Journal of Fluency Disorders最新文献_第10页

Investigation of the effect of delayed auditory feedback and transcranial direct current stimulation (DAF-tDCS) treatment for the enhancement of speech fluency in adults who stutter: A randomized controlled trial 延迟听觉反馈和经颅直流电刺激(DAF-tDCS)治疗对口吃成人语言流畅性增强的效果研究:一项随机对照试验

IF 2.1 3区医学 Q1 Arts and Humanities

Journal of Fluency Disorders

Pub Date : 2022-06-01 DOI: 10.1016/j.jfludis.2022.105907

Narges Moein , Reyhane Mohamadi , Reza Rostami , Michael Nitsche , Reza Zomorrodi , Amir Ostadi

Background

Stuttering is a disorder that begins in childhood and can persist into adulthood. In the present study, it was hypothesized that the combined intervention of transcranial direct current stimulation (tDCS) and Delayed Auditory Feedback (DAF) would cause greater improvement in speech fluency in comparison to the intervention with DAF alone.

Methods

A randomized, double-blind, sham-controlled clinical trial was conducted to investigate the effects of the combined intervention. Fifty adults with moderate to severe stuttering (25 females, 25 males, Mean age=26.92, SD=6.23) were randomly allocated to the anodal or sham tDCS group. In the anodal tDCS group, participants received DAF combined with anodal tDCS (1 mA), while the sham tDCS group was exposed to sham tDCS simultaneously with DAF. In this study, a 60-ms delay was used for DAF intervention, and tDCS was applied over the left superior temporal gyrus. Each individual participated in six 20-minute intervention sessions (held on six consecutive days). Speech fluency was assessed before and after the intervention.

Results

In the anodal tDCS group, the scores of the Stuttering Severity Instrument, Overall Assessment of the Speaker’s Experience of Stuttering questionnaire, and the percentage of stuttered syllable reduced significantly (from average baseline rates of 8.45%, across three tasks, to 5.36% at the follow-up assessment) after the intervention.

Conclusion

The results of this study suggest that delivery of anodal tDCS when combined with DAF may enhance stuttering reduction effects for six weeks following the intervention.

背景:口吃是一种始于童年并可能持续到成年的疾病。本研究假设经颅直流电刺激(tDCS)和延迟听觉反馈(DAF)联合干预比单独DAF干预对言语流畅性的改善更大。方法采用随机、双盲、假对照临床试验，观察联合干预的效果。50例成人中重度口吃患者(女25例，男25例，平均年龄26.92岁，SD=6.23)随机分为正畸组和假tDCS组。在阳极tDCS组中，参与者接受DAF联合阳极tDCS (1 mA)，而假tDCS组同时暴露于假tDCS和DAF。在本研究中，延迟60 ms进行DAF干预，tDCS应用于左侧颞上回。每个人参加6次20分钟的干预疗程(连续6天)。在干预前后分别评估语言流利程度。结果在正常tDCS组，干预后口吃严重程度量表、说话人口吃体验综合评估问卷得分和口吃音节百分比均显著降低(从三个任务的平均基线率8.45%降至随访评估时的5.36%)。结论本研究结果表明，在干预后的6周内，与DAF联合使用阳极tDCS可增强口吃减少效果。

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引用次数: 0

Systematic review of implementation quality of non-pharmacological stuttering intervention trials for children and adolescents 儿童和青少年非药物口吃干预试验实施质量的系统评价

IF 2.1 3区医学 Q1 Arts and Humanities

Journal of Fluency Disorders

Pub Date : 2022-03-01 DOI: 10.1016/j.jfludis.2021.105884

Hilde Hofslundsengen , Melanie Kirmess , Linn Stokke Guttormsen , Kari-Anne Bottegaard Næss , Elaina Kefalianos

Purpose

This narrative systematic review in line with PRISMA guidelines aims to investigate the implementation quality of previously published group comparison clinical trials of stuttering interventions for children and adolescents (under age 18 years).

