Journal of Fluency Disorders最新文献

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.

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.

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.

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.

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.

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.

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.

The experience of stuttering is wide ranging and includes a variety of perceived and unperceived behaviors and experiences. One of those experiences is anticipation of stuttering. While anticipation of stuttering is commonly discussed in terms of being a prediction of an upcoming event, it has also been equated to an internal realization of stuttering – which is the conceptualization applied here. The aim of this paper is to impress upon the reader that anticipated moments of stuttering (whether at a conscious or subconscious level) must be met with an adaptive reaction or response (which may also occur consciously or subconsciously). While these adaptive reactions and responses may differ based on whether they promote positive or negative communicative behaviors, they still represent adaptations by the speaker. Among the broad category of reactions and responses to anticipation of stuttering are motoric adaptations to speech, which include characteristic stuttering behaviors and other adaptations that may contribute to speech that is perceived by listeners as fluent. An outcome of this conceptualization is, even when adaptations result in listener perceived fluency, the speech of the person who stutters is still controlled by stuttering – meaning that some observable or unobservable adaptation is required. It is critical that speech-language pathologists recognize that the behaviors of people who stutter may reflect reactions and responses to an internal realization of stuttering and observable and unobservable reactions and responses must be considered in both assessments and interventions.

Purpose

This study uses the Simplified Chinese version of the Overall Assessment of the Speaker’s Experience of Stuttering for Adults (OASES-A-SC) to examine the stuttering experience of people in China and determine if there are differences between the data collected in China and other countries.

Methods

A total of 139 responses to the OASES-A-SC were collected in an online self-help community of people in China who stutter. Descriptive analyses were conducted to obtain the understanding of how stuttering impacts the life experience of people in China who stutter. Comparisons were conducted regarding the groups of gender, highest education, and therapy history. Cross-cultural comparisons among the data collected from China, Australia, the Netherlands, Japan, Sweden, and the USA were also conducted.

Results

The data for the OASES-A-SC showed a skewed distribution toward the severe end of the OASES-A impacting scale. About 93.5% participants rated the overall impact of stuttering on their life at and above the “Moderate” category. The mean scores of the General Information, Reaction to Stuttering, and Qualify of Life sections fell in the moderate-to-severe category. Compared with the data in other five countries, the Chinese data were significantly higher in the impact severity level.

Conclusion

The results showed that people in China who stutter have more adverse experiences related to stuttering compared with their counterparts in western or developed countries. Higher negative attitudes toward stuttering in China, social stigma against people with disabilities, and the fewer professional supports were discussed to be associated with this more adverse experience. Cultural differences such as a greater power distance and higher collectivism in Chinese culture were considered to be associated with the elevated level of adverse impact of stuttering in China.