Journal of Fluency Disorders最新文献

Non-invasive neuromodulation methods such as transcranial Direct Current Stimulation (tDCS) and Transcranial Magnetic Stimulation (TMS), have been extensively utilized to enhance treatment efficacy for various neurogenic communicative disorders. Recently, these methods have gained attention for their potential to reveal more about the underlying nature of stuttering and serve as adjunct therapeutic approaches for stuttering intervention. In this review, we present existing research and discuss critical factors that might influence the efficacy of these interventions, such as location, polarity, intensity, and duration of stimulation, as well as the impact of combined behavioral training. Additionally, we explore implications for future studies, including the application of different neuromodulation methods to address various aspects of stuttering such as speech fluency and associated psychological and cognitive aspects in people who stutter.

Purpose: Children who stutter (CWS) in clinical settings may present with concomitant disorders (CDs), which can complexify the delivery of the Lidcombe Program (LP). However, there is limited evidence on how CDs influence treatment outcomes in CWS, leaving clinicians with little guidance regarding best practices with these children. This exploratory study, conducted in partnership with a rehabilitation center's clinical team, aims to understand which CDs and suspected CDs speech-language pathologists document when treating CWS with the LP and their relationship to treatment characteristics and outcomes.

Method: A retrospective chart review was conducted on 47 children diagnosed with developmental stuttering who received the LP between 2016 and 2018.

Results: 38 CWS (80.9 %) had either at least one confirmed (59.6 %) or suspected (21.3 %) CD, of which 61.7 % were language-related and 27.6 % attention-related. CWS with diagnosed and suspected CDs had significantly higher stuttering severity rating (SR) scores post-treatment as compared to CWS without CDs (p =.001), although all groups significantly reduced their stuttering. There were high drop-out rates in all groups. CWS with diagnosed and suspected CDs who dropped out had significantly higher SR scores than CWS without CDs who progressed to Stage 2 (p =.011 and p =.014, respectively).

Conclusion: The LP is effective in improving fluency in both CWS with and without CDs. However, CWS with diagnosed or suspected CDs finished or dropped out of Stage 1 with significantly higher SR scores than CWS without CDs. Future research is needed to confirm these results and investigate the factors underlying the observed differences.

Background and aim: An increasing body of research indicates that many adults who stutter (AWS) experience anxiety in social and verbal situations. The Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) scales were developed to assess speech-related anxiety and negative cognitions associated with stuttering. This study aimed to translate the UTBAS into Persian, investigate its psychometric properties for Persian-speaking AWS, and compare the results with previously published UTBAS scores across various cultures.

Method: The UTBAS scales were translated into Persian according to the protocols of the International Quality of Life Assessment Project and the World Health Organization. Sixty-two adults with developmental stuttering, aged between 18 and 51 years, participated in this study. The psychometric properties of UTBAS-P were investigated using similar measures to those used in previous studies where valid and reliable versions were available. Additionally, UTBAS-P scores were compared to UTBAS scores previously reported for Australian, Japanese, and Turkish participants.

Results: The results showed that UTBAS-P had an acceptable face, content, and construct validity. It was significantly correlated with other anxiety-related measures. Additionally, its low and negative correlations with unrelated constructs, such as the NEO-PI-R domains of openness, agreeableness, and conscientiousness, confirmed its divergent validity. Regarding reliability, the significant test-retest reliability score (Pearson r = 0.87, p < 0.001) confirmed the stability of UTBAS-P scores over time, and its internal consistency was confirmed by Cronbach's alpha of 0.99. Similarities and differences were found between participants' UTBAS scores across different cultures.

Conclusion: All four currently translated versions of the UTBAS have demonstrated high levels of validity and reliability, showing strong correlations with well-known anxiety measures. These findings suggest that the UTBAS has potential for use both clinically and in cross-cultural studies.

Introduction: This study investigated the attitude of Belgian (Flemish) high school students of 15 years and older toward stuttering, compared them with international samples and evaluated the impact of an attitude program about stuttering.

Method: Nine schools participated in this study. The students completed the POSHA-S before and after the program. The program consisted of a class discussion guided by a PowerPoint presentation about six stuttering-related topics and the song Time To Talk, written for this project by Portland. The first questionnaire was filled out by N = 582. For N = 229, answers from pre- and post-intervention could be matched.

Results: In general, female adolescents had a more positive attitude toward people who stutter, as did students from the highest education level. Catholic and atheist adolescents differed from Islamic adolescents, as well as adolescents who were born in Belgium from those who were born in another country, for one construct (cause of stuttering). The scores of the Belgian sample showed a similar variability as those of the other European samples and the POSHA-S database. A statistically significant attitude change was observed after the attitude program for helping people who stutter (Pre M = 37.35 versus Post M = 47.59, p < .001).

