Vowel duration in stutterers participating in precision fluency shaping

The purpose of this study was to determine the extent to which stutters manipulate vowel duration to achieve fluency after participating in Precision Fluency Shaping. Nine stutterers who read an all-voiced sentence fluently before and after therapy were selected for study. Wide-band spectrograms were made of the initial phrase of the sentences, and vowel durations were computed. Results indicated that extended vowel durations were characteristic of the fluency of stutterers posttherapy. The subject that had the highest rate of disfluency after therapy also had the shortest vowel durations. Clinical implications concerning the importance of speech rate during carryover practice are made.     

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.     

A comparison between two treatment programs for stuttering: A personal account

This article features a personal evaluation of two treatment methods for stuttering, the Precision Fluency Shaping Program (PFSP) (Webster, 1990; 1986), and the Comprehensive Stuttering Program (CSP) (Boberg and Kully, 1985). The CSP program is described as promoting natural-sounding speech by focusing, from the outset, on smooth blending of syllables or within breath groups. The PFSP program is described as tending to focus on syllables or words in isolation, particularly during early stages of instruction. In addition, the Boberg/ Kully program featured individualized instruction by a series of clinicians interacting with clients in accordance with a rotating schedule. In contrast, the PFSP program emphasized solitary interaction with a voice monitor and client manual. Differences in timing of instruction and calculation of speech rates are discussed. Treatment refinements are suggested, including enhanced precision in distinguishing between soft phrase onsets on individual words.     

The relationship between locus of control and long-term stuttering treatment outcome in adult stutterers

The present study was designed to investigate the extent to which adult stutterers' scores on the Locus of Control of Behaviour (LCB) scale are predictive of their ability to maintain speech fluency immediately following intensive treatment and approximately 2 years later. Twenty-one subjects participated in a 3-week intensive treatment program based on the Precision Fluency Shaping Program. Thirteen subjects could be contacted again 2 years later to participate in a follow-up evaluation. While most subjects showed a significant long-term improvement in fluency, no predictive relationship was found between scores on the LCB scale and the level of fluency, measured in percentage of words stuttered, post-treatment or at follow-up. However, LCB scores were found to be predictive of the subjects' fluency self-evaluation measured post-treatment and at follow-up. Overall, the present study suggests that while the LCB scale may contribute to the prediction of long-term treatment outcome, particularly as perceived by the client, other client and process variables will need to be considered as well.     

The use of a portable delayed auditory feedback unit in stuttering therapy

A portable on-the-body delayed auditory feedback was used in the establishment and transfer modes of fluent speech in a stutterer while he was on the Monterey Fluency Program. The performance of the client was compared with a “standard” population of stutterers. The portable DAF was comparable to the larger DAF in establishment and superior in transfer with minimal behavioral and technical problems. Use and potential value of the portable DAF in transfer and maintenance phases of therapy are discussed.     

Update: School-age stutterers

Field-test data is reported on 48 school-age stutterers evaluated with the Assessment of Fluency in School-Age Children during the 1980–1981 school year in East-Central Ohio, which is largely rural in character with small industrial cities. The data answers questions proposed in 1977 regarding issues relating to the identification of young stutterers, their awareness of disfluent speech, and management problems in a school setting.     

Patterns of spontaneous recovery in aphasic groups: A study of adult stroke patients

The recovery of 31 aphasic stroke patients in the first three months postonset was investigated. Improvements on eight comprehension, repetition, and expression tasks were documented for four groups. These groups, retrospectively defined on the basis of initial scores on a fluency and a comprehension task, were: Low Fluency/Low Comprehension (LFLC), Low Fluency/High Comprehension (LFHC), High Fluency/Low Comprehension (HFLC), and High Fluency/High Comprehension (HFHC). Examination of each group's recovery revealed (1) equal improvement on nearly all language tasks for the two High Comprehension groups and (2) a more selective improvement largely in comprehension and imitation tasks for the two Low Comprehension groups. Implications of this selective improvement in initially low comprehending aphasics are discussed.     

