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Journal of Fluency Disorders最新文献

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Linguistic features of stuttering during spontaneous speech 自发讲话时口吃的语言特征。
IF 2.1 3区 医学 Q1 Arts and Humanities Pub Date : 2023-09-30 DOI: 10.1016/j.jfludis.2023.106016
Haley J. Warner , Ravi Shroff , Arianna Zuanazzi , Richard M. Arenas , Eric S. Jackson

Purpose

Previous work shows that linguistic features (e.g., word length, word frequency) impact the predictability of stuttering events. Most of this work has been conducted using reading tasks. Our study examined how linguistic features impact the predictability of stuttering events during spontaneous speech.

Methods

The data were sourced from the FluencyBank database and consisted of interviews with 35 adult stutterers (27,009 words). Three logistic regression mixed models were fit as the primary analyses: one model with four features (i.e., initial phoneme, grammatical function, word length, and word position within a sentence), a second model with six features (i.e., the features from the previous model plus word frequency and neighborhood density), and a third model with nine features (i.e., the features from the previous model plus bigram frequency, word concreteness, and typical age of word acquisition). We compared our models using the Area Under the Curve statistic.

Results

The four-feature model revealed that initial phoneme, grammatical function, and word length were predictive of stuttering events. The six-feature model revealed that initial phoneme, word length, word frequency, and neighborhood density were predictive of stuttering events. The nine-feature model was not more predictive than the six-feature model.

Conclusion

Linguistic features that were previously found to be predictive of stuttering during reading were predictive of stuttering during spontaneous speech. The results indicate the influence of linguistic processes on the predictability of stuttering events such that words associated with increased planning demands (e.g., longer words, low frequency words) were more likely to be stuttered.

目的:先前的研究表明,语言特征(如单词长度、单词频率)会影响口吃事件的可预测性。这项工作大多是通过阅读任务完成的。我们的研究考察了语言特征如何影响自发言语中口吃事件的可预测性。方法:数据来源于FluencyBank数据库,包括对35名成年口吃者(27009个单词)的采访。三个逻辑回归混合模型被拟合为主要分析:一个模型具有四个特征(即初始音素、语法功能、单词长度和句子中的单词位置),第二个模型具有六个特征(如前一个模型的特征加上单词频率和邻域密度),以及具有九个特征的第三个模型(即,来自先前模型的特征加上双字频率、单词具体性和单词习得的典型年龄)。我们使用曲线下面积统计数据对我们的模型进行了比较。结果:四特征模型显示,初始音位、语法功能和单词长度对口吃事件具有预测作用。六特征模型显示,初始音素、单词长度、单词频率和邻域密度可以预测口吃事件。九特征模型并不比六特征模型更具预测性。结论:先前发现的可预测阅读过程中口吃的语言特征可预测自发言语过程中的口吃。结果表明,语言过程对口吃事件的可预测性有影响,因此与计划需求增加相关的单词(例如,较长的单词、低频单词)更有可能口吃。
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引用次数: 0
Reduced stuttering for school-age children: A systematic review 学龄儿童口吃的减少:一项系统综述。
IF 2.1 3区 医学 Q1 Arts and Humanities Pub Date : 2023-09-22 DOI: 10.1016/j.jfludis.2023.106015
Georgina Johnson , Mark Onslow , Sarah Horton , Elaina Kefalianos

Background

Treatment of school-age children (6–12 years of age) who stutter is a public health priority. Their clinical needs include a psychosocial focus and stuttering reduction. For the latter clinical need, there is a critical window of opportunity for these children warranting research attention.

Purpose

The purpose of the review is to guide future clinical research by establishing (a) what interventions are associated with stuttering reduction for school-age children (b) the reported immediate and longer-term effects of those interventions, and (c) the level of evidence for these interventions in terms of study design.

Methods

Fourteen databases and three conference proceedings were searched for interventions used to reduce stuttering in school-age children. Primary outcomes were mean stuttering reductions pre-treatment, immediately post-treatment, and any follow-up assessments.

Results

Of the 4305 studies identified from the databases, 67 studies met inclusion criteria. Five different treatment approaches were reported in the literature that might reduce stuttering for a school-age child, but with varying effect sizes. These include (a) operant methods, (b) speech restructuring, (c) combined operant methods and speech restructuring, (d) machine-driven treatments, and (e) treatments with a cognitive behaviour therapy component.

