Acquired stuttering as a forerunner of motor-neuron disease

A case of acquired stuttering that included repetitions, blocks, prolongations, fillers, and, later on, also synkinesias is reported. This stutter turned out to be the forerunner of a motor-neuron disease.     

Acquired stuttering following right frontal and bilateral pontine lesion: a case study

We report neurological information and experimental data regarding acquired neurogenic stuttering in a 57-year-old male following ischemic lesion to the orbital surface of the right frontal lobe and the pons. The experimental data consist of stuttering frequency measures under various conditions that are well known to enhance fluency in most individuals with developmental stuttering. Specifically, we report data for adaptation, unison reading, delayed auditory feedback (DAF), and frequency altered feedback (FAF). This work is the first published report of such a comprehensive examination of a variety of fluency-enhancing conditions in acquired stuttering. The patient read six 200-word texts under different conditions: Six solo readings (Text 1), five unison readings followed by five solo readings (Text 2), five readings with non-altered auditory feedback (Text 3), five readings with 50 ms delayed auditory feedback (Text 4), five readings with increased FAF (Text 5), and five readings with decreased FAF (Text 6). Results indicate that, unlike the typical situation for developmental stuttering, this individual with acquired neurogenic stuttering did not show increased fluency during an adaptation paradigm or under unison, DAF, and FAF conditions. We discuss possible implications of these findings and emphasize the need for further research on acquired neurogenic stuttering.     

Horn stuttering

This is a case report on an adult male stutterer who also exhibited stuttering-like behavior while playing the French horn. The effects of speech fluency targets on the playing and the physiological and psychological correlates between the stutter in speech and the “stuttering-like” behaviors when playing an instrument are discussed. Etiological implications are considered.     

Flute stuttering

A case is reported of a stutterer who exhibited stuttering-like behavior while playing the flute in a highly competitive school orchestra. Theoretical implications are discussed.     

Rethinking covert stuttering

PurposeThe experience of passing as fluent, also called covert stuttering, has been uncritically framed as an inherently negative pursuit. Historically passing has been understood as a repression of one’s true, authentic self in response to either psychological distress or social discrimination. The authors of this paper seek a more nuanced understanding of passing. We ask, how must a person relate to herself in order to pass as fluent?MethodologyThis is a qualitative research study in which the authors utilized the ethical theories of philosopher Michel Foucault to contextualize data obtained from semi-structured interviews with nine participants who pass as fluent.ResultsRather than a repression of an authentic self our data suggests passing is more usefully understood as a form of resistance by people who stutter to a hostile society. Participants learned from experiences of delegitimization that their stuttering had ethical ramifications. Consequently, they used a variety of self-forming practices to pass and thereby achieve the privileges that come with perceived able-bodiedness.ConclusionPassing as fluent is not an inauthentic form of stuttering but a form of stuttering that is produced through the use of specific technologies of communication. These technologies of communication are constituted by the unique ethical relationship of the person who stutters with herself. Passing can be understood as an active form of resistance rather than a passive form of repression. By theorizing passing as fluent as an ethical relationship, we open up the possibility of changing the relationship and performing it differently.     

Tokens for stuttering

Four young stutterers were observed during 10 weekly sessions. Each session was divided into pretreatment, treatment, and posttreatment segments. Redeemable tokens were administered contingent upon stuttering behaviors in the treatment segment of the Experimental condition. In a Parallel Control condition, no tokens were administered during the entire session. The differences between the pretreatment and treatment segments were compared for the two conditions. Three subjects had dramatically fewer stuttering behaviors when tokens were being administered, while the fourth had more stuttering under the same condition. The subject whose stuttering increased had a history of therapy in which voluntary, “faked” stuttering had been called for, and the behaviors that increased were judged to be of this type. The decreases were interpreted as suggesting that the contingent tokens acted to countercondition the aversiveness of the stuttering experience, which reduced the anticipation of stuttering and hence the stuttering itself. The increase was felt to be simple reinforcement. The counterconditioning interpretation was borne out in two clinical applications in which money was presented contingent on stuttering behaviors judged to be aversive to the stutterer, and in which dramatically sudden, but long-lasting, improvement was seen.     

Stroke-associated acquired stuttering

In this case report, the syndrome of acquired stuttering is described including its etiology, common presenting features, and differences from developmental stuttering. A case is described in an elderly female patient with sudden acquired stuttering associated with ischemic infarct near the left basal ganglia.     