A second-order factor analysis of reasoning abilities

This article reports a second-order factor analysis of the 13 interpretable first-order factors of Adkins and Lyerly based on 66 variables for 200 Army men. The approach to simple structure for 6 second-order factors was unusually good. Loadings of the original 66 variables on the second-order factors were also obtained. Five of the factors are tentatively interpreted as Precision in Formation and Use of Verbal Concepts, General Verbal Fluency, Visualizing Spatial Constancy During Movement, Speed in Analysis, and Flexibility in Analysis.     

Time-limited desensitisation, implosion and shaping for phobic patients: A crossover study

A comparison was made of the short-term time-limited efficacy of three forms of behaviour therapy in phobic patients: Systematic Desensitization (in imagination), Implosion (in imagination) and Shaping, or Reinforced Practice. A block design was used, all patients receiving all treatments in randomised order. Improvement was measured behaviourally and by symptom rating scales. Differences emerged only on the behavioural measures: Shaping was significantly superior to Desensitisation, with Implosion between the two, and not significantly different from either. Comparison of treated with untreated phobias within subjects showed Shaping to be more specific than the other two forms of treatment. It was concluded that Implosion and Shaping are potentially useful types of therapy, worthy of further study and application.     

Contribution of the speech musculature to apparent human EEG asymmetries prior to vocalization

Vocalizations are preceded by slow EEG waves over inferior frontal scalp regions, but some controversy exists as to whether these slow potentials are left-lateralized as a function of speech. In this study both speech and non-speech vocalizations were studied, under conditions of repetitive and variable production. Averaged responses over the speech musculature, including the temporalis, masseter, orbicularis oris, and mylohyoid muscles, as well as the eyes and tongue, were calculated simultaneously with scalp EEG averages. The responses of the temporalis and masseter muscles, as well as that of the tongue, were correlated with EEG sites at specific latencies prior to speech, suggesting that no part of the inferior frontal EEG record was free from myogenic confounds. In addition, all significant EEG differences between speech and non-speech conditions were subsequently eliminated by covariance analysis, using selected muscle channels as covariates. Previous reports of asymmetrical “speech potentials” in the EEG probably reflected a combination of several myogenic confounds.     

Fluency breaks in older speakers: Implications for a model of stuttering throughout the life cycle

In order to test a model describing the occurence of fluency breaks throughout the life cycle, spontaneous speech samples of 40 nonstutterers and 4 stutterers above the age of 50 were perceptually analyzed. Fluency breaks were classified into categories of formulative or motoric breaks. The results supported research, noting an increase in formulative fluency breaks (especially fillers and interjections) for older speakers. There was, however, a significant decrease in the occurence of formulative fluency breaks during the final years of late adulthood. No change was found in the occurence of motoric fluency breaks in the nonstuttering speakers. Stuttering speakers had significantly less formulative breaks and significantly more motoric breaks than nonstuttering speakers.     

The effect of fast speech rate on stuttering frequency during delayed auditory feedback

Delayed auditory feedback (DAF) has been documented to improve fluency in those who stutter. The increased fluency has been attributed to the slowed speech rate induced by DAF, but recent experiments have suggested that increasing the speech rate may also decrease stuttering under DAF. This investigation described the effect of combining a fast speech rate and DAF on the fluency of four people who stutter. Fluency of the two mildly dysfluent subjects was the same for both no DAF and DAF conditions at normal and at fast oral reading rates. In contrast, the two severely dysfluent subjects improved in fluency from the no DAF to the DAF conditions. They were found to be dysfluent at both normal and fast oral reading rates without DAF. The results of the study point to the need for further research on the relationship between speech rate and stuttering frequency under conditions of DAF and no DAF. EDUCATIONAL OBJECTIVES: Readers will learn about and be able to describe how the frequency of stuttering is affected by: (1) speech rates; (2) DAF; and (3) how stuttering severity influences such effects.     

