Factors affecting judgments of fluency: II. Word repetitions

Six speech samples containing varying amounts of whole-word repetitions were tape-recorded and presented to 36 male and 36 female listeners. For each sample, listeners were asked to make judgments of fluent, disfluent, and stuttered speech, and to answer the question, “Would you recommend speech therapy?” Results showed that samples containing 5% or more word repetitions were not judged fluent speech by a majority of listeners. Judgments of disfluent and stuttered speech were nearly equal for speech samples containing word repetitions from 5% to 15%. At 20%, however, the judgments of stuttered speech were found to be more likely than judgments of disfluent speech. A majority of listeners recommended clinical services for speech samples containing 5% or more word repetitions. Generally, the results indicated that (1) the presence of whole-word repetitions is not normal regardless of frequency, (2) fluent speech may not contain 5% or more word repetitions, and (3) with 20% word repetitions the judgments of stuttering may be more likely than judgments of disfluency.     

Quality and readability of internet information about stuttering

PurposeWe examined the quality and readability of English-language Internet information about stuttering and evaluated the results considering recommendations by experts in health literacy.MethodA search of Internet websites containing information about stuttering was conducted. Three key words (i.e., stuttering, stammering, speech disfluency) were entered into five country-specific versions of the most commonly used Internet search engine. A total of 79 websites were assessed. Their origin (commercial, non-profit, government, personal or university), quality [Health On the Net (HON) certification and DISCERN scores], and readability [Flesch Reading Ease (FRE) score, Flesch-Kincaid Grade Level Formula (F-KGL), and Simple Measure of Gobbledygook (SMOG)] were assessed.ResultsOf the 79 websites, 38 % were of commercial, 42 % were of nonprofit organization, 15 % were of government and 5% were of university origins, respectively. Only 13 % had obtained HON certification and the mean DISCERN scores was 3.10 in a 5-point scale. The mean reading grade levels were at 13th and 14th grade and 100 % of the websites exceeded the recommended 5th to 6th reading grade level for health information.ConclusionsThe quality of Internet-based health information about the treatment of stuttering is generally adequate, but actual usability of the sites examined in this study may be limited due to poor readability levels. This is problematic in persons with poor literacy skills. Since the Internet can be readily accessed as a valuable consumer information resource, speech-language pathologists and other healthcare professionals have an opportunity to direct consumers to websites that provide readable information of good quality.     

The Adams and Reis observations revisited

This experiment was designed as a replication of the Adams and Reis (1971, 1974) experiments, which posited a direct relationship between frequency of stuttering and the number of “off-on” laryngeal adjustments during speech. Twenty adult stutterers read two prose passages equivalent in length, word length, and semantic content. The first passage contained a normal distribution of syllable-initial voiced and voiceless consonants whereas the second contained only voiced phonemes. The results demonstrated significantly greater stuttering during reading of the all-voiced passage (P?0.05). These results did not confirm the earlier observations of Adams and Reis and mitigate the hypothesized relationships between stuttering frequency and “off-on” laryngeal adjustments.     

Word fragmentations and repetitions in the spontaneous speech of 2–6-yr-old children

Samples of spontaneous speech of 110 nursery school children, aged 2 yr, 1 mo to 6 yr, were written down. Two of the children were regarded as stutterers by the parents and the nursery school personnel. Instances of word and phrase repetitions and word fragmentations were marked. Fragmentation of a word before the whole word is pronounced was used as criterion of stuttering. The nonstutterers had an average frequency of word repetitions of 6.3%, while word fragmentations were virtually nonoccurrent. The frequency of word repetitions decreased with increasing age. Relating word repetitions to grammatical complexity of speech, it was found that the decrease was particularly large at a certain point of the grammatical development. The two stutterers had, in addition to normal frequencies of word repetitions, marked occurences of word fragmentations (2.8 and 4.1%).     

Influence of stuttering therapy on clinicians'' disfluencies: Effects of client modeling

This study investigated whether student clinicians working with stutterers subsequently produce more disfluencies than student clinicians providing therapy to clients with other speech and language disorders. Seventeen graduate students working in a 6-wk summer camp setting were divided into two groups: eight who provided treatment for stutterers (group 1) and nine who provided therapy for clients with other communication disorders (group 2). All student clinicians were recorded during spontaneous speaking and oral reading tasks prior to camper arrival and following camper departure. An eight-category classification system was used to determine disfluency types. Findings revealed that Group 1 clinicians significantly decreased their total disfluencies between pre- and post-camp recordings on the spontaneous speaking task. Unexpectedly, this same group also substantially increased part-word repetitions and sound prolongations. The possibilities of incidental learning, reverse modeling, and overidentification with stuttering clients are discussed.     

