Onset and termination of accessory facial movements during stuttering

In this study the onset and offset times of seven types of accessory facial movements during oral and silent prolongations were described in three severe stutterers. For each observed facial movement the onset and offset times were determined by means of slow motion analysis of video-recorded speech samples. For two of the three subjects significant differences in the onset and offset times at the various facial movements were found; however, no consistent patterns in the separate facial movements could be observed. On the contrary, the onset of most facial movements appeared to be located at the very start and their offset at the end of the stuttering moment. The implications of these findings with respect to the function of accessory facial movements in stuttering are discussed.     

The recovery rate of early stuttering

PurposeAcross studies there is great variability in reported rates of stuttering recovery. This study examined the impact that different definitions of recovery had on calculation of recovery rates and factors associated with recovery within the same sample of children.MethodSpeech samples and parents and child reports of their experiences of stuttering were collected from 38 children who stuttered aged 2–5 years of age (Occassion-1) and again at 9–13 years of age (Occassion-2). Four different criteria for recovery that were developed representing variations in criteria reported in previous research were applied to data from these children.Results. The majority of the participants (82%) showed very little disfluent speech (<1% syllables stuttered) at Occasion 2. Recovery rate varied greatly depending on the criteria used, ranging from 13.2%–94.7%. Definitions ordered from least to greatest recovery that were (a) parent and clinician report no stuttering and no stuttering observed (13.2 %); (b) ≤1% syllables stuttered; severity rated at ≤1; parent, clinician, and child report recovery (55.3 %); (c) ≤1% syllables stuttered; severity rated at ≤1; parent and clinician report recovery (71.1 %); (d) <3.0 % syllables stuttered (94.7 %). Five participants were considered recovered and two were considered persistent stutters across all criteria. Different factors were associated with recovery from stuttering depending on the criterion used.ConclusionThe concept of recovery from stuttering is complex and estimations of recovery rate are likely to be greatly affected by differences in definitions and measurement across studies. This has a flow-on effect in determining the factors associated with recovery from stuttering.     

"Roadblocks" revisited: neural change, stuttering treatment, and recovery from stuttering

In light of emerging findings concerning untreated recovery and neural plasticity, this paper re-examines the viability of an NIH conference recommendation [Cooper, J. A. (1990). Research directions in stuttering: Consensus and conflict. In Cooper, J. A. (Ed.), Research needs in stuttering: Roadblocks and future directions (pp. 98-100). Rockville, MD: American Speech-Language-Hearing Association.] that adults who have recovered from stuttering might inform our understanding of the nature and treatment of persistent stuttering. It is suggested that those who have recovered could constitute a behavioral, cognitive, and neurophysiologic benchmark for evaluating stuttering treatment for adolescents and adults, while helping to identify the limits of recovery from a persistent disorder. This possibility seems especially promising because of findings from recent studies investigating untreated recovery during childhood and adulthood, the emerging evidence concerning neural plasticity and reorganization, and reports of neural system changes during stuttering treatment. Potential obstacles to applying findings from unassisted recovery to treatment do exist, but the benefits of attempts to fully understand stuttering certainly outweigh the difficulties. EDUCATIONAL OBJECTIVES: After completing this activity, the learner will be able to: (1) describe two complexities involved in determining whether recovery from stuttering was assisted or unassisted; (2) discuss the implications for stuttering research of two neural plasticity research findings from areas other than stuttering; and (3) evaluate the possible implications for stuttering treatment of a coordinated research program that addresses behavioral, cognitive, and neurological characteristics of assisted and unassisted recovery from stuttering.     

The relationship between anxiety, fatigue and spontaneous recovery in stuttering

There is apparently no formalized hypothesis regarding the antecedents of spontaneous recovery of stuttering. Since adaptation and recovery appear to be functionally related, antecedents of adaptation have been considered to be antecedent to spontaneous recovery. Two disparate hypotheses of adaptation which have experimental support are the anxiety hypothesis and the fatigue hypothesis. The present study was initiated to investigate the relationship of anxiety and/or fatigue, if any, to spontaneous recovery. Twenty-one subjects (stutterers) participated in four conditions. Each condition consisted of eight oral readings of a passage. The experimental variables were introduced into the respective conditions after the fifth oral reading. They were: (I) no rest, same passage; (II) rest, same passage; (III) no rest, different passage; and, (IV) rest, different passage. Palmar sweat fingerprints of anxiety were taken concurrently with the first thirty seconds of trials one, three, five, six, seven and eight for all conditions. The results of the investigation led to the conclusions that: (1) there was no necessary relationship between a change in the frequency of stuttering and a change in the anxiety level ; (2) the Hullian concepts of reactive and conditioned inhibition appeared to provide a meaningful approach to the question of spontaneous recovery of stuttering behaviour.     