Monitoring and self-repair in speech

Making a self-repair in speech typically proceeds in three phases. The first phase involves the monitoring of one's own speech and the interruption of the flow of speech when trouble is detected. From an analysis of 959 spontaneous self-repairs it appears that interrupting follows detection promptly, with the exception that correct words tend to be completed. Another finding is that detection of trouble improves towards the end of constituents. The second phase is characterized by hesitation, pausing, but especially the use of so-called editing terms. Which editing term is used depends on the nature of the speech trouble in a rather regular fashion: Speech errors induce other editing terms than words that are merely inappropriate, and trouble which is detected quickly by the speaker is preferably signalled by the use of ‘uh’. The third phase consists of making the repair proper. The linguistic well-formedness of a repair is not dependent on the speaker's respecting the integrity of constituents, but on the structural relation between original utterance and repair. A bi-conditional well-formedness rule links this relation to a corresponding relation between the conjuncts of a coordination. It is suggested that a similar relation holds also between question and answer. In all three cases the speaker respects certain structural commitments derived from an original utterance. It was finally shown that the editing term plus the first word of the repair proper almost always contain sufficient information for the listener to decide how the repair should be related to the original utterance. Speakers almost never produce misleading information in this respect.It is argued that speakers have little or no access to their speech production process; self-monitoring is probably based on parsing one's own inner or overt speech.     

Influences of rate, length, and complexity on speech disfluency in a single-speech sample in preschool children who stutter

The purpose of the present study was (1) to determine whether speech rate, utterance length, and grammatical complexity (number of clauses and clausal constituents per utterance) influenced stuttering-like disfluencies as children became more disfluent at the end of a 1200-syllable speech sample [Sawyer, J., & Yairi, E. (2006). The effect of sample size on the assessment of stuttering severity. American Journal of Speech-Language Pathology, 15, 36-44] and (2) to explore the interaction of speech rate, length, and grammatical complexity at the beginning (syllables 1-300, Section A) and the end (syllables 901-1200, Section B) of the speech sample. Participants were eight boys and six girls (M=40.9 months) who were selected from the Sawyer and Yairi [Sawyer, J., & Yairi, E. (2006). The effect of sample size on the assessment of stuttering severity. American Journal of Speech-Language Pathology, 15, 36-44] study. Mean length of utterance (MLU) in morphemes, the number of clauses, clausal constituents, and articulation rate, measured in syllables per second were analyzed from the children's conversational speech. The median split procedure [Logan, K., & Conture, E. (1995). Length, grammatical complexity, and rate differences in stuttered and fluent conversational utterances of children who stutter. Journal of Fluency Disorders, 20, 35-61; Yaruss, J. S. (1997). Utterance timing and childhood stuttering. Journal of Fluency Disorders, 22, 263-286] was used to study interactions between articulation rate, utterance length, and grammatical complexity across the two sections. The mean number of clauses per utterance, clausal constituents per utterance, and articulation rate revealed no significant differences between Section A and Section B, whereas MLU significantly increased in Section B (p=.013). Clausal constituents and MLU were significantly correlated both in Sections A and B. The median split procedure revealed trends for utterances characterized as high length and low-speech rate to be greater in number in Section B than A, but the differences were not significant. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to: (a) describe the influence of grammatical complexity and mean length of utterance on disfluent speech; (b) compare different procedures for assessing speech rate and determine why the effects of articulation rate have been inconclusive; (c) discuss procedures for comparing length, rate, and complexity across a single-speech sample; and (d) explain why therapeutic methods that emphasize shorter utterance lengths, rather than only slower speech rates, are advisable in establishing fluency in preschool children who stutter.     

Factors affecting judgments of fluency: I. interjections

Six speech samples containing varying amounts of schwa interjections were tape-recorded and presented to 36 male and 36 female listeners. For each sample, listeners were asked to make judgments of fluent, disfluent, and stuttered speech, and to answer the question “Would you recommend speech therapy?” Results indicated that speech samples containing 5% or more interjections evoked a judgment of disfluent speech by a majority of listeners. The sample containing 20% interjections, however, was found to evoke judgments of disfluent and stuttered speech about equally. Varying numbers of listeners recommended clinical services for disfluent speech. In general, the results indicated that (1) the presence of interjections in connected speech is not normal regardless of frequency, (2) fluent speech may not contain interjections in excess of 5%, and (3) with 20% interjections in speech, the distinction between disfluency and stuttering may be blurred.     

