Stuttering and its treatment in adolescence: the perceptions of people who stutter

Adolescence is a complicated phase of maturation during which a great deal of physical, neurological and social development occurs. Clinically this phase is thought to be the last chance to arrest the development of the disorder of stuttering before it becomes chronic in adulthood. However, little treatment development for this age group has occurred. Previous research on the impact of stuttering during adolescence presents a complex picture of apprehension about speaking which does not, however, appear to interfere with social life. The purpose of the present study was to investigate further the experiences of adolescents who stutter with respect to: (1) their experience of stuttering during the adolescent years, (2) reasons for seeking or not seeking therapy during the adolescent years, (3) barriers to seeking therapy during the adolescent years, (4) their experience of therapy during the adolescent years, and finally (5) suggested improvements to therapy for adolescents. Two focus groups and seven individual interviews were conducted with 13 adolescents and young adults. The major finding was a perceived lack of awareness about stuttering by teachers and parents, as well as other adolescents. In addition it appeared that having a stutter was, in itself, not enough reason to seek treatment. However when adolescents did seek treatment, for reasons such as joining the workforce, group therapy was well liked. Educational objectives: The reader will summarize key features that characterize: (1) the complex developmental phase of adolescence, (2) evaluate the experience of stuttering during the adolescent years, (3) discuss the experience of stuttering therapy during the adolescent years, (4) list adolescents' reported barriers to seeking therapy during the adolescent years, and (5) suggest possible ways to improve management of stuttering in adolescence.     

Stuttering attitudes among Turkish family generations and neighbors from representative samples

PurposeAttitudes toward stuttering, measured by the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S), are compared among (a) two different representative samples; (b) family generations (children, parents, and either grandparents or uncles and aunts) and neighbors; (c) children, parents, grandparents/adult relatives, and neighbors of the same family/neighbor units vs. individuals from different family/neighbor units; and (d) attitudes from one Turkish city with an international database archive.MethodsFollowing a school-based, three-stage, cluster probability sampling scheme, two sets of children, parents, grandparents/adult relatives, and neighbors (50 each) in Eski?ehir, Turkey (PROB1 and PROB2) completed Turkish translations of the POSHA-S. The POSHA-S measures attitudes toward stuttering within the context of other attributes, such as obesity and mental illness.ResultsBoth replicates of the sampling procedure yielded strikingly similar attitudes for stuttering between children, parents, grandparents/adult relatives, and neighbors in PROB1 vs. PROB2, and between all pair-wise comparisons within PROB1 and PROB2. By contrast, attitudes toward obesity and mental illness were dissimilar. Correlations were small to moderate among attitudes of the same family/neighbor units but were essentially nonexistent between different family/neighbor units. Attitudes toward stuttering in Eski?ehir were estimated to be less positive than attitudes from a wide range of samples around the world, although exceptions occurred.ConclusionsA school-based probability sampling procedure yielded consistent findings that are likely different from results from convenience samples. Families appear to be an important influence in determining public attitudes toward stuttering and other human attributes.Educational objectives: The reader will be able to: (i) identify similarities and differences among attitudes toward stuttering across generations; (ii) identify similarities and differences among attitudes toward stuttering in Turkey vs. other places in the world; (iii) describe a school-based probability sampling scheme; (iv) describe advantages of using a standard instrument to measure public attitudes toward stuttering.     

Lexical morphology and its role in the writing process: evidence from a case of acquired dysgraphia

A case of acquired dysgraphia is presented in which the deficit is attributed to an impairment at the level of the Graphemic Output Buffer. It is argued that this patient's performance can be used to identify the representational character of the processing units that are stored in the Orthographic Output Lexicon. In particular, it is argued that the distribution of spelling errors and the types of lexical items which affect error rates indicate that the lexical representations passed from the lexical output system to the Graphemic Output Buffer correspond to the productive morphemes of the language.     

Differences in spatial knowledge acquired from maps and navigation

Models of the spatial knowledge people acquire from maps and navigation and the procedures required for spatial judgments using this knowledge are proposed. From a map, people acquire survey knowledge encoding global spatial relations. This knowledge resides in memory in images that can be scanned and measured like a physical map. From navigation, people acquire procedural knowledge of the routes connecting diverse locations. People combine mental simulation of travel through the environment and informal algebra to compute spatial judgments. An experiment in which subjects learned an environment from navigation or from a map evaluates predictions of these models. With moderate exposure, map learning is superior for judgments of relative location and straight-line distances among objects. Learning from navigation is superior for orienting oneself with respect to unseen objects and estimating route distances. With extensive exposure, the performance superiority of maps over navigation vanishes. These and other results are consonant with the proposed mechanisms.     