Conclusions

Operant methods warrant investigation in future clinical trial research, as do variants of speech restructuring. Hybrid approaches showed encouraging results, including speech restructuring variants combined with operant methods or with cognitive behaviour therapy. However, evidence is preliminary only at Phase I and II trials. Several treatments with reported clinical promise have been overlooked for decades and require further investigation.

背景:学龄儿童(6-12岁)口吃的治疗是公共卫生的优先事项。他们的临床需求包括关注心理社会和减少口吃。对于后一种临床需求,这些儿童有一个关键的机会之窗,值得研究关注。目的:该综述的目的是通过确定(a)哪些干预措施与学龄儿童口吃的减少有关(b)这些干预措施的近期和长期效果,以及(c)从研究设计的角度来看,这些干预的证据水平,来指导未来的临床研究。方法:检索14个数据库和3个会议记录,寻找用于减少学龄儿童口吃的干预措施。主要结果是治疗前、治疗后立即和任何后续评估的平均口吃减少。结果:在数据库中确定的4305项研究中,67项研究符合纳入标准。文献中报道了五种不同的治疗方法,这些方法可能会减少学龄儿童的口吃,但效果各不相同。其中包括(a)操作方法,(b)言语重组,(c)操作方法和言语重组的组合,(d)机器驱动治疗,以及(e)具有认知行为治疗成分的治疗。结论:操作方法值得在未来的临床试验研究中进行研究,语音重组的变体也是如此。混合方法显示出令人鼓舞的结果,包括与操作方法或认知行为疗法相结合的言语重组变体。然而,证据仅在第一阶段和第二阶段试验中是初步的。几十年来,一些有临床前景的治疗方法一直被忽视,需要进一步研究。
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引用次数: 0
Contemporary clinical conversations about stuttering: Neurodiversity and ableism 关于口吃的当代临床对话:神经多样性和能力主义。
IF 2.1 3区 医学 Q1 Arts and Humanities Pub Date : 2023-09-19 DOI: 10.1016/j.jfludis.2023.106014
Rosalee Shenker , Naomi Rodgers , Barry Guitar , Mark Onslow

Purpose

To discuss issues about neurodiversity and ableism, and how they pertain to clinical management of stuttering, with particular reference to early childhood stuttering.

Methods

During a webinar this year, the issue emerged of how concepts of neurodiversity and ableism apply to early childhood stuttering during the pre-school years. It became apparent that this topic elicited disparate views and would be of particular interest to students of speech-language pathology. Consequently, the leaders of that webinar continued the conversation by written dialogue for the purpose of placing it on record.

Results

The discussants reached agreement on many points, but there was some diversity of viewpoint about how neurodiversity and ableism should apply to clinical practice with children who have recently begun to stutter.

目的:讨论有关神经多样性和能力障碍的问题,以及它们如何与口吃的临床管理有关,特别是与儿童早期口吃有关。方法:在今年的一次网络研讨会上,出现了神经多样性和能力主义的概念如何应用于学前儿童口吃的问题。很明显,这个话题引发了不同的观点,并且会引起言语病理学学生的特别兴趣。因此,该网络研讨会的领导人通过书面对话继续对话,目的是将其记录在案。结果:讨论者在许多方面达成了一致,但对于神经多样性和能力主义应如何应用于最近开始口吃的儿童的临床实践,存在一些不同的观点。
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引用次数: 0
书评
IF 2.1 3区 医学 Q1 Arts and Humanities Pub Date : 2023-09-04 DOI: 10.1016/j.jfludis.2023.106013
Joseph Agius
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引用次数: 0
Nonword reading by adults who stutter in a transparent orthography 口吃成年人在透明正字法中的非单词阅读
IF 2.1 3区 医学 Q1 Arts and Humanities Pub Date : 2023-09-01 DOI: 10.1016/j.jfludis.2023.105996
Horabail Venkatagiri , Nuggehalli P. Nataraja , Theja Kuriakose

Purpose

Using word- and nonword-reading passages in Kannada, which has a transparent orthography, we attempted to determine (a) whether orthographic differences between English and Kannada may explain the observed differences in stutter rates on nonwords, and (b) whether longer nonwords, like words, incur higher rates of stutters.

