Developing physiologic stress profiles for school-age children who stutter

Purpose

Physiologic reactivity profiles were generated for 9 school-age children with a history of stuttering. Utilizing salivary sampling, stress biomarkers cortisol and alpha-amylase were measured in response to normal daily stressors. Children with a history of stuttering were characterized as high or low autonomic reactors when compared to age-normed references established for cortisol and alpha-amylase levels.

Method

Salivary samples were collected four times daily over three consecutive days from children (6 boys and 3 girls) aged 6–11 years. Samples were measured for two important stress biomarkers, cortisol and alpha-amylase. Following laboratory training on appropriate sampling technique using the Salivette, families collected all samples in their homes.

Results

Compared to published references established for normal children, children with a history of stuttering exhibited mean cortisol and alpha-amylase levels that were significantly lower, though within normal limits.

Conclusions

Results reflect an initial investigation into the use of salivary sampling to measure reactivity in children who stutter. As children who stutter have historically been excluded from physiologic stress studies, salivary sampling appears to provide an innovative and minimally invasive option for investigators. Though interpreted with caution secondary to the small sample size, initial findings suggest that in response to normal daily stressors, school-age children with a history of stuttering do not exhibit significantly elevated stress biomarkers.Educational objectives: The reader will be able to: (1) identify two biomarkers that reflect activation of the body's stress response; (2) discuss possible implications the generation of individualized stress profiles may have on the treatment of stuttering; and (3) discuss and evaluate the research needs associated with the inclusion of children in physiological studies of fluency.     

The effect of filled pauses on the processing of the surface form and the establishment of causal connections during the comprehension of spoken expository discourse

The purpose of this study was to examine the effect of filled pauses (uh) on the verification of words and the establishment of causal connections during the comprehension of spoken expository discourse. With this aim, we asked Spanish-speaking students to listen to excerpts of interviews with writers, and to perform a word-verification task and a question-answering task on causal connectivity. There were two versions of the excerpts: filled pause present and filled pause absent. Results indicated that filled pauses increased verification times for words that preceded them, but did not make a difference on response times to questions on causal connectivity. The results suggest that, as signals of delay, filled pauses create a break with surface information, but they do not have the same effect on the establishment of meaningful connections.     

Acoustic correlates of subjective pauses

This study investigates the perception of subjective pauses, i.e., pauses that do not correspond to silent pauses. Experiment I used stimuli which were excerpts from spontaneous speech which were presented in two versions: spectrally normal and spectrally inverted. Experiment II used stimuli which were generated by first cross-splicing the two halves of two sentences; they were further manipulated for fundamental frequency, intensity, or duration of the vowel just preceding the splice point. The task in both experiments was to press a button when a speech interruption was heard. The purpose of the experiments was to identify the grammatical and acoustic correlates of the subjective pauses thus reported. The results of Experiment I show, for the inverted speech condition, but not for the normal speech condition, an increase in pause reports as the duration of the prepausal vowel increased. The results of Experiment II show an increase in pause reports with increasing vowel duration. The implications of increased prepausal duration functioning as a pause signal are discussed.     

Speech sound articulation abilities of preschool-age children who stutter

Purpose

The purpose of this study was to assess the association between speech sound articulation and childhood stuttering in a relatively large sample of preschool-age children who do and do not stutter, using the Goldman–Fristoe Test of Articulation-2 (GFTA-2; Goldman & Fristoe, 2000).

Method

Participants included 277 preschool-age children who do (CWS; n = 128, 101 males) and do not stutter (CWNS; n = 149, 76 males). Generalized estimating equations (GEE) were performed to assess between-group (CWS versus CWNS) differences on the GFTA-2. Additionally, within-group correlations were performed to explore the relation between CWS’ speech sound articulation abilities and their stuttering frequency and severity, as well as their sound prolongation index (SPI; Schwartz & Conture, 1988).

Results

No significant differences were found between the articulation scores of preschool-age CWS and CWNS. However, there was a small gender effect for the 5-year-old age group, with girls generally exhibiting better articulation scores than boys. Additional findings indicated no relation between CWS’ speech sound articulation abilities and their stuttering frequency, severity, or SPI.

