Japanese normative data for the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) Scales for adults who stutter

PurposeThis study reports Japanese normative data for the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) scales. We outline the translation process, and evaluate the psychometric properties of the Japanese version of the UTBAS scales.MethodsThe translation of the UTBAS scales into Japanese (UTBAS-J) was completed using the standard forward-backward translation process, and was administered to 130 Japanese adults who stutter. To validate the UTBAS-J scales, scores for the Japanese and Australian cohorts were compared. Spearman correlations were conducted between the UTBAS-J and the Modified Erickson Communication Attitude scale (S-24), the self-assessment scale of speech (SA scale), and age. The test-retest reliability and internal consistency of the UTBAS-J were assessed. Independent t-tests were conducted to evaluate the differences in the UTBAS-J scales according to gender, speech treatment experience, and stuttering self-help group participation experience.ResultsThe UTBAS-J showed good test-retest reliability, high internal consistency, and moderate to high significant correlations with S-24 and SA scale. A weak correlation was found between the UTBAS-J scales with age. No significant relationships were found between UTBAS-J scores, gender and speech treatment experience. However, those who participated in the stuttering self-help group demonstrated lower UTBAS-J scores than those who did not.ConclusionGiven the current scarcity of clinical assessment tools for adults who stutter in Japan, the UTBAS-J holds promise as an assessment tool and outcome measure for use in clinical and research environments.     

Exposure therapy for social anxiety disorder in people who stutter: An exploratory multiple baseline design

Background & objectives: Social anxiety disorder (SAD) is a debilitating condition, and approximately half of adults who stutter have SAD. Cognitive-behavioral therapy (CBT) has shown promise in decreasing social anxiety symptoms among adults who stutter, but exposure, arguably the essential component for successful CBT for SAD, has been understudied and underemphasized. Aims of this study were to develop an exposure therapy protocol designed specifically for people who stutter and have SAD and evaluate its potential efficacy in reducing social anxiety and stuttering severity using a multiple baseline design.Methods: Six participants received ten sessions of exposure therapy. Participants reported daily social anxiety, and social distress and stuttering severity were evaluated at major assessment points.Results: There were substantial reductions in social anxiety and considerable improvements in affective, behavioral, and cognitive experiences of stuttering. No consistent change was observed for stuttering frequency. Gains were mostly maintained after six-months.Conclusions: Results suggest that the novel exposure approach may decrease social distress, but not necessarily influence speech fluency. These findings underscore the importance of the assessment and treatment of SAD among adults who stutter and suggest that the integration of care between clinical psychologists and speech-language pathologists may prove beneficial for this population.     

Resting autonomic activity in adults who stutter and its association with self-reports of social anxiety

PurposeThe purpose of this study was to investigate resting autonomic activity in adults who stutter (AWS) compared to adults who do not stutter (ANS) and the relationship this has on self-reports of social anxiety.MethodsThirteen AWS and 15 ANS completed the Social Interaction Anxiety Scale (SIAS; Mattick & Clark, 1998) and Brief Fear of Negative Evaluation (BFNE; Leary, 1983). Following this, measures of skin conductance levels (i.e. index of sympathetic activity) and respiratory sinus arrhythmia (i.e. index of parasympathetic activity) were taken during a 5-minute resting, baseline period. Independent sample t tests were used to assess differences between groups on self-reports of anxiety (SIAS, BFNE) and resting autonomic levels (SCL, RSA). Separate multiple regression analyses were performed in order to assess the relationship between self-reports of anxiety and autonomic measures.ResultsResults showed significantly higher mean SCL and lower mean RSA levels in the AWS compared to the ANS at resting, baseline. Regression analysis showed that self-reports from the SIAS had a significant effect on RSA levels for the AWS but not the ANS. No significant effects were found for BFNE on RSA. Nor was there a significant effect from SIAS or BFNE on SCL levels for either group.ConclusionFindings suggest that resting RSA levels may be a physiological marker for social anxiety levels in adults who stutter.     