Methods

Stutters are defined as sound or syllable repetitions, sound prolongations, broken words or nonwords (a pause within a word or nonword), abnormal pauses, and intrusive vowel-like sounds. Twenty-six persons, who stutter, read the word and nonword passages. The nonwords were created by changing the first syllable of each word; otherwise words and nonwords were equivalent in length and syllable structure. Stutters were counted from audio-recordings and statistically analyzed.

Results

PWS stuttered on words in varying amounts and in significantly larger amounts on nonwords. Stutter frequency increased roughly in proportion to the increase in the length of phonological words (previously known) and nonwords (reported for the first time here).

Conclusion

The results cannot be attributed to the difficulty of pronouncing nonwords because Kannada orthography has a one-to-one relationship between the written and spoken forms of words. Speech production is a multi-stage process consisting of ideation, lemma selection, phonological word creation, and the articulatory planning and execution. Because nonwords lack meaning and clearly identifiable part of speech, it appears that stutters arise late in the speech production process at the phonological word formation and articulatory planning stages. Meaning, lexicality, and morphosyntax may not contribute significantly to the occurrence of stutters.

目的使用具有透明正字法的卡纳达语中的单词和非单词阅读段落,我们试图确定(a)英语和卡纳达语之间的正字法差异是否可以解释非单词口吃率的差异,以及(b)较长的非单词,如单词,是否会导致更高的口吃率。方法口吃是指发音或音节重复、发音延长、断词或非词(词内停顿或非词内停顿)、异常停顿和侵入性元音。26名口吃者阅读单词和非单词段落。非单词是通过改变每个单词的第一个音节而产生的;除此之外,单词和非单词在长度和音节结构上是相等的。从录音中统计口吃者并进行统计分析。结果PWS在单词上有不同程度的口吃,在非单词上有明显较大的口吃。口吃频率的增加大致与语音单词(先前已知)和非单词(本文首次报道)的长度增加成比例。结论这一结果不能归因于非单词的发音困难,因为卡纳达语正写法在单词的书面形式和口语形式之间有一对一的关系。言语产生是一个多阶段的过程,包括构思、引理选择、语音造词以及发音计划和执行。由于非单词缺乏意义和清晰可识别的词性,口吃似乎出现在语音单词形成和发音计划阶段的语音产生过程的后期。意义、词汇性和形态语法可能对口吃的发生没有显著影响。
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引用次数: 0
The Fifth Croatia Stuttering Symposium: Part III. Mental health and early stuttering 第五届克罗地亚口吃研讨会:第三部分心理健康与早期口吃
IF 2.1 3区 医学 Q1 Arts and Humanities Pub Date : 2023-09-01 DOI: 10.1016/j.jfludis.2023.106000
Mark Onslow , Robyn Lowe , Suzana Jelčić Jakšić , Marie-Christine Franken , Anna Hearne , Irma Uijterlinde , Kurt Eggers

Purpose

The Fifth Croatia Stuttering Symposium of 2022 continued the Fourth Croatia Stuttering Symposium 2019 theme of the connection between research and clinical practice. At the 2022 Symposium, there were 145 delegates from 21 countries. This paper documents the contents of the third of three Symposium modules.

Methods

The module topic was mental health and early stuttering, and that pre-schoolers who stutter are at risk of developing mental health issues. A clinical situation was considered where a parent of a 3-year-old child asked a clinician what the early signs of mental health issues might be for a child who stutters.

Results

A distinguished scholar presented a 5-minute video interpretation of research about this topic. Three master clinicians then each presented a 2-minute video demonstration of how that research might be applied in a clinical situation. Following that, the convenors moderated a discussion between the distinguished scholar, master clinicians, and delegates regarding the research and how it applies to clinical practice.