Representing logical and semantic structure of knowledge acquired from discourse

A network model of logical and semantic structures from which speakers or writers generate linguistic messages at the discourse level is presented. While linguistic structures were considered in developing the model, the semantic and logical networks are defined without reference to linguistic structures and thus may be used to represent knowledge structures acquired from both linguistic and nonlinguistic sources. A second problem addressed is that of determining what logical and semantic information is acquired when a text is understood. To assess acquired knowledge, a procedure is presented for coding a subject's verbal reconstruction of knowledge acquired from a presented text (or other input) against the logical and semantic structure from which the text (or other input) was derived. The procedures are illustrated using data obtained from children who were asked to “retell” simple narrative stories.     

Predicting brain organization from dichotic listening performance: Cortical and subcortical functional asymmetries contribute to perceptual asymmetries

The patterns of perceptual asymmetry elicited by dichotic speech and complex pitch stimuli were evaluated in a group of 28 normal, right-handed subjects. As in previous studies, between 70 and 75% of the subjects showed a right-ear advantage for speech and left-ear advantage for pitch. However, less than half of the subjects (46%) showed the expected pattern on both tests. It is argued that the assumption of symmetrical, contralateral auditory pathway superiority during dichotic stimulation is only appropriate in roughly half of the dextral population. In the remaining half, significant subcortical asymmetries and/or a lack of contralateral advantage appear to be present. The assessment of complementary cortical functions should provide a way to reduce the confounding of cortical and subcortical contributions to auditory perceptual asymmetries, and thus provide a more accurate behavioral index of brain organization.     

Temporally graded,context-specific retrograde amnesia and its alleviation by context preexposure: effects of postconditioning exposures to morphine in the rat

Five experiments studied retrograde impairments in Pavlovian fear conditioning following prolonged exposure to the opioid receptor agonist morphine. Injections of morphine commencing 1-7 days but not 14 days after conditioning produced amnesia for that conditioning episode. This amnesia was (a) selective such that morphine impaired freezing to the conditioning context but not to the auditory conditioned stimulus, (b) independent of the interval between the last injection of morphine and test, and (c) accompanied by a failure of contextual discrimination. Context preexposure protected context conditioning and discrimination from the amnestic effects of morphine. These results show that retrograde deficits in contextual fear conditioning are mediated by failures to consolidate a contextual representation.     

Transection of direct anterior thalamic afferents from the hippocampus: effects on activity and active avoidance in rats

This investigation demonstrates the importance of the direct hippocampo-anterior thalamic component of the postcommissural fornix in the control of general locomotion and active avoidance. Transection of anterior thalamic afferents from the hippocampal formation (subicular cortex), at the point where they exit from the fornix posterior to the septum, is sufficient to enhance bidirectional active avoidance acquisition and increase general activity. This transection may also interrupt fibers to or from other thalamic nuclei and the anterior septum. However, destruction of connections of the anterior septum with the hippocampus, habenula, and thalamus by transection in the coronal plane anterior to the descending fornix columns, without damage to the subiculothalamic fibers, increases general activity levels without damage to the subiculothalamic fibers, increases general activity levels without affecting active avoidance behavior. The activity increase in this case resembles that seen after septal lesions rather than that seen after hippocampal lesions. Thus, destruction of a single fornix component contributing afferents to the anterior thalamic nuclei reproduces at least part of the hippocampal syndrome. This suggests that these fibers contribute significantly to the control of these behaviors and may mediate active avoidance changes resulting from hippocampal and fornix damage.     

Structure and function in acquired prosopagnosia: Lessons from a series of 10 patients with brain damage

Acquired prosopagnosia varies in both behavioural manifestations and the location and extent of underlying lesions. We studied 10 patients with adult‐onset lesions on a battery of face‐processing tests. Using signal detection methods, we found that discriminative power for the familiarity of famous faces was most reduced by bilateral occipitotemporal lesions that involved the fusiform gyri, and better preserved with unilateral right‐sided lesions. Tests of perception of facial structural configuration showed severe deficits with lesions that included the right fusiform gyrus, whether unilateral or bilateral. This deficit was most consistent for eye configuration, with some patients performing normally for mouth configuration. Patients with anterior temporal lesions had better configuration perception, though at least one patient showed a more subtle failure to integrate configural data from different facial regions. Facial imagery, an index of facial memories, was severely impaired by bilateral lesions that included the right anterior temporal lobe and marginally impaired by fusiform lesions alone; unilateral right fusiform lesions tended to spare imagery for facial features. These findings suggest that (1) prosopagnosia is more severe with bilateral than unilateral lesions, indicating a minor contribution of the left hemisphere to face recognition, (2) perception of facial configuration critically involves the right fusiform gyrus and (3) access to facial memories is most disrupted by bilateral lesions that also include the right anterior temporal lobe. This supports assertions that more apperceptive variants of prosopagnosia are linked to fusiform damage, whereas more associative variants are linked to anterior temporal damage. Next, we found that behavioural indices of covert recognition correlated with measures of overt familiarity, consistent with theories that covert behaviour emerges from the output of damaged neural networks, rather than alternative pathways. Finally, to probe the face specificity of the prosopagnosic defect, we tested recognition of fruits and vegetables: While face specificity was not found in most of our patients, the data of one patient suggested that this may be possible with more focal lesions of the right fusiform gyrus.     

