Systematic slowed speech: a new treatment for stuttering.

The purpose of the present study was to determine the effectiveness of a treatment for stuttering based on systematic slowing of speech and anxiety management. Subjects were six stutterers between the ages of 21 and 36. Assessment tasks consisted of recorded conversations with strangers, reading and telephone conversations with strangers, conducted pre- and post-treatment and once a month following treatment for six months. Participants were taught to read and speak progressively at 50, 70 and 90 words a minute over a two week period and received anxiety management training to facilitate maintenance of slowed speech outside of treatment sessions. The results indicated a significant treatment effect for both reading and conversation that was maintained for six months. The telephone task, which was used as a measure of generalization, improved significantly but did not maintain over time.     

Choral reading with filtered speech: effect on stuttering

This study investigated use of choral reading with filtered components of speech and whispered speech on the frequency of stuttering. Three passages read by a normal adult male were lowpass filtered with kneepoint frequencies at 100 Hz (approximate glottal source), 500 Hz (source and first formant), and 1 kHz (source and the first two formants). Along with a whispered passage, a normal passage, and a control condition, these stimuli were used in a repeated-measures design with 12 adult stutterers as they read passages while listening to one of the stimuli. Frequencies of stuttering in each condition were analyzed. The choral speech, the 500-Hz, the 1-kHz, and the whispered speech conditions all decreased the frequency of stuttering while the 100-Hz stimuli did not. It is suggested that articulatory events, chiefly the encoded speech output from the vocal tract, create effective cues and may induce fluent speech in people who stutter.     

Prognostic indicators for stuttering: the value of computer-based speech analysis

There are currently no known acoustic parameters by which stuttering children can be appraised in order to predict the further course of their speech disfluency. The present study investigates the usefulness of a computer-based speech analysis of fluent utterances. Correlations between acoustic variables, severity, and course of stuttering were sought in a prospective longitudinal study. This analyzed 57 preschool children at 6-month intervals over a period of 4.6 years. The acoustic analyses yielded no clearly distinguishing characteristics. There was, however, one subgroup consisting of children who were still disfluent at study end which showed more variable values at various measurement points for different parameters. Speech control seems to be different in children exhibiting chronic stuttering.     

Syntactic determinants of stuttering in the spontaneous speech of normally fluent and stuttering children

Conflicting findings have been reported concerning whether fluent children use more complex syntactic structures than stutterers and whether or not stutterers experience specific difficulty with complex syntactic structures. On critical examination, the first of these apparent discrepancies appears to be due to (a) differences in the methods employed for syntactic analysis in different studies, and (b) misleading impressions gained by looking at speakers within a single age range. Data were reanalyzed where one method of analysis had shown that fluent speakers and stutterers did not differ with regard to syntactic structures used but where they did show a propensity for stuttering to occur on complex syntactic structures. These data cover a range of age groups. When the second method of syntactic analysis was applied, a difference was found between fluent speakers and stutterers, with the stutterers initially using more simple structures and fewer complex ones. This difference decreased over age groups. However, a difference still remained with respect to which syntactic structures stutterers experience difficulty. An additional analysis, not formerly conducted on these data, showed that, as reported elsewhere, there was a higher probability of stuttering on clause-initial and. It was also shown that this tendency decreased with age group of the stutterers.     

Behavioral engineering: stuttering as a function of stimulus duration during speech synchronization

Past studies have shown that stuttering is eliminated when speech is synchronized with a metronomic beat, but the speech sounds artificial. The present study investigated the effect of increasing the duration of these individual stimulus beats with the stimulus-off period constant at 1 sec. When subjects were instructed to speak during the stimulus-on period, stuttering was an inverse function of stimulus duration, indicating that the known metronome effect on stuttering is one point on a continuum of effective rhythm procedures. The "naturalness" of speech increased as the stimulus duration increased up to durations of about 2 sec, and then decreased. At optimal values, stuttering was greatly reduced and naturalness and rapidity of speech were retained. These optimal values effectively controlled stuttering in a field test that used two types of specially designed portable instruments, one of which produced a tactual stimulus and the other an auditory stimulus.     