目的2022年第五届克罗地亚口吃研讨会延续了2019年第四届克罗地亚口吃会议的主题,即研究与临床实践之间的联系。在2022年研讨会上,来自21个国家的145名代表出席了会议。本文记录了研讨会三个模块中的第三个模块的内容。方法本模块的主题是心理健康和早期口吃,口吃的学龄前儿童有发展心理健康问题的风险。考虑了一种临床情况,一位3岁孩子的父母问临床医生,口吃儿童的心理健康问题的早期迹象可能是什么。结果一位著名学者对本课题的研究进行了5分钟的视频解读。然后,三位临床医生每人展示了一段2分钟的视频,演示如何将该研究应用于临床。随后,召集人主持了杰出学者、临床医生大师和代表之间关于该研究及其如何应用于临床实践的讨论。
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引用次数: 0
Differences in auditory verbal working memory between adults who do and do not stutter on an N-back task 在N背任务中口吃和不口吃的成年人之间听觉-言语工作记忆的差异
IF 2.1 3区 医学 Q1 Arts and Humanities Pub Date : 2023-09-01 DOI: 10.1016/j.jfludis.2023.105998
Zoi Gkalitsiou , Courtney Byrd

Purpose

The purpose of this study was to investigate auditory verbal working memory in adults who do (AWS) and do not (AWNS) stutter using a highly demanding linguistic N-back task.

Methods

Fifteen AWS and 15 AWNS matched in age, gender and educational level were asked to hear series of words and respond by pressing a “yes” button if the word they just heard was the same as the word one, two, or three trials back. Words were either phonologically similar (i.e., Phonological Linguistic Condition) or phonologically dissimilar (i.e., Neutral Linguistic Condition). Accuracy and false alarms rates as well as reaction time on correct target trials, missed target trials and false alarms were collected and analyzed.

Results

Differences were not found between AWS and AWNS in accuracy. Both groups were more accurate and significantly faster in 1- followed by 2- followed by 3-back trials. However, AWS were significantly slower than AWNS in the 2-back level, regardless of linguistic condition. Furthermore, AWS demonstrated more false alarms compared to AWNS.

Conclusion

Results revealed differences in auditory verbal working memory and interference control between AWS and AWNS when processing highly linguistically demanding stimuli.

目的本研究的目的是通过一项要求很高的语言N背任务,调查有(AWS)和没有(AWNS)口吃的成年人的听觉-言语工作记忆。方法15名年龄、性别和教育水平匹配的AWS和15名AWNS被要求听到一系列单词,如果他们刚刚听到的单词与第一次、第二次或第三次试验中的单词相同,则按下“是”按钮。单词在语音上相似(即语音语言条件),或在语音上不同(即中性语言条件)。收集并分析正确目标试验、脱靶试验和假警报的准确率和假警报率以及反应时间。结果AWS与AWNS在准确性上无明显差异。两组在1次、2次、3次背部试验中都更准确、速度更快。然而,无论语言条件如何,AWS在2背水平上都明显慢于AWNS。此外,与AWNS相比,AWS表现出更多的假警报。结论结果显示,在处理高语言要求的刺激时,AWS和AWNS在听觉-言语工作记忆和干扰控制方面存在差异。
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引用次数: 0
Norwegian speech-language pathologists treatment practices for preschool children who stutter: An explorative study 挪威言语病理学家对学龄前口吃儿童的治疗实践:一项探索性研究
IF 2.1 3区 医学 Q1 Arts and Humanities Pub Date : 2023-09-01 DOI: 10.1016/j.jfludis.2023.105999
Melanie Kirmess , Linn Stokke Guttormsen , Hilde Hofslundsengen , Kari-Anne Bottegaard Næss , Elaina Kefalianos

Purpose

This study investigated the treatment practices of speech-language pathologists (SLPs) with preschool children who stutter to explore variations in service delivery and, consequently to better inform and support evidence-based practice.

Method

121 Norwegian SLPs completed an online survey about stuttering treatment for preschool children aged up to six years. They reported on treatment training, choices, setting, dosage, and outcomes. Data was analysed descriptively. Correlation analyses between years of clinical experience and clinician perceived outcomes were conducted.

Result

Sixty-eight percent of SLPs were trained in one or more stuttering treatment programs. The majority of SLPs (83 %) provided treatment in person in preschool centers; 59 % reported providing treatment once a week. Thirty-four percent of SLPs reported that they often or always delivered the whole treatment program. Treatment practice addressed various elements, including advising parents about language and communication strategies, supporting the child's self-image, and perceived outcomes. The SLPs reported their clinician perceived outcomes as ‘always’ or ‘often’ reduction of audible stuttering (70 %), reduced cognitive and emotional reactions (55 %), and improved communication skills (58 %). Factors influencing treatment choices were identified at the systemic level (e.g., work place regulations) and individual level (e.g., SLPs competency, child’s best).

