Communicating in the real world: accounts from people who stammer

This qualitative study used in-depth interviews to explore the communicative experiences and coping strategies of 14 adults who stammer. Their accounts revealed that those participants with persistent developmental dysfluency felt that stammering had limited their lives especially in the areas of employment, education and self-esteem. All participants shared key styles of communicative management with avoidance and confrontation developing during childhood. The participants who had undertaken therapy during adulthood, relied upon a range of speech management techniques including self-evolved and therapeutic strategies. Many of the strategies regularly used by the respondents contributed to the limiting experience of stammering. This study highlights the experience of stammering on the individual, discusses the variety of strategies used to manage dysfluency and indicates the complexities of day-to-day communication. These findings are discussed in relation to speech and language therapy for adults who stammer.

Educational objectives: The reader will learn about and be able to give examples of: (1) the lived experience of stammering; (2) the communicative strategies used by adults; and (3) the situational management of stammering.     

Treatment of stammering by reinforcement of fluent speech

A series of small experimental studies was conducted with three stammerers. The studies show that stammering may be controlled by positive reinforcement of fluent speech in a machine reading task. This new procedure for the treatment of stammering is convenient and effective in producing fluent speech in the laboratory. Evidence suggests some generalization of a stable kind to outside settings.

Stammering interrupts speech and disturbs communication. It has been treated by a variety of methods, ranging from physical assault on the speech organs, through procedures designed to establish new speech patterns, training in deliberate speech control, and masking of auditory feedback, to psychotherapy and behaviour therapy.

Negative practice has brought about improvement in up to a third of cases (Dunlap, 1932; Fishman. 333 1937; Sheehan, 1953; Lehner, 1954; Jones, 1955; Case, 1960). The other common form of behaviour therapy has usually involved negative reinforcement or punishment. Flanagan, Goldiamond and Azrin (1958) used a loud blast of noise every time subjects stammered. Stammering rate was markedly depressed during the aversive conditioning, but when the aversive conditions were discontinued, stammering rate showed a pronounced increase. More recently, Goldiamond (1965) used fluency to terminate a noxious stimulus and reported a reduction in stammering.     

Stammering and therapy views of people who stammer

This study used a postal questionnaire to seek the views of adults who stammer concerning the effect of stammering on their lives, the speech and language therapy and other remedies they have tried, and their hopes for speech and language therapy in the future. The 332 returned questionnaires indicated that stammering had the greatest adverse effect on school life and occupation. Speech and language therapy had been helpful to many, but the nature of the benefits and specific therapies used were not cited in many responses. An emergent theme in unhelpful therapy was the dissatisfaction that arises when individual needs are not met. In the future, people want help in controlling stammering and in developing coping strategies. The desire for timely and effective therapy for children, ongoing help and for group or intensive work has implications for service organization and therapist's skills. The survey highlights the need for therapists and clients to negotiate therapy aims and procedures that are clearly defined, appropriate to individual needs, achievable, and, if possible, recorded and measured. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to list (1) the areas most and least affected by stammering, (2) the therapy approaches respondents had found helpful, and (3) other remedies that tried to help stammering.     

How school-aged students define stuttering and stammering

Fifty students from each of the grades 2, 4, 6, 8, 10, and 12 were asked to complete a questionnaire containing the following three questions: 1) What is stuttering? 2) What is stammering? 3) How did you know that? Analysis of their responses indicated students were more familiar with stuttering as opposed to the term stammering. From grade 6 onward, we can expect at least three-fourths of the students to define stuttering as a disruption of speech consisting chiefly of sound or syllable repetitions. Only about one-fourth of students in grade 6 and above defined stammering as a speech disruption. This disruption was characterized chiefly by repetitions, injections, and pauses. Most of the students were unable to specify how they learned the definitions. The few who did identified family and friends as their chief source of knowledge.     