A novel approach for measuring social participation in adults who stutter

This paper reports a preliminary study which trialled a novel approach for measuring speech output and social participation. The amount of phonation was accumulated via an objective measure called an Ambulatory Phonation Monitor (APM).Purpose(1) To establish whether adults who stutter will tolerate wearing an APM for an extended period of time (three days), (2) to test whether the APM can accumulate useful data about the amount of phonation adults who stutter produce in the course of a normal day and (3) to examine a possible relationship between stuttering severity and amount of phonation.MethodThree adults who stutter wore an APM for three consecutive days during their waking hours. Each completed a questionnaire regarding the device and kept a speech diary outlining daily speaking activities and self-reported stuttering severity. APM data regarding amount of phonation was collected, analysed and compared with the participants’ speech diaries.ResultsEach adult tolerated wearing the APM and while they felt comfortable speaking wearing the device, it was somewhat cumbersome. Variations in the amount of speaking across each day and in different speaking situations were evident. For two participants there was a positive correlation between phonation time and severity rating.ConclusionsPreliminary data suggests that the APM can provide valuable information about the amount adults who stutter speak. The APM is sufficiently sensitive to differentiate variations in the amount of phonation during different speaking situations. These favourable preliminary results suggest the value of a larger scale study.Educational Objectives: The reader will be able to: (a) describe the different aspects of stuttering currently routinely measured in clinical practice; (b) discuss the limitations of current measurement procedures; (c) discuss the advantages of speech measures obtained by an Ambulatory Phonation Monitor APM); (d) describe the perspectives of adults who stutter who have worn an APM to measure phonation time.     

Stuttering and social anxiety

The aim of the present study was to investigate the presence of social anxiety in adults who stutter. This was done by administering the Inventory of Interpersonal Situations (IIS) (Van Dam-Baggen & Kraaimaat, 1999), a social anxiety inventory, to a group of 89 people who stuttered and 131 people who did not stutter. Two components of social anxiety were measured by the ISS, the extent to which emotional tension or discomfort is perceived in social situations and the frequency with which social responses are executed. The people who stuttered displayed significantly higher levels of emotional tension or discomfort in social situations. They also reported a significantly lower frequency of social responses compared to their nonstuttering peers. In addition, about 50% of the scores of the people who stuttered fell within the range of a group of highly socially anxious psychiatric patients. The results of the study suggest that the measurement of social anxiety is an important element in the assessment of adults who stutter. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to describe (1) the IIS as an assessment procedure for evaluating social anxiety, (2) the level of discomfort expressed by adult stutterers in social situations, and (3) the effect of social anxiety on stutterers' responsiveness in social situations.     

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.     

A model clarifying the role of mediators in the variability of mood states over time in people who stutter

PurposeElevated negative mood states such as social anxiety and depressive mood have been found in adults who stutter. Research is needed to assist in the development of a model that clarifies how factors like self-efficacy and social support contribute to the variability of negative mood states over time.MethodParticipants included 200 adults who stutter. A longitudinal design was employed to assess change in mood states over a period of five months. Hierarchical directed regression (path analysis) was used to determine contributory relationships between change in mood states and self-efficacy, social support, socio-demographic and stuttering disorder variables. Participants completed a comprehensive assessment regimen, including validated measures of mood states, perceived control (self-efficacy) and social support.ResultsResults confirmed that self-efficacy performs a protective role in the change in mood states like anxiety and depressive mood. That is, self-efficacy cushioned the impact of negative mood states. Social support was only found to contribute a limited protective influence. Socio-demographic variables had little direct impact on mood states, while perceived severity of stuttering also failed to contribute directly to mood at any time point.ConclusionsMood was found to be influenced by factors that are arguably important for a person to cope and adjust adaptively to the adversity associated with fluency disorder. A model that explains how mood states are influenced over time is described. Implications of these results for managing adults who stutter with elevated negative mood states like social anxiety are discussed.Educational Objectives: The reader will be able to describe: (a) the method involved in hierarchical (directed) regression used in path analysis; (b) the variability of mood states over a period of five months; (c) the nature of the mediator relationship between factors like self-efficacy and social support and mood states like anxiety, and (d) the contribution to mood states of socio-demographic factors like age and education and stuttering disorder variables like stuttering frequency and perceived severity.     