Conclusions

Findings suggest no apparent association between speech sound articulation—as measured by one standardized assessment (GFTA-2)—and childhood stuttering for this sample of preschool-age children (N = 277).Educational objectives: After reading this article, the reader will be able to: (1) discuss salient issues in the articulation literature relative to children who stutter; (2) compare/contrast the present study's methodologies and main findings to those of previous studies that investigated the association between childhood stuttering and speech sound articulation; (3) identify future research needs relative to the association between childhood stuttering and speech sound development; (4) replicate the present study's methodology to expand this body of knowledge.     

Emotional reactivity and regulation in preschool-age children who stutter

Purpose.

This study experimentally investigated behavioral correlates of emotional reactivity and emotion regulation and their relation to speech (dis)fluency in preschool-age children who do (CWS) and do not (CWNS) stutter during emotion-eliciting conditions.

Method.

Participants (18 CWS, 14 boys; 18 CWNS, 14 boys) completed two experimental tasks (1) a neutral (“apples and leaves in a transparent box,” ALTB) and (2) a frustrating (“attractive toy in a transparent box,” ATTB) task, both of which were followed by a narrative task. Dependent measures were emotional reactivity (positive affect, negative affect), emotion regulation (self-speech, distraction) exhibited during the ALTB and the ATTB tasks, percentage of stuttered disfluencies (SDs) and percentage of non-stuttered disfluencies (NSDs) produced during the narratives.

Results.

Results indicated that preschool-age CWS exhibited significantly more negative emotion and more self-speech than preschool-age CWNS. For CWS only, emotion regulation behaviors (i.e., distraction, self-speech) during the experimental tasks were predictive of stuttered disfluencies during the subsequent narrative tasks. Furthermore, for CWS there was no relation between emotional processes and non-stuttered disfluencies, but CWNS's negative affect was significantly related to nonstuttered disfluencies.

Conclusions.

In general, present findings support the notion that emotional processes are associated with childhood stuttering. Specifically, findings are consistent with the notion that preschool-age CWS are more emotionally reactive than CWNS and that their self-speech regulatory attempts may be less than effective in modulating their emotions.Educational objectives. The reader will be able to: (a) communicate the relevance of studying the role of emotion in developmental stuttering close to the onset of stuttering and (b) describe the main findings of the present study in relation to previous studies that have used different methodologies to investigate the role of emotion in developmental stuttering of young children who stutter.     

Vocal congruence in mother-infant play

Turn-taking is the fundamental temporal structure of adult dialogue. This structure defines two types of joint silence: intrapersonal pause (silence bounded by the vocalizations of a single speaker) and switching pause (silence bounded by the vocalizations of different speakers). Switching pauses mark the boundaries of the turn exchange. In adult conversation the mean durations of both types of pause are characteristically matched between partners. This matching, termed vocal congruence, occurs developmentally earlier in the case of switching pauses. We hypothesized and confirmed that mothers and infants match switching pauses but not intrapersonal pauses at 4 months, even though the infants' vocalizations are prelinguistic. Second, since there are known affective correlates of vocal congruence in adult conversation, we hypothesized a similar affective correlate for mother-infant vocal congruence. We found, for the intrapersonal pause only, that the degree of matching within a dyad correlated with infant affective engagement. We conclude, from switching pause congruence, that a turntaking dialogic structure is being regulated in the mother-infant pair at 4 months in the same way as seen in adult conversation. Thus, both the temporal structure of adult dialogue and its affective correlate are prelinguistic.Supported in part by NIMH grant No. 41675.     

Testing orofacial abilities of children who stutter: the Movement, Articulation, Mandibular and Sensory awareness (MAMS) assessment procedure

Objective

The purpose of this article is to introduce a new assessment designed to measure the orofacial abilities of children who stutter (CWS), the Movement, Articulation, Mandibular and Sensory Awareness (MAMS) Orofacial Assessment. The new instrument was developed and validated to measure orofacial abilities in a comprehensive manner.