Voluntary stuttering suppresses true stuttering: a window on the speech perception-production link

In accord with a proposed innate link between speech perception and production (e.g., motor theory), this study provides compelling evidence for the inhibition of stuttering events in people who stutter prior to the initiation of the intended speech act, via both the perception and the production of speech gestures. Stuttering frequency during reading was reduced in 10 adults who stutter by approximately 40% in three of four experimental conditions: (1) following passive audiovisual presentation (i.e., viewing and hearing) of another person producing pseudostuttering (stutter-like syllabic repetitions) and following active shadowing of both (2) pseudostuttered and (3) fluent speech. Stuttering was not inhibited during reading following passive audiovisual presentation of fluent speech. Syllabic repetitions can inhibit stuttering both when produced and when perceived, and we suggest that these elementary stuttering forms may serve as compensatory speech gestures for releasing involuntary stuttering blocks by engaging mirror neuronal systems that are predisposed for fluent gestural imitation.     

Factors affecting judgments of fluency: I. interjections

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

Critical words and the locus of stuttering in speech

The locus of stuttering in the communicative speech of 26 stutterers was studied in situations where subjects received and conveyed specific information. It was hypothesized that a larger proportion of critical rather than noncritical words would be stuttered. Critical words were those which necessarily had to be pronounced if a listener should be able to understand and act according to the messages given. The critical words were selected by the experimenter before the experiment started. The results showed that 35.8% of the critical and 8.4% of the noncritical words were stuttered. There was also significantly more stuttering on critical words than on long noncritical words. The largest proportion of critical words appeared in the final position of sentences, which was also where most stuttering was located. Whole-word repetitions, an instance of normal nonfluency, were associated with noncritical words. No correlation between frequency of stuttering and whole-word repetitions was found.     

Clinician's molar and molecular stuttering analyses of expanded and nonexpanded speech

Twenty speech pathologists measured total words and completed molar and molecular stuttering analyses from audio-recorded contrived samples of stuttered speech. Each subject completed a criterion referenced test prior to performing the experimental tasks. Analyses were performed under two conditions: Condition I consisted of samples presented at 100 wpm as recorded (nonexpanded); Condition II consisted of parallel samples recorded at 100 wpm as recorded (nonexpanded condition); Condition II consisted of parallel samples recorded at 100 wpm but presented at 59 wpm via a speech time expander. Results indicate that presentation of expanded samples (Condition II) significantly increased subject accuracy for the specific disfluency form-types word repetitions and part-word repetitions. Similar trends were noted for sound prolongations and hard contacts. Theoretical, experimental, and clinical implications are offered.     

Subjective distress associated with chronic stuttering

Stuttering is a chronic condition involving involuntary disruption to speech fluency. While elevated social anxiety has been found to be a risk factor for adults who have stuttered all their lives, it is unclear how stuttering influences other negative mood states such as interpersonal sensitivity and depressive mood. Consequently, controlled research was conducted that investigated negative affectivity across a number of domains in adults who stutter. Participants included 200 adults who have stuttered since childhood, with comparisons made to 200 non-stuttering controls of similar age and sex. The adults who stuttered were found to have significantly elevated levels of distress and negative mood states compared to the controls. As expected, significant differences were found for anxiety, however, significant and substantial differences were also found across a broad range of negative affect, including dimensions such as somatization, interpersonal sensitivity, depressive mood, hostility and paranoia. The implications of these findings for the better management of stuttering are discussed.Educational objectives: The reader will be able to describe: (a) the negative impact of a chronic disorder like stuttering on people who have stuttered all their life; (b) the factor structure of the SCL-90-R; (c) the negative affectivity construct, and (d) the difference between psychogenic theories of stuttering and neurological theories of stuttering.     

Choral reading with filtered speech: effect on stuttering

This study investigated use of choral reading with filtered components of speech and whispered speech on the frequency of stuttering. Three passages read by a normal adult male were lowpass filtered with kneepoint frequencies at 100 Hz (approximate glottal source), 500 Hz (source and first formant), and 1 kHz (source and the first two formants). Along with a whispered passage, a normal passage, and a control condition, these stimuli were used in a repeated-measures design with 12 adult stutterers as they read passages while listening to one of the stimuli. Frequencies of stuttering in each condition were analyzed. The choral speech, the 500-Hz, the 1-kHz, and the whispered speech conditions all decreased the frequency of stuttering while the 100-Hz stimuli did not. It is suggested that articulatory events, chiefly the encoded speech output from the vocal tract, create effective cues and may induce fluent speech in people who stutter.     