Methods

We searched for publications in the databases Eric, PsychInfo, PubMed and Web of Science using the search terms ‘stutt*’ or ‘stamm*’and ‘intervention’, ‘trial’ or ‘treatment’. We reviewed the implementation elements reported in studies and how these elements were used to report intervention outcomes.

Results

3,017 references published between 1974–2019 were identified. All references were screened for eligibility using predefined selection criteria resulting in 21 included studies. The implementation quality details reported varied between studies. Existing studies most commonly lacked details about the support system provided to SLPs administering the interventions and monitoring of treatment fidelity both in the clinical setting and in the home environment. Support systems for participant’s parents and treatment dosage were generally well reported. Dosage was the most common implementation quality element considered in analyses of treatment effect and within discussions of findings.

Conclusion

Findings highlight the need for future clinical trials of stuttering interventions to closely adhere to systematic guidelines for reporting implementation quality to ensure reliability of trial outcomes. A checklist for reporting clinical trials of non-pharmacological stuttering interventions is proposed.

目的:根据PRISMA指南，本综述旨在调查先前发表的儿童和青少年(18岁以下)口吃干预组比较临床试验的实施质量。方法我们在Eric、PsychInfo、PubMed和Web of Science数据库中检索出版物，检索词为“stutt*”或“stamm*”，以及“intervention”、“trial”或“treatment”。我们回顾了研究中报告的实施要素以及如何使用这些要素来报告干预结果。结果共检索到1974-2019年间发表的文献3017篇。使用预定义的选择标准筛选所有参考文献的合格性，最终纳入21项研究。各研究报告的实施质量细节各不相同。现有的研究通常缺乏关于在临床环境和家庭环境中向特殊家庭家庭提供的支持系统的细节，这些支持系统管理干预措施和监测治疗的保真度。参与者父母的支持系统和治疗剂量一般都有很好的报道。剂量是治疗效果分析和结果讨论中考虑的最常见的实施质量因素。结论研究结果强调，未来的口吃干预临床试验需要严格遵循报告实施质量的系统指南，以确保试验结果的可靠性。提出了一份报告非药物口吃干预临床试验的清单。

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引用次数: 3

IF 2.1 3区医学 Q1 Arts and Humanities

Journal of Fluency Disorders

Pub Date : 2022-03-01 DOI: 10.1016/j.jfludis.2021.105883

Mark O’Malia

引用次数: 0

书评

IF 2.1 3区医学 Q1 Arts and Humanities

Journal of Fluency Disorders

Pub Date : 2022-03-01 DOI: 10.1016/j.jfludis.2021.105882

Charles Repine

引用次数: 0

The effect of gap duration on the perception of fluent versus disfluent speech 间隔时间对流利与不流利言语知觉的影响

IF 2.1 3区医学 Q1 Arts and Humanities

Journal of Fluency Disorders

Pub Date : 2022-03-01 DOI: 10.1016/j.jfludis.2022.105896

Haley J. Warner , D.H. Whalen , Daphna Harel , Eric S. Jackson

Purpose

Gap duration contributes to the perception of utterances as fluent or disfluent, but few studies have systematically investigated the impact of gap duration on fluency judgments. The purposes of this study were to determine how gaps impact disfluency perception, and how listener background and experience impact these judgments.

Methods

Sixty participants (20 adults who stutter [AWS], 20 speech-language pathologists [SLPs], and 20 naïve listeners) listened to four tokens of the utterance, “Buy Bobby a puppy,” produced at typical speech rates. The gap duration between “Buy” and “Bobby” was systematically manipulated with gaps ranging from 23.59 ms to 325.44 ms. Participants identified stimuli as fluent or disfluent.

Results

The disfluency threshold – the point at which 50 % of trials were categorized as disfluent – occurred at a gap duration of 126.46 ms, across all participants and tokens. The SLPs exhibited higher disfluency thresholds than the AWS and the naïve listeners.