Design

A group of 43 CWS (mean age 13.10 years, S.D. 2.10 years) and a control group of 32 fluent children (mean age 13.4 years, S.D. 2.6 years) were tested with the new tool. It was hypothesized, that (a) the MAMS is a reliable and valid instrument to measure orofacial abilities in CWS, (b) fluent children have better orofacial abilities than CWS and (c) that the therapy outcome of CWS depend on their orofacial abilities.

Results

The MAMS Orofacial Assessment proved to be a valid and reliable instrument to assess orofacial abilities. Compared with their fluent peers, CWS had significantly worse orofacial abilities. CWS with better orofacial abilities had a better prognosis for therapy outcome.

Conclusions

The new instrument is a reliable and valid tool to measure orofacial abilities and MAMS distinguishes CWS and controls. Orofacial abilities are one set of factors that influence therapy outcome for CWS.Educational objectives: The reader will get an overview over of the literature on orofacial abilities in people who stutter and will learn about and be able to (1) describe different characteristics of orofacial abilities, (2) use the MAMS Orofacial Assessment in the diagnostic process for CWS and for research purposes, and (3) interpret the results of the MAMS to use them for therapy planning.     

The long and short of it: Reports of pause occurrence and duration in speech

Native speakers of American English and of German listened to a passage several minutes in duration in each language and reported occurrence and duration of pauses. Subjects overestimated occurrence (false positives) and understimated duration. Overall analyses of variance indicated that Germans reported a higher percentage of pauses than Americans; that a higher percentage of pauses was reported in native than in nonnative passages; that Americans reported a higher percentage of pauses in English passages, whereas Germans' percentages were the same in both languages; that American women reported more false positives than American men, whereas German men reported more than German women; and that Americans and Germans both reported more false positives in English than in German. Detailed analyses of the individual passages yielded reliable differences between Germans and Americans in their reports of pauses in three duration brackets: .3;,<1.0;1.0 sec. Pause reports of this kind diverge from objectively measured pause data as a function of a number of independent variables and are therefore not to be trusted as objective estimates of either pause occurrence or pause duration.     

The use of English stress assignment rules by children taught either with traditional orthography or with the initial teaching alphabet

This experiment examines children's use of spelling conventions as a guide to pronunciation, and their ability to handle stress assignment rules. The subjects, 7-year-old school children, of whom half had learned to read and write using traditional orthography (t.o.) and half had learned using the initial teaching alphabet (i.t.a.), read out short simple sentences each containing a two-syllable nonsense word. The grammatical category and the spelling of the nonsense words were varied systematically. It was found that, in assigning stress, both groups of children were influenced by phonemic and grammatical features in a manner similar to that predicted by Chomsky and Halle (1968), but they differed in their handling of the silent final e. It was the i.t.a. children whose use of this orthographic device was more in accordance with Chomsky and Halle's theory, despite their relative lack of experience with it. A comparison with Smith and Baker's (1976) adult subjects indicated substantial differences between adults and children, particularly in their treatment of words with a lax final vowel.     

Changing adolescent attitudes toward stuttering

Purpose

Live oral or recorded video presentations on stuttering were delivered to high school students in order to determine the extent to which their attitudes toward stuttering could be improved.

Methods

A classroom teacher administered the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) to two health classes before and after an oral live presentation by a person who stutters. She also gave the POSHA-S to two other similar classes before and after a True Life^®: I Stutter video presentation. The stuttering person in the oral condition was one of three people featured in the video. Also, following the video condition, students filled out the POSHA-S a third time after a short oral presentation by the same person who stutters.

Results

Measured attitudes improved overall on the POSHA-S and on selected items.

Conclusions

High school students hold similar attitudes toward stuttering and stutterers as adults, and these attitudes can be improved, at least temporarily, by a presentation on stuttering but more via a live presentation than a professionally prepared video.Educational objectives: (1) The reader will identify different ways to improve attitudes toward stuttering in high school students. (2) The reader will list advantages and disadvantages of live oral presentations and recorded video presentations as strategies to change attitudes toward stuttering. (3) The reader will identify characteristics of a speaker that can assist in attitude changes of high school students.     