Speech sound articulation abilities of preschool-age children who stutter

Purpose

The purpose of this study was to assess the association between speech sound articulation and childhood stuttering in a relatively large sample of preschool-age children who do and do not stutter, using the Goldman–Fristoe Test of Articulation-2 (GFTA-2; Goldman & Fristoe, 2000).

Method

Participants included 277 preschool-age children who do (CWS; n = 128, 101 males) and do not stutter (CWNS; n = 149, 76 males). Generalized estimating equations (GEE) were performed to assess between-group (CWS versus CWNS) differences on the GFTA-2. Additionally, within-group correlations were performed to explore the relation between CWS’ speech sound articulation abilities and their stuttering frequency and severity, as well as their sound prolongation index (SPI; Schwartz & Conture, 1988).

Results

No significant differences were found between the articulation scores of preschool-age CWS and CWNS. However, there was a small gender effect for the 5-year-old age group, with girls generally exhibiting better articulation scores than boys. Additional findings indicated no relation between CWS’ speech sound articulation abilities and their stuttering frequency, severity, or SPI.

Conclusions

Findings suggest no apparent association between speech sound articulation—as measured by one standardized assessment (GFTA-2)—and childhood stuttering for this sample of preschool-age children (N = 277).Educational objectives: After reading this article, the reader will be able to: (1) discuss salient issues in the articulation literature relative to children who stutter; (2) compare/contrast the present study's methodologies and main findings to those of previous studies that investigated the association between childhood stuttering and speech sound articulation; (3) identify future research needs relative to the association between childhood stuttering and speech sound development; (4) replicate the present study's methodology to expand this body of knowledge.     

Patterns of regional cerebral blood flow during attempted reading aloud by stutterers both on and off haloperidol medication: Evidence for inadequate left frontal activation during stuttering

Two stutterers, both recent college graduates, were subjected to regional cerebral blood flow measurements while attempting to read aloud. Each one received two measurements, one of which was under the influence of haloperidol, 3 mg daily. Both subjects showed improvement on medication, allowing a stuttering versus essentially no stuttering comparisons for each subject. Both subjects showed higher Broca's area flow in the right compared to the left hemisphere, during stuttering. Both showed higher Wernicke's area flow in the left compared to the right hemisphere, however, during stuttering. During reading aloud without stuttering, however, the Brocas's area flows were reversed, now showing a left hemisphere advantage. The results were interpreted as consistent with H. M. Sussman and P. F. MacNeilage's (1975, Neuropsychologia, 13, 19–26) proposal that stutterers exhibit conventional left cerebral dominance for speech reception, but inadequate left cerebral dominance for speech production.     

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.     

Middle school students' perceptions of a peer who stutters

Little is known about how middle school students perceive a similar-aged peer who stutters. Therefore, the purpose of this study was to examine the influence of stuttering frequency, Likert statement type (affective, behavioral, cognitive), and the gender of the listener on middle school students' perceptions of a peer who stutters. Sixty-four middle school students (10-14 years) individually viewed a video sample of a teen telling a joke at one of four stuttering frequencies (<1%, 5%, 10%, 14%). After the students viewed one of the video samples, they were asked to rate 11 Likert statements that reflected their affective, behavioral, and cognitive perceptions of a peer who stuttered. The results revealed an interaction between stuttering frequency and Likert statement type. Ratings of behavioral statements (speech production characteristics) were significantly more positive for the sample containing <1% stuttering than 10% and 14% stuttering. Ratings for cognitive statements (thought and beliefs) were significantly more positive for the sample containing <1% stuttering than 10% and 14% stuttering. The stuttering frequency of the peer did not significantly influence how students rated affective statements (feelings and emotions). It was also found that male and female middle school students did not significantly differ in their perceptions of a male peer who stutters. Clinical implications are discussed relative to peer teasing, friendship, listener comfort, and social acceptance within a middle school setting for a student who stutters. Future research directions are also discussed. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) summarize how middle school students perceive stuttering; (2) explain how the frequency of stuttering influences middle school students' perceptions of a peer who stutters; and (3) provide clinical implications of the data from this study.     