Self-efficacy and quality of life in adults who stutter

PurposeSelf-efficacy has emerged as a potential predictor of quality of life for adults who stutter. Research has focused primarily on the positive relationship self-efficacy has to treatment outcomes, but little is known about the relationship between self-efficacy and quality of life for adults who stutter. The purpose of this mixed- methods study is to determine the predictive value of self-efficacy and its relationship to quality of life for adults who stutter.MethodThe Self-Efficacy Scale for Adult Stutterers and the Overall Assessment of the Speaker’s Experience with Stuttering were administered to 39 adults who stutter, aged 18– 77. Percentage of syllables stuttered was calculated from a conversational speech sample as a measure of stuttered speech frequency. Qualitative interviews with semi-structured probes were conducted with 10 adults and analyzed using thematic analysis to explore the lived experience of adults who stutter.ResultsSelf-efficacy emerged as a strong positive predictor of quality of life for adults living with a stuttered speech disorder. Stuttered speech frequency was a moderate negative predictor of self-efficacy. Major qualitative themes identified from the interviews with the participants were: encumbrance, self-concept, confidence, acceptance, life-long journey, treatment, and support.ConclusionResults provide clarity on the predictive value of self-efficacy and its relationship to quality of life and stuttered speech frequency. Findings highlight that the unique life experiences of adults who stutter require a multidimensional approach to the assessment and treatment of stuttered speech disorders.     

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.     

A systematic review of interventions for adults who stutter

PurposeTo examine the effectiveness of (i) face to face interventions (ii) models of service delivery and (iii) psychological treatments combined with speech-focused interventions for adults who stutter.MethodsFive electronic databases and three clinical trial registries were searched. Systematic reviews, randomised controlled trials (RCTs) and studies that applied an intervention with adults who stutter were included. Pharmaceutical interventions were excluded. Primary outcomes included a measure of stuttering severity. Risk of bias assessment was conducted on included studies and overall quality of the evidence was graded.ResultsFive RCTS, four registered trials and three systematic reviews met inclusion criteria. Intervention approaches included speech restructuring programs (e.g. Camperdown Program) and transcranial direct current stimulation (tDCS). One study investigated cognitive behaviour therapy (CBT) alongside speech restructuring. Overall, studies were classified low risk of bias and good quality. Speech restructuring was included in all but one study (tDCS study) and had the most evidence i.e. supported by the greatest number of RCTs. On average, stuttering frequency was reduced by 50–57 % using speech restructuring approaches. No study reduced stuttering to the same level as community controls who don’t stutter. The study on tDCS reduced stuttering frequency by 22–27 %. Speech restructuring delivered via telehealth was non-inferior to face-to-face intervention. One study reported CBT was an effective adjunct to speech restructuring interventions.ConclusionSpeech restructuring interventions were found to reduce stuttering in adults, however degree and maintenance of fluency varied. The body of evidence surrounding tDCS and psychological interventions is limited. Replication studies should be considered.     

Cognitive control of action naming in adults who stutter

PurposeBased on previous evidence that cognitive control of lexical selection in object (noun) naming operates differently in adults who stutter (AWS) versus typically-fluent adults (TFA), the aim was to investigate cognitive control of lexical selection in action (verb) naming in AWS.Method12 AWS and 12 TFA named line drawings depicting actions using verbs. Half of the pictures had high-agreement action names and the other half low-agreement action names. Naming accuracy and reaction times (RT), and event-related potentials (ERPs) time-locked to picture onset, were compared between groups.ResultsNaming RTs were slower for low- versus high-agreement trials, and the magnitude of this effect was larger in AWS versus TFA. Delta-plot analysis of naming RTs revealed that individual differences in selective inhibition were associated with the agreement effect on naming RTs in AWS but not TFA. Action naming elicited frontal-central N2 activity in both agreement conditions in TFA but not AWS. Additionally, a later, posterior P3b component was affected by agreement in TFA only. In AWS, low-agreement action naming elicited frontal P3a activation.ConclusionsResults suggest that cognitive control of action name selection was qualitatively different between groups. In TFA, cognitive control of lexical selection in action naming involved nonselective inhibition, as well as more efficient working memory updating on high- versus low-agreement trials. In AWS, cognitive control of low-agreement action naming involved increased focal attention. Individual differences in selective inhibition may have moderated cognitive control of action naming in AWS.     