Semantic priming in French children with varying comprehension skills

Semantic priming was analysed in two groups of French children contrasted on comprehension skills with a visual lexical-decision task using a long SOA (800 ms). Two relation types between related primes and targets were examined: pure semantic relation (categorical vs. functional), and lexical association strength (strong vs. weak). Targets were preceded by related, unrelated, and neutral primes. Skilled comprehenders showed semantic priming only for category-related words, whatever their association strength, and without any evidence of an associative boost. Less-skilled comprehenders also showed semantic priming for category-related words, irrespective of their association strength, but with an indication of an associative boost. They also displayed semantic priming for function-related awords that are strongly associated, but not for those that are weakly associated. These results are discussed within the theoretical frame proposed by Plaut and Booth (2000 Plaut, D. C. and Booth, J. R. 2000. Individual and developmental differences in semantic priming: Empirical and computational support for a single-mechanism account of lexical processing. Psychological Review, 4: 786–823.  [Google Scholar]).     

Contrasting Grammatical and Lexical Determiners

This paper investigates the difference between the production of grammatical determiners and lexical determiners in the production of adjective-noun phrases (NPs) in Danish. Models of sentence processing (Garrett in Psychology of learning and motivation, Academic press, New York, pp 133–177, 1975; Bock in J Mem Lang 26(2):119–137, 1987) suggest that the phonological encoding stage of grammatical items can only be specified once lexical items have been phonologically encoded. In their usage-based linguistic theory of the grammar-lexicon distinction, Boye and Harder (Lang 88(1):1–44, 2012) propose that this later encoding of grammatical elements is motivated by two specific features of grammatical elements. The first feature, dependence, is that grammatical items (morphemes, words, constructions) cannot be produced in isolation, but are always dependent on a lexical host item. This feature entails a more complex processing which might lead to longer reaction times when comparing the production of NPs with a grammatical determiner to a lexical one. Additionally, a more complex processing might lead to a lower accuracy rate for the grammatical condition relative to the lexical one. The second feature, low prominence, is that grammatical items code background information and therefore cannot convey the main point of a linguistic message. Less focus on grammatical elements might lead to a lower accuracy rate for the production of grammatical elements relative to lexical ones. Those predictions were tested in a task comparing the production of Danish grammatical determiners (indefinite articles) with the production of lexical ones (numerals, which are homonymous with the articles except for a stress difference) in similar contexts. Group-based analyses were performed in order to take inter-individual differences into account. The results show that the two features as proposed by Boye and Harder (2012) are only revealed for the fastest speakers group but not the slower ones.     

The developmental activities engaged in by elite youth soccer players who progressed to professional status compared to those who did not

Objectives

We examined differences in the development pathways of elite youth soccer players in England who progressed to professional status in adulthood compared to those who did not.

Design

Comparative research design.

Method

Participants were elite youth soccer players (n = 32, 15 years of age). They completed the Participation History Questionnaire (PHQ; Ford, Low, McRobert, & Williams, 2010) under supervision.

Results

The participation history profiles of professional players followed the early engagement pathway in which they engaged in significantly more soccer play and practice compared to elite youth players who did not become professional, supporting previous work (e.g., Ford, Ward, Hodges, & Williams, 2009). The two groups of players engaged in four other sports, suggesting greater diversification than previously reported for soccer players, but less than that found in studies of team sport athletes in Australia and North America.

Conclusions

Professional soccer players in England follow an early engagement pathway during childhood and early adolescence.     

Recurrent involuntary imagery in people who stutter and people who do not stutter

Objective

To compare intrusive memories in groups of people who do (PWS), and who do not (PWNS), stutter.

Method

Twenty-one participants who stuttered and 21 matched controls were given a semi-structured interview which explored imagery in speaking situations. The data were analyzed using a Content Analysis approach. Other outcome measures were the Beck Anxiety Inventory, the Beck Depression Inventory, the Post Traumatic Stress Disorder, PTSD, Symptom Scale: Self-Report Version.

Results

Significantly more stuttering participants than control participants indicated both recurrent imagery and associated memories. Content Analysis revealed themes of disfluency, anxiety, negative social evaluation, self-focus and pressure to speak that were common to both groups’ reports. Additional themes of helplessness, shame, sadness and frustration were found only in the images and memories of the stuttering group. No group differences were evident for the number of sensory modalities involved in images and memories, or for ratings of their vividness or strength of associated emotions, or on self-reports of depression, anxiety and trauma.