Recent empirical and theoretical approaches to the experimental manipulation of speech in normal subjects and in stammerers

Empirical studies of the effects of delayed auditory feedback on normal speech, and of the characteristics of stammerers are reviewed. An outline is given of theoretical interpretations of the main facts relating to delayed auditory feedback and stammering and it is shown that the two sets of phenomena may ultimately be subsumed under a single theory.     

Neuropsychological aspects of disorders of higher functions of the cerebral cortex in children with speech disorders

A complex and multiaspects study of the high cerebral function--speech, gnosis, praxis, gesture and mimics has been coducted on 98 children with proved speech defects--alalia, dyslalia, dysgraphia, dyslexia and stammering. In high percentage of the children various focal neurological signs have been established (so called soft neurological symptoms). Very high was the percentage of the children with visual-space defects. Rhythm gnosis and praxis suffered mostly in children with motor alalia. The tests for gesture and mimics prevailed. The unified mechanism of the disturbed development of the speech and the other high cerebral functions were discussed.     

Stammering: A stress index in Caribbean classrooms

Speech communities in the British West Indies typically include two major dialect or code distinctions: (1) a standard variety of British West Indian English, and (2) a local variety of English-based dialect. Each dialect or code is intimately linked with political, social, racial, and economic class distinctions. In bicultural settings, characterized by diglossia, there are special situations in which loyalty to one's mother tongue conflicts with social, economic, and political expediency. “No win” speech events or contests, the product of conflicting sociocultural values, become salient features of this particular kind of bicultural setting. A comparatively high incidence of teacher-reported stammering found in two British West Indian speech communities supports this notion and suggests that stress, originating at a sociocultural level, is symbolically expressed through attitudes toward and usages of language. These results further suggest that the classroom, now a “battleground”, will suffer as an effective teaching/learning environment. This paper presents arguments for the teaching of Standard English as a second language with an emphasis on giving regional dialects appropriate and long overdue recognition.     

The treatment of stammering in children by the shadowing method

There are very few reports about the application of behaviour therapy to child stammering and these are not encouraging. Remedial education treatment is followed by frequent relapses. The present work gives data about the methods, effects and long-term results in nineteen child stammerers treated by the shadowing technique. A discussion of some of the theoretical problems involved is given and shows how the theoretical analysis influences treatment procedures. Seventy per cent of the cases were successfully treated by the shadowing technique and subsidiary procedures; relapses occurred in only 12 per cent of the cases.     

An evaluation of a multi-component intervention for loud speech among children with autism spectrum disorder

Idiosyncratic patterns of speech are common among individuals with autism spectrum disorder (ASD) and can greatly affect their ability to participate successfully in various social and educational settings. We evaluated a treatment package with three children with ASD and a history of loud speech. A multiple baseline across participants design and a decibel meter application were used to evaluate whether the multi-component intervention (i.e., a rule, differential reinforcement, and in vivo feedback) would effectively reduce participants' rates of loud speech. The results showed that the intervention decreased rates of loud speech for all participants. Results are discussed in terms of (a) their extension of the literature regarding speech prosody in ASD by demonstrating an effective intervention for loud speech, (b) clinical implications, and (c) potential future research regarding this nuanced, yet crucial aspect of social communication, including appropriate methods for addressing loud speech in individuals with ASD.     

THE APPLICATION OF NATURALISTIC CONVERSATION TRAINING TO SPEECH PRODUCTION IN CHILDREN WITH SPEECH DISABILITIES

The purpose of this experiment was to test the effectiveness of including speech production into naturalistic conversation training for 2 children with speech production disabilities. A multiple baseline design across behaviors (target phonemes) and across subjects (for the same phoneme) indicated that naturalistic conversation training resulted in improved spontaneous speech production. The implications of these findings are discussed relative to existing models of speech production training and other aspects of communication disorders.     

