). Rispoli and colleagues (2008) suggest a schema for categorizing speech disruptions in terms of revisions and stalls. The purpose of this exploratory study was to use this schema to evaluate whether CWS show a pattern over time in their production of stuttering, revisions, and stalls. Nine CWS, ages 2;1 to 4;11, participated in the study, producing language samples each month for 10 months. MLU and vocd analyses were performed for samples across three time periods. Active declarative sentences within these samples were examined for the presence of disruptions. Results indicated that the proportion of sentences containing revisions increased over time, but proportions for stalls and stuttering did not. Visual inspection revealed that more stuttering and stalls occurred on longer utterances than on shorter utterances. Upon examination of individual children’s language, it appears two-thirds of the children showed a pattern in which, as MLU increased, revisions increased as well. Findings are similar to studies of children with typical fluency, suggesting that, despite the fact that CWS display more (and different) disfluencies relative to typically fluent peers, revisions appear to increase over time and correspond to increases in MLU, just as is the case with peers.

from Journal of Fluency Disorders

Cognitive behavior therapy for adults who stutter: A tutorial for speech-language pathologists

This paper explores the relationships between anxiety and stuttering and provides an overview of cognitive-behavior therapy (CBT) strategies that can be applied by speech-language pathologists. There is much support for the idea that adults who stutter (AWS) may need CBT. First, approximately 50% of AWS may be suffering from social anxiety disorder. A difficult developmental history marked by problematic peer relationships and bullying may contribute to this. Stereotypes in the general community lead AWS to have occasional experiences that confirm their fears of negative evaluation. This can leave AWS with significant social and occupational avoidance and can impact on their quality of life. Second, in a recent large study of behavioral treatment for AWS, participants who had a mental health disorder, including social anxiety, failed to maintain the benefits of treatment. Available evidence supports the contention that CBT can effectively decrease anxiety and social avoidance, and increase engagement in everyday speaking situations for AWS. The components of CBT presented here are drawn from a model widely used in clinical psychology, and existing supportive data reviewed. Worksheets for speech-language pathologists undertaking CBT in this population are provided. CBT procedures, in their essentials, are straightforward to implement. Hence, the present authors suggest that speech-language pathologists who have had training in conducting CBT should be able to apply the techniques described in this paper.

from Journal of Fluency Disorders

University Students’ Perceptions of the Life Effects of Stuttering

An open-ended, written survey was administered to 146 university students who did not stutter to obtain their impressions of the effects of stuttering on the lives of people who stutter (PWS). Participants first wrote about the general effects of stuttering and then considered how their lives would be different if they stuttered. Both types of responses, while not qualitatively different, indicated that participants were more likely to focus on negative listener reactions and barriers to social, academic, and occupational success when they imagined themselves as PWS. Fewer participants indicated that PWS may positively cope with their stuttering through acceptance of stuttering, motivation and determination, and support systems. Quantitative differences based on gender and familiarity with PWS were not observed. The findings suggest that while university students are generally sensitive to the issues which can affect PWS, they may also tend to exaggerate the limitations placed on PWS by their stuttering.

from the Journal of Communication Disorders

Screening for Personality Disorders Among Adults Seeking Speech Treatment for Stuttering

Stuttering is frequently associated with negative consequences which typically begin in early childhood. Despite this, no previous studies have investigated the presence of personality disorders among adults who stutter. Therefore, the aims of the present study were to screen for personality disorders among adults who stutter, and to compare these screening estimates with matched controls from a national population sample. Using a matched case-control design, participants were 94 adults seeking treatment for stuttering, 92 of whom completed the International Personality Disorders Examination Questionnaire (IPDEQ) as a first-stage screener, and 920 age- and gender-matched controls from the Australian National Survey of Mental Health and Well-being (ANSMHWB). A conditional logistic regression model was used to estimate odds ratios for the primary outcome: first-stage presence of any personality disorder; as well as specific personality disorders. Based on first-stage screening, the presence of any personality disorder was significantly higher for adults in the stuttering group than matched controls, demonstrating almost three-fold increased odds. This difference between groups remained significant for all specific personality disorders, with four- to seven-fold increased odds found for Dissocial, Anxious, Borderline, Dependent and Paranoid personality disorders, and two- to three-fold increased odds found for Histrionic, Impulsive, Schizoid and Anankastic personality disorders. In conclusion, stuttering appears to be associated with a heightened risk for the development of personality disorders. These results highlight the need for research regarding the assessment and treatment of personality disorders among adults who stutter.

from Journal of Fluency Disorders

Comparison of acoustic and kinematic approaches to measuring utterance-level speech variability

Purpose: The spatio-temporal index (STI) is one measure of variability. As currently implemented, kinematic data are used, requiring equipment that cannot be used with some patient groups or in scanners. An experiment is reported that addressed whether STI can be extended to an audio measure of sound pressure of the speech envelope over time, that did not need specialized equipment.