Conclusion

This study determined, based on the specific set of stimuli used, when the perception of utterances tends to shift from fluent to disfluent. Group differences indicated that SLPs are less inclined to identify disfluencies in speech potentially because they aim to be less critical of speech that deviates from “typical”.

目的间隔持续时间有助于感知话语的流利或不流利，但很少有研究系统地研究间隔持续时间对流利判断的影响。本研究的目的是确定间隙如何影响不流畅感知，以及听者的背景和经验如何影响这些判断。方法60名参与者(20名口吃的成年人，20名言语语言病理学家和20名naïve听众)以典型的语速听了“给鲍比买一只小狗”这句话的四个符号。“Buy”和“Bobby”之间的间隔时间被系统地操纵，间隔时间从23.59 ms到325.44 ms。参与者将刺激识别为流利或不流利。结果不流畅阈值- 50%的试验被归类为不流畅的点-发生在126.46 ms的间隙持续时间，所有参与者和标记。slp表现出比AWS和naïve听众更高的不流利阈值。结论本研究根据所使用的特定刺激，确定了话语感知从流利转向不流利的时间。群体差异表明，特殊语言表达者不太倾向于识别言语中的不流畅性，因为他们的目标是对偏离“典型”的言语不那么挑剔。

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引用次数: 2

Complex nonverbal response inhibition and stopping impulsivity in childhood stuttering 儿童口吃的复杂非语言反应抑制和停止冲动

IF 2.1 3区医学 Q1 Arts and Humanities

Journal of Fluency Disorders

Pub Date : 2021-12-01 DOI: 10.1016/j.jfludis.2021.105877

Levi C. Ofoe, Julie D. Anderson

Purpose

The primary purpose of this study was to examine complex nonverbal response inhibition and stopping impulsivity in children who do (CWS) and do not stutter (CWNS).

Method

A total of 30 CWS and 30 CWNS between the ages of 3;1 and 6;0 (years; months) performed the Peg-Tapping Task (PTT; Diamond & Taylor, 1996; Luria, 1966), in which children were required to tap a dowel once when an examiner taps twice and vice versa. The main dependent variables were the number of practice trials, response accuracy, response latency for accurate responses, and the number of extra taps (i.e., tapping more than two times).

Results

The CWS were less accurate and slower on the PTT than the CWNS, with no differences in the number of practice trials. Furthermore, the CWS, especially boys, produced more extra taps than the CWNS.

Conclusions

Findings revealed that preschool CWS have weaknesses in complex response inhibition and stopping impulsivity in the nonverbal domain compared to CWNS. Taken together, these findings along with those of previous studies indicate that CWS may have weaknesses in inhibition and impulsivity in the nonverbal domain as well as the verbal domain, suggesting a domain-general weakness.

目的本研究的主要目的是探讨口吃儿童(CWS)和非口吃儿童(CWNS)的复杂非语言反应抑制和冲动的停止。方法选取年龄在3岁、1岁~ 6岁、6岁、6岁、6岁、5岁、5岁的产妇30例。月)执行敲钉任务(PTT;钻石,泰勒,1996;Luria, 1966)，当考官敲两次时，孩子们被要求敲一次销子，反之亦然。主要的因变量是练习次数、反应准确性、准确反应的反应延迟和额外敲击次数(即敲击两次以上)。结果CWS在PTT测试中的准确性和速度低于CWNS，但在实践试验次数上无差异。此外，CWS，尤其是男孩，比CWNS产生了更多的额外水龙头。结论学龄前CWS儿童在非语言领域的复杂反应抑制和停止冲动方面存在缺陷。综上所述，这些发现以及之前的研究表明，CWS可能在非语言领域和语言领域都存在抑制和冲动方面的弱点，这表明了一种领域普遍的弱点。

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引用次数: 0

Preliminary study of self-perceived communication competence amongst adults who do and do not stutter 结巴和非结巴成人自我感知沟通能力的初步研究

IF 2.1 3区医学 Q1 Arts and Humanities

Journal of Fluency Disorders

Pub Date : 2021-12-01 DOI: 10.1016/j.jfludis.2021.105848

Danielle Werle, Katherine L. Winters, Courtney T. Byrd

Purpose

Adults who stutter report a significant impact of stuttering on their quality of life, including negative thoughts and attitudes toward communication. In addition to this impact, adolescents who stutter also report lower levels of self-perceived communication competence (SPCC) compared to fluent peers. The purpose of this study was to extend the investigation of SPCC to adults who do and do not stutter. Additional aims investigated included if 1) SPCC predicted overall impact of stuttering, and, 2) stuttering frequency predicted SPCC among adults who stutter.