Compatibility of person-centered planning and applied behavior analysis

In response to Osborne (1999), the aims and practices of person-centered planning (PCP) are compared to the basic principles of applied behavior analysis set forth by Baer, Wolf, and Risley (1968, 1987). The principal goal of PCP is social integration of people with disabilities; it qualifies as a socially important behavior, and its problems have been displayed sufficiently. However, social integration is a complex social problem whose solution requires access to system contingencies that influence lifestyles. Nearly all of the component goals of PCP proposed by O'Brien (1987b) have been reliably quantified, although concurrent measurement of outcomes such as friendship, autonomy, and respect presents a formidable challenge. Behavioral principles such as contingency and contextual control are operative within PCP, but problems in achieving reliable implementation appear to impede an experimental analysis.     

EVALUATION OF AN ENHANCED STIMULUS‐STIMULUS PAIRING PROCEDURE TO INCREASE EARLY VOCALIZATIONS OF CHILDREN WITH AUTISM

Evidence to support stimulus‐stimulus pairing (SSP) in speech acquisition is less than robust, calling into question the ability of SSP to reliably establish automatically reinforcing properties of speech and limiting the procedure's clinical utility for increasing vocalizations. We evaluated the effects of a modified SSP procedure on low‐frequency within‐session vocalizations that were further strengthened through programmed reinforcement. Procedural modifications (e.g., interspersed paired and unpaired trials) were designed to increase stimulus salience during SSP. All 3 participants, preschoolers with autism, showed differential increases of target over nontarget vocal responses during SSP. Results suggested an automatic reinforcement effect of SSP, although alternative interpretations are discussed, and suggestions are made for future research to determine the utility of SSP as a clinical intervention for speech‐delayed children.     

Quality and readability of internet information about stuttering

PurposeWe examined the quality and readability of English-language Internet information about stuttering and evaluated the results considering recommendations by experts in health literacy.MethodA search of Internet websites containing information about stuttering was conducted. Three key words (i.e., stuttering, stammering, speech disfluency) were entered into five country-specific versions of the most commonly used Internet search engine. A total of 79 websites were assessed. Their origin (commercial, non-profit, government, personal or university), quality [Health On the Net (HON) certification and DISCERN scores], and readability [Flesch Reading Ease (FRE) score, Flesch-Kincaid Grade Level Formula (F-KGL), and Simple Measure of Gobbledygook (SMOG)] were assessed.ResultsOf the 79 websites, 38 % were of commercial, 42 % were of nonprofit organization, 15 % were of government and 5% were of university origins, respectively. Only 13 % had obtained HON certification and the mean DISCERN scores was 3.10 in a 5-point scale. The mean reading grade levels were at 13th and 14th grade and 100 % of the websites exceeded the recommended 5th to 6th reading grade level for health information.ConclusionsThe quality of Internet-based health information about the treatment of stuttering is generally adequate, but actual usability of the sites examined in this study may be limited due to poor readability levels. This is problematic in persons with poor literacy skills. Since the Internet can be readily accessed as a valuable consumer information resource, speech-language pathologists and other healthcare professionals have an opportunity to direct consumers to websites that provide readable information of good quality.     

Phencyclidine (PCP): a dangerous drug,but useful in schizophrenia research

Phencyclidine (PCP) is a dangerous drug, and the federal government has placed it on Schedule II of the Controlled Substance Act (see http:// www .mninter.net/-publish/csa2.htm#Schedule%20III). Typically, users smoke PCP, and it is often mixed with parsley, marijuana, or cocaine. Most researchers have conducted experiments on animals rather than on people, and a few have been done on persons diagnosed with schizophrenia, so answers to questions about its addictive potential or development of tolerance are not clear. In healthy volunteers, PCP can induce symptoms that mimic those of schizophrenia, lasting from a few days to more than a week. The neurotransmitter glutamate and N-methyl-D-aspartate (NMDA) appear to play a role in the mechanism by which PCP induces positive and negative schizophrenic symptoms and cognitive defects (D. C. Javitt & S. R. Zukin, 1991; A. Lahti, B. Koffel, D. LaPorte, & C. A. Tamminga, 1995; T. W. Robbins, 1990). Because PCP can induce symptoms that are almost indistinguishable from those associated with schizophrenia, further research may lead to new medications that could be helpful to people who do not respond to neuroleptics that are currently available.     

