Journal of Fluency Disorders最新文献

Purpose

The purpose of this study was to investigate the emotional and stuttering experience of adults who stutter (AWS) in everyday life, and how that experience may be shaped by personal (i.e., trait social anxiety) and situational factors (i.e., social partner reaction, communication channel type, social closeness, stuttering knowledge).

Method

AWS completed ecological momentary assessments on their smartphones multiple times a day for up to three weeks. Data (n = 62) were analyzed with multilevel models to determine how situational factors and trait social anxiety influence the Negative Affect (NA), Positive Affect (PA), and self-reported stuttering severity of AWS.

Results

Results indicated that having high (vs. low) trait social anxiety was associated with a tendency to experience high NA, low PA, and high self-reported stuttering severity among AWS. A range of situational factors significantly influenced the within-person variation of NA, PA, and self-reported stuttering severity in everyday life. In addition, interacting with distant social partners relative to being alone heightened NA, and the effect was more prominent among AWS with high (vs. low) trait social anxiety.

Conclusions

Overall, the findings suggest that the variation of affects and stuttering severity among AWS can be partly accounted for by factors from both the situational and personal levels. Clinicians should be aware of the low PA experienced by AWS who have high (vs low) trait social anxiety in everyday life.

Background

The Overall Assessment of the Speaker’s Experience of Stuttering for Adults (OASES-A; Yaruss & Quesal, 2016) is a widely used measurement tool designed to evaluate the adverse impact associated with stuttering. Items examine general perceptions of stuttering, personal reactions to stuttering, functional communication difficulties, and consequences for quality of life. This paper presents a shortened research version of the OASES-A response form (OASES-A-R) that can be used by researchers in scientific studies involving adults who stutter that reflect the Section and Total Scores of the original OASES-A using fewer items.

Method

Previously collected OASES-A data (N = 315) were analyzed via graded response modeling to identify discrimination values of each OASES-A item in measuring each OASES-A Section Total Score. Items with the highest discrimination and items judged by expert clinicians to be more important in measuring adverse impact (N = 27) were used to create a shortened OASES-A-R. The shortened OASES-A-R response form was then validated and compared to the full OASES-A response form in an independent sample (N = 156).

Results

The shortened 25-item OASES-A-R response form demonstrated very high and positive correlations with the full OASES-A response form. Similarly, each OASES-A-R Section demonstrated high internal reliability coefficients similar to those of the OASES-A.

Discussion

The resulting 25-item OASES-A-R response form provides a reflection of the speaker’s experience of stuttering as measured by the original 100-item OASES-A that is suitable for use in certain research studies of adults who stutter. Clinical use is not recommended, as the full OASES-A provides additional insights about a client’s experience of stuttering that are necessary for effective treatment planning and intervention.

Stuttering poses challenges to social, occupational, and educational aspects of life. Traditional behavioral therapies can be helpful but effects are often limited. Pharmaceutical treatments have been explored but there are no FDA-approved treatments for stuttering. Interest has grown in the potential use of classic psychedelics, including psilocybin and LSD, which have shown effectiveness in treating disorders with similar symptoms (e.g., anxiety, depression, PTSD). The potential effects of psychedelics on stuttering have not been explored. We conducted a preliminary investigation of self-identified stutterers who report their experiences taking classic psychedelics on the online messaging forum, Reddit. We qualitatively analyzed 114 publicly available posts, extracting meaningful units and assigning descriptor codes inductively. We then deductively organized responses into an established framework of psychedelics which includes behavioral, emotional, cognitive, belief-based, and social effects. These effects were subsequently grouped under organizing themes (positive, negative, neutral). Descriptive statistics revealed that the majority of users (74.0%) reported positive overall short-term effects particularly related to behavioral and emotional change (e.g., reduced stuttering and anxiety), but negative (9.6%), mixed (positive and negative; 4.8%), and neutral overall experiences (11.6%) were also reported. The results support the possibility that psychedelics may impact stuttering, but caution must be applied in their interpretation given the entirely uncontrolled research setting and potential adverse health effects of psychedelics as reported elsewhere. While these results do not encourage the use of psychedelics by stutterers, they suggest that future work could examine the impact of psychedelics on stuttering under supervised and in clinically controlled settings.

Introduction

Preschool-age children use mental state verbs (MSVs; e.g., think, know) to reference thoughts and other cognitive states. In play-based language, MSV use requires conversational flexibility, as speakers shift from discussion of actions happening in the here-and-now to more abstract discussion of mental states. Some evidence suggests that children who stutter (CWS) demonstrate subtle differences in shifting on experimental tasks of cognitive flexibility, differences which may extend to conversational flexibility. This study explored MSV use in conversational language between CWS and their mothers.

Methods

Thirty-five preschool-age CWS and 35 age- and gender-matched children who do not stutter (CWNS), all performing within the typical range on standardized language testing, conversed with their mothers during play. Samples were transcribed and coded for MSV use.

Results

No between-group differences were observed in MSV use, either between the CWS and CWNS or between the groups of mothers. Age and language skills were positively associated with MSV use in the CWNS group only. For both groups of dyads, mothers’ MSV use corresponded at least to some extent to their children’s language skills. Finally, correspondence between CWNS and their mothers was observed for two conversational language measures, representing lexical diversity and morphosyntax; this overall pattern was not observed in the CWS dyad group.

Conclusions

Although these findings point to similar use of MSVs among the groups of children and their mothers, for the CWS group, the patterns of use in relation to age and language skills are somewhat different from developmental expectations.

Background

For children older than 6 years who stutter, there is a gap in clinical research. This is an issue for speech-language pathologists because the tractability of stuttering decreases and the risk of long-term psychological consequences increase with age.

Purpose

To report a Phase II trial of a telehealth version of the Lidcombe Program with school-age children.

Methods

Participants were 37 children who stuttered, 6–12 years of age, from Australia, New Zealand, Hong Kong, and Singapore. Parents were trained by video telehealth how to deliver the Lidcombe Program to their child. Primary and secondary outcomes were stuttering severity and psychosocial functioning measured pre-treatment and at 6 months and 12 months after starting treatment. Parents submitted two 10-minute recordings of their child speaking in conversation, and three measures of anxiety, impact of stuttering, and communication attitude.

Results

Six months after starting treatment, seven children (18.9%) attained Lidcombe Program Stage 2 criteria, 25 children (67.6%) showed a partial response to treatment, and five children (13.5%) showed no response. By 12 months, 12 children (32.4%) had reached Stage 2 criteria. Psychosocial improvements were observed 6 and 12 months after starting treatment.

Conclusions

The Lidcombe Program may eliminate or nearly eliminate stuttering for about one third of children 6–12 years of age. Randomized controlled trials with this age group involving the Lidcombe Program are warranted. In the interim, the Lidcombe Program is a clinical option clinicians can implement with this age group to reduce stuttering and its psychosocial impacts.

Purpose

To document the trajectory of early childhood stuttering longitudinally for 14. years with a consideration on the features of overt and covert stuttering related to recovery status.

Method

Thirty-eight participants were observed longitudinally at three different time points: early childhood (Occasion 1), middle childhood (Occasion 2), and late adolescence (Occasion 3). Data collection involved speech samples and reports of stuttering experiences. Recovery on Occasion 3 was estimated through analysis of speech samples, parent and expert judgments, and self- judgement. Two categories of persistence were used: persistent-subjective (no observable stuttering) and persistent-objective (observable stuttering).

Results

The recovery rate was 65.6 %. The majority of the participants showed minimal disfluent speech with 88 % showing less than 1 % syllables stuttered and 97 % showing less than 3 % syllables stuttered in the collected speech samples. All participants classified as persistent reported covert symptoms of stuttering. No relapses in recovery were observed between Occasion 2 and Occasion 3. Late recovery was only observed for those classified as persistent-subjective on Occasion 2. About 64 % of the participants showing observable stuttering (persistent-objective) on Occasion 2 showed no observable stuttering (persistent-subjective) on Occasion 3.

Conclusions

Children continue to recover from early childhood stuttering as they age.The inclusion of self-reports adds to the understanding of recovery especially concerning the covert stuttering behaviours. The presence of overt symptoms of stuttering in the speech samples of children aged 7 to 13 years seems to be associated with the likelihood of late recovery of stuttering

Purpose

Our study aimed to translate the Stuttering Generalization Self-Measure (SGSM) into Persian and investigate its validity, reliability, and internal responsiveness in the Iranian population.

Method

This study was conducted on 30 adults who stutter (AWS) and 30 adults who do not stutter (AWNS). The International Quality of Life Assessment protocol (IQOLA) was applied to translate SGSM into Persian. The face and content validity were determined. Also, the discriminant validity was evaluated by comparing the scores of two groups. In addition, the internal consistency test-retest, and inter-judge reliability were assessed with Cronbach’s alpha and intra-class correlation coefficients (ICC). Moreover, the mean standardized response (MSR) and the standardized effect size were measured to determine the internal responsiveness using pre- and post-treatment data.

Results

All the items were comprehensible and clear. The content validity ratio (CVR) and content validity index (CVI) for all nine questions were obtained higher than.62 and.9, respectively. The internal consistency value was high (Cronbach’s alpha =.98). For the test-retest reliability, ICC values were excellent, ranging from.93 to.99. The discriminant validity results revealed a significant difference between AWS and AWNS (p < .001). Pre- and post-treatment results indicated high internal responsiveness to changes for percentage of syllable stuttered (SS%) (MSR = 1.09).

Conclusion

The Persian version of SGSM (P-SGSM) benefits from the high values for validity and reliability. Furthermore, it distinguishes the AWS and AWNS and reflects the treatment changes significantly.

A clinical, evidence-based model to inform clients and their parents about the nature of stuttering is indispensable for the field. In this paper, we propose the Erasmus Clinical Model of Stuttering 2.0 for children who stutter and their parents, and adult clients. It provides an up-to-date, clinical model summary of current insights into the genetic, neurological, motoric, linguistic, sensory, temperamental, psychological and social factors (be it causal, eliciting, or maintaining) related to stuttering. First a review is presented of current insights in these factors, and of six scientific theories or models that have inspired the development of our current clinical model. Following this, we will propose the model, which has proven to be useful in clinical practice. The proposed Erasmus Clinical Model of Stuttering visualizes the onset and course of stuttering, and includes scales for stuttering severity and impact, to be completed by the (parent of) the person who stutters. The pathway of the model towards stuttering onset is based on predisposing and mediating factors. In most children with an onset of stuttering, stuttering is transient, but if stuttering continues, its severity and impact vary widely. The model includes the circle of Engel (1977), which visualizes unique interactions of relevant biological, psychological, and social factors that determine the speaker’s experience of stuttering severity and its impact. Discussing these factors and their interaction with an individual client can feed into therapeutic targets. The model is supplemented by a lifeline casus.

Purpose

This study aimed to identify what types of major discrimination have been experienced by adults who stutter throughout their lives, and investigate the association between the number of different types of major discrimination events experienced and quality of life.

Methods

Measures of quality of life (Kemp Quality of Life Scale) and major discrimination (adapted Major Experiences of Discrimination Scale) were completed by 303 adults who stutter. Correlational and regression analyses were conducted with these variables.

Results

A majority (56%) of the participants had experienced at least one episode of major discrimination due to stuttering during their lives. The major discrimination experiences most commonly reported included not being hired for a job and being discouraged by a teacher or advisor from pursuing certain careers or jobs because of stuttering. There was a significant negative relationship between quality of life and major discrimination. Increased major discrimination predicted lower quality of life even after taking into account demographic variables and severity of physical speech disruption.

Conclusions

The findings of a negative association between major discrimination and quality of life add support to the notion that reducing societal stigma related to stuttering should be a priority of the field. Discriminatory practices of listeners constitute a social-environmental barrier to communicative participation and quality of life in people who stutter and should be addressed by professionals in the field of speech-language pathology and other stakeholders.

Background

Differences in core auditory processing abilities, such as sound timing, frequency discrimination, auditory perception, and auditory memory, have been suggested in stutterers, despite the fact that the precise origin of stuttering is not entirely understood. It is suggested that these differences may play a role in the development of stuttering. The aim of our study is to assess the temporal central auditory processing performance in individuals with stuttering and compare it to individuals without stuttering to uncover potential differences stuttering and compare it to individuals without stuttering to reveal potential differences.

Method

In current study, a total of 60 right-handed participants between the ages of 8 and 17 were included, divided into two balanced groups based on age, education, and gender: individuals with stuttering (n = 30) and individuals without stuttering (n = 30). All participants underwent the Frequency Pattern Test, Duration Pattern Test, and Gaps-In-Noise test.

Results

Individuals who stutter showed lower performance in the gap detection threshold and the percentage of total correct gap identification parameters of the Frequency Pattern Test, Duration Pattern Test, and Gaps-In-Noise test compared to fluent speakers.

Conclusions

The findings indicate a potential relationship between stuttering and central auditory processing. In this context, incorporating central auditory processing measures into the assessment and therapy processes for stuttering may enhance the likelihood of obtaining more accurate results.