Bilingual children who stutter: Convergence,gaps and directions for research

PurposeThe aim of this systematic review is to examine the early interactions between bilingualism and stuttering to synthesize knowledge that could inform diagnosis and treatment for bilingual children who stutter.MethodScopus, Science Direct, PubMed, ERIC Ebsco, and Google Scholar were searched with no limits placed on the year of publication. Search terms consisted of: (“stuttering” [MeSH] OR “stutter”) AND (“child” [MeSH] OR “children”) AND (“multilingualism” [MeSH] OR “bilingualism”). Inclusion criteria were children who stutter, bilinguals who stutter, empirical research articles, and published in peer review journals. Exclusion criteria were studies that reported on only adults, only monolinguals, or were not published in English.ResultsA total of 50 articles met the criteria. There was convergence with monolingual studies reporting sexually dimorphic and familial trends in the prevalence of stuttering and rates of recovery. Findings surrounding language proficiency, cross-linguistic stuttering severity, and development were ambivalent. Results point to the difficulty in identifying stuttering in bilingual children, and the need for culturally competent research and interpretations.ConclusionCurrent findings offer a fragmented view of bilingual development and echoes a recurring theme, i.e., the current understanding of bilingualism and stuttering is limited and more research is warranted.     

Children and adolescents who stutter: Further investigation of anxiety

PurposeDespite the greatly increased risk of social anxiety disorder in adults who stutter, there is no clear indication of the time of onset of this disorder in childhood and adolescence. The purpose of this study was to explore this issue further using the Revised Children's Manifest Anxiety Scale (RCMAS), so that appropriate interventions can be developed prior to adulthood. This is the first time the RCMAS has been completed by children younger than 11 years. Using the same test for both school-age children and adolescents can potentially identify when anxiety starts to develop from age 6 years through to adulthood.MethodsThe RCMAS was administered to 18 school-age boys, five school-age girls, 41 adolescent boys and nine adolescent girls who were seeking treatment for their stuttering. Participants also rated the severity of their own stuttering.ResultsAll mean scaled scores on the four RCMAS subscales and Total Anxiety scores were within normal limits. However, for both groups of boys, scores on the Lie Scale were significantly higher than scores on the other three subscales.ConclusionsExperts suggest high scores on the RCMAS Lie Scale are indicative of participants attempting to present themselves in a positive light and so cast doubt on the veracity of their other responses on the test. One interpretation, then, is that the boys were concealing true levels of anxiety about their stuttering. The results suggest why findings of anxiety studies in children and adolescents to date are equivocal. Clinical implications are discussed.Educational objectives: The reader will be able to: (a) discuss why understanding when anxiety starts in people who stutter is important, (b) describe the function of the RCMAS Lie sub scale and (c) summarize the possible implications of the RCMAS findings in this study.     

Effects of perceptual and conceptual similarity in semantic priming

Summary The study investigates the different contributions to semantic priming of two components of the semantic representation underlying a word. The two components are perceptually based information and conceptually based information. Perceptual information is based on physical attributes such as shape or color, while conceptual information consists of more abstract elements such as functional attributes. The question asked in this study was whether both components would produce an effect in semantic priming. Pairs of words either related because of a conceptual property (banana-apple), a perceptual property (ball-apple), or both because of a perceptual and conceptual property (cherry-apple) were presented as prime and target in a lexical decision and a word-naming task. The results showed independent contributions of perceptual and conceptual attributes to semantic priming.This research was supported by a grant from the Dutch Organization for the Advancement of Pure Research (ZWO). All three authors are senior authors and have contributed to all parts of the project.     