Identifying correlates of self-stigma in adults who stutter: Further establishing the construct validity of the Self-Stigma of Stuttering Scale (4S)

PurposeThis study was set up to further establish the construct validity of the Self-Stigma of Stuttering Scale (4S) by demonstrating its associations with other established scales and replicating its original factor structure and reliability estimates.MethodWeb surveys were completed by 354 adults who stutter recruited from Board Certified Specialists in Fluency Disorders, and adult chapters of the National Stuttering Association. Participants completed a series of psychometrically validated scales measuring self-stigma, hope, empowerment, quality of life, social support, anxiety, depression, and self-rated speech disruption.ResultsHigher subscale and total stigma scores on the 4S were associated with significantly lower levels of hope, empowerment, quality of life, and social support, and significantly higher levels of anxiety, depression, and self-rated speech disruption. The original factor structure of the 4S was replicated, and reliability estimates of the subscales ranged from adequate to excellent.ConclusionsThe findings of this study support the construct validity of the 4S and its use by clinicians and researchers intending to measure the construct of self-stigma in adults who stutter.Educational objectives: Readers should be able to: (a) distinguish between the various components of self-stigma; (b) describe how the various components of the self-stigma model relate to hope, empowerment, quality of life, and social support, self-rated speech disruption, anxiety, and depression; (c) summarize the psychometric properties of the Self-Stigma of Stuttering Scale (4S) in terms of reliability, factor structure, and construct validity; (d) discuss how the 4S could be used in research and clinical practice.     

Comparing acceptance and rejection in the classroom interaction of students who stutter and their peers: A social network analysis

PurposeRecent work has reported adverse effects of students’ stuttering on their social and emotional functioning at school. Yet, few studies have provided an in-depth examination of classroom interaction of students who stutter (SWS). The current study uses a network perspective to compare acceptance and rejection in the classroom interaction between SWS and their peers in secondary education.MethodsThe sample comprised 22 SWS and 403 non-stuttering peers (22 classes) of secondary education in Flanders (Belgium). Students' nominations regarding three acceptance and three rejection criteria were combined. Social network analysis offered procedures that considered direct and indirect interaction between all classmates.ResultsWe found few significant differences: SWS and their peers were distributed similarly across positive and negative status groups. Both considered and were considered by, on average, six or seven classmates as ‘a friend', who they liked and could count on, and nominated or were nominated by one or two classmates as ‘no friend', somebody who they disliked and could not count on. On average, SWS and their classmates also did not differ in terms of structural position in the class group (degree, closeness and betweenness), reciprocated rejection, and clique size. However, SWS do tend to be slightly more stringent or more careful in nominating peers, which led to fewer reciprocated friendships.ConclusionOur results suggest that SWS are quite accepted by peers in secondary education in Flanders. Such positive peer interaction can create a supportive and encouraging climate for SWS to deal with specific challenges.     

The relationship between the experience of stuttering and demographic characteristics of adults who stutter

PurposeThis study aims to examine the association between adults’ experience of stuttering and their age, gender and marital status, as well as to evaluate the psychometric properties of the Hebrew version of the OASES-A.MethodsThe Hebrew version of the OASES-A was administered to 91 adults-who-stutter. The validity of the translated version was evaluated using a subset of 43 participants, who also completed three additional instruments: (a) a Perceived Stuttering Severity (PSS) self-rating scale, (b) the Situation Avoidance Behavior Checklist (SABC), (c) the Students Life Satisfaction scale (SLSS). Finally, the correlations between the participants’ OASES-A scores and their age, gender and marital status were calculated.ResultsA negative correlation was found between the participants’ OASES-A impact scores and their age (p < 0.01). In addition, married participants exhibited lower OASES-A impact scores compared with unmarried participants (p < 0.05). On the other hand, the speakers’ gender was not associated with OASES-A impact scores.Resultsrevealed high internal consistency of the Hebrew OASES-A, and moderate to strong correlations with the additional examined instruments. Finally, results of the Hebrew version of the questionnaire were comparable with those obtained in other languages.ConclusionOur results indicated that, within our cohort, age and marital status are significantly associated with the personal experience of stuttering, whereas gender is not. In addition, the Hebrew version of the OASES-A is valid and comparable with equivalent versions in other languages. This facilitates the application of the OASES-A in future clinical and research settings.     