Perceptual learning and acquired face familiarity: Evidence from inversion,use of internal features,and generalization between viewpoints

Pairs of similar faces were created from photographs of different people using morphing software. The ability of participants to discriminate between novel pairs of faces and between those to which they had received brief, unsupervised, exposure (5×2 s each) was assessed. In all experiments exposure improved discrimination performance. Overall, discrimination was better when the faces were upright, but exposure produced improved discrimination for both upright and inverted faces (Experiment 1). The improvement produced by exposure was selective to internal face features (Experiment 2) and was evident when there was a change in orientation (three-quarter to full face or vice versa) between exposure and test (Experiment 3). These findings indicate that perceptual learning observed following brief exposure to faces exhibit well-established hallmarks of familiar face processing (i.e., internal feature advantage and insensitivity to a change of viewpoint). Considered in combination with previous studies using the same type of stimuli (Mundy, Honey, & Dwyer, 2007), the current results imply that general perceptual learning mechanisms contribute to the acquisition of face familiarity.     

The representation of response effector and response location in episodic memory for newly acquired actions: Evidence from retrieval-induced forgetting

Information retrieval can cause forgetting for related but non-retrieved information. Such retrieval-induced forgetting (RIF) has been previously found for semantically and episodically related information. The current study used RIF to examine whether response effector and location are encoded explicitly in action memory. Participants learned unique touchscreen responses to ten novel objects. Correct actions to each object involved left-hand or right-hand pushing of one of four possible object buttons. After learning, participants practiced two of the ten object-specific sequences. Unpracticed actions could share hand only, button only, both hand and button, or neither hand nor button, with the practiced actions. Subsequent testing showed significant RIF (in retrieval accuracy and speed measures) for actions that shared hand only, button only, or both hand and button with the practiced action. The results have implications for understanding the representations mediating episodic action memory, and for the potential of RIF as a tool for elucidating feature-based representations in this and other domains.     

Holistic processing of shape cues in face identification: Evidence from face inversion,composite faces,and acquired prosopagnosia

According to a classical functional architecture of face processing (Bruce & Young, 1986), sex processing on faces is a parallel function to individual face recognition. One consequence of the model is thus that sex categorization on faces is not influenced by face familiarity. However, the behavioural and neuro-psychological evidences supporting this dissociation are yet equivocal. To test the independence between sex processing on faces and familiar face recognition, familiar (learned) faces were morphed with new faces, generating facial continua of visual similarity to familiar faces. First, a pilot experiment shown that subjects familiarized with one extreme of the face continuum roughly perceive one half of the continuum (60 to 100% of visual similarity to familiar faces) as made of familiar faces and the other part as unfamiliar. In the experiment proper, subjects were familiarized with faces and tested in a sex decision task made on faces at the different steps of the continua. Subjects were significantly quicker at telling the sex of faces perceived as familiar (60-100%), and the effect was not observed in a control (untrained) group. These results indicate that familiar face representations are activated before sex categorization is completed, and can facilitate this processing. The nature of the interaction between sex categorization on faces and familiar face recognition is discussed.     

Extraversion and its positive emotional core--further evidence from neuroscience

Converging evidence from self-report data demonstrated that extraversion and dispositional positive affect are systematically related. Several authors therefore considered positive affect as the conceptual core of extraversion. Because the ventral striatum is regarded as a core region in the physiological basis of extraversion, the present study examines the importance of this neural substrate with a special focus on positive affect. Baseline cerebral blood flow was measured in 38 participants and regressed to the extraversion and dispositional positive affect scales. Partial correlational and indirect-effects analyses indicated that striatal blood flow was no longer associated with extraversion when positive affect was statistically controlled. In contrast, when extraversion was statistically controlled, striatal blood flow was still associated with positive affect. This finding suggests that the striatal region is not a biological basis of extraversion per se. Rather, this region sustains positive affect, which in turn appears to be a core feature of extraversion.     

Wittgenstein, Moorean Absurdity and its Disappearance from Speech

G. E. Moore famously observed that to say, “ I went to the pictures last Tuesday but I don’t believe that I did” would be “absurd”. Why should it be absurd of me to say something about myself that might be true of me? Moore suggested an answer to this, but as I will show, one that fails. Wittgenstein was greatly impressed by Moore’s discovery of a class of absurd but possibly true assertions because he saw that it illuminates “the logic of assertion”. Wittgenstein suggests a promising relation of assertion to belief in terms of the idea that one “expresses belief” that is consistent with the spirit of Moore’s failed attempt to explain the absurdity. Wittgenstein also observes that “under unusual circumstances”, the sentence, “It’s raining but I don’t believe it” could be given “a clear sense”. Why does the absurdity disappear from speech in such cases? Wittgenstein further suggests that analogous absurdity may be found in terms of desire, rather than belief. In what follows I develop an account of Moorean absurdity that, with the exception of Wittgenstein’s last suggestion, is broadly consistent with both Moore’s approach and Wittgenstein’s.