Conclusion: Mainly the variables sex and type of education explain observed attitude differences among the adolescents. Adding music to an attitude program about stuttering seems a viable way to increase better insight in how to help people who stutter in adolescents aged 15 and older.

Background and purpose: Speech-language pathologists (SLPs) can play an integral role working with people who stutter (PWS) across the lifespan. There is a rich, yet relatively recent, history of research capturing specific aspects of the role, yet no paper has sought to combine the published literature relating to it. This review is intended to: (1) establish key themes related to SLPs' experiences, practices and attitudes of working with PWS; (2) determine how these may have changed over time; and (3) identify what gaps in the knowledge about this topic still exist.

Methods: A scoping review was conducted to synthesise all relevant peer-reviewed literature. Studies were included if they met the following inclusion criteria: a) reported on primary research; b) published in a peer-reviewed journal; c) written in English, and, d) reported on SLPs working with people who stutter.

Results: A total of 897 articles were identified and reviewed, with 27 included in the final analysis. Content analysis of the study results revealed themes relating to SLP factors, SLP attitudes, clinical management and service delivery.

Conclusion: While much has been published on this topic, and considerable change has been observed over time, there is still much to learn. Future investigations may include more in-depth exploration of SLPs' lived experience working with PWS and a systematic approach to increase SLP competency and confidence in working with PWS.

Purpose: Stuttering epidemiology is reviewed with a primary goal of appraising methods used to identify stuttering in large populations. Secondary goals were to establish a best estimate of adult stuttering prevalence; identify data that could subgroup stuttering based upon childhood versus adult onset and covert versus over behaviour; and conduct a preliminary assessment of the degree to which stuttering features as a co-occurring diagnosis.

Methods: Systematic review followed PRISMA guidelines. Quality assessment was based on the Joanna Briggs Institute Prevalence Critical Appraisal Tool, with criteria adjusted for appraisal of stuttering.

Results: 15 sets of data were assessed for quality, with three meeting criteria for inclusion. These estimated adult stuttering prevalence at 0.67% at age 14-17 years (Taghipour et al., 2013); 0.21% at age 16-20 years (Tsur et al., 2021); and 0.63% when aged over 21 years (Craig et al., 2002).

Conclusion: Systematic review indicates adult stuttering prevalence is between 0.6-0.7%. A false positive paradox follows from the low prevalence of stuttering in the general population, creating a need for very high specificity when measuring stuttering in the general population. Failure to achieve high specificity (99.9% is suggested) leads to loss of statistical power due to presence of false positives. A corollary of the false positive paradox is that sensitivity in measurement of stuttering can be relatively low (90% is suggested) before general population estimates of stuttering prevalence are appreciably affected. Despite this relaxation of measurement requirements regarding sensitivity, covert stuttering is likely to have been underestimated. Covert stuttering might be accounted for using data from prospective cohort studies, however such a revision seems unlikely to exceed the widely-accepted 1% adult stuttering prevalence estimate; see Gattie, Lieven & Kluk (2024 this issue) for an estimate at 0.96 %. When used to estimate stuttering prevalence, data reported by Tsur et al. (2021) are outlying, with the relatively low estimate possibly due to origin as military conscript data and/or generalised healthcare screening.

Purpose: Epidemiological research of stuttering has frequently focused on children, with a relative paucity of population level data specific to adults. Prevalence data for adults are reassessed here, including a breakdown of whether stuttering is overt or covert, and whether onset was in childhood or adulthood. The engagement of adults who stutter with stuttering communities is also estimated.

Methods: Prevalence calculations were based on data from studies having the strongest designs, following the systematic review of Gattie, Lieven & Kluk (2024, this issue). Original data for engagement with stuttering communities were gathered from English language internet stuttering support groups, a national stuttering charity in the UK and a regional stuttering support group in Manchester, UK.

Results: Adult stuttering prevalence was estimated at 0.96% (95% CI 0.65, 1.44). This can be broken down to 0.63% overt stuttering (95% CI 0.46, 0.79) comprising 0.53% childhood onset and 0.10% adult onset; and 0.33% covert stuttering (95% CI 0.19, 0.58) comprising 0.28% childhood onset and 0.05% adult onset. Covert stuttering will have been overestimated, and may often be very mild. Engagement with stuttering communities was estimated at 0.99% internationally, 0.63% nationally and 1.01% regionally. Actual engagement will have been lower due to attrition and overcounting.

Conclusion: The adult stuttering prevalence estimate of 0.96% is consistent with the widely-cited all ages stuttering prevalence estimate of 1%. Of adults who stutter, fewer than 1% engage with stuttering communities.