Language in right-handers with right-hemisphere lesions: A preliminary study including anatomical, genetic, and social factors

A comprehensive test battery was devised to study the effects of right hemisphere lesions on the speech and language of “nonaphasic” dextrals. Data were thus obtained for 62 subjects, 20 of them neurologically healthy and 42 with a focal right hemisphere lesion resulting from a cerebro-vascular accident. A preliminary global analysis of these data is reported. Anomalies were observed in 33 brain-damaged subjects. Although discreet in all cases, these anomalies were shown to have various degrees of severity. Given the population submitted to this study, the subject most likely to show such anomalies was defined, genetically, as a right-handed adult with a family history of ambidextrality or left-handedness and, socially, as one with a relatively limited education. The implications of these findings are discussed together with the problem of the anatomo-clinical correlations of language disorders resulting from right hemisphere lesions in “nonaphasic” dextrals.     

Perceptions of self-efficacy in providing multidimensional school-age stuttering therapy among board certified fluency specialists in the United States

PurposeThe purpose of this study was to document fluency specialists’ self-efficacy beliefs for providing multidimensional treatment to children who stutter and to identify cognitive, affective, and behavioral correlates of self-efficacy.MethodSixty-six Board Certified Specialists in Fluency in the United States completed an online survey measuring self-efficacy in providing multidimensional stuttering therapy, perceived importance of multidimensional aspects of therapy, feelings of comfort in providing therapy, perceived treatment success, and employment and demographic questions. Open-ended questions were also asked for participants to describe why they chose to specialize and what benefits they received from it.ResultsParticipants reported high levels of self-efficacy (averages above 9 on a scale from 0 to 10) in speech-related, cognitive, emotional, and social domains of stuttering therapy, as well as high levels of comfort and clinical success. Higher ratings of overall self-efficacy were significantly correlated with beliefs about the importance of multidimensional treatment, τ = 0.27, treatment comfort, τ = 0.25, and self-reported treatment success, τ = .49. Responses indicated that many participants believed that their self-efficacy grew because of specialty certification.ConclusionAlthough not the same as treatment outcome data, self-efficacy among clinical service providers is an important variable to consider. Board Certified Specialists in Fluency in the United States report very high levels of self-efficacy for school-age stuttering treatment. The process of certification helps to increase self-efficacy and provides a means for advertising competence in stuttering treatment. This information could help in recruiting the next generation of fluency specialists.     

Genetic and environmental influences on early literacy skills across school grade contexts

Recent research suggests that the etiology of reading achievement can differ across environmental contexts. In the US, schools are commonly assigned grades (e.g. ‘A’, ‘B’) often interpreted to indicate school quality. This study explored differences in the etiology of early literacy skills for students based on these school grades. Participants included twins drawn from the Florida Twin Project on Reading (n = 1313 pairs) aged 4 to 10 years during the 2006–07 school year. Early literacy skills were assessed with DIBELS subtests: Oral Reading Fluency (ORF), Nonsense Word Fluency (NWF), Initial Sound Fluency (ISF), Letter Naming Fluency (LNF), and Phoneme Segmentation Fluency (PSF). School grade data were retrieved from the Florida Department of Education. Multi‐group analyses were conducted separately for subsamples defined by ‘A’ or ‘non‐A’ schools, controlling for school‐level socioeconomic status. Results indicated significant etiological differences on pre‐reading skills (ISF, LNF, and PSF), but not word‐level reading skills (ORF and NWF). There was a consistent trend of greater environmental influences on pre‐reading skills in non‐A schools, arguably representing ‘poorer’ environmental contexts than the A schools. Importantly, this is the case outside of resources linked with school‐level SES, indicating that something about the direct environment on pre‐reading skills in the non‐A school context is more variable than for A schools.