Conclusion

Stuttering treatment services in Norway differ from those reported in existing literature as treatment is given in preschool settings, only 34 % of SLPs deliver programs as intended whilst the majority use treatment elements only, and still experience positive changes. Provision is variable, and seems influenced by SLP training and competence.

目的本研究调查了言语语言病理学家(SLP)对学龄前口吃儿童的治疗实践,以探索服务提供的差异,从而更好地为循证实践提供信息和支持。方法121名挪威SLP完成了一项关于6岁以下学龄前儿童口吃治疗的在线调查。他们报告了治疗训练、选择、设置、剂量和结果。对数据进行描述性分析。进行了多年临床经验和临床医生感知结果之间的相关性分析。结果68%的SLP接受过一个或多个口吃治疗项目的培训。大多数SLP(83%)在学前中心亲自提供治疗;59%的人报告每周提供一次治疗。34%的SLP报告说,他们经常或总是提供整个治疗方案。治疗实践涉及各种因素,包括就语言和沟通策略向父母提供建议,支持孩子的自我形象和感知结果。SLP报告称,他们的临床医生认为结果是听觉口吃“总是”或“经常”减少(70%),认知和情绪反应减少(55%),沟通技能提高(58%)。从系统层面(如工作场所规定)和个人层面(如SLP能力、儿童最佳水平)确定了影响治疗选择的因素。结论挪威的口吃治疗服务与现有文献中报道的不同,因为治疗是在学前环境中进行的,只有34%的SLP按预期提供方案,而大多数SLP仅使用治疗元素,并且仍然经历积极的变化。供应是可变的,似乎受到SLP培训和能力的影响。
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引用次数: 0
Developmental stuttering, physical concomitants associated with stuttering, and Tourette syndrome: A scoping review 发育性口吃、与口吃相关的身体并发症和抽动秽语综合征:范围界定综述
IF 2.1 3区 医学 Q1 Arts and Humanities Pub Date : 2023-09-01 DOI: 10.1016/j.jfludis.2023.105992
Christelle Nilles , Lindsay Berg , Cassidy Fleming , Davide Martino , Tamara Pringsheim

Background and purpose

Developmental stuttering and Tourette syndrome (TS) are common neurodevelopmental disorders. Although disfluencies may co-occur in TS, their type and frequency do not always represent pure stuttering. Conversely, core symptoms of stuttering may be accompanied by physical concomitants (PCs) that can be confused for tics. This scoping review aimed to explore the similarities and differences between stuttering and tics in terms of epidemiology, comorbidities, phenomenology, evolution, physiopathology, and treatment. We also described the nature of PCs in stuttering and disfluencies in TS.

Methods

A literature search on Medline, Embase and PsycInfo was executed in March 2022. From 426 studies screened, 122 were included in the review (a majority being narrative reviews and case reports).

Results

TS and stuttering have several epidemiological, phenomenological, comorbidity, and management similarities suggesting shared risk factors and physiopathology (involving the basal ganglia and their connections with speech and motor control cortical regions). PCs in stuttering commonly involve the face (eyelids, jaw/mouth/lip movements) and sometimes the head, trunk and limbs. PCs can be present from early stages of stuttering and vary over time and within individuals. The function of PCs is unknown. Some individuals with TS have a distinct disfluency pattern, composed of a majority of typical disfluencies (mostly between-word disfluencies), and a mix of cluttering-like behaviors, complex phonic tics (e.g. speech-blocking tics, echolalia, palilalia), and rarely, atypical disfluencies.

Conclusion

Future investigations are warranted to better understand the complex relationships between tics and stuttering and address the management of disfluencies in TS and PCs in stuttering.