Conclusions

Recurrent imagery about events in childhood is a potent factor in the memories of PWS. It is worth modifying interventions that have been successfully applied for treating social anxiety for use with people who stutter.Educational objectives: After reading this article, participants will be able to: (a) identify the role of intrusive memories in psychiatric disorders and stuttering; (b) investigate how DSM criteria can be employed with people who stutter; (c) employ anxiety instruments used for assessing psychiatric disorders for stuttering; (d) distinguish between the intrusive memories experienced by people who stutter, and people who do not stutter; (e) apply treatments for intrusive memories in psychiatric disorders to work with people who stutter.     

Time processing in children with Tourette’s syndrome

Background

Tourette syndrome (TS) is characterized by dysfunctional connectivity between prefrontal cortex and sub-cortical structures, and altered meso-cortical and/or meso-striatal dopamine release. Since time processing is also regulated by fronto-striatal circuits and modulated by dopaminergic transmission, we hypothesized that time processing is abnormal in TS.

Methods

We compared time processing abilities between nine children with TS-only (i.e. without major psychiatric comorbidities) and 10 age-matched healthy children, employing a time reproduction task in which subjects actively reproduce different temporal intervals, and a time comparison task in which subjects judge whether a test interval is longer or shorter than a reference interval. IQ, sustained and divided attention, and working memory were assessed in both groups using the Leiter International Performance Scale-Revised, and the Digit Span sub-test of the WISC-R.

Results

Children with TS-only reproduced in an overestimated fashion over-second, but not sub-second, time intervals. The precision of over-second intervals reproduction correlated with tic severity, in that the lower the tic severity, the closer the reproduction of over-second time intervals to their real duration. Time reproduction performance did not significantly correlate with IQ, attention and working memory measures in both groups. No differences between groups were documented in the time comparison task.

Conclusions

The improvement of time processing in children with TS-only seems specific for the over-second range of intervals, consistent with an enhancement in the ‘cognitively controlled’ timing system, which mainly processes longer duration intervals, and depends upon dysfunctional connectivity between the basal ganglia and the dorso-lateral prefrontal cortex. The absence of between-group differences on time comparison, moreover, suggests that TS patients manifest a selective improvement of ‘motor’ timing abilities, rather than of perceptual time abilities. Our data also support an enhancement of cognitive control processes in TS children, probably facilitated by effortful tic suppression.     

Language and syntactic impairment following stroke in late bilingual aphasics

Purpose

Bilingual aphasia generally affects both languages. However, the age of acquisition of the second language (L2) seems to play a role in the anatomo-functional correlation of the syntactical/grammatical processes, thus potentially influencing the L2 syntactic impairment following a stroke. The present study aims to analyze the influence of late age of acquisition of the L2 on syntactic impairment in bilingual aphasic patients.

Methods

Twelve late bilingual participants (speaking French as L2 and either English, German, Italian or Spanish as L1) with stroke-induced aphasia participated in the study. The MAST or BAT aphasia batteries were used to evaluate overall aphasia score. An auditory syntactic judgement task was developed and used to test participants syntactic performance.

Results

The overall aphasia scores did not differ between L1 and L2. In a multiple case analysis, only one patient had lower scores in L2. However, four patients presented significantly lower performances in syntactic processing in the late L2 than in their native language (L1). In these four patients the infarct was localized, either exclusively or at least partially, in the pre-rolandic region.

Conclusion

This pilot study suggests that, in late bilingual aphasics, syntactic judgment abilities may be more severely impaired in L2, and that this syntactic deficit is most likely to occur following anterior lesions.     