Method: STI indices of variability were obtained from lip track (L-STI) and amplitude envelope (E-STI) signals. These measures were made concurrent whilst either fluent speakers or speakers who stutter repeated “Buy Bobby a puppy” 20 times.

Results: L-STI and E-STI correlated significantly. STI reduced with age for both L-STI and E-STI. E-STI scores and L-STI scores discriminated successfully between fluent speakers and speakers who stutter.

Conclusion: The amplitude envelope over time STI scores can be used to obtain an STI score. This STI score can be used in situations where lip movement STI scores are precluded.

from the Journal of Speech, Language, and Hearing Research

The impact of stuttering on the quality of life in adults who stutter

Stuttering is an involuntary fluency disorder that is not uncommon in society. However, the impact of stuttering on a composite measure such as quality of life has rarely been estimated. Quality of life (QOL) assesses the well-being of a person from a multidimensional perspective, and valid and reliable general QOL measures are available that can be used to estimate the impact of stuttering on QOL. This study involved the use of a general measure of QOL called the Medical Outcomes Study Short Form-36 (SF-36) in order to assess the impact of stuttering in 200 adults who stutter (AWS). Comparisons to 200 adults of similar age and sex ratio who do not stutter were made so that the unique contribution of stuttering on QOL could be estimated. Findings indicated that stuttering does negatively impact QOL in the vitality, social functioning, emotional functioning and mental health status domains. Results also tentatively suggest that people who stutter with increased levels of severity may have a higher risk of poor emotional functioning. These findings have implications for treatment such as the necessity to address the emotional and psychological aspects of QOL in AWS and the need for additional clinical resources to be invested in stuttering treatment.

from Journal of Fluency Disorders

The Peer Attitudes Toward Children Who Stutter Scale: Reliability, known groups validity, and negativity of elementary school-age children’s attitudes

Psychometric properties of the Peer Attitudes Toward Children who Stutter (PATCS) scale (Langevin & Hagler, 2004) and the extent to which peer attitudes are negative were re-examined. Results show that internal consistency was .97 and test-retest reliability was .85. In a known groups analysis participants who had contact with someone who stutters had statistically significant higher mean scores (more positive attitudes) than those who had not had contact. Nonsignificant findings for gender and grade call into question the usefulness of these variables as discriminators in future tests of known groups validity of peer attitudes toward children who stutter. Approximately one-fifth of participants had PATCS scores that were somewhat to very negative. These findings support calls for school-based education about stuttering.

from the Journal of Fluency Disorders

Randomized controlled non-inferiority trial of a telehealth treatment for chronic stuttering: the Camperdown Program

Conclusions & Implications: The results provide evidence to support the use of the Camperdown Program delivered by telehealth as an alternate to the face-to-face treatment delivery of this programme for adults who stutter. Such a model will increase accessibility to this evidence-based treatment for adults currently isolated from treatment services.

from the International Journal of Language and Communication Disorders

Unhelpful thoughts and beliefs linked to social anxiety in stuttering: development of a measure

Conclusions & Implications: Implications for the use of the UTBAS as an outcome measure and a clinical tool are discussed, along with the potential value of the UTBAS to explore the well-documented social anxiety experienced by those who stutter.

from the International Journal of Language and Communication Disorders

The Peer Attitudes Toward Children who Stutter (PATCS) scale: an evaluation of validity, reliability and the negativity of attitudes

Conclusions & Implications: Results provide evidence of the validity and reliability of PATCS and confirm the need for school-based education about stuttering. The PSD and SP factors suggest that education include discussions about (1) similarities and differences among children who do and do not stutter in order to increase acceptance, and (2) making personal choices and handling peer pressure in thinking about children who stutter. The VI factor suggests that open discussion about stuttering may alleviate frustration experienced by listeners and provide the opportunity to give strategies for responding appropriately. Results also suggest that education involve contact with a person who stutters.

from the International Journal of Language and Communication Disorders

Speech rate according to stuttering severity

CONCLUSIONS: the rate of fluent speech during a repetition task differentiated the studied individuals according to the severity of stuttering.

from Pró-Fono Revista de Atualização Científica