Blog Archives

The influence of word extension and the position of speech disruption within the syllable structure in the speech of stuttering and fluent adolescents and adults

Overall, results suggest that speech disruptions occur at the beginning of words and syllables, thus indicating difficulty in synchronizing phonological selection and activation. This fact happens independently of word extension.

from Revista de Sociedade Brasileira de Fonoaudiologia

Psychometric evaluation of the Dutch translation of the Overall Assessment of the Speaker’s Experience of Stuttering for adults (OASES-A-D)

The Overall Assessment of the Speaker’s Experience of Stuttering for adults (OASES-A; Yaruss & Quesal, 2006, 2010) is a patient-reported outcome measure that was designed to provide a comprehensive assessment of “the experience of the stuttering disorder from the perspective of individuals who stutter” (Yaruss & Quesal, 2006, p.90). This paper reports on the translation process and evaluates the psychometric performance of a Dutch version of the OASES-A. Translation of the OASES-A into Dutch followed a standard forward and backward translation process. The Dutch OASES-A (OASES-A-D) was then administered to 138 adults who stutter. A subset of 91 respondents also evaluated their speech on a 10-point Likert scale. For another subset of 45 respondents, a clinician-based stuttering severity rating on a 5-point Likert scale was available. Thirty-two of the respondents also completed the Dutch S-24 scale (Brutten & Vanryckeghem, 2003). The OASES-A-D showed acceptable item properties. No ceiling effects were observed. For 30 out of 100 items, most of which were in Section IV (Quality of Life), floor effects were observed. Cronbach’s alpha coefficients for all sections and subsections surpassed the 0.70 criterion of good internal consistency and reliability. Concurrent validity was moderate to high. Construct validity was confirmed by distinct scores on the OASES-A-D for groups with different levels of stuttering severity as rated by the speakers themselves or by clinicians. These results suggest that the OASES-A-D is a reliable and valid measure that can be used to assess the impact of stuttering on Dutch adults who stutter.

from Journal of Fluency Disorders

Documenting Changes in Adult Speakers’ Locus of Causality during Stuttering Treatment using Origin and Pawn Scaling

The concepts of locus of control and locus of causality are similar and refer to the degree to which a person perceives daily occurrences to be a consequence of his or her own behavior. Locus of control is considered to be a unidimensional construct indicating an inverse relationship between the polls of internality and externality. The locus of control is generally determined by using questionnaires with a limited number of items. Locus of causality is considered to be a two-dimensional construct where Origin and Pawn values, which are similar to internality and externality, respectively, are not necessarily inversely related. Locus of causality is determined by content analysis of freely spoken or written narratives. In the current study Origin and Pawn scores were obtained from twenty adults prior to and following a three-week intensive stuttering treatment program. Brief narratives written by the participants were analyzed to obtain Origin and Pawn values. These scores were compared with traditional measures of therapeutic outcome (Locus of Control, OASES, PSI, percentage of syllables stuttered). Results indicated statistically significant increases in pre- to post-treatment Origin scores (p = .001; Cohen’s d = 1.44) and statistically significant decreases in pre- to post-treatment Pawn scores (p = .003; Cohen’s d = 1.11). Origin and Pawn scores showed significant relationships with other measures of stuttering, indicating concurrent and construct validity. Origin and Pawn scaling procedures appear to provide a valid, sensitive, and nonreactive indicator of the speaker’s locus of causality and ability to develop an autonomous and agentic lifestyle.

from Journal of Fluency Disorders

Corpus Callosum Differences associated with Persistent Stuttering in Adults

Recent studies have implicated anatomical differences in speech-relevant brain regions of adults who stutter (AWS) compared to normally fluent adults (NFA). The present study focused on the region of the corpus callosum (CC) which is involved in interhemispheric processing between the left and right cerebral hemispheres. Two-dimensional segmentation of area and voxel based morphometry were used to evaluate the corpus callosum. Results revealed that the rostrum and anterior midbody of the CC was larger in AWS than NFA. In addition, the overall callosa area was larger in AWS than NFA. The group comparison of white matter volume showed a cluster of increased white matter volume predominantly encompassing the rostrum across the midline portion in AWS. These results potentially reflect anatomical changes associated with differences in the hemispheric distribution of language processes that has been reported previously in AWS.

