Dichotic ear preferences of stuttering children and adults.

39 stutterers and 39 normal speakers indicated their ear preferences for dichotically presented words and digits. A single response mode for both dichotic words and digits was selected to study speech perception. Stutterers showed significantly less of the normal right-ear preference for dichotic words and digits than non-stutterers. The proportion of stutterers who failed to demonstrate a right-ear preference for dichotic words was significantly greater than for non-stutterers. 18% of the stutterers and none of the non-stutterers showed reversed or a left-ear preference for dichotic digits. Although non-stuttering children and adults performed alike on the dichotic tasks, the right-ear dichotic-words scores of stuttering children were significantly smaller than those of adult stutterers. The results are related to an early notion that stuttering may be related to mixed dominance and recent evidence showing that large percentages of older stuttering children show spontaneous remission of stuttering.     

Voice reaction time of stuttering and nonstuttering children and adults

The voice reaction time (VRT) of 5-yr old, 9-yr old, and adult stutterers and nonstutterers was investigated. Subjects initiated the sound / Λ / in response to fifty-five 1000-Hz tones of 1 sec duration. The tones were presented in five equal sets of 11 tones each with the silent intervals between the tones randomly selected to be 3, 4, 5, or 6 sec. Data analysis was based on responses 2–11 for each set. The VRTs for both the stutterers and the nonstutterers decreased significantly as an inverse function of age, with the largest decrease in reaction time occuring between 5 and 9 yr. The VRTs for the stutterers, however, were significantly slower than those of the nonstutterers at each of the three age levels. The results suggest that observed disruption in the laryngeal behavior for at least some stutterers may not result from the development of stuttering with age, but may contribute to early difficulty in the child's ability to produce fluent speech. Consideration of central factors are discussed.     

Speech timing skills of normally fluent and stuttering children and adults

This study was designed to explore the speech timing skills of normally fluent and stuttering children and adults producing two sentences, ten consecutive times at basal and modified speaking rates. Spectrographic displays of subjects' utterances in both conditions were made in order to obtain consonant, vowel, pause, and utterance duration measures. Results showed that (1) the two groups of children produced speech durational values similar to those of the two adult groups and (3) there were no consistent between- and within-group differences in the basal and modified rate conditions. Findings are discussed in terms of methodological and sampling differences that exist between the present study and past research on stutterers' speech production abilities.     

Message therapy: Language approach to stuttering therapy with children

Message therapy is a clinical procedure designed to be used as a carry-over technique with school-age stutterers or as a sole technique with the preschooler. The focus of therapy is on a unit of communication rather than on the moment or place of stuttering. One of the basic assumptions of the procedure is that the child is beginning to monitor how he/she is speaking rather than what is being communicated (i.e., the “message”)—each task requiring a different cognitive process. The emphasis of the therapy is to redirect the child's attention to “what he/she is saying.” The clinical procedures are discussed as they relate to the specific population.     

Results of intensive stuttering therapy with adults who clutter and stutter

The purpose of this investigation was to report on the identification of adult clients who clutter and stutter, evaluate their response to a stuttering therapy program, and determine if speech measures typically used in evaluating therapy outcome are sufficiently sensitive indicators of change for clients who clutter and stutter. Results suggest that cluttering-stuttering subjects had a very positive response to stuttering therapy, but greater improvements may have been achieved with additional therapy time and expanded therapy goals. Results also indicate that pretreatment and posttreatment measures of articulatory rate may be a more sensitive measure of change for cluttering-stuttering clients.     

Programmed stuttering therapy for children: Comparison of four establishment programs

Four different establishment programs (programmed traditional, delayed auditory feedback, pause, and gradual increase in length and complexity of utterance) for improving the fluency of school-age children who stutter were compared. The programs were carried out by eight public school clinicians with 16 children (eight elementary and eight junior-senior high school) in their respective schools. All four programs produced important improvement in the speech fluency of the 16 children. All the children demonstrated transfer of fluency to extratraining settings. The delayed auditory feedback program required the least therapy hours, but it was difficult for the clinicians to operate correctly. The gradual increase in length and complexity of utterance programs produced the best overall results. The transfer and maintenance programs provided for additional generalization and permanency of fluency. Follow-up revealed that the children continued their increased level of fluency.     

Rate reduction strategies used by normally fluent and stuttering children and adults

Speech rate can be reduced by prolonging the duration of phonetic units, by pausing between words, or through a combination of these approaches. Child and adult normally fluent speakers and stutterers were tested in basal and modified speaking rate conditions. Subjects' utterances in both conditions were converted to spectrographic displays so that measures of phonetic and pause durations could be made. Comparisons of these measures across conditions revealed that all four groups of subjects spontaneously extended pause and phonetic durations, the former more than the latter, when instructed to voluntarily reduce speech rate.     

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

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

Syntactic determinants of stuttering in the spontaneous speech of normally fluent and stuttering children

Conflicting findings have been reported concerning whether fluent children use more complex syntactic structures than stutterers and whether or not stutterers experience specific difficulty with complex syntactic structures. On critical examination, the first of these apparent discrepancies appears to be due to (a) differences in the methods employed for syntactic analysis in different studies, and (b) misleading impressions gained by looking at speakers within a single age range. Data were reanalyzed where one method of analysis had shown that fluent speakers and stutterers did not differ with regard to syntactic structures used but where they did show a propensity for stuttering to occur on complex syntactic structures. These data cover a range of age groups. When the second method of syntactic analysis was applied, a difference was found between fluent speakers and stutterers, with the stutterers initially using more simple structures and fewer complex ones. This difference decreased over age groups. However, a difference still remained with respect to which syntactic structures stutterers experience difficulty. An additional analysis, not formerly conducted on these data, showed that, as reported elsewhere, there was a higher probability of stuttering on clause-initial and. It was also shown that this tendency decreased with age group of the stutterers.     