言语产生的认知神经机制

从认知神经科学的角度阐述了言语产生中时间进程及其激活脑区的研究进展。首先简单介绍了言语产生中词汇通达的2种理论观点。在此基础上介绍了运用电生理技术指标LRP和N200,采用双重判断任务范式对言语产生的时间进程的研究。最后论述了有关语言产生的神经心理学研究和脑成像研究,重点阐述了言语产生中时间进程相对应的激活脑区,言语产生的脑区表现出左侧化趋势。     

Phencyclidine use in delinquent males committed to a training school

Delinquent males committed to a training school were interviewed to determine the extent and the effects of phencyclidine use. Nine of 109 (8%) drug using subjects knowingly had used phencyclidine in the past. These nine subjects were multiple drug abusers of other substances and had started taking drugs at an average age of 9.38 years which was significantly younger than non PCP users. Six of the nine PCP users had committed proven offenses against persons and in four cases violent actions were directly attributed to PCP use. Suicide attempts were made by five (55%) of the PCP users which was significantly more frequent than suicide attempts made by non PCP users.     

言语想象的神经机制

言语想象不仅在大脑预处理机制方面起到重要的作用,还是目前脑机接口领域研究的热点。与正常言语产生过程相比,言语想象的理论模型、激活脑区、神经传导路径等均与其有较多相似之处。而言语障碍群体的言语想象、想象有意义的词语和句子时的脑神经机制与正常言语产生存在差异。鉴于人类言语系统的复杂性,言语想象的神经机制研究还面临一系列挑战,未来研究可在言语想象质量评价工具及神经解码范式、脑控制回路、激活通路、言语障碍群体的言语想象机制、词语和句子想象的脑神经信号等方面进一步探索,为有效提高脑机接口的识别率提供依据,为言语障碍群体的沟通提供便利。     

THE EFFECTS OF OBSERVER EXPECTATIONS,TASK AMBIGUITY,AND MEDIUM OF PRESENTATION ON LOW- AND HIGH-INFERENCE JUDGMENTS OF COMMUNICATIVE BEHAVIOR1

This study investigated the effects of observer expectations about a speaker's nonfluency level on nonfluency counts made during a taped speech and on post-performance evaluations of nonfluency, anxiety, central idea, organization, language, delivery, and general effectiveness. The influence of task ambiguity and medium of presentation on expectancy effects was also explored. Results indicate: (a) in a high-ambiguity condition, observers who expected a fluent speaker counted fewer nonfluencies in his speech than observers who expected a nonfluent speaker; (b) fluent-expectation observers rated the speaker more positively on the seven evaluative measures; (c) low task ambiguity eliminated expectancy effects on nonfluency counts and ratings of organization but not on the other six evaluative measures; and (d) auditory and auditory-visual presentations of the speech did not produce significant differences.     

THE INFLUENCE OF ANTECEDENTS AND CONSEQUENCES ON THE OCCURRENCE OF BIZARRE SPEECH IN INDIVIDUALS WITH DEMENTIA

We conducted a series of assessments to determine the differential effects of common antecedents and consequences that can influence the occurrence of bizarre speech in three women with moderate to severe dementia. First, a traditional functional analysis was conducted to assess the function of bizarre speech. After results revealed differentially higher levels of bizarre speech during control sessions, an antecedent analysis was conducted. During this second assessment, all consequences were held constant, and only the antecedents (i.e., open‐ended questions, yes/no questions, and comments) were altered. Bizarre speech was differentially higher when open‐ended questions were presented, replicating previous studies. The final assessment conducted was a modified functional analysis to further assess the effects of consequences on bizarre speech. More typical consequences were assessed, including two tests for a positive function (attention in the form of correction and attention in the form of following along) and two tests for a negative function (a break from one question and a break from all questions). Results consistently revealed that antecedents produced greater differentiation in responding than social consequences. These findings provide evidence that behavioral assessments may need to be modified to better capture the relevant environmental variables that influence problem behavior in individuals with dementia. Copyright © 2014 John Wiley & Sons, Ltd.