from the Journal of Communication Disorders

Quality of Life in adults who stutter

Although persistent developmental stuttering is known to affect daily living, just how great the impact is remains unclear. Furthermore, little is known about the underlying mechanisms which lead to a diminished quality of life (QoL). The primary objective of this study is to explore to what extent QoL is impaired in adults who stutter (AWS). In addition, this study aims to identify determinants of QoL in AWS by testing relationships between stuttering severity, coping, functioning and QoL and by testing for differences in variable scores between two AWS subgroups: receiving therapy versus not receiving therapy. A total of 91 AWS filled in several questionnaires to assess their stuttering severity, daily functioning, coping style and QoL. The QoL instruments used were the Health Utility Index 3 (HUI3) and the EuroQoL EQ-5D and EQ-VAS. The results indicated that moderate to severe stuttering has a negative impact on overall quality of life; HUI3 derived QoL values varied from .91 (for mild stuttering) to .73 (for severe stuttering). The domains of functioning that were predominantly affected were the individual’s speech, emotion, cognition and pain as measured by the HUI3 and daily activities and anxiety/depression as measured by the EQ-5D. AWS in the therapy group rated their stuttering as more severe and recorded more problems on the HUI3 speech domain than AWS in the non-therapy group. The EQ-VAS was the only instrument that showed a significant difference in overall QoL between groups. Finally, it was found that the relationship between stuttering severity and QoL was influenced by the individual’s coping style (emotion-oriented and task-oriented). These findings highlight the need for further research into stuttering in relation to QoL, and for a broader perspective on the diagnosis and treatment of stuttering, which would take into consideration quality of life and its determinants.

from the Journal of Communication Disorders

The Stammering Information Programme A Delphi Study

This study demonstrates the value of including service users when devising materials aimed for the benefit of CWS. The methodology employed ensured that ideas, perceptions and needs were representative of a range of people who experience stuttering from different perspectives. The results indicated that each expert panel had different priorities of what should be included. The resulting resources may therefore be considered to have high content validity and would be predicted to meet the needs of those who require them.

from Journal of Fluency Disorders

Stuttering severity and educational attainment

Future research is needed to investigate how this result should be addressed in educational institutions.

from Journal of Fluency Disorders

Developing the therapeutic relationship: from ‘expert’ professional to ‘expert’ person who stutters

This article looks back over the years and identifies some of the most influential thinkers, writers, and researchers who have had a profound effect on the way the therapy at the Michael Palin Centre for Stammering Children in London has evolved. It tracks the changes that have occurred in theoretical perspective, treatments offered, and the delivery of therapy. In particular this author is interested in the changing nature of the therapeutic relationship between professionals and people who stutter (PWS), and describes the way it has developed from the “expert professional” towards a more collaborative relationship that recognises the “expert patient”. It was inspired by a book written in 1902 by Mr Beasley, a person who stammered. After several unsuccessful attempts to find a ’cure’ he found his own solution to his stuttering and then used what he had learned to help many others. Much of what he wrote was well ahead of his time and reminds us, the professionals, of the importance of listening to and taking account of the views of PWS in therapy and designing treatment that meets the needs of the individual. This article also looks briefly at evidence based practice (EBP) and the issues involved in measuring outcomes that reflect the complex and individual nature of the problem. Finally the importance of the research in developing the knowledge and skill base of clinicians as well as PWS is acknowledged and discussed and the way ahead signposted.

from Journal of Fluency Disorders

Group therapy for school-aged children who stutter: a survey of current practices

Although group therapy is recommended for school-aged children who stutter (CWS), it is not widely researched. This study aimed to explore this provision, using a postal survey which investigated the current practices of Speech & Language Therapists (SLTs) in the UK. Seventy percent of SLT services provided some group therapy, but the level of provision was variable. There was a lack of consensus on what the main aims of group therapy should be. Important barriers to group therapy provision were identified, including a perceived lack of clients’ interest in group therapy, and insufficient numbers of clients able to travel to group venues. This study enhances the profession’s understanding of the provision of group therapy for CWS by identifying patterns of service delivery and highlighting areas of need.