Regional brain activity change predicts responsiveness to treatment for stuttering in adults

Developmental stuttering is known to be associated with aberrant brain activity, but there is no evidence that this knowledge has benefited stuttering treatment. This study investigated whether brain activity could predict progress during stuttering treatment for 21 dextral adults who stutter (AWS). They received one of two treatment programs that included periodic H₂¹⁵O PET scanning (during oral reading, monologue, and eyes-closed rest conditions). All participants successfully completed an initial treatment phase and then entered a phase designed to transfer treatment gains; 9/21 failed to complete this latter phase. The 12 pass and 9 fail participants were similar on speech and neural system variables before treatment, and similar in speech performance after the initial phase of their treatment. At the end of the initial treatment phase, however, decreased activation within a single region, L. putamen, in all 3 scanning conditions was highly predictive of successful treatment progress.     

Theory and therapy in stuttering: A complex relationship

There are many treatments currently available for stuttering, for both children and adults. These range from direct interventions intended to reduce the severity and/or frequency of the speech behaviors of stuttering, to those intended to alleviate the anxiety and other mental health issues that can accompany the disorder. However, as there are little supporting data for many of these treatments, there is little consensus about which to use. Another way to evaluate stuttering treatments is to explore the extent to which they address the cause of the disorder. However, the cause of stuttering is not yet known. In this theoretical paper, a 3-factor causal model is presented, to which the mechanisms thought to be driving different treatments are then aligned. The model is innovative, in that it attempts to explain moments of stuttering. It is argued that all causal factors must be operating at each moment of stuttering. The model is intended as a new way of looking at cause, and how treatments may address cause. It is hoped this will stimulate discussion and lead to further lines of inquiry.Educational objectives: The reader will be able to: (a) describe the P&A 3-factor causal model of moments of stuttering; (b) state how indirect direct stuttering treatments relate to cause, according to the P&A model; (c) describe how direct stuttering treatments relate to cause, according to the P&A model; (d) state the purpose of cognitive behavior therapy; and (e) describe at least one suggestion for further research arising from the P&A model.     

Mindfulness training in stuttering therapy: a tutorial for speech-language pathologists

The use of mindfulness training for increasing psychological well-being in a variety of clinical and nonclinical populations has exploded over the last decade. In the area of stuttering, it has been widely recognized that effective long-term management often necessitates treatment of cognitive and affective dimensions of the disorder in addition to behavioral components. Yet, mindfulness based strategies and their possible usefulness in stuttering management have not been described in detail in the literature. This article seeks to engage professionals who treat stuttering in a conversation about the possible usefulness of incorporating mindfulness training into stuttering management. A review of the literature reveals that there is a substantial overlap between what is required for effective stuttering management and the benefits provided by mindfulness practices. Mindfulness practice results in decreased avoidance, increased emotional regulation, and acceptance in addition to improved sensory-perceptual processing and attentional regulation skills. These skills are important for successful long-term stuttering management on both psychosocial and sensory-motor levels. It is concluded that the integration of mindfulness training and stuttering treatment appears practical and worthy of exploration. Mindfulness strategies adapted for people who stutter may help in the management of cognitive, affective, and behavioral challenges associated with stuttering.Educational objectives: Readers should be able to: (1) describe what mindfulness is and how it is cultivated; (2) identify the benefits that can be produced from mindfulness practice; (3) summarize how the benefits of mindfulness practice parallel what is often required for effective long-term stuttering management; and (4) identify specific mindfulness techniques that can be taught in stuttering therapy and explain their rationale.     

Timing and stiffness in speech motor control of stuttering and nonstuttering adults

Twelve stutterers and 12 nonstutterers were investigated in order to measure speech movements of the jaw. They spoke the nonsense word /papapas/ with stress on either the first or second syllable and with three speech rates (fast, moderate, and slow). During these trials, jaw movements were analyzed with a selspot-like optical tracking system. It was shown that stutters and nonstutterers applied the same strategies for realizing jaw movements of accented and unaccented syllables. The first strategy (stiffness variation) was used to achieve fast jaw movements while the second strategy (timing) was used in order to realize jaw movements for accented syllables. These results were taken as evidence for the assumption that, in general, stutterers and nonstutterers used the same control strategies when speaking fluently. However, it was also evident that stutterers produced lengthened jaw opening and closing durations as well as reduced peak velocities and maximal opening and closing displacements. This deviating movement pattern was supposed to reflect motor compensations necessary to achieve fluent speech rather than anomalies of the speech neuromotor system.     

Voice initiation and termination time in stuttering and nonstuttering children

Voice initiation time (VIT) and voice termination time (VTT) was measured in seven stuttering and eight nonstuttering children ranging in age from 4 yr, 6 mo to 6 yr, 10 mo. The experimental task was the production of /a/ in response to a 1000-Hz pure tone. Voice initiation time was defined as the period of time elapsing between the onset of the auditory stimulus and the onset of the subject's response of /a/, as displayed on an oscilloscope. Voice termination time was defined as the latency between termination of the stimulus tone and the point at which the oscilloscopic signal decreased by 90%. No statistically significant differences were found between the two groups with respect to either VIT or VTT. In addition, no apparent relationships were present among VIT, VTT, or stuttering severity.     

Effect of directed attention on cerebral asymmetries in stuttering adults

9 stutterers and 9 nonstutterers were administered a dichotic digits test under conditions of free recall and directed attention. Analysis indicated right-ear preference for both groups and no differences between the free recall and directed listening conditions. Results are discussed in relation to previous studies in which dichotic digit-stimuli were presented to stutterers.