Teacher attitudes toward stuttering

Attitudes of 100 elementary school teachers toward stuttering were studied using the Teacher Attitudes Toward Stuttering (TATS) Inventory. Teacher attitudes, as indicated by TATS Inventory scores, were compared with teacher knowledge of stuttering, age of teacher, number of years teaching experience, educational level, and whether the teacher had personal experience with a stutterer. Results indicated that significant positive correlations existed between teacher attitudes toward and knowledge of stuttering. Significant negative correlations were demonstrated between teacher attitudes/knowledge of stuttering and the presence of a stuttering child in the classroom. The applicability of the TATS Inventory as a clinical instrument in its current form and the research needed to enhance its flexibility are discussed.     

Controversies about stuttering therapy

Current controversies with respect to (1) the need to attend to the feelings and attitudes of stutterers; (2) the teaching of controlled stuttering as opposed to shaping fluency; (3) criteria for determining successful therapy; (4) the problem of relapse; and (5) therapy for the young stutterer are briefly discussed. It is noted that while there may be many controversies in the area of stuttering therapy, the author presently believes that the issue of whether or not to attent to the feelings and attitudes of stutterers is the most important and that the proliferation on the market of exclusively behavior-oriented therapy programs may be fostering the training of technicians without the skills necessary to assist others in identifying and handling feelings and attitudes.     

The epigenesis of stuttering

This paper examines the data on which the Demands and Capacities Model (DCM) is based with the purpose of identifying areas where future research might determine consilience among genetic influences at the physiological, behavioral, and cultural levels. The determination of consilience across different levels would tend to validate the genetic influence on stuttering, but more importantly it would also sharpen the focus of researchers interested in the various possible expressions that genetic influences might have and the way in which they influence the development of the disorder.

Educational objectives: The reader will (1) learn about the distinction, as outlined in the DCM, between environmental/contextual influences on stuttering development and intrinsic/genetic influences on stuttering development; (2) learn about the concept of consilience and its usefulness in conferring validity on parallel constructs at the physiological, behavioral, and cultural levels of stuttering theory; and (3) be able to identify potential areas for research that might help in refining our understanding of the genetic influences on stuttering development.     

Evidence-based treatment of stuttering: II. Clinical significance of behavioral stuttering treatments

An evidence-based framework can be described as an empirically-driven, measurement-based, client-sensitive approach for selecting treatments. It is believed that using such a framework is more likely to result in a clinically significant outcome. For this paper, a clinically significant outcome was defined as a meaningful treatment change. It was suggested that there are at least three groups for whom a treatment's outcome is meaningful. These groups include clinicians/clinical researchers, the clients, and relevant others who have some interest in the outcome (e.g., parents of a child who stutters). The meaning and measurement of clinical significance was discussed for each of these three groups, based on research from the behavioral stuttering treatment literature. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to (1) broadly define a clinically significant outcome and identify some of the groups who are interested in such an outcome and (2) describe how clinical significance has been evaluated in stuttering treatment within an evidence-based framework.     

Voluntary stuttering suppresses true stuttering: a window on the speech perception-production link

In accord with a proposed innate link between speech perception and production (e.g., motor theory), this study provides compelling evidence for the inhibition of stuttering events in people who stutter prior to the initiation of the intended speech act, via both the perception and the production of speech gestures. Stuttering frequency during reading was reduced in 10 adults who stutter by approximately 40% in three of four experimental conditions: (1) following passive audiovisual presentation (i.e., viewing and hearing) of another person producing pseudostuttering (stutter-like syllabic repetitions) and following active shadowing of both (2) pseudostuttered and (3) fluent speech. Stuttering was not inhibited during reading following passive audiovisual presentation of fluent speech. Syllabic repetitions can inhibit stuttering both when produced and when perceived, and we suggest that these elementary stuttering forms may serve as compensatory speech gestures for releasing involuntary stuttering blocks by engaging mirror neuronal systems that are predisposed for fluent gestural imitation.     

Early position and stuttering occurrence

Early sentence position is one of several features of verbal expression frequently reported to be associated with stuttering occurrence. Some studies also have reported the concurrence of these features with normal disfluencies. A review of the pertinent literature reveals that, among these features, early position is associated significantly more often with stuttering than with normal dysfluencies. Results of a study investigating stress patterns in the fluent utterances of stuttering and normal speakers yielded contrasts which speak pointedly to the relationship between early position and stuttering occurrence.