Masked translation priming asymmetry in Chinese-English bilinguals: Making sense of the Sense Model

Masked translation priming asymmetry is the robust finding that priming from a bilingual's first language (L1) to their second language (L2) is stronger than priming from L2 to L1. This asymmetry has been claimed to be task dependent. The Sense Model proposed by Finkbeiner, Forster, Nicol, and Nakamura (2004) claims that the asymmetry is reduced in semantic categorization relative to lexical decision due to a category filtering mechanism that limits the features considered in categorization decisions to dominant, category-relevant features. This paper reports two pairs of semantic categorization and lexical decision tasks designed to test the Sense Model's predictions. The experiments replicated the finding of Finkbeiner et al. that L2-L1 priming is somewhat stronger in semantic categorization than lexical decision, selectively for exemplars of the category. However, the direct comparison of L2-L1 and L1-L2 translation priming across tasks failed to confirm the Sense Model's central prediction that translation priming asymmetry is significantly reduced in semantic categorization. The data therefore fail to support the category filtering account of translation priming asymmetry. Rather, they suggest that pre-activation of conceptual features of the target category provides feedback to lexical forms that compensates for the weak connections between the lexical and conceptual representations of L2 words.     

Visual exogenous and endogenous attention and visual memory in preschool children who stutter

PurposeAttention develops gradually from infancy to the preschool years and beyond. Exogenous attention, consisting of automatic responses to salient stimuli, develops in infancy, whereas endogenous attention, or voluntary attention, begins to develop later, in the preschool years. The purpose of this study was to examine (a) exogenous and endogenous attention in young children who stutter (CWS) and children who do not stutter (CWNS) through two conditions of a visual sustained selective attention task, and (b) visual short-term memory (STM) between groups within the context of this task.Method42 CWS and 42 CWNS, ages 3;0–5;5 (years;months), were pair-matched in age, gender (31 males, 11 females per group), and socioeconomic status. Children completed a visual tracking task (Track-It Task; Fisher et al., 2013) requiring sustained selective attention and engaging exogenous and endogenous processes. Following each item, children were asked to recall the item they had tracked, as a memory check.ResultsThe CWS group demonstrated significantly less accuracy in overall tracking and visual memory for the tracked stimuli, compared to the CWNS group. Across groups, the children performed better in sustained selective attention when the target stimuli were more salient (the condition tapping both exogenous and endogenous attention) than when stimuli were less so (the condition tapping primarily endogenous processes).ConclusionsRelative to peers, preschool-age CWS, as a group, display weaknesses in visual sustained selective attention and visual STM.     

Loci of stuttering of English- and Korean-speaking children who stutter: Preliminary findings

PurposeThe purpose of the study was to determine whether differences exist between young English- and Korean-speaking children who stutter (CWS) in the loci of stuttering.MethodParticipants were 10 Korean-speaking and 11 English-speaking CWS between the ages of 3 and 7 years. Participants produced narratives while viewing various picture scenes and a wordless picture book.ResultsFindings indicated that Korean-speaking CWS stuttered more on content than function words whereas English-speaking CWS stuttered more on function than content words. Furthermore, both Korean- and English-speaking CWS tended to stutter more on utterance-initial words. These findings appear to be related to the differences in linguistic/syntactic structures between Korean and English. Specifically, in the Korean-speaking CWS’s narratives, most utterance-initial words (73.60 %) were content words whereas in the English-speaking CWS’s narratives, most utterance-initial words (83.57 %) were function words.ConclusionThese preliminary findings, although in need of replication with a larger sample size, seem to suggest that the word class (i.e., content/function words) contributions to stuttering loci are more language-specific whereas the word position (i.e., utterance-initial position) contributions to stuttering loci are more language-nonspecific. Given that the true characteristics of stuttering may be rather language-nonspecific than language-specific, further research may need to focus more on stuttering loci related to word position than word class.     

Comparison of pausing behavior in children who stutter and children who have Asperger syndrome

Purpose

The objective of this research was to compare the number and types of grammatical and non-grammatical silent pauses presented by stutterers and subjects with Asperger syndrome in their narratives.

Method

Ten children who stutter and four participants with Asperger syndrome (mean ages of both groups 10 years) were assessed at the Speech and Language Disorders Department of the Universidade Federal de São Paulo/Brasil. They narrated a story based on a pre-selected sequence of pictures. They were filmed and their productions were analyzed using version 5.0.47 of Praat (http://www.fon.hum.uva.nl/praat/download_win.html). Silent intervals in the speech that ranged from 0.25 to 4 s were considered pauses. The pauses were classified as grammatical and non-grammatical, depending on the words that preceded and followed them.