Comprehension of two types of negative comparisons in children

English-speaking and Italian-speaking children between the ages of 6 years 8 months and 9 years 10 months were asked to solve instructional relation problems (i.e., to complete a picture on the basis of a sentence). Sentences contained either marked or unmarked adjectival forms in one of three types of comparative construction:positive comparative (e.g., bigger più grande),negative-equative constructions as explicit negative forms (e.g., not as big as, non è grande come), orcomparative-with-less constructions e.g., less big, meno grande) as implicit negative forms. Subjects had to focus on either the grammatical subject or the grammatical object of a sentence to complete, the picture. Three findings were consistent with predictions derived by considering syntactic and pragmatic differences between explicit and implicit types of negative comparisons. First, comprehension depended on the type of comparative construction, with the poorest comprehension for the implicit comparative-with-less construction. Second, the effect of the marked adjective depended on the type of comparison. Third, in all three types of comparison, accuracy was greater when the question was focused on the grammatical subject instead of the grammatical object.     

Loss of control eating and psychological maintenance in children: An ecological momentary assessment study

Objective

Recent research suggests that binge eating is a common experience in youth. However, it remains largely unknown how children's binge eating presents in everyday life and which psychological factors serve to maintain this binge eating.

Methods

Children aged 8-13 years with binge eating (n = 59), defined as at least one episode of loss of control (LOC) over eating within the past three months, and 59 matched children without LOC history were recruited from the community. Following a combined random- and event-sampling protocol, children were interviewed about their day-to-day eating behavior, mood, and eating disorder-specific cognitions using child-specific cell phones during a 4-day assessment period in their natural environment.

Results

LOC episodes led to a significantly greater intake of energy, particularly from carbohydrates, than regular meals of children with and without LOC eating. While LOC episodes were preceded and followed by cognitions about food/eating and body image, there was minimal evidence that negative mood states were antecedents of LOC eating.

Conclusions

The results provide support for the construct validity of LOC eating in children. Maintenance theories of binge eating for adults apply to children regarding eating disorder-specific cognitions, but the association with affect regulation difficulties requires further investigation.     

Generalizability of WISC-IV index and subtest score profiles in children with traumatic brain injury

The Wechsler Intelligence Scale for Children, 4th edition (WISC-IV) is often used to assess children with traumatic brain injury (TBI); although limited information is available regarding its psychometric properties in these children. Two recent reports suggest that the Perceptual Reasoning Index is not uniquely sensitive to TBI, which differs from the Perceptual Organization Index of the WISC-III. The current study examined WISC-IV profiles in two independently gathered samples of children with TBI. Examination of profiles indicated similarities between the current findings and those reported in other studies, in that the greatest deficits were present on the Processing Speed Index and its component subtests of Coding and Symbol Search, while the Perceptual Reasoning index score was comparable to the Verbal Comprehension Index. Also, no significant index or subtest score differences were present when the current sample was compared to the children with TBI reported by Allen, Thaler, Donohue and Mayfield (2010 Allen, D. N., Thaler, N. S., Donohue, B. and Mayfield, J. 2010. WISC-IV profiles in children with traumatic brain injury: Similarities to and differences from the WISC-III. Psychological Assessment, 22(1): 57–64. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). The present findings are consistent with two prior studies of the WISC-IV in children with TBI, providing additional evidence for profile differences between the WISC-III and WISC-IV. The results also suggest that WISC-IV profiles reported in prior studies are generalizable across TBI samples and study sites.     

A study of timing in a manual and a spoken language: American sign language and English

A comparative analysis of the time variables in the production of speech and sign reveals that signers modify their global physical rate primarily by altering the time they spend articulating, whereas speakers do so by changing the time they spend pausing. When signers increase or decrease their pause time, however little they do so, they alter the number and the length of the pauses equally, whereas speakers primarily alter the number of pauses and leave their pause durations relatively constant. An analysis of the durations of signs reveals that signs are longer at the end of sentences than within sentences and that the first occurrence of a sign is longer than the second when syntactic location is controlled (both these findings have already been reported for spoken language). The inherent duration of a sign can be accounted for almost totally by the movement characteristic; handshape, location, and number of hands in a sign are of little importance. Finally, signers retain their regular quiet-breathing respiratory pattern across signing rates and inhale at locations independent of syntactic importance. In this they are quite unlike speakers, who breathe at syntactic breaks.This research was supported in part by Grant R03 MH 28133, Department of Health, Education, and Welfare.