Methods

Twenty-four adults who stutter and twenty-seven adults who do not stutter matched for age, gender, and education completed the Self-Perceived Communication Competence Scale (Richmond & McCroskey, 1997). All participants who stutter completed the Overall Assessment of the Speaker’s Experience of Stuttering (OASES [ages 18+]; Yaruss & Quesal, 2006) and speaking samples to measure stuttering frequency.

Results

Adults who stutter reported significantly lower SPCC scale total scores than adults who do not stutter. For adults who stutter, lower SPCC scale scores significantly predicted more severe overall impact of stuttering as measured by the OASES. Stuttering frequency did not predict SPCC scale scores.

Discussion

This is the first study to report differences in self-perceived communication competence between adults who do and do not stutter. Results suggest adults who stutter report lower self-perceived communication competence compared to adults who do not stutter. Adults who perceive themselves to have greater communication competence reported less severe overall impact of stuttering, and stuttering frequency did not influence SPCC. Clinical implications for intervention are discussed.

目的口吃的成年人报告说，口吃对他们的生活质量有重大影响，包括消极的想法和对沟通的态度。除了这种影响之外，与流利的同龄人相比，口吃的青少年自我感知的沟通能力(SPCC)水平也较低。本研究的目的是将SPCC的调查扩展到有口吃和没有口吃的成年人。研究的其他目的包括:1)SPCC预测口吃的总体影响;2)口吃频率预测成人口吃者的SPCC。方法24名口吃成人和27名年龄、性别、教育程度相匹配的非口吃成人完成了自我感知沟通能力量表(Richmond &McCroskey, 1997)。所有口吃的参与者都完成了说话者口吃经历的总体评估(OASES)[年龄在18岁以上];Yaruss,Quesal, 2006)和说话样本来测量口吃频率。结果口吃者的SPCC量表总分明显低于非口吃者。对于口吃的成年人，较低的SPCC量表得分显著预示着更严重的口吃总体影响。口吃频率不能预测SPCC量表得分。这是第一个报告有口吃和没有口吃的成年人之间自我感知的沟通能力差异的研究。结果表明，与不口吃的成年人相比，口吃的成年人自我认知的沟通能力较低。自认为沟通能力较强的成年人报告的口吃总体影响较轻，口吃频率对SPCC没有影响。讨论了干预的临床意义。

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引用次数: 13

Does stammering act as a barrier to exercise and sport in Irish adults who stammer? 对于爱尔兰口吃的成年人来说，口吃是否成为锻炼和运动的障碍?

IF 2.1 3区医学 Q1 Arts and Humanities

Journal of Fluency Disorders

Pub Date : 2021-12-01 DOI: 10.1016/j.jfludis.2021.105880

Siobhán O’Connor , Kieran A. Moran , Enda F. Whyte , Aisling C. Lacey

Purpose

Exercise and sport participation lead to many physical and psychosocial benefits. However, barriers to exercise and sporting participation exist. This study aims to examine if stammering acts as a barrier to exercise and sporting participation in adults.

Methods

One hundred and six adults who stammer (male n = 74, female n = 32; 33.83 ± 14.5 years) completed an anonymous questionnaire which evaluated their stammering history, exercise and sporting participation, views on why they exercise, whether stammering prevented or negatively influenced their participation in exercise or sport. Descriptive statistics were then calculated.