Results

Both groups presented grammatical and non-grammatical pauses and the former predominated. The children with Asperger syndrome produced a greater number of pauses than the stutterers.Educational objectives: The reader will be able to: (1) characterize the use of pauses in the oral narrative; (2) distinguish a grammatical pause from a non-grammatical pause regarding the use and function; (3) recognize the pattern of pause found in the two populations.     

Effect of phonological and morphological factors on speech disfluencies of Kannada speaking preschool children who stutter

PurposeEmpirical investigations have revealed a strong association between linguistic factors and stuttering, specifically phonological and morphological factors. However, the effect of these factors is suggested to vary across languages owing to the differences in their linguistic structure. Further, the trend is found to vary between AWS and CWS. Literature in this regard is scarce in the Kannada language, particularly in children. Hence, the study was driven by the need to understand the effect of phonological and morphological factors on stuttering in Kannada speaking CWS.MethodSpontaneous speech samples were obtained from twenty Kannada speaking preschool CWS with a confirmed diagnosis of stuttering by an experienced speech-language pathologist. The recorded samples were transcribed, and disfluencies were marked. Further, the stuttered words were analysed for phonological and morphological features. The phonological factors included were phoneme position in a word, phoneme type and word length. Morphological factors consisted of word class and word end inflectional morphology. The percentage of stuttering was calculated with respect to each of the factors mentioned above.ResultsPhoneme in the initial position of a word and words beginning with consonants had a higher rate of stuttering. Word length, word class and word end inflections were found to have no significant effect on the rate of stuttering in CWS.ConclusionOverall, current findings revealed that stuttering might manifest differently across languages varying in their linguistic structures.     

Effects of the degree of meaning similarity on cross-language semantic priming in highly proficient bilinguals

This study aimed to determine if access to meaning can be directly achieved from the words in the two languages, examining the influence of the degree of semantic overlap between related words across languages in the pattern of priming effects. Nonassociative semantically related words (members of the same category) were used, avoiding explicitly associative relationships. Using a priming paradigm, highly proficient Catalan–Spanish bilinguals were visually presented with pairs of words that either were translations of each other, had a very close semantic relationship (in terms of shared features), a close semantic relationship, or no semantic relationship at all. Participants performed either a lexical decision task (Experiment 1) or a semantic decision task (Experiment 2). The main results of the study were the same in both language directions (Spanish–Catalan and Catalan–Spanish), showing that the degree of semantic overlap (in terms of shared features) between words in different languages can modulate priming effects, regardless of the language of the prime and the task used. These results demonstrate that there is cross-language activation of shared semantic representations and, thus, that highly proficient bilinguals can have direct access to word meaning from the two languages.     

On the role of the upper part of words in lexical access: Evidence with masked priming

More than 100 years ago, Huey (1908/1968) indicated that the upper part of words was more relevant for perception than the lower part. Here we examined whether mutilated words, in their upper/lower portions (e.g., ), can automatically access their word units in the mental lexicon. To that end, we conducted four masked repetition priming experiments with the lexical decision task. Results showed that mutilated primes produced a sizeable masked repetition priming effect. Furthermore, the magnitude of the masked repetition priming effect was greater when the upper part of the primes was preserved than when the lower portion was preserved—this was the case not only when the mutilated words were presented in lower case but also when the mutilated words were presented in upper case. Taken together, these findings suggest that the front-end of computational models of visual-word recognition should be modified to provide a more realistic account at the level of letter features.     

Anxiety and speaking in people who stutter: An investigation using the emotional Stroop task