背景和目的发育性口吃和抽动秽语综合征(TS)是常见的神经发育障碍。尽管TS中可能同时出现障碍,但其类型和频率并不总是代表纯粹的口吃。相反,口吃的核心症状可能伴随着身体伴随物(PC),这可能与抽搐混淆。本范围综述旨在探讨口吃和抽搐在流行病学、合并症、现象学、进化、病理生理学和治疗方面的异同。我们还在TS中描述了PC在口吃和功能障碍中的性质。方法于2022年3月在Medline、Embase和PsycInfo上进行了文献检索。在筛选的426项研究中,122项被纳入综述(大多数是叙述性综述和病例报告)。结果TS和口吃在流行病学、现象学、共病和管理方面有一些相似之处,表明共同的风险因素和病理生理学(涉及基底节及其与言语和运动控制皮层的联系)。口吃的PC通常涉及面部(眼睑、下巴/嘴巴/嘴唇的运动),有时还涉及头部、躯干和四肢。PC可以从口吃的早期阶段就出现,并且随着时间的推移和个体内部的变化而变化。PC的功能未知。一些TS患者有明显的不流畅模式,包括大多数典型的不流畅(主要在单词不流畅之间),以及混杂的类似杂乱的行为、复杂的语音抽搐(如语音阻塞抽搐、回声抽搐、栅栏音),以及罕见的非典型不流畅。结论未来的研究有助于更好地理解抽搐和口吃之间的复杂关系,并解决口吃患者TS和PC的障碍管理问题。
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引用次数: 0
A cross-sectional investigation of disfluencies in typically developing Spanish-English bilingual children 典型发展中的西班牙语-英语双语儿童不易受影响的横断面调查
IF 2.1 3区 医学 Q1 Arts and Humanities Pub Date : 2023-09-01 DOI: 10.1016/j.jfludis.2023.105988
Raúl Rojas , Farzan Irani , Svenja Gusewski , Natalia Camacho

Purpose

This study examined the language skills and the type and frequency of disfluencies in the spoken narrative production of typically developing Spanish-English bilingual children.

Method

A cross-sectional sample of 106 bilingual children (50 boys; 56 girls) enrolled in kindergarten through Grade 4, produced a total of 212 narrative retell language samples in English and Spanish. A specialized fluency coding system was implemented to index the percentage of total (%TD) and stuttering-like disfluencies (%SLD) in each language. Large-scale reference databases were used to classify children’s dual language proficiency profiles (balanced, English dominant, Spanish dominant) based on language sample analysis measures of morphosyntax and lexical diversity.

Results

The bilingual Spanish-English children in this study did not demonstrate significant cross-linguistic differences for mean %TD or %SLD. However, the mean %TD and %SLD in both languages exceeded the risk threshold based on monolingual English-speaking norms. English dominant bilingual children demonstrated significantly lower %TD in English than Spanish. Spanish dominant children demonstrated significantly lower %SLD in Spanish than English.

Conclusions

This study included the largest sample size of bilingual Spanish-English children investigated to date from a fluency perspective. The frequency of disfluencies was found to be variable across participants and change dynamically as a function of grade and dual language proficiency profiles, indicating the need for studies that employ larger sample sizes and longitudinal designs.

目的本研究考察了典型发展中的西班牙语-英语双语儿童的语言技能以及口语叙事产生中不流畅的类型和频率。方法对106名幼儿园至四年级的双语儿童(50名男孩;56名女孩)进行横断面抽样,共产生212个英语和西班牙语的叙述性复述语言样本。实现了一个专门的流利度编码系统,以索引每种语言中总流利度(%TD)和口吃样流利度(%SLD)的百分比。基于形态句法和词汇多样性的语言样本分析,使用大规模参考数据库对儿童的双语能力档案(平衡、英语为主、西班牙语为主)进行分类。结果本研究中的西班牙-英国双语儿童在平均%TD和%SLD方面没有表现出显著的跨语言差异。然而,两种语言的平均%TD和%SLD都超过了基于单语英语规范的风险阈值。以英语为主的双语儿童在英语方面的TD明显低于西班牙语。以西班牙语为主的儿童在西班牙语中的SLD百分比明显低于英语。结论这项研究包括了迄今为止从流利度角度调查的最大样本量的西班牙语-英语双语儿童。研究发现,不同参与者的不流利频率是可变的,并随着年级和双语言熟练程度的变化而动态变化,这表明需要采用更大样本量和纵向设计的研究。
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引用次数: 0
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Journal of Fluency Disorders
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