Critical words and the locus of stuttering in speech

The locus of stuttering in the communicative speech of 26 stutterers was studied in situations where subjects received and conveyed specific information. It was hypothesized that a larger proportion of critical rather than noncritical words would be stuttered. Critical words were those which necessarily had to be pronounced if a listener should be able to understand and act according to the messages given. The critical words were selected by the experimenter before the experiment started. The results showed that 35.8% of the critical and 8.4% of the noncritical words were stuttered. There was also significantly more stuttering on critical words than on long noncritical words. The largest proportion of critical words appeared in the final position of sentences, which was also where most stuttering was located. Whole-word repetitions, an instance of normal nonfluency, were associated with noncritical words. No correlation between frequency of stuttering and whole-word repetitions was found.     

Stopping speech suppresses the task-irrelevant hand

Some situations require one to quickly stop an initiated response. Recent evidence suggests that rapid stopping engages a mechanism that has diffuse effects on the motor system. For example, stopping the hand dampens the excitability of the task-irrelevant leg. However, it is unclear whether this ‘global suppression’ could apply across wider motor modalities. Here we tested whether stopping speech leads to suppression of the task-irrelevant hand. We used Transcranial Magnetic Stimulation over the primary motor cortex with concurrent electromyography from the hand. We found that when speech was successfully stopped the motor evoked potential from the task-irrelevant hand was significantly reduced compared to when the participant failed to stop speaking, or responded on non stop signal trials, or compared to baseline. This shows that when speech is quickly stopped, there is a broad suppression across the motor system. This has implications for the neural basis of speech control and stuttering.     

The effects of simulated stuttering and prolonged speech on the neural activation patterns of stuttering and nonstuttering adults

Functional magnetic resonance imaging was used to investigate the neural correlates of passive listening, habitual speech and two modified speech patterns (simulated stuttering and prolonged speech) in stuttering and nonstuttering adults. Within-group comparisons revealed increased right hemisphere biased activation of speech-related regions during the simulated stuttered and prolonged speech tasks, relative to the habitual speech task, in the stuttering group. No significant activation differences were observed within the nonstuttering participants during these speech conditions. Between-group comparisons revealed less left superior temporal gyrus activation in stutterers during habitual speech and increased right inferior frontal gyrus activation during simulated stuttering relative to nonstutterers. Stutterers were also found to have increased activation in the left middle and superior temporal gyri and right insula, primary motor cortex and supplementary motor cortex during the passive listening condition relative to nonstutterers. The results provide further evidence for the presence of functional deficiencies underlying auditory processing, motor planning and execution in people who stutter, with these differences being affected by speech manner.     

The effect of SpeechEasy on stuttering frequency, speech rate, and speech naturalness

The effects of SpeechEasy on stuttering frequency, stuttering severity self-ratings, speech rate, and speech naturalness for 31 adults who stutter were examined. Speech measures were compared for samples obtained with and without the device in place in a dispensing setting. Mean stuttering frequencies were reduced by 79% and 61% for the device compared to the control conditions on reading and monologue tasks, respectively. Mean severity self-ratings decreased by 3.5 points for oral reading and 2.7 for monologue on a 9-point scale. Despite dramatic reductions in stuttering frequency, mean global speech rates in the device condition increased by only 8% in the reading task and 15% for the monologue task, and were well below normal. Further, complete elimination of stuttering was not associated with normalized speech rates. Nevertheless, mean ratings of speech naturalness improved markedly in the device compared to the control condition and, at 3.3 and 3.2 for reading and monologue, respectively, were only slightly outside the normal range. These results show that SpeechEasy produced improved speech outcomes in an assessment setting. However, findings raise the issue of a possible contribution of slowed speech rate to the stuttering reduction effect, especially given participants' instructions to speak chorally with the delayed signal as part of the active listening instructions of the device protocol. Study of device effects in situations of daily living over the long term is necessary to fully explore its treatment potential, especially with respect to long-term stability. Educational objectives: The reader will be able to discuss and evaluate: (1) issues pertinent to evaluating treatment benefits of fluency aids and (2) the effects of SpeechEasy on stuttering frequency, speech rate, and speech naturalness during testing in a dispensing setting for a relatively large sample of adults who stutter.     