Relationships between stuttering,depression, and suicidal ideation in young adults: Accounting for gender differences

PurposeThe purpose of this study was to investigate the relationship between depressive symptoms and suicidal ideation and living with stuttering while accounting for time, sex, and health-related confounders.MethodThe data for this study come from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative survey study that has followed 13,564 respondents over the course of 14 years. Responses to the question “Do you have a problem with stuttering or stammering?” at two time points were used to establish stuttering and non-stuttering groups. Regression analysis, propensity score matching, and structural equation modeling were used.ResultsCompared to their fluent counterparts, males and females reported significantly elevated symptoms of depression. Although symptoms of depression among males who stutter were stable over time, depressive symptoms among females who stutter increased with age. Compared to males who do not stutter, males who stutter were significantly more likely to report feelings of suicidal ideation. There were no differences in suicidal ideation between females who do and do not stutter.ConclusionsSpeech-language pathologists should be aware of the associations between stuttering and depressive symptoms, as well as the increased risk for suicidal ideation among males who stutter. Clinicians should be knowledgeable about symptoms of depression and suicidal ideation and be familiar with processes to refer as needed.     

Comparing stuttering attitudes of preschool through 5th grade children and their parents in a predominately rural Appalachian sample

BackgroundTheories relating to young children’s social cognitive maturity and their prevailing social groups play important roles in the acquisition of attitudes. Previous research has shown that preschool and kindergarten children’s stuttering attitudes are characterized by stronger negative beliefs and self reactions than those of parents. By contrast, 12 year-old children’s stuttering attitudes have been shown to be similar to their parents’ attitudes. Other research indicates that parental stuttering attitudes are no different from attitudes of adults who are not parents.PurposeThe purpose of this study was to explore children’s stuttering attitudes of preschool through 5th grade children and to compare them to their parents’ attitudes.MethodChildren and parents from a rural Appalachian elementary school and child/parent pairs from other areas in the region responded to child and adult versions of the Public Opinion Survey of Human Attributes–Stuttering (POSHA–S/Child and POSHA–S). Seven grade levels were included: preschool, kindergarten, 1^st grade, 2^nd grade, 3^rd grade, 4^th grade, and 5^th grade.ResultsConfirming earlier research, younger children’s attitudes toward stuttering were considerably less positive than those of their parents. As children matured up to the fifth grade, however, their stuttering attitudes progressively were more positive. Parents’ stuttering attitudes were quite consistent across all seven grade levels.ConclusionsConsistent with theories of attitudinal development, between the ages of 4 and 11 years, children’s measured attitudes toward stuttering improved and gradually approximated the attitudes of their parents and the general public.     

Life partners’ perceptions of the emotional,speech disruptive,and attitudinal correlates of stuttering

PurposeThe purpose of the current investigation was to explore the extent to which the life partners (LPs) of people who stutter (PWS) perceive their loved ones’ speech-situation specific emotional reaction, expectancy of speech disruption, and speech-related communication attitude.MethodsThree subtests of the Behavior Assessment Battery (BAB): the Speech Situation Checklist - Emotional Reaction (SSC-ER), the Speech Situation Checklist - Speech Disruption (SSC-SD) and the Communication Attitude Test for Adults Who Stutter (BigCAT) were administered to 33 PWS and modified versions were administered to their LPs via Qualtrics Survey Software. Effect of relationship duration on subtest scores was considered. Perceived stuttering severity by the participant and their LP was also queried as part of a demographic questionnaire.ResultsPWS and their LPs rated BigCAT items in a similar way, while they rated certain SSC-ER and SSC-SD items differently. Importantly, between-group agreement was not affected by relationship duration. Among the PWS and LP, perceived stuttering severity influenced all BAB subtest scores.ConclusionLPs of PWS appear to be in tune with the cognitive aspects of their partner’s experience of stuttering. This has important clinical implications as it relates to active involvement of the family in speech intervention targeting fluency.     

The voice problems of stutterers: A practical approach from clinical experience

Voice disorders, which may be caused by the stuttering problem, have been noted in at least one-third of stutterers seen. Basically, stutterers have false speech images that normal speech is perfect and without natural dysfluencies (repetitions, pauses, etc.). Many stutterers also have erroneous vocal images of how they should or should not sound. Both images control speech and voice. Clinical experience indicates that vocal rehabilitation should be used in conjunction with speech therapy for many stutterers.