Effect of word phonetic properties on stuttering anticipation and speech production in adults who stutter

PurposeStuttering anticipation is a significant factor in an individual’s stuttering experience. People who stutter have reported words and sounds that they anticipate stuttering on. Attempts at understanding the association between stuttering anticipation and stuttering outcomes and the impact of phonetic properties on stuttering anticipation and overt stuttering have been insufficiently examined. This study aims to address these important issues.MethodsData were collected as part of a larger brain imaging study. Twenty adults who stutter rated a 414 word-list on stuttering anticipation. Participant-specific ‘high’ and ‘low’ anticipated words were selected. Twelve of the 20 participants returned for a second session 2–11 weeks later, during which they read the selected words again and stuttering occurrence was recorded.ResultsAmong the 20 participants, three sub-groups with “high” (N = 6), “moderate” (N = 5) and “low” (N = 9) stuttering anticipation were identified. Significant “high stuttering” anticipation was found on consonants, plosives, bilabials and alveolars, as well as labials and coronals. In 5 of the 8 participants who stuttered during session 2, more than 80 % of words stuttered were previously rated with high anticipation. Consonants, plosives, bilabials and alveolars, and labials and coronals were the most frequently stuttered (>27 %).ConclusionWhile not all adults who stutter demonstrate high word-specific stuttering anticipation, we found that more than half anticipated this to a high degree. Furthermore, both word-specific phonetic properties and stuttering anticipation impact stuttering occurrence. The inclusion of word-specific stuttering anticipation ratings may increase the likelihood of stuttering in experimental studies and improve treatment outcomes through individualized intervention.     

Preliminary study of self-perceived communication competence amongst adults who do and do not stutter

PurposeAdults who stutter report a significant impact of stuttering on their quality of life, including negative thoughts and attitudes toward communication. In addition to this impact, adolescents who stutter also report lower levels of self-perceived communication competence (SPCC) compared to fluent peers. The purpose of this study was to extend the investigation of SPCC to adults who do and do not stutter. Additional aims investigated included if 1) SPCC predicted overall impact of stuttering, and, 2) stuttering frequency predicted SPCC among adults who stutter.MethodsTwenty-four adults who stutter and twenty-seven adults who do not stutter matched for age, gender, and education completed the Self-Perceived Communication Competence Scale (Richmond & McCroskey, 1997). All participants who stutter completed the Overall Assessment of the Speaker’s Experience of Stuttering (OASES [ages 18+]; Yaruss & Quesal, 2006) and speaking samples to measure stuttering frequency.ResultsAdults who stutter reported significantly lower SPCC scale total scores than adults who do not stutter. For adults who stutter, lower SPCC scale scores significantly predicted more severe overall impact of stuttering as measured by the OASES. Stuttering frequency did not predict SPCC scale scores.DiscussionThis is the first study to report differences in self-perceived communication competence between adults who do and do not stutter. Results suggest adults who stutter report lower self-perceived communication competence compared to adults who do not stutter. Adults who perceive themselves to have greater communication competence reported less severe overall impact of stuttering, and stuttering frequency did not influence SPCC. Clinical implications for intervention are discussed.     