Past speech therapy experiences of individuals exploring a new stuttering treatment

Perceptions of benefits of speech therapy, success of therapy across clinical settings, reasons for returning to therapy, client-clinician relationships, and clinicians' competency were assessed in 57 participants (47 men, 10 women; M age = 34 yr.) trying a new therapy. A majority of respondents had cumulatively five or more years in therapy and at least two stuttering therapies. Respondents rated university or hospital settings as more successful than services in public schools. 70% of the respondents noted difficulty communicating basic needs; they blamed themselves for inability to maintain posttherapeutic gains while perceiving their clinicians to be competent and attentive--although 47% of the respondents had minimal to no contact with their therapist after therapy.     

Dichotic speech perception: A comparison between stuttering and nonstuttering children

A stop consonant-vowel dichotic listening task was administered to 90 right- handed boys, 30 in each age group of 5, 7, and 9 yr. Half in each group were stutterers, half nonstutterers. Two and a half times as many stutterers as nonstutterers were found to display either a left-ear advantage (LEA) or no ear advantage (NEA). This finding suggested a greater tendency on the part of stutterers, as opposed to nonstutterers, for reversed or bilateral representation of the auditory speech areas of the brain. In addition, both stutterers and nonstutterers displayed significant developmental increases in the number of times they were able to identify both dichotic speech stimuli, thereby supporting the hypothesis of an age-related increase in children's total information processing capacity. The results are discussed in terms of the differences between stutterers and nonstutterers with respect to the issues of motor representation, cognitive modes, and higher-order linguistic processes.     

Gestural overlap in consonant clusters: effects on the fluent speech of stuttering and non-stuttering subjects

This study was designed to investigate if persons who stutter differ from persons who do not stutter in the coproduction of different types of consonant clusters, as measured in the number of dysfluencies and incorrect speech productions, in speech reaction times and in word durations. Based on the Gestural Phonology Model of Browman and Goldstein, two types of consonant clusters were formed: homorganic and heterorganic clusters, both intra-syllabic (CVCC) and inter-syllabic (CVC#CVC). Overall, the results indicated that homorganic clusters elicited more incorrect speech productions and longer reaction times than the heterorganic clusters, but there was no difference between the homorganic and the heterorganic clusters in the word duration data. Persons who stutter showed a higher percentage dysfluencies and a higher percentage incorrect speech productions than PWNS but there were no main group effects in reaction times and word durations. However, there was a significant three-way interaction effect between group, cluster type and cluster place: homorganic clusters elicited longer reaction times than heterorganic clusters, but only in the inter-syllabic condition and only for persons who stutter. These results suggest that the production of two consonants with the same place of articulation across a syllable boundary puts higher demands on motor planning and/or initiation than producing the same cluster at the end of a syllable, in particular for PWS. The findings are discussed in light of current theories on speech motor control in stuttering. EDUCATIONAL OBJECTIVES: The reader will be able to describe: (1) the effect of gestural overlap between consonant clusters on speech reaction time and word duration of people who do and do not stutter and be able to (2) identify the literature in the field of gestural overlap between consonant clusters.     

The relevance of DAF-induced speech disruption to the understanding of stuttering

The literature on delayed auditory feedback (DAF) repeatedly makes reference to the occurence of disfluencies under DAF in nonstutterers. However, no attempt has been made to determine the relative frequency of occurence of various types of disfluencies in nonstutterers under DAF. The present study investigated the frequency of occurence of various types of disfluencies in normal-speaking subjects in five successive oral readings under DAF. Twenty-four young adults read aloud a prose passage five times successively under 200 msec of bilateral DAF. Measures of the frequency of different types of disfluencies, locus of occurence of disfluencies in the speech sample, adaptation and consistency indicate that DAF-induced disfluencies are remarkably similar to those found in stuttering. It is suggested that DAF and stuttering disrupt speech at approximately the same “level” along the speech production process, possibly at the prosodic level.     

Some effects of the Edinburgh Masker on stuttering during oral reading and spontaneous speech

This study assessed the effect of a voice-activated masking unit, known as the Edinburgh Masker, on the speech of four stutterers during oral reading and spontaneous speech. The results show that one stutterer reduced stuttering almost completely whenever the masker was activated. Two subjects showed either marginal or temporary reductions of stuttering during one speaking condition but showed no change in the other condition. The other subject reduced stuttering only during spontaneous speech. No reduction in stuttering was associated with reduced speech rate. A perceptual analysis procedure conducted to assess for altered speech quality during masking conditions found changes in speech quality were evident in two subjects. The clinical implications of these findings are discussed.     