from Journal of Fluency Disorders

The Public Opinion Survey of Human Attributes-Stuttering (POSHA-S): Summary Framework and Empirical Comparisons

The final POSHA-S, together with an ongoing and growing archive, can provide increasingly meaningful comparisons for stakeholders measuring public attitudes toward stuttering

from Journal of Fluency Disorders

Technology and the evolution of clinical methods for stuttering

The World Wide Web (WWW) was 20 years old last year. Enormous amounts of information about stuttering are now available to anyone who can access the Internet. Compared to 20 years ago, people who stutter and their families can now make more informed choices about speech-language interventions, from a distance. Blogs and chat rooms provide opportunities for people who stutter to share their experiences from a distance and to support one another. New technologies are also being adopted into speech-language pathology practice and service delivery. Telehealth is an exciting development as it means that treatment can now be made available to many rural and remotely located people who previously did not have access to it. Possible future technological developments for speech-language pathology practice include Internet based treatments and the use of Virtual Reality. Having speech and CBT treatments for stuttering available on the Internet would greatly increase their accessibility. Second Life also has exciting possibilities for people who stutter.

from Journal of Fluency Disorders

Revisiting the acquired neurogenic stuttering in the light of developmental stuttering

The neural underpinnings of acquired neurogenic stuttering (ANS) remain largely speculative owing to the multitude of etiologies and cerebral substrates implicated with this fluency disorder. Systematic investigations of ANS under various fluency-enhancing conditions have begun only in the recent past and these studies are indicative of the heterogeneous nature of the disorder. In this context, we present the case of a subject with ANS who exhibited marked reduction in dysfluencies under masked auditory feedback (MAF), singing, and pacing (speech therapy). However, the adaptation effect was absent in our subject. By explaining these features in the light of recent explanatory hypotheses derived from developmental stuttering (DS), we highlight on the possible similarity in the neural underpinnings of ANS and DS.

from the Journal of Neurolinguistics

Preverbal error-monitoring in stutterers and fluent speakers

This study was designed to characterize the brain system that monitors speech in people who stutter and matched controls. We measured two electrophysiological peaks associated with action-monitoring: the error-related negativity (ERN) and the error positivity (Pe). Both the ERN and Pe were reliably observed after errors in a rhyming task and a nonverbal flanker task, replicating previous reports of a language-monitoring ERN and demonstrating that the Pe can also be elicited by phonological errors. In the rhyming task, stutterers showed a heightened ERN peak regardless of whether they actually committed an error. Similar results, though only marginally significant, were obtained from the flanker task. These results support the vicious cycle hypothesis, which posits that stuttering results from over-monitoring the speech plan. The elevation of the ERN in stutterers and the similarity of the results between the flanker and rhyming tasks implies that speech-monitoring may rely on the same neural substrate as action-monitoring.

from Brain and Language

Stuttering, attractiveness and romantic relationships: The perception of adolescents and young adults

The purpose of this study was to investigate the possible negative impact of stuttering on romantic opportunities for adolescents and young adults who stutter. The first part of the study investigated if being a person who stutters affects the attractiveness of adolescents and young adults to their peers. To this end, 343 males and 393 females were shown age-matched pictures with an accompanying verbal description of a person opposite his or her own sex which they scored for attractiveness. In half of the participants the verbal description mentioned that the individual depicted was as person who stutters, in the other participants no such reference was included. In a second part, 354 adolescents and young adults completed a questionnaire investigating their attitude towards engaging in a romantic relationship with a peer who stutters. In particular it was asked if stuttering would hold them from (a) starting a conversation, (b) having a date or (c) possibly “going steady” with a person. Results showed that to some extent adolescents and young adults consider peers who stutter less attractive than non-stuttering peers and that they are less likely to engage in a romantic relationship with them. Clinicians need to be aware of the obstacles that adolescent and young adult clients may have to face in their social development.

from Journal of Fluency Disorders

Testing orofacial abilities of children who stutter: The Movement, Articulation, Mandibular and Sensory awareness (MAMS) assessment procedure

The new instrument is a reliable and valid tool to measure orofacial abilities and MAMS distinguishes CWS and controls. Orofacial abilities are one set of factors that influence therapy outcome for CWS.

from Journal of Fluency Disorders