Responses of adults who stutter to the anticipation of stuttering

PurposeMany people who stutter experience the phenomenon of anticipation—the sense that stuttering will occur before it is physically and overtly realized. A systematic investigation of how people who stutter respond to anticipation has not been previously reported. The purposes of this study were to provide self-report evidence of what people do in response to anticipation of stuttering and to determine the extent to which this anticipation occurs.MethodsThirty adults who stutter indicated on a Likert rating scale the extent to which they anticipate stuttering and answered three open-ended (written) questions regarding how they respond to anticipation.ResultsAll participants reported experiencing anticipation at least “sometimes,” and 77% of the participants reported experiencing anticipation “often” or “always.” The extent to which participants reported experiencing anticipation was not related to stuttering severity, impact, or treatment history. Analysis of written responses revealed 24 major categories, which were heuristically divided into action or non-action responses. Categories representing avoidance and self-management strategies were further divided into 14 and 19 subcategories, respectively. Participants were just as likely to view anticipation as helpful as they were to view it as harmful.ConclusionFindings demonstrate that most, if not all, adults who stutter experience anticipation, and the majority of adults who stutter report doing so at least often. Adults who stutter respond to this anticipation by altering the speech production process in various ways. Results highlight the importance of the role that anticipation plays in how stuttering behaviors manifest themselves.Educational Objectives: The reader will be able to: (a) summarize existing literature on the anticipation of stuttering; (b) describe the role and extent of anticipation of stuttering in adults; (c) describe the various ways that adults who stutter respond to anticipation; (d) describe the importance of measuring anticipation in clinical and research domains.     

Phoneme monitoring in silent naming and perception in adults who stutter

The present study investigated phonological encoding skills in persons who stutter (PWS). Participants were 10 PWS (M = 31.8 years, S.D. = 5.9) matched for age, gender, and handedness with 12 persons who do not stutter (PNS) (M = 24.3 years, S.D. = 4.3). The groups were compared in a phoneme monitoring task performed during silent picture naming. The phonological complexity of the target items in the task was varied such that participants monitored either compound words or noun phrases. Performance in this task was compared to phoneme monitoring performed on aurally presented target words to investigate whether any differences observed in silent naming were also evident in perception. Analysis of the response time data, in milliseconds, indicated that PWS were significantly slower as compared to PNS in phoneme monitoring during silent naming; group differences were not obtained in the perception task. The groups were also comparable in the response time to phoneme monitoring within compound words and noun phrases in both silent naming and perception. The findings suggested that PWS were slower in the encoding of segmental, phonological units during silent naming. Furthermore, absence of such differences in perception ruled out a general monitoring deficit in PWS. Findings are interpreted within the context of the psycholinguistic theories of stuttering that postulate phonological encoding and/or monitoring as a causal variable in stuttering.

Educational objectives: As a result of this activity, the participant should: (1) describe relevant literature on phonological encoding skills in children and adults who stutter, (2) identify paradigms that can be used to investigate phonological processing in PWS, and (3) discuss the role of phonological encoding in speech production.     

Working memory in adults who stutter using a visual N-back task

PurposeThe purpose of this study was to investigate working memory in adults who do (AWS) and do not (AWNS) stutter using a visual N-back task. Processes involved in an N-back task include encoding, storing, rehearsing, inhibition, temporal ordering, and matching.MethodsFifteen AWS (11 males, 4 females; M = 23.27 years, SD = 5.68 years) and 15 AWNS (M = 23.47 years, SD = 6.21 years) were asked to monitor series of images and respond by pressing a “yes” button if the image they viewed was the same as the image one, two, or three trials back. Stimuli included images with phonologically similar (i.e., phonological condition) or phonologically dissimilar (i.e., neutral condition) names. Accuracy and manual reaction time (mRT) were analyzed.ResultsNo difference was found between AWS and AWNS in accuracy. Furthermore, both groups were more accurate and significantly faster in 1- followed by 2- followed by 3-back trials. Finally, AWNS demonstrated faster mRT in the phonological compared to neutral condition, whereas AWS did not.ConclusionResults from this study suggest different processing mechanisms between AWS and AWNS for visually presented phonologically similar stimuli. Specifically, a phonological priming effect occurred in AWNS but not in AWS, potentially due to reduced spreading activation and organization in the mental lexicon of AWS. However, the lack of differences between AWS and AWNS across all N-back levels does not support deficits in AWS in aspects of working memory targeted through a visual N-back task; but, these results are preliminary and additional research is warranted.