Effect of reading with reversed speech on frequency of stuttering in adults

This study explored the effect of reading with reversed speech on the frequency of stuttering. Eight adults who stutter served as participants and read four 300-syllable passages while listening to three types of speech stimuli: normal speech (choral reading), reversed speech at normal speed, reversed speech at half speed, and a control condition of no auditory feedback. A repeated-measures analysis of variance showed a significant decrease in stuttering frequency in the choral reading condition but not in reversed speech at normal and half speed. However, the reversed speech at half-speed condition showed a large effect size (omega2 = 0.32). Data suggest that a forward moving speech feedback is not essential to decrease the frequency of stuttering in adults who stutter.     

Effects of false increasing,decreasing, and true electromyographic biofeedback on the frequency of stuttering

Adult stutterers received auditory feedback of laryngeal area muscle activity while reading aloud under three conditions: (1) False Increasing Feedback, (2) False Decreasing Feedback, and (3) True Feedback. The subjects were unaware that the feedback in two conditions was being altered and were instructed not to manipulate the feedback signal. Decreases in the frequency of stuttering were observed for both the false increase and true feedback conditions. Factors contributing to the effectiveness of biofeedback techniques with stutterers are discussed.     

Perceptual evaluation of the speech before and after fluency shaping stuttering therapy

An often-cited criterion for assessing the effect of a stuttering therapy is the ability of the stutterers to produce normally fluent speech. Many modern stuttering therapies use special techniques that may produce stutter-free speech that does not sound completely normal. The present study investigates this problem in the framework of the Dutch adaptation of the Precision Fluency Shaping Program.

Pre-, post-, and -year follow-up therapy speech samples of 32 severe stutterers who were treated in a four-week intensive therapy are compared with comparable samples of 20 nonstutterers. For that aim the samples were rated on 14 bipolar scales by groups of about 20 listeners. The results show that the speech of the stutterers in all three conditions differs significantly from the speech of the nonstutterers. The pretherapy speech takes an extreme position on a Distorted Speech dimension, due to the large proportion of disfluencies. The posttherapy speech has extremely low scores on a Dynamics/Prosody dimension, a‘1 while the follow-up therapy speech differs from the normal speech on both dimensions, but now the distances are smaller. These results are discussed in relation to the severity of the stuttering problem in the group of treated stutterers. Finally, implications for future research on therapy evaluation are discussed.     

Childhood stuttering and speech disfluencies in relation to children's mean length of utterance: a preliminary study

The purpose of this study was to examine the influence of utterance length and complexity relative to the children's mean length of utterance (MLU) on stuttering-like disfluencies (SLDs) for children who stutter (CWS) and nonstuttering-like disfluencies (nonSLDs) for children who do not stutter (CWNS). Participants were 12 (3;1-5;11, years;months) children: 6 CWS and 6 age-matched (+/-5 months) CWNS, with equal numbers in each talker group (CWS and CWNS) exhibiting MLU from the lower to the upper end of normal limits. Data were based on audio-video recordings of each child in two separate settings (i.e., home and laboratory) during loosely structured, 30-min parent-child conversational interactions and analyzed in terms of each participant's utterance length, MLU, frequency and type of speech disfluency. Results indicate that utterances above children's MLU are more apt to be stuttered or disfluent and that both stuttering-like as well as nonstuttering-like disfluencies are most apt to occur on utterances that are both long and complex. Findings were taken to support the hypothesis that the relative "match" or "mismatch" between linguistic components of an utterance (i.e., utterance length and complexity) and a child's language proficiency (i.e., MLU) influences the frequency of the child's stuttering/speech disfluency. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to: (1) compare different procedures for assessing the relationship among stuttering, length and complexity of utterance, (2) describe the difference between relative and absolute measures of utterance length, (3) discuss the measurement and value of mean length of utterance and its possible contributions to childhood stuttering, and (4) describe how length and complexity influence nonstuttering-like disfluencies of children who stutter as well as the stuttering-like disfluencies of children who do not stutter.