Listener perceptions of stuttering and stuttering modification techniques

PurposeThe purpose of this study was to analyse naïve listener perceptions of speech containing unmodified stuttering, use of the pull-out technique, and use of preparatory-sets.MethodParticipants (N = 62) were randomly assigned to listen to one audio sample (unmodified stuttered speech, speech with pull-outs, or speech with preparatory-sets) and completed a survey assessing perceptions of the speaker’s speech and personality and the listener’s comfort level and willingness to social interact with the speaker.ResultsSurvey results revealed low perceptual ratings in all experimental conditions. Unmodified stuttered speech received significantly more positive ratings than the stuttering modification conditions in all measurements except for speech naturalness. Listeners reported being less willing to socially interact with those who use preparatory-sets than unmodified stuttered speech.ConclusionThe use of stuttering modification techniques did not improve listeners’ perceptions or willingness to interact with persons who stutter. Clinicians and those who stutter should be aware that the use of speech techniques will not decrease negative social interactions or stereotypes.     

Sudden recovery from stuttering after an epileptic attack: A case report.

This case report concerns a boy 5.06 years of age, who began to stutter from about his fifth birthday. In the course of a six-month period, his disfluencies became more and more pronounced until a sudden and complete recovery took place following an epileptic attack. Some references are made to the literature on the relationship between stuttering and epilepsy. Some comparisons are made also with more-or-less-similar adult cases, as mentioned in the literature, but we have the strong feeling that these do not hold completely.     

Unassisted recovery from stuttering: self-perceptions of current speech behavior, attitudes, and feelings

The purpose of this study was to investigate the nature of recovery from stuttering based on the experiences of adults who recovered without treatment. Using a semi-structured, open-ended interview format, 15 speakers verified as persons who recovered without treatment were asked to describe their status as everyday speakers. Seven speakers reported that they no longer stuttered and eight reported that they still stuttered on occasion. Interview material was coded and analyzed by the investigators and checked by independent judges. Results suggested that complete recovery was possible for speakers who reported that they no longer stuttered; whereas, those who still stuttered occasionally appeared to no longer be handicapped by stuttering, but required some vigilance to maintain their relatively fluent speech.

Educational objectives: After completing this activity, the learner will be able to: (1) describe the relevance of self-report data for evaluating the nature of recovery from stuttering without treatment; (2) describe the differences in self-perception concerning the nature of recovery for those who no longer have any tendency to stutter compared to those who still have an occasional tendency to stutter; and (3) suggest the possible implications for understanding the nature of recovery from persistent stuttering based on investigations of late recovery without treatment.     

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.     

The chronic perseverative stuttering syndrome; Incurable stuttering

After recounting the story of Todd to illustrate the significance of the issue, the chronic perseverative stuttering (CPS) syndrome is defined and its characteristics identified. After a discussion of treatment goals for the CPS syndrome client, the significance of its identification in the client's teenage years and its relevance to support groups for stutterers, the paper concludes with a call for acknowledging the reality of the CPS syndrome and for establishing realistic therapy goals in view of its existence.     

Acquired stuttering

Working from a case of degeneration of the nervous system accompanied by stutterlike repetitions, this article raises the question whether patients should be said to have acquired stuttering when they evidence only one of the typical symptoms of the syndrome. On the other hand, it is shown that when acquired stuttering is polysymptomatic, it can hardly be distinguished from developmental stuttering on the basis of the patient's verbal behavior. This may have important medicolegal implications. When acquired stuttering occurs in the context of aphasia, both affections appear to be relatively independent of each other. Specifically, there seems to be no causal relationship between them.     

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.     

Speech motor skill and stuttering

The authors review converging lines of evidence from behavioral, kinematic, and neuroimaging data that point to limitations in speech motor skills in people who stutter (PWS). From their review, they conclude that PWS differ from those who do not in terms of their ability to improve with practice and retain practiced changes in the long term, and that they are less efficient and less flexible in their adaptation to lower (motor) and higher (cognitive-linguistic) order requirements that impact on speech motor functions. These findings in general provide empirical support for the position that PWS may occupy the low end of the speech motor skill continuum as argued in the Speech Motor Skills approach (Van Lieshout, Hulstijn, & Peters, 2004).     

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.     

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.     

Utterance timing and childhood stuttering

Articulatory speaking rate and response time latency are believed by many to be important factors in determining whether stuttering will occur in a given utterance. Currently, however, there is little empirical evidence to suggest that these measures of utterance timing are directly related to stuttering. This study examined the relationship between articulatory speaking rate and response time latency in the conversational speech of 12 boys who stutter (mean age = 55.2 months; SD = 8.8 months) who participated in 30-min conversational interactions with their mothers. Discriminant function analyses were conducted on 75 utterances drawn from each child's speech sample to determine if the articulatory speaking rate or response time latency of a specific utterance was related to the likelihood that the child would stutter on that utterance. No significant relationships between these measures of utterance timing and stuttering were found for any of the 12 subjects, and there were no significant relationships between these two measures of utterance timing. Findings do not provide support for many current theories of stuttering and suggest that the role of these measures of utterance timing in predicting the occurrence of stuttering in conversational speech in these theories may need to be reexamined.     

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.