Results

The majority (90.6 %) of participants take part in some form of exercise/sport. However, their stammer prevented them from taking part in a specific exercise/sport at least once (49.1 %), due to being too nervous to introduce themselves, nervous or fear of stammering or being judged. Their stammer also negatively impacted their involvement when participating at least once (42.4 %), with not feeling part of the team and fear of speaking reported. Self-disclosure of their stammer and improving awareness of stammering were identified as common facilitators for taking part in exercise/sport.

Conclusion

Stammering was not found to impact general participation in exercise and sport but was identified as a barrier to partaking in specific exercise and sport and their enjoyment thereof. Encouraging those who stammer to inform those involved in sport and exercise (e.g. fellow players, coaches) about their stammer and improving stammer awareness across the general and sporting population may encourage further participation in exercise and sport in those who stammer.

目的:锻炼和参加体育运动对身体和心理都有好处。然而，锻炼和参与体育活动的障碍仍然存在。这项研究的目的是研究口吃是否会成为成年人锻炼和参加体育活动的障碍。方法成人结巴116例(男74例，女32例;(33.83±14.5岁)完成一份匿名问卷，评估他们的口吃史、运动和体育参与情况、对运动原因的看法、口吃是否阻碍或负面影响他们参加运动或体育活动。然后计算描述性统计。结果大多数(90.6%)的参与者参加某种形式的锻炼/运动。然而，他们的口吃使他们至少有一次(49.1%)无法参加特定的锻炼/运动，原因是他们太紧张而不敢自我介绍，紧张或害怕口吃或被评判。当他们至少参加一次(42.4%)时，口吃也对他们的参与产生了负面影响，他们感到不属于团队的一部分，并且害怕说话。自我披露口吃和提高对口吃的认识被认为是参与运动/运动的共同促进因素。结论结巴不影响一般的运动和运动的参与，但被确定为参加特定的运动和运动和享受的障碍。鼓励口吃者告知参与运动和锻炼的人(如其他运动员、教练)他们的口吃，提高公众和体育人群对口吃的认识，可能会鼓励口吃者进一步参与运动和锻炼。

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引用次数: 1

No other choice: Speech-Language Pathologists’ attitudes toward using telepractice to administer the Lidcombe Program during a pandemic 没有其他选择:语言病理学家对在流行病期间使用远程实践管理Lidcombe计划的态度

IF 2.1 3区医学 Q1 Arts and Humanities

Journal of Fluency Disorders

Pub Date : 2021-12-01 DOI: 10.1016/j.jfludis.2021.105879

Gissella Santayana , Brenda Carey , Rosalee C. Shenker

Purpose

Telepractice has been shown to be a viable modality for the delivery of stuttering treatment. Since the advent of COVID-19, speech-language pathologists must adapt in-clinic treatments for online presentation. This research aimed to gather information from speech-language pathologists on their experiences of telepractice to deliver the Lidcombe Program to treat stuttering in young children.

Methods

This paper presents the findings of an online survey that polled the clinical experiences of 106 speech-language pathologists who were delivering the Lidcombe Program via telepractice during COVID-19.

Results

The majority of respondents were experienced clinicians from the United States and Canada who had attended a Lidcombe Program workshop. Prior to COVID-19, 80 % had provided some clinical services online (up to 10 % of the time), and at the start of COVID-19 public lockdown orders, 77 % viewed telepractice as both a necessity and an opportunity. Three months after the public lockdown orders, the large majority, 94 %, said that they would continue to use both telepractice and in-clinic treatment in the future. Technology issues, concerns about establishing the clinical relationship, and identification of mild stuttering featured as challenges of telepractice service delivery, while benefits included time efficiency, flexibility of scheduling, and improved clinical processes.

Conclusion

Respondents reported that the Lidcombe Program was easily translatable to telepractice and the majority intend to continue telepractice in the future.