People with anxiety disorders show an attentional bias towards threat or negative emotion words. This exploratory study examined whether people who stutter (PWS), who can be anxious when speaking, show similar bias and whether reactions to threat words also influence speech motor planning and execution. Comparisons were made between 31 PWS and 31 fluent controls in a modified emotional Stroop task where, depending on a visual cue, participants named the colour of threat and neutral words at either a normal or fast articulation rate. In a manual version of the same task participants pressed the corresponding colour button with either a long or short duration. PWS but not controls were slower to respond to threat words than neutral words, however, this emotionality effect was only evident for verbal responding. Emotionality did not interact with speech rate, but the size of the emotionality effect among PWS did correlate with frequency of stuttering. Results suggest PWS show an attentional bias to threat words similar to that found in people with anxiety disorder. In addition, this bias appears to be contingent on engaging the speech production system as a response modality. No evidence was found to indicate that emotional reactivity during the Stroop task constrains or destabilises, perhaps via arousal mechanisms, speech motor adjustment or execution for PWS.Educational objectives: The reader will be able to: (1) explain the importance of cognitive aspects of anxiety, such as attentional biases, in the possible cause and/or maintenance of anxiety in people who stutter, (2) explain how the emotional Stroop task can be used as a measure of attentional bias to threat information, and (3) evaluate the findings with respect to the relationship between attentional bias to threat information and speech production in people who stutter.     

A comparison of the performance of Persian speaking children who do and do not stutter on three nonwords repetition tasks

PurposeThe purpose of the study was to examine the performance of Persian speaking children who stutter (CWS) and children who do not stutter (CWNS) on three nonword repetition tasks, while also focusing on which task and scoring method best differentiates the two groups of children.MethodThirty CWS and 30 CWNS between the ages of 5;0 to 6;6 completed three nonword repetition tasks that varied in complexity. Each task was scored using two methods: nonwords correct and phonemes correct. Between-group differences in performance on each task were examined, along with disfluencies for CWS and the task and scoring method that best differentiated the CWS and CWNS.ResultsThe findings revealed that, across all three nonword repetition tasks, the CWS consistently produced fewer nonwords correct and phonemes correct than the CWNS group at virtually all syllable lengths. The CWS produced more disfluencies on longer nonwords than shorter nonwords in all three nonword repetition tasks. The nonword repetition task with lower wordlikeness and more phonologically complex items best differentiated the two groups of children. Findings further revealed that discriminative accuracy was highest for scoring based on the number of phonemes produced correctly.ConclusionFindings provide further evidence to suggest that CWS may have difficulty with phonological working memory and/or phonological processing.     

Category size effects revisited: frequency and masked priming effects in semantic categorization

Previous work indicates that semantic categorization decisions for nonexemplars (e.g., deciding that TURBAN is not an animal name) are faster for high-frequency words than low-frequency words. However, there is evidence that this result might depend on category size. When narrow categories are used (e.g., Months, Numbers), there is no frequency effect for nonexemplars. This result is confirmed, and is explained in terms of a category search model, which allows a "No" decision to be generated without access to the lexical entry for the target word. This explains the absence of a frequency effect, but not the presence of a strong masked repetition priming effect, which is assumed to have a lexical source. It is shown that this effect may not be lexical, since nonwords also show similar priming. Both of these priming effects disappear when a larger category is used. This pattern of results is explained on the assumption that category search is only possible with small categories, and that tentative category decisions are generated for the unconsciously perceived prime, which leads to a marked response congruence effect.     

Resilience in people who stutter: Association with covert and overt characteristics of stuttering

PurposeRecent literature stresses the importance of resilience, as a trait, for successful coping with life’s difficulties or stressors. However, only a limited number of studies were conducted on resilience among people-who-stutter (PWS). These studies did not examine the association between resilience and the specific characteristics of stuttering. This study was, therefore, aimed to directly examine the association between resilience and measures of both the covert and overt characteristics of stuttering.MethodThirty adults who stutter completed the Connor-Davidson Resilience Scale (CD-RISC) and the Overall Assessment of Speaker’s Experience of Stuttering - Adults (OASES-A). In addition, stuttering severity of all participants was quantified using the Stuttering Severity Instrument-4 (SSI-4). The associations between all measures were examined statistically.ResultsA strong and significant association was found between the participants' scores on the CD-RISC and the OASES-A (r= -.79, p < .001). In contrast, no significant correlation was found between the participants' scores in the CD-RISC and the SSI-4 (r = .02, p > .05). Within our cohort, no significant association was observed between the participants’ gender and age and their resilience levels (p > 0.05).ConclusionThis study demonstrates the role of resilience in shaping the individual's experience with stuttering. Results also show that the individuals' resilience levels do not necessarily predict stuttering severity per se, or its overt manifestations but can predict the individuals' subjective perception of his/her stuttering. This highlights the importance of addressing and promoting resilience among PWS in stuttering therapy.     

Motor sequence learning in children with recovered and persistent developmental stuttering: preliminary findings

PurposePrevious studies have associated developmental stuttering with difficulty learning new motor skills. We investigated non-speech motor sequence learning in children with persistent developmental stuttering (CWS), children who have recovered from developmental stuttering (CRS) and typically developing controls (CON).MethodsOver the course of two days, participants completed the Multi-Finger Sequencing Task, consisting of repeated trials of a10-element sequence, interspersed with trials of random sequences of the same length. We evaluated motor sequence learning using accuracy and response synchrony, a timing measure for evaluation of sequencing timing. We examined error types as well as recognition and recall of the repeated sequences.ResultsCWS demonstrated lower performance accuracy than CON and CRS on the first day of the finger tapping experiment but improved to the performance level of CON and CRS on the second day. Response synchrony showed no overall difference among CWS, CRS and CON.Learning scores of repeated sequences did not differ from learning scores of random sequences in CWS, CRS and CON. CON and CRS demonstrated an adaptive strategy to response errors, whereas CWS maintained a high percentage of corrected errors for both days.ConclusionsOur study examined non-speech sequence learning across CWS, CRS and CON. Our preliminary findings support the idea that developmental stuttering is not associated with sequence learning per se but rather with general fine motor performance difficulties.     

The relationship of self-conception to perceived stuttering severity in children and adults who stutter

This explorative study addresses differences in the experience history with stuttering of children and adults who stutter. One-hundred persons, 40 elementary school children, and 60 adults, were administered a Communication Situation Scale to indicate perceived severity of their stuttering, and the Comprehensive System for the Rorschach Inkblot Test to indicate the degree to which their self-conception might be based on participation within social interactions. The findings showed a positive relationship between these two variables for children, especially with regard to interactions in dyads (pairs) and strangers, and a negative relationship for adults in dyads. The findings also showed that the relationship between these two variables was significantly inverse between children and adults, especially with regard to interactions in the above situations.     

Phonological neighborhood density in the picture naming of young children who stutter: preliminary study

The purpose of this study was to assess the effect of phonological neighborhood density on the speech reaction time (SRT) and errors of children who do and do not stutter during a picture-naming task. Participants were nine 3-5-year-old children who stutter (CWS) matched in age and gender to nine children who do not stutter (CWNS). Initial analyses indicated that both CWNS and CWS were significantly faster (i.e., exhibited shorter SRTs) and more accurate on phonologically sparse than phonologically dense words, findings consistent with those found with older children (Newman & German, 2002). Further analyses indicated that talker group differences in receptive language scores weakened these findings. These preliminary findings were taken to suggest that phonological neighborhood density appears to influence the picture-naming speed and accuracy of preschool-aged children. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to: (1) recognize the relevance of examining phonological variables in relation to childhood stuttering; and (2) describe the method of measuring speech reaction times and errors during a picture-naming task as a means of assessing linguistic skills.     

On the role of regular phonological variation in lexical access: evidence from voice assimilation in French

The present study investigated whether lexical access is affected by a regular phonological variation in connected speech: voice assimilation in French. Two associative priming experiments were conducted to determine whether strongly assimilated, potentially ambiguous word forms activate the conceptual representation of the underlying word. Would the ambiguous word form [sud] (either assimilated soute 'hold' or soude 'soda') facilitate "bagage" 'luggage', which is semantically related to soute but not to soude? In Experiment 1, words in either canonical or strongly assimilated form were presented as primes. Both forms primed their related target to the same extent. Potential lexical ambiguity did not modulate priming effects. In Experiment 2, the primes such as assimilated soute pronounced [sud] used in Experiment 1 were replaced with primes such as soude canonically pronounced [sud]. No semantic priming effect was obtained with these primes. Therefore, the effect observed for assimilated forms in Experiment 1 cannot be due to overall phonological proximity between canonical and assimilated forms. We propose that listeners must recover the intended words behind the assimilated forms through the exploitation of the remaining traces of the underlying form, however subtle these traces may be.