目的:实践已被证明是提供口吃治疗的一种可行方式。自COVID-19出现以来，语言病理学家必须调整临床治疗以适应在线呈现。本研究旨在从语言病理学家那里收集他们远程实践的经验，以提供利德库姆项目来治疗幼儿口吃。方法对106名语音语言病理学家在新冠肺炎期间通过远程实践提供Lidcombe项目的临床经验进行在线调查。结果大多数受访者是来自美国和加拿大的经验丰富的临床医生，他们曾参加过Lidcombe计划研讨会。在COVID-19之前，80%的人在线提供一些临床服务(高达10%的时间)，在COVID-19公共封锁命令开始时，77%的人认为远程医疗既是必要的，也是机会。在公共封锁令发布三个月后，绝大多数人(94%)表示，他们未来将继续使用远程诊疗和门诊治疗。技术问题、对建立临床关系的关注和轻度口吃的识别是远程医疗服务提供的挑战，而好处包括时间效率、日程安排的灵活性和改进的临床流程。结论被调查者认为Lidcombe计划很容易转化为远程实践，并且大多数人打算在未来继续远程实践。

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引用次数: 2

Working memory in adults who stutter using a visual N-back task 使用视觉N-back任务的口吃成人的工作记忆

IF 2.1 3区医学 Q1 Arts and Humanities

Journal of Fluency Disorders

Pub Date : 2021-12-01 DOI: 10.1016/j.jfludis.2021.105846

Zoi Gkalitsiou, Courtney T. Byrd

Purpose

The purpose of this study was to investigate working memory in adults who do (AWS) and do not (AWNS) stutter using a visual N-back task. Processes involved in an N-back task include encoding, storing, rehearsing, inhibition, temporal ordering, and matching.

Methods

Fifteen AWS (11 males, 4 females; M = 23.27 years, SD = 5.68 years) and 15 AWNS (M = 23.47 years, SD = 6.21 years) were asked to monitor series of images and respond by pressing a “yes” button if the image they viewed was the same as the image one, two, or three trials back. Stimuli included images with phonologically similar (i.e., phonological condition) or phonologically dissimilar (i.e., neutral condition) names. Accuracy and manual reaction time (mRT) were analyzed.

Results

No difference was found between AWS and AWNS in accuracy. Furthermore, both groups were more accurate and significantly faster in 1- followed by 2- followed by 3-back trials. Finally, AWNS demonstrated faster mRT in the phonological compared to neutral condition, whereas AWS did not.

Conclusion

Results from this study suggest different processing mechanisms between AWS and AWNS for visually presented phonologically similar stimuli. Specifically, a phonological priming effect occurred in AWNS but not in AWS, potentially due to reduced spreading activation and organization in the mental lexicon of AWS. However, the lack of differences between AWS and AWNS across all N-back levels does not support deficits in AWS in aspects of working memory targeted through a visual N-back task; but, these results are preliminary and additional research is warranted.

目的本研究的目的是通过视觉N-back任务来研究有口吃和无口吃的成年人的工作记忆。N-back任务涉及的过程包括编码、存储、排练、抑制、时间排序和匹配。方法15例AWS患者(男11例，女4例;M = 23.27岁，SD = 5.68岁)和15名AWNS (M = 23.47岁，SD = 6.21岁)被要求监测一系列图像，如果他们看到的图像与一、二或三次试验前的图像相同，则按下“是”键。刺激包括音系相似(即音系条件)或音系不同(即中性条件)名称的图像。分析了准确性和人工反应时间(mRT)。结果两种方法在准确率上无显著差异。此外，在1- 2- 3-back试验中，两组都更准确，显著更快。最后，与中性条件相比，AWNS在语音方面表现出更快的mRT，而AWS则没有。结论本研究结果提示脑侧神经网络和脑侧神经网络对视觉呈现的语音相似刺激的加工机制不同。具体来说，语音启动效应发生在AWS而不发生在AWS，这可能是由于AWS心理词汇的扩散激活和组织减少。然而，在所有N-back水平上，AWS和AWS之间缺乏差异并不支持AWS在通过视觉N-back任务靶向的工作记忆方面的缺陷;但是，这些结果是初步的，需要进一